[Show abstract][Hide abstract] ABSTRACT: Diffuse Nodular Lymphoid Hyperplasia (DNLH) of the intestine is a rare lymphoproliferative disorder of uncertain etiology, which is characterized by the presence of multiple nodular lesions. It can present as an asymptomatic disease or manifest with gastrointestinal symptoms like abdominal pain, chronic diarrhea, occult bleeding or rarely intestinal obstruction. DNLH has been seen in association with common variable immunodeficiency (CVID) where it poses a risk of malignant transformation. We present a case of diffuse lymphoid nodular lymphoid hyperplasia in a patient who was presented with abdominal pain and diarrhea, and was later found to have IgG2 subclass immunodeficieny, autoimmune hemolytic anemia and Hashimoto's (autoimmune) thyroiditis. Through this report, we wish to review current literature as well as share our clinical experience in managing this rare entity.
Journal of gastrointestinal and liver diseases: JGLD 12/2012; 21(4):431-4. · 1.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Laparoscopic sleeve gastrectomy has been a recently developed technique for treating morbid obesity. Gagner and Patterson performed the first laparoscopic sleeve gastrectomy as part of a duodenal switch procedure at Mount Sinai Hospital in New York in 1999. Since then many surgeons and institutions have adopted this technique. One of the most dreaded complications of sleeve gastrectomy is a leak along the staple line. We present the case of a 23-year-old female with gastric sleeve leak managed successfully with a fully covered wall flex stent. Our aim is to examine the incidence, causes, classification, and presentation of gastric sleeve leaks and to evaluate the use of endoscopic stents in its management.
Case reports in gastrointestinal medicine. 01/2012; 2012:205979.
[Show abstract][Hide abstract] ABSTRACT: Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS) revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer.
Case Reports in Gastroenterology 01/2012; 6(1):135-42.