Gastric Pseudomelanosis: An Uncommon Finding.

Gastric pseudomelanosis is a benign condition that has been characterized by pigment deposition within subepithelial macrophages inside the stomach wall. Occurrence of the condition is rare, with pseudomelanosis occurring more often within the duodenal mucosa. Few cases have reported pseudomelanosis within the gastric mucosa. We report a case of an 86-year-old female who presented with worsening iron deficiency anemia concerning for gastrointestinal bleeding. Her endoscopic evaluation was remarkable for a speckled pattern of dark pigmentation within the stomach, confirmed to be pseudomelanosis by histologic evaluation with pigment showing positive staining for iron.

Severe Pulmonary Hypertension in a Patient with Scurvy: Can a Vitamin Reverse It?

INTRODUCTION: Pulmonary hypertension secondary to scurvy is a rare manifestation that historically has not been well studied and is only described in a handful of case reports. CASE: Our case is about a 35-year-old female with a history significant for drug and tobacco abuse, obesity, poor diet, anxiety, and major depressive disorder who was found to have severe pulmonary hypertension in the setting of vitamin C deficiency (<0.01 mg/L). CONCLUSION: We present a case that shows pulmonary hypertension can be associated with scurvy and reversed rapidly with adequate vitamin C supplementation.

Transrectal Endoscopic Ultrasound-Guided Drainage of a Tubo-Ovarian Abscess Via a Lumen-Apposing Metal Stent.

Tubo-ovarian abscess (TOA) is a potentially lethal condition, often requiring a combination of medical and surgical interventions. Endoscopic ultrasound (EUS)-guided drainage is a known modality for safe and effective management of pelvic fluid collections, but its role for the treatment of TOA is not well documented. We report the first known case of successful treatment of a large TOA with EUS-guided transrectal drainage using a lumen-apposing metal stent.

Lactulose to the Rescue: A Case of Toxic Hepatic Encephalopathy Caused by Portosystemic Shunting and Epistaxis in a Patient with Hereditary Hemorrhagic Telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT) is an uncommon autosomal dominant disorder characterized by telangiectasias and arteriovenous malformations. Multiple organ systems are involved including the skin, lungs, gastrointestinal tract, and brain. Hepatic encephalopathy is an extremely rare complication of HHT and early diagnosis and treatment can be life-saving. We present a rare case of hepatic encephalopathy caused by HHT-induced portosystemic shunting treated with lactulose.