Vasculitis is an accumulation of inflammatory leucocytes in the blood vessels with reactive damage to mural structures. Isolated vasculitis of the gastrointestinal tract without systemic involvement is rare. We report a unique case of a female patient who presented with abdominal pain, and was found, on serology, to have elevated inflammatory markers without autoantibodies. A computed tomography scan of the abdomen and pelvis was suggestive of vasculitis of the hepatic artery. To the best of our knowledge, this is the first case, to date, of vasculitis of hepatic artery. Vascul itis is an accumulation of inflammatory leucocytesin the blood vessels with reactive damage to mural structures. Vasculitis of the gastrointestinal tract is a manifestation of systemic vasculitis in 20% of cases, 1 but isolated vasculitis of the gastrointestinal tract without systemic involvement is rare. We report a unique case of a female patient who presented with abdominal pain, and was found, on serology, to have elevated inflammatory markers without autoantibodies. A computed tomography scan of the abdomen and pelvis was suggestive of vasculitis of the hepatic artery. To the best of our knowledge, this is the first reported case of vasculitis of the hepatic artery. There have been reports of single organ vasculitis, especially in the intestines, gallbladder, and appendix; however, to date, none have been reported in the liver. Case PresentationA 53-year-old woman with a past history of cholecystectomy was admitted with complaint of epigastric discomfort of 2-days duration. The pain was localized, and she reported bloating and nausea, but denied vomiting, fever, chills, melena, urinary or gastrointestinal complaints.Physical examination showed the patient was afebrile with stable vital signs. Her cardiovascular and respiratory examinations were normal. Abdominal examination demonstrated minimal tenderness on deep palpation of the epigastrium without distension, guarding, or rigidity. A complete blood count showed normal white blood cell count at 6.3 x 10 3 /μL and normal hemoglobin at 14.2 g/dL. Basic metabolic panel and liver enzymes were normal, and amylase and lipase levels were not elevated.Radiographs of the abdomen revealed normal bowel gas pattern, but a CT scan of the abdomen and pelvis showed circumferential thickening of the wall of the common hepatic artery and its right and left hepatic branches, with a narrowed but patent lumen, suggestive of vasculitis (figure 1). The remaining arteries of the abdomen and pelvis were unremarkable. A CT scan of the abdomen and pelvis taken 2 years prior had been unremarkable. Magnetic resonance angiography (MRA) of the visceral arteries of the abdomen and pelvis confirmed the findings.The erythrocyte sedimentation rate (ESR) upon admission was elevated at 25 mm/hr (normal 0-17 mm/hr) and C-reactive protein (CRP) was elevated at 2.6 mg/dL (normal 0-1 mg/dL). Further history and examination was done to rule out systemic vasculitis in view of the elevated sedimentation rate. The patient de...

Pyogenic liver abscess commonly occurs as a complication of biliary tract and gastrointestinal infections, with diverticulitis and perforated bowel becoming leading causes in recent years. We report the first case of liver abscess as a complication of asymptomatic diverticulitis with no bacteremia, as well as colovesical fistula. And, with this case presentation, we stress the importance of considering diverticulitis in asymptomatic patients with liver abscess, as well as the importance of early and prompt treatment with antibiotics and percutaneous drainage.

Follow this and additional works at: https://aurora.org/jpcrr Part of the Gastroenterology Commons, and the Hepatology Commons Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationMali P, Kanth R, Muduganti S. Albumin administration in patients with spontaneous bacterial peritonitis at a tertiary hospital: a retrospective clinical analysis. J Patient Cent Res Rev. 2015;2:51-55.

Colon polyposis, such as familial adenomatous polyposis, Puetz-Jegher's Syndrome, mutY homolog-associated polyposis, and hyperplastic/serrated polyposis syndrome, have been linked to several different types of cancer, including cancers of the gastrointestinal tract, thyroid, liver, central nervous system, genital tract, breast, pancreas, bone, sebaceous glands, ovaries, bladder, and skin. However, to date there have been no reports of an association between any of the aforementioned types of colon polyposis and lymphoma. Here, we report the case of a 79-year-old man with multiple hyperplastic polyps in the colon who was diagnosed with diffuse large B cell lymphoma of the pelvic bone. Future reporting of such associations and follow-up genetic testing is necessary to determine if there is a familial association and whether steps are needed to prevent occurrence by screening.

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