Complicated Cases in GI

Dr. Anthony Kalloo and Dr. Jonathan M. Buscaglia have taken years of experience at Johns Hopkins Hospital and created a collection of unique and interesting cases revolving around gastrointestinal and liver diseases. Complicated Cases in GI follows patient-physician interactions and includes over 50 cases that are complex in their nature, interesting in their presentations, or a representation of a unique therapeutic challenge. Each chapter case includes: • A detailed summary of a particular patient presentation • Associated pathology slides, radiology films, or endoscopy photographs • A brief evidence-based discussion focusing on the main learning objectives • Three to five key learning points listed to highlight the most important features Complicated Cases in GI also includes 150 board review-like questions taken directly from the cases themselves. The questions highlight the salient aspects and are meant to reinforce the learning objectives involved in each case. They will also serve as a useful study aid for anyone preparing for an examination in general medicine, gastroenterology or hepatology. Complicated Cases in GI is ideal for residents, fellows, practicing physicians preparing for recertification, nurses, and students looking for a quick reference text that can be read and absorbed over time—one case at a time.

Contents Dedication Acknowledgments About the Editors Contributing Authors Preface Introduction Foreword SECTION I: Esophagus Chapter 1: Endoscopic Therapy for an Esophageal Dissection Jonathan Buscaglia, MD Chapter 2: A 63-Year-Old Man With Intractable Hiccups John Clarke, MD Chapter 3: “When I Eat, Food Gets Stuck” John Clarke, MD Chapter 4: A Benign Form of Progressive Dysphagia Eun Ji Shin, MD Chapter 5: A Rare Form of Esophageal Toxicity Samuel Giday, MD Chapter 6: Diffuse Squamous Cell Dysplasia of the Esophagus Samuel Giday, MD SECTION II: Stomach Chapter 7: Abdominal Pain and an Ovarian Mass Michel Kafrouni, MD Chapter 8: Fever, Flood Water, and Gastritis Geoffrey Nguyen, MD, PhD Chapter 9: A 53-Year-Old Woman With a Pelvic Mass Geoffrey Nguyen, MD, PhD Chapter 10: AIDS and Nodular Gastric Antritis Eun Ji Shin, MD Chapter 11: Twisted Turn of Events Eun Ji Shin, MD Chapter 12: A Rare Cause of Steatorrhea, Weight Loss, and Failure to Thrive Ghazaleh Aram, MD Chapter 13: A 73-Year-Old Woman With a “Juvenile” Disease Ghazaleh Aram, MD Chapter 14: A Surprising Cause for Bleeding Gastric Varices Anurag Maheshwari, MD SECTION III: Small Intestine Chapter 15: Postprandial Pain and Eosinophilia John Clarke, MD Chapter 16: A Rare Cause of Gastrointestinal Bleeding in an Adult Jonathan Buscaglia, MD Chapter 17: A 58-Year-Old Woman With Fistulizing Crohn’s Disease John Clarke, MD Chapter 18: Not Your Average Case of Diverticulitis Geoffrey Nguyen, MD, PhD Chapter 19: Diarrhea and Weight Loss in a Healthy Young Woman Kerry Dunbar, MD Chapter 20: Small Bowel Arterio-Venous Malformation Karen Krok, MD Chapter 21: Capsule Retention in Small Bowel Diverticulosis Samuel Giday, MD Chapter 22: A 53-Year-Old Man With Crohn’s Disease and Renal Failure Farida Millwala, MD SECTION IV: Colon/Rectum Chapter 23: Difficult-to-Diagnose Cecal Mass Jonathan Buscaglia, MD Chapter 24: Ulcerative Colitis Presenting With a Rectal Mass Geoffrey Nguyen, MD, PhD Chapter 25: Crohn’s Disease or Behcet’s Syndrome? Octavia Pickett-Blakely, MD Chapter 26: A 76-Year-Old Male With Chronic Watery Diarrhea Eun Ji Shin, MD Chapter 27: Sessile Serrated Adenomas: A Lesion Not to be Missed Michel Kafrouni, MD Chapter 28: Colonic Obstruction in a Patient With Multiple Medical Problems Karen Krok, MD Chapter 29: Right Lower Quadrant Pain in a 39-Year-Old Woman Karen Krok, MD Chapter 30: Abdominal Distention Within the Intensive Care Unit Karen Krok, MD Chapter 31: Rectal Bleeding Following Craniotomy Karen Krok, MD Chapter 32: Constipation and Decreased Urinary Output in a 32-Year-Old Male Ghazaleh Aram, MD Chapter 33: An Unusual Cause of Ileo-Colonic Obstruction Ghazaleh Aram, MD Chapter 34: An Opportunistic Infection Masquerading as Crohn’s Disease Priscilla Magno, MD SECTION V: Pancreas/Biliary Chapter 35: An Unusual Cause of Recurrent Acute Pancreatitis Kerry Dunbar, MD Chapter 36: A 74-Year-Old Male With Refractory Diarrhea John Clarke, MD Chapter 37: Diarrhea, Abdominal Pain, and a Dilated Biliary Tree Eun Ji Shin, MD Chapter 38: Biliary Drainage Through the Minor Papilla? Samuel Giday, MD Chapter 39: Elevated Serum Alkaline Phosphatase in an Asymptomatic Patient Samuel Giday, MD SECTION VI: Liver Chapter 40: Progressive Ascites in a Patient From Sierra Leone John Clarke, MD Chapter 41: Hyperemesis Gravidarum and Ataxia Jonathan Buscaglia, MD Chapter 42: Fulminant Hepatic Failure Following an Elective Colonoscopy Eun Ji Shin, MD Chapter 43: New Onset Jaundice in a Bodybuilder Michel Kafrouni, MD Chapter 44: An Uncommon Cause of Ascites Karen Krok, MD Chapter 45: Elevated Liver Enzymes After In Vitro Fertilization Karen Krok, MD Chapter 46: Elevated Alkaline Phosphatase Level and Renal Cell Carcinoma Karen Krok, MD Chapter 47: Fever and a Baltimore Alleyway James Hamilton, MD Chapter 48: Fulminant Hepatic Failure Following a Walk in the Woods James Hamilton, MD Chapter 49: Primary Hepatic B-Cell Lymphoma Masquerading as a Liver Abscess Ghazaleh Aram, MD Chapter 50: Seaside Septicemia Anurag Maheshwari, MD SECTION VII: GI Manifestations of Systemic Diseases Chapter 51: Unexpected Cause for Persistent Nausea and Vomiting Kerry Dunbar, MD Chapter 52: New Onset Dysphagia and Electrolyte Disturbance Michel Kafrouni, MD Chapter 53: An Unusual Cause of Ascites and Gastrointestinal Hemorrhage John Clarke, MD Chapter 54: Gastrointestinal Bleeding and a Purpuric Rash Karen Krok, MD Chapter 55: A Strange Cause for Weight Loss Karen Krok, MD Chapter 56: An Inherited Form of Abdominal Pain, Fever, and Arthritis James Hamilton, MD Chapter 57: Abdominal Pain Following Liver Transplantation Anurag Maheshwari, MD Chapter 58: An Unusual Presentation of Acute Recurrent Pancreatitis Priscilla Magno, MD Chapter 59: An Extraordinary Right Ankle Wound Octavia Pickett-Blakely, MD Section VIII: Test QUESTIONS AND ANSWERS Test Questions Test Answers Index  

 "The book is written in a way that it can easily be read in a “piecemeal” fashion. The cases are short and succinct. The simple organization makes it easy to read and learn from. The authors do a fine job of presenting the cases in the above mentioned format, complimented by excellent imaging, including endoscopic, radiologic, and histiologic pictures. There is a nice mix of interesting core issues in GI and unusual, unique cases. Overall, the authors and editors have done a good job in presenting an educational and interesting book. However, given the unique nature of many of the cases, the book can serve as a good refresher to the fellowship-trained gastroenterologist." 

— Jeffrey A. Smith, MD, Texas Digestive Disease Consultants, Practical Gastroenterology

Jonathan Buscaglia, MD is a board-certified internal medicine physician and gastroenterologist specializing in therapeutic endoscopy. He completed medical school at the State University of New York at Buffalo, and then trained in internal medicine at Montefiore Medical Center, part of the Albert Einstein College of Medicine. From there, he completed both his general gastroenterology fellowship and his advanced endoscopy training at the Johns Hopkins Hospital, where he later served on the faculty as Instructor of Medicine. Currently, he is a full-time faculty member and Assistant Professor of Medicine at the State University of New York at Stony Brook. He serves as the Director of Endoscopy at Stony Brook University Medical Center, and also as Visiting Assistant Professor of Medicine at Johns Hopkins University School of Medicine. He is the former editor for the Fellows’ Corner section of Gastrointestinal Endoscopy (GIE), the premier peer-review journal for advanced endoscopy. He is currently a member of GIE’s Editorial Review Board, and associate editor for the DAVE Project (Digital Atlas of Video Education); an educational website dedicated to teaching advanced diagnostic and therapeutic endoscopy.

Anthony Kalloo, MD is Professor of Medicine at Johns Hopkins University School of Medicine and is the Director of The Division of Gastroenterology and Hepatology at Johns Hopkins. After receiving his medical degree from the University of West Indies Medical School, Dr. Kalloo interned and trained in Internal Medicine at Howard University Hospital in Washington, D.C. He completed his fellowship training program at the combined Georgetown University, VA Medical Center and NIH program. He was an Instructor in Medicine at Georgetown University prior to joining the faculty at Johns Hopkins in 1988. He has special interests in Natural Orifice Surgery, therapeutic endoscopy, biliary and pancreatic diseases, and sphincter of Oddi dysfunction. He is the pioneer of Natural Orifice Translumenal Endoscopic Surgery and is a past Panel Chair for Gastroenterology and Urology Devices with the United States Food and Drug Administration. He is a past Associate Editor for Gastrointestinal Endoscopy. He is a member of the Apollo group, a think-tank endoscopy group. Dr. Kalloo and the Division of Gastroenterology and Hepatology aim to advance the understanding, diagnosis, treatment, and prevention of gastrointestinal and liver disease through patient care, education, and research.