ABSTRACT
Background Gastroparesis, characterized by delayed gastric emptying without mechanical obstruction, is a significant complication, especially in diabetic individuals. It manifests through symptoms such as abdominal bloating, feelings of fullness, and pain. This study investigates the prevalence of gastroparesis among non-diabetic and diabetic patients, exploring associations with demographic data, hemoglobin A1C (HbA1C) levels, and symptoms. Methodology This retrospective, observational, cohort study included patients with gastroparesis symptoms who underwent a nuclear gastric emptying study from January 2021 to April 2023. The study analyzed demographic data, symptoms, and HbA1c levels to identify correlations with delayed gastric emptying. Results Of 157 patients, 34.4% exhibited delayed gastric emptying. Diabetic patients comprised 29.3% of the sample, with a notable disease duration of over 10 years in 77.3% of cases. Symptoms such as nausea, vomiting, epigastric pain, and early satiety were prevalent, with significant associations between delayed emptying and female gender, higher HbA1c, and vomiting. Conclusions Delayed gastric emptying is significantly associated with female gender, elevated HbA1c levels, and when vomiting is the presenting symptom. Highlighting the importance of awareness among healthcare providers and the community, the findings encourage collaborative efforts for further gastroparesis research to better understand the predictive factors and mechanisms.
ABSTRACT
Celiac disease (CD) is a chronic immune-mediated small-intestinal disorder. The tissue transglutaminase (TTG) antibodies test is the initial step in the diagnosis of CD. Intussusception is a process where one segment of the bowel invaginates into the lumen of an adjacent segment. Despite that, the association between adult intussusception and CD has been descried previously, and it is still not widely recognized. We report a case of adult intussusception as the first manifestation of CD. A 28-year-old nonalcoholic and nonsmoker, previously healthy man, presented to the emergency department with a 1-week history of progressive diffuse abdominal pain associated with abdominal distension, nausea, vomiting, diarrhea, and 7 kg weight loss. The physical exam was remarkable for thin body habitus with no lymphadenopathy. Laboratory testing was significant for hypochromic microcytic anemia, AST 214 IU/L, ALT 217 IU/L, alkaline phosphatase 183 IU/L, and INR 2.9. An abdominal radiograph showed distended gas-filled small- and large-bowel loops. An abdominal computed tomography scan with contrast was done and demonstrated a telescoping of the small bowel in at least 3 areas with a target sign appearance with no signs of obstruction that suggested small-bowel intussusception. Following this imaging result, the patient was admitted under general surgery and kept nothing by mouth. The surgical team approached the gastroenterology team for push enteroscopy with biopsy which the patient refused. Further investigation included TTG antibodies; IgA and IgG were significantly elevated, 4,965.5 CU and 431.9 CU, respectively (reference: <19.9 CU). The diagnosis of CD leading to adult intussusception was made. The patient was advised to start a gluten-free diet. During the hospital stay, the patient had complete resolution of his symptoms and was discharged home. In summary, this case highlights the potential link between adult intussusception and CD. Adult intussusception is a rare condition that its underlying etiology should be meticulously investigated to expedite treatment and prevent unnecessary surgical intervention.
ABSTRACT
Wilson's disease (WD) is an autosomal recessive disease affecting the copper metabolism resulting in various clinical presentations. Diagnosis includes the presence of low serum copper and ceruloplasmin concentrations, increased urinary copper excretion, and/or increased hepatic copper concentrations. Yet, genetic testing remains diagnostic. Management includes copper chelating agents and liver transplant in advance cases. We report a case of WD presenting with liver function impairment in late adult life and started on treatment. Therefore, early diagnosis and treatment of WD can prevent related complications.
