Endoscopic management of esophageal discontinuity.

Background: The management of esophageal discontinuity remains challenging and often involves complex reconstructive surgeries.

Methods And Results: We describe a unique and successful treatment of esophageal discontinuity using a modification of the natural orifice translumenal surgery (NOTES) approach in a patient presenting with long-standing esophageal discontinuity resulting from an iatrogenic esophageal injury.

Conclusion: This case provided an opportunity to affirm the efficacy of endoscopy for treating esophageal discontinuities to minimize the degree of morbidity and mortality normally associated with the surgical treatment of this type of injury.

Labor-associated eosinophilic gastroenteritis.

A 30-year-old woman who was 2 weeks postpartum presented with intermittent dysphagia since delivery. Esophagogastroduodenoscopy (EGD) revealed linear furrowing, trachealization, and a B-type distal esophageal ring with normal appearing stomach and duodenum. Biopsies showed eosinophilic esophagitis.

Falsely elevated cardiac troponin-I in patients with seropositive rheumatoid arthritis.

Objective: To determine if patients with seropositive rheumatoid arthritis (RA) have abnormally elevated concentrations of cardiac troponin-I (cTnI). Reports suggest the presence of serum rheumatoid factor (RF) may interfere with the cTnI assay, leading to falsely elevated cTnI levels. One study reported a falsely elevated cTnI in 15 out of 100 serum samples with elevated RF using the Abbott assay, but no elevated level using the Bayer assay.