ABSTRACT
This study addresses the risks of medication-induced esophageal injury through a case presentation of a 30-year-old patient treated with doxycycline. The case highlights the importance of proper medication administration and the role of endoscopic evaluation in diagnosis and management. The broader discussion emphasizes the prevalence of such injuries, especially with antibiotics, and factors influencing their occurrence. A clinical study illustrates the corrosive effect of tetracycline, highlighting the role of pH and hyperosmolar properties. The study concludes with a reminder of the critical role of healthcare professionals in recognizing and managing medication-induced esophagitis, with endoscopy as a key diagnostic tool.
ABSTRACT
This case report discusses a complex medical scenario involving a 25-year-old female patient initially diagnosed with acute hepatitis A virus (HAV) who later developed symptoms indicative of autoimmune hepatitis (AIH). The transition from uncomplicated HAV to impending subacute hepatic failure and autoimmune overlap syndrome highlights the importance of vigilant monitoring and a comprehensive diagnostic approach. The patient's medical evaluation revealed autoantibodies, elevated IgG levels, and liver biopsy findings consistent with steatohepatitis. Management included immunosuppressive therapy, resulting in a positive treatment response. The phenomenon of AIH following acute HAV infection, though rare, remains a subject of medical interest and presents diagnostic and therapeutic challenges. Further research and clinical experience are needed to develop effective strategies for these infrequent cases.
ABSTRACT
BACKGROUND: Oesophageal cancer is the fourth most common cause of cancer-related deaths in India. Esophageal squamous cell carcinomas (ESCCs) arise from the epithelial layer, and commonly present as polypoidal, ulcerative or ulceroproliferative growth in the oesophageal lumen. In contrast, oesophageal submucosal tumours are a distinct group of tumours arising from the mesenchyme (examples include leiomyoma, fibrovasculoma, lipoma, granular cell tumour or carcinoid), and mostly do not breach the mucosa. Oesophageal submucosal tumours are a distinct group of tumours arising from the mesenchyme, and mostly do not breach the mucosa. Complete intramural growth of an advanced primary ESCC is an exceedingly rare presentation, with only six cases reported in the literature thus far. We herein report a case of primary ESCC with complete intramural invasion that endoscopically mimics a submucosal lesion. CASE SUMMARY: A 50 year old male presented with a progressive mechanical type of dysphagia for one month. His history was significant, including squamous cell carcinoma of the tongue that was treated with surgery and chemoradiation 1 year prior. Upper gastrointestinal endoscopy revealed a large, hemispherical lesion with normal-appearing overlying mucosa about 4 cm × 5 cm in size extending from 30-34 cm from incisors. The patient underwent endoscopic ultrasound (EUS), and a fineneedle biopsy was performed, which was suggestive for squamous cell carcinoma. We herein report a case of primary ESCC with complete intramural invasion, endoscopically mimicking a submucosal lesion. The diagnosis could be established only by a EUS-guided biopsy. CONCLUSION: This case report highlights that intramural ESCC may look like a submucosal lesion in endoscopy, and EUS biopsy is needed for final diagnosis.
