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The paradigm for the diagnosis and management of gastric cancer is changing with advanced diagnostic and therapeutic interventions. Prior gastric surgery (20 years or more) is one of the risk factors for gastric cancer. Increased intragastric carcinogen formation is thought to contribute toward gastric cancer development in the remaining portion of the stomach. This case illustrates the importance of a thorough clinical and pathologic workup and highlights the advanced technique of single-balloon enteroscopy (SBE) and its role in managing patient's health.
RESUMO
Netherton syndrome (NS) is a rare autosomal recessive disorder characterized by a triad of congenital ichthyosiform erythroderma (CIE) or ichthyosis linearis circumflexa (ILC), hair shaft abnormalities, and atopic diathesis (elevated serum IgE ). We report a case of a two-year-old boy presented with intractable pruritus, scaling, dry skin and generalized eczematous lesions resistant to atopic dermatitis therapy. Netherton syndrome misdiagnosed as atopic dermatitis due to the presence of eczematous skin lesions and allergic problems. The family counseled about the diagnosis and need of genetic testing for confirmation, but they refused for genetic testing. The patient got treatment with topical corticosteroids and skin moisturizers. There is no cure or satisfactory treatment currently available for NS. Further understanding of the underlying pathophysiology of integumentary changes will lead to more effective treatment. Netherton syndrome should be in the differential diagnosis when characteristic skin manifestation of CIE or ILC, and elevated serum IgE present.
RESUMO
There is a well-established association of Sjogren's syndrome with renal tubular acidosis (RTA). Rarely there is a retrospective diagnosis where the patient presents with RTA and the workup reveals Sjogren's syndrome. Our case report is about a patient who presented with generalized weakness and hypokalemia, which upon further workup turned out to be RTA. Various tests were performed to find out the cause of RTA. A favorable profile for the anti-nuclear antibody, anti-Ro/SSA, and anti-La/SSB was consistent with Sjogren's syndrome. Treatment with corticosteroid improved hypokalemia. The patient did not have typical glandular symptoms of Sjogren's syndrome, and follow-up is needed to see whether the patient develops symptoms in the future and to prevent any possible complication.
RESUMO
Foreign body ingestion is commonly encountered in clinical practice. According to standard guidelines, urgent therapeutic endoscopy should be performed in cases involving sharp objects to prevent complications. Although several extraction methods are available, few cases may still pose a therapeutic challenge. This report describes a novel endoscopic technique utilizing modification of the standard overtube to facilitate the removal of a large razor blade. This technique offers a minimally invasive approach for rapid retrieval of large sharp-edged foreign bodies, obviating the need for a surgical exploration. Additionally, this article compares various imaging modalities for prompt detection of gastrointestinal foreign bodies to avoid unnecessary delays in endoscopic intervention.