Intragastric fish bones migrate into the liver:A case report

BACKGROUND A foreign body in the digestive tract is a common disease in the clinic.However,it is rare for a foreign body to migrate into the liver.Most patients are diagnosed before or after perforation of the digestive tract.Laparoscopic removal of intrahepatic foreign bodies is an effective treatment method.CASE SUMMARY A 55-year-old male patient was admitted to the hospital due to fever for 3 d,in addition to pain and discomfort in the right side of his waist.After admission,abdominal computed tomography showed a foreign body in the liver,and gastroscopy did not indicate obvious erosion or ulcers.The patient then underwent laparoscopic surgery.During the operation,an abscess was seen near the gastric antrum and between the caudate lobes of the liver.It was approximately 30 mm×31 mm×23 mm in size.The abscess was cut open,and a fish bone was found inside.The fish bone had penetrated the liver and was successfully removed.It was confirmed that the fish bone migrated from the stomach to the liver.CONCLUSION Although intrahepatic foreign bodies are rare,they should be diagnosed and treated as early as possible to avoid serious complications such as intrahepatic abscess,which may lead to liver resection and even life-threatening events.

Gastroesophageal varices in a patient presenting with essential thrombocythemia:A case report

BACKGROUND Gastroesophageal varices are a rare complication of essential thrombocythemia(ET).ET is a chronic myeloproliferative neoplasm(MPN)characterized by an increased number of blood platelets.CASE SUMMARY A 46-year-old woman,who denied a history of liver disease,was admitted to our hospital on presentation of hematemesis.Laboratory examination revealed a hemoglobin level of 83 g/L,and a platelet count of 397×109/L.The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive.Abdominal computed tomography revealed cirrhosis,marked splenomegaly,portal vein thrombosis and portal hypertension.In addition,bone marrow biopsy and evidence of mutated Janus kinase 2,substantiated the onset of ET.The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period.Therefore,in this case,gastroesophageal varices were induced by ET.CONCLUSION MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices.An integrated approach such as laboratory tests,radiological examination,and pathological biopsy,should be included to allow optimal decisions and management.

Acute pancreatitis as a rare complication of gastrointestinal endoscopy:A case report

BACKGROUND Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy,especially if the patient has none of the common risk factors associated with pancreatitis;such as alcoholism,gallstones,hypertriglyceridemia,hypercalcemia or the use of certain drugs.CASE SUMMARY A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy.The pain was predominantly in the upper and middle abdomen and was persistent and severe.The patient was diagnosed with acute pancreatitis.Treatment included complete fasting,octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion,ulinastatin injection to inhibit pancreatic enzymes activity,esomeprazole for gastric acid suppression,fluid replacement and nutritional support.Over the next 3 d,the patient's symptoms improved.The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state.CONCLUSION Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.

Gastric syphilis mimicking gastric cancer: A case report

BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.CASE SUMMARY A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week,which was aggravated for two days.The patient had been sexually active with the same male partner for the past years,but her partner was promiscuous.Abdominal contrastenhanced computed tomography(CT)and positron emission tomography/CT suggested gastric cancer.The gastroscopy revealed an antral gastric ulcer with gastric retention,and also suggested gastric cancer.But no cancer cells were found in the biopsies taken during the two gastroscopies.Treponema pallidum(T.pallidum)antibodies:ELISA positive,rapid plasma reagin titer 1:16.Hematoxylin and eosin(HE)stain showed macrophage infiltration in the lamina propria.Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T.pallidum.The patient was finally diagnosed with gastric syphilis.CONCLUSION Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer.Penicillin can relieve symptoms of gastric syphilis.