Esophageal intramural pseudodiverticulosis(EIPD)is a rare,benign condition of uncertain etiology and pathogenesis,which usually presents with either progressive or intermittent dysphagia.Acute presentation with food i...Esophageal intramural pseudodiverticulosis(EIPD)is a rare,benign condition of uncertain etiology and pathogenesis,which usually presents with either progressive or intermittent dysphagia.Acute presentation with food impaction,requiring emergency esophago-gastroduodenoscopy(EGD),is rare.We report a case of EIPD presenting as food bolus impaction in an elderly black female.The patient had no previous history of dysphagia or odynophagia.Currently accepted risk factors,such as diabetes mellitus,chronic alcoholism,and reflux esophagitis,were not present in our patient.Emergency EGD established the diagnosis and also dislodged the food bolus.Histopathological evaluation of the mucosa diagnosed co-existent acute candidal infection.Medical treatment with proton pump inhibitor and azole antifungal led to resolution of her symptoms.Review of the literature revealed that stenosis,strictures,perforation,gastro-intestinal bleed,and fistula formation are potential complications of EIPD.Multiple motility abnormalities have been described but are not consistent.Treatment of the underlying inflammatory and or infectious condition is the mainstay of management of this unusual condition.展开更多
Chronic hepatitis E virus(HEV)infection is increasingly being reported in immunosuppressed individuals with HIV,patients with haematological malignancy and transplant recipients.The diagnosis of cirrhosis and liver fa...Chronic hepatitis E virus(HEV)infection is increasingly being reported in immunosuppressed individuals with HIV,patients with haematological malignancy and transplant recipients.The diagnosis of cirrhosis and liver failure post chronic HEV is controversial due to lack of standard diagnostic criteria.The treatment benefits of ribavirin in chronic HEV of genotype 1 are not well reported.We report a case of chronic HEV infection of genotype 1 leading to chronic liver disease in a child cured of acute leukaemia.Our report also highlights the successful use of ribavirin for eradicating chronic HEV infection and its subsequent survival benefits.Chronic hepatitis E may be an emerging disease of immunosuppressed patients and should be suspected in the presence of cryptogenic transaminitis.Ribavirin is an effective therapy for controlling HEV.展开更多
文摘Esophageal intramural pseudodiverticulosis(EIPD)is a rare,benign condition of uncertain etiology and pathogenesis,which usually presents with either progressive or intermittent dysphagia.Acute presentation with food impaction,requiring emergency esophago-gastroduodenoscopy(EGD),is rare.We report a case of EIPD presenting as food bolus impaction in an elderly black female.The patient had no previous history of dysphagia or odynophagia.Currently accepted risk factors,such as diabetes mellitus,chronic alcoholism,and reflux esophagitis,were not present in our patient.Emergency EGD established the diagnosis and also dislodged the food bolus.Histopathological evaluation of the mucosa diagnosed co-existent acute candidal infection.Medical treatment with proton pump inhibitor and azole antifungal led to resolution of her symptoms.Review of the literature revealed that stenosis,strictures,perforation,gastro-intestinal bleed,and fistula formation are potential complications of EIPD.Multiple motility abnormalities have been described but are not consistent.Treatment of the underlying inflammatory and or infectious condition is the mainstay of management of this unusual condition.
文摘Chronic hepatitis E virus(HEV)infection is increasingly being reported in immunosuppressed individuals with HIV,patients with haematological malignancy and transplant recipients.The diagnosis of cirrhosis and liver failure post chronic HEV is controversial due to lack of standard diagnostic criteria.The treatment benefits of ribavirin in chronic HEV of genotype 1 are not well reported.We report a case of chronic HEV infection of genotype 1 leading to chronic liver disease in a child cured of acute leukaemia.Our report also highlights the successful use of ribavirin for eradicating chronic HEV infection and its subsequent survival benefits.Chronic hepatitis E may be an emerging disease of immunosuppressed patients and should be suspected in the presence of cryptogenic transaminitis.Ribavirin is an effective therapy for controlling HEV.
