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1.
J Investig Med High Impact Case Rep ; 12: 23247096241253348, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38757744

RESUMO

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the digestive tract and arise from the interstitial cells of Cajal in the mesenteric plexus. These tumors can originate in any part of the GI tract; however, a higher burden has been observed in the stomach and small intestines. Mesenteric GISTs are exceedingly rare, with unique clinicopathological features and a poorer prognosis. Herein, we describe a unique case of a 66-year-old female with a remote history of appendectomy who presented to the emergency room complaining of severe abdominal pain and vomiting. On imaging, the patient was found to have a large inflammatory mass associated with small bowel loops, and the pathology confirmed a mesenteric GIST. The tumor was resected, and the genomic test results confirmed the KIT (exon 11) mutation. Although the tumor had a low mitotic rate, the tumor was large enough to warrant the initiation of adjuvant imatinib mesylate for 36 months with regular bloodwork and imaging.


Assuntos
Abdome Agudo , Tumores do Estroma Gastrointestinal , Mesilato de Imatinib , Mesentério , Humanos , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/patologia , Feminino , Idoso , Abdome Agudo/etiologia , Mesilato de Imatinib/uso terapêutico , Mesentério/patologia , Proteínas Proto-Oncogênicas c-kit/genética , Tomografia Computadorizada por Raios X , Mutação , Antineoplásicos/uso terapêutico
2.
J Investig Med High Impact Case Rep ; 12: 23247096231224328, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38193443

RESUMO

Trichuriasis is a neglected tropical disease caused by Trichuris trichiura that spreads through the ingestion of embryonated eggs in contaminated soil, water, or food. In nonendemic areas, T trichiura infestation is very rare and sporadic and is often diagnosed in immigrants from endemic countries such as the Philippines. Whipworms feed on human blood and also erode the colonic mucosa, thereby evoking an inflammatory response. In milder forms, trichuriasis can be asymptomatic and often an incidental diagnosis on screening colonoscopy. Heavily infested patients usually present with abdominal pain, nausea, vomiting, tenesmus, chronic diarrhea, iron deficiency anemia, or stunted growth. T trichiura worms can be removed with biopsy forceps during a colonoscopy; however, most patients require a course of albendazole, mebendazole, or ivermectin. We describe a unique case of T trichiura as an incidental finding during a screening colonoscopy. The whipworms were retrieved using biopsy forceps and the patient was treated with albendazole. At the time of the colonoscopy, the patient did not exhibit any specific symptoms related to the worm infestation.


Assuntos
Tricuríase , Trichuris , Humanos , Animais , Tricuríase/diagnóstico , Tricuríase/tratamento farmacológico , Albendazol/uso terapêutico , Achados Incidentais , Colonoscopia
3.
J Investig Med High Impact Case Rep ; 12: 23247096241242569, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38546011

RESUMO

Cocaine is an indirect-acting sympathomimetic drug that inhibits norepinephrine and dopamine reuptake in the adrenergic presynaptic cleft. Cocaine use has been associated with strokes, angina, arrhythmias, and agitation. Data on gastrointestinal complications such as mesenteric ischemia, bowel necrosis, ulceration, and perforation are scarce. Here, we present a rare case of cocaine-induced esophageal, gastric, and small bowel necrosis that contributes to the limited literature on this subject. Diagnosis of cocaine-induced gastrointestinal complications involves a combination of imaging studies, laboratory assessments, and histopathological examinations. Timely surgical resection, supported by intravenous fluids, antibiotics, and pain management, is the mainstay of treatment. The prognosis varies but is significantly influenced by the promptness and effectiveness of the intervention, underscoring the importance of vigilant clinical care in such cases.


Assuntos
Transtornos Relacionados ao Uso de Cocaína , Cocaína , Gastroenteropatias , Doenças Vasculares , Humanos , Cocaína/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/complicações , Gastroenteropatias/complicações , Necrose/induzido quimicamente , Necrose/complicações
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