Rapid Rectal Polyposis Development in a Patient With Familial Adenomatous Polyposis.

Familial adenomatous polyposis (FAP) is a well-described genetic condition that results in the development of multiple benign and malignant lesions throughout the gastrointestinal tract. The development of colorectal cancer is nearly universal in classic FAP, and total proctocolectomy after polyp development is recommended. We present a patient with FAP who was unable to undergo proctectomy. Despite careful removal of all rectal polyps before subtotal colectomy with ileorectal anastomosis, he developed 12 rectal polyps, including 4 advanced neoplastic lesions, within 73 days after initial endoscopic removal. This case highlights the rapid regrowth rate of colorectal adenomas in FAP.

Treatment of Esophageal Stricture After Lye Ingestion.

Caustic ingestions represent a well-known public health concern. Ingestion of highly alkali agents (lye ingestion) from the consumption of cleaning products is common, with an estimated 200,000 cases reported annually in the United States. Long-term complications of lye ingestion include esophageal strictures, gastric stenosis, and cancer. We describe a 53-year-old woman who suffered from lye ingestion as a child complicated by refractory esophageal strictures. Twenty years after esophagectomy and colon interposition, she developed debilitating dysphagia with daily regurgitation. The case highlights the long-term gastrointestinal consequences of lye ingestion and the evolution of endoscopic and surgical treatments of known complications.

The Spiraling Case of a Yellow Chef: Isolated Hyperbilirubinemia.

Leptospirosis is a common bacterial disease in tropical regions of the world due to greater exposure to rodents and domestic animals; however, this condition can also occur in US urban areas, though it often goes unrecognized. Gastrointestinal symptoms are very commonly seen, and icteric leptospirosis is often confused for other conditions resulting in delayed diagnosis and worse outcomes. As mortality increases with more extensive hepatic involvement, gastroenterologists should be aware of the constellation of gastrointestinal symptoms related to leptospirosis, as it can occur in the absence of classic exposure history.