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Safety and efficacy of over-the-scope clip-assisted full thickness resection of duodenal subepithelial tumors:A case report 被引量:1
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作者 Ammar B Nassri Ahmad Alkhasawneh +2 位作者 James S Scolapio Miguel H Malespin bruno de souza ribeiro 《World Journal of Gastrointestinal Endoscopy》 CAS 2019年第2期168-173,共6页
BACKGROUND Over-the-scope clip-assisted endoscopic full thickness resection(eFTR) of subepithelial tumors is a novel and promising endoscopic technique. Recently,there have been prospective studies investigating its u... BACKGROUND Over-the-scope clip-assisted endoscopic full thickness resection(eFTR) of subepithelial tumors is a novel and promising endoscopic technique. Recently,there have been prospective studies investigating its use for colonic masses, but data regarding its use and efficacy in the duodenum are limited to a few reports.CASE SUMMARY A 65-year-old African American female presents for evaluation of persistent gastroesophageal reflux disease not responsive to medical treatment. A 1 cm nodule was incidentally found in the duodenum and biopsies revealed a low grade well differentiated neuroendocrine tumor. The nodule was removed using over-the-scope clip-assisted eFTR and pathology revealed clear margins. We review the available literature with a discussion on the efficacy and safety of clipassisted eFTR s of subepithelial lesions in the duodenum.CONCLUSION Clip assisted eFTR appears to be a safe and efficacious treatment approach to duodenal subepithelial lesions. Further prospective studies are needed to investigate the long-term utility and safety of clip-assisted eFTR in the management of subepithelial duodenal lesions. 展开更多
关键词 Case report DUODENUM CARCINOID Endoscopic full thickness RESECTION
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Ipilimumab and Nivolumab induced steroid-refractory colitis treated with infliximab: A case report 被引量:1
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作者 Ammar B Nassri Valery Muenyi +4 位作者 Ahmad AlKhasawneh bruno de souza ribeiro James S Scolapio Miguel Malespin Silvio W de Melo Jr 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 CAS 2019年第1期29-34,共6页
BACKGROUND A variety of immune-modulating drugs are becoming increasingly used for various cancers. Despite increasing indications and improved efficacy, they are often associated with a wide variety of immune mediate... BACKGROUND A variety of immune-modulating drugs are becoming increasingly used for various cancers. Despite increasing indications and improved efficacy, they are often associated with a wide variety of immune mediated adverse events including colitis that may be refractory to conventional therapy. Although these drugs are being more commonly used by Hematologists and Oncologists, there are still many gastroenterologists who are not familiar with the incidence and natural history of gastrointestinal immune-mediated side effects, as well as the role of infliximab in the management of this condition.CASE SUMMARY We report a case of a 63-year-old male with a history of metastatic renal cell carcinoma who presented to our hospital with severe diarrhea. The patient had received his third combination infusion of the anti-CTLA-4 monoclonal antibody Ipilimumab and the immune checkpoint inhibitor Nivolumab and developed severe watery non-bloody diarrhea the same day. He presented to the hospital where he was found to be severely dehydrated and in acute renal failure. An extensive workup was negative for infectious etiologies and he was initiated on high dose intravenous steroids. However, he continued to worsen. A colonoscopy was performed and revealed no endoscopic evidence of inflammation. Random biopsies for histology were obtained which showed mild colitis, and were negative for Cytomegalovirus and Herpes Simplex Virus. He was diagnosed with severe steroid-refractory colitis induced by Ipilimumab and Nivolumab and was initiated on Infliximab. He responded promptly to it and his diarrhea resolved the next day with progressive resolution of his renal impairment. On follow up his gastrointestinal side symptoms did not recur.CONCLUSION Given the increasing use of immune therapy in a variety of cancers, it is important for gastroenterologists to be familiar with their gastrointestinal side effects and comfortable with their management, including prescribing infliximab. 展开更多
关键词 COLITIS INFLIXIMAB BIOLOGICS Immune mediated ADVERSE events IPILIMUMAB Nivolumab Case report
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