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When the Gleam of Obstruction Isn't Just Stones: A Case Report of Intraductal Papillary Neoplasm of the Bile Duct (IPNB) and the Role of Cholangioscopy in Its Management.
Cureus
December 2024
Gastroenterology and Hepatology, Aberdeen Royal Infirmary Hospital, Aberdeen, GBR.
Intraductal papillary neoplasm of the bile duct (IPNB) is a precursor lesion to biliary tract carcinoma. It is characterised by papillary growth within the bile ducts. The diagnosis and management of IPNB are challenging due to its varying presentations and overlapping features with other biliary diseases.
View Article and Find Full Text PDFFulminant Type 1 Diabetes Mellitus Leading to Diabetic Ketoacidosis and Mesenteric Ischemia With Necrosis Following Pembrolizumab Administration: A Case Report.
Cureus
December 2024
Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JPN.
Immune checkpoint inhibitors (ICIs), such as pembrolizumab, have revolutionized cancer therapy but can lead to severe immune-related adverse events (irAEs). We present a case of fulminant type 1 diabetes mellitus (T1DM) with diabetic ketoacidosis (DKA) and mesenteric ischemia in a 78-year-old woman with recurrent stage IIIC1 cervical cancer treated with pembrolizumab. Thirty-four days after initiating a pembrolizumab-containing regimen, she presented with vomiting, severe hyperglycemia, metabolic acidosis, and strongly positive urine ketones.
View Article and Find Full Text PDFObjective: Skull base chordoma and chondrosarcoma are distinct sarcomas of the skull base but share significant therapeutic challenges due to their proximity to critical neurovascular structures, making surgical resection difficult. We sought to establish factors associated with outcome predictors in a national cohort of patients.
Methods And Analysis: Data for all patients referred with a diagnosis of skull base chordoma or chondrosarcoma from April 2017 to December 2022 were obtained.
Combined Anterograde and Retrograde Endoscopic Management of Complete Esophageal Obstruction in Absence of Fluoroscopic Guidance.
ACG Case Rep J
February 2025
Department of Medicine, Division of Gastroenterology & Hepatology, Rutgers New Jersey Medical School, Newark, NJ.
Complete esophageal obstruction is a major side effect of radiotherapy for head and neck cancers. We present a 65-year-old man with complete esophageal obstruction due to chemoradiotherapy and 7 years of gastric tube dependence. A combined anterograde and retrograde endoscopic procedure was successfully performed using direct transillumination from the anterograde scope to visualize and excise the obstructing mucosa, without fluoroscopic guidance.
View Article and Find Full Text PDFObjectives: Endoscopic ultrasonography (EUS)-guided radiofrequency ablation has recently been introduced as one of the management strategies for small pancreatic neuroendocrine neoplasms (PNENs). However, prospective data on its safety and efficacy remain limited.
Methods: This prospective pilot study was conducted at Okayama University Hospital from May 2023 to December 2024.
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