ABSTRACT
A female patient in her 80s presented with chronic iron-deficiency anaemia secondary to gastric antral vascular ectasia (GAVE), despite repeated endoscopic treatment. Her medical history was notable for chronic myeloid leukaemia, for which she took imatinib. Due to a possible association between imatinib and GAVE described in a small number of case reports, cessation of imatinib was trialled. This led to a significant improvement in the patient's anaemia and resolution of GAVE on repeat endoscopy. GAVE is an uncommon cause of gastrointestinal bleeding, the aetiology of which is uncertain. This report describes an approach to the differential diagnosis of chronic iron-deficiency anaemia and an overview of GAVE syndrome. It illustrates the benefit of broadening the differential when the diagnosis is uncertain and the utility of case reports in informing the differential diagnosis.
Subject(s)
Anemia, Iron-Deficiency , Antineoplastic Agents , Gastric Antral Vascular Ectasia , Imatinib Mesylate , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Female , Humans , Anemia, Iron-Deficiency/drug therapy , Anemia, Iron-Deficiency/etiology , Gastric Antral Vascular Ectasia/chemically induced , Gastric Antral Vascular Ectasia/diagnosis , Gastric Antral Vascular Ectasia/therapy , Gastrointestinal Hemorrhage/etiology , Imatinib Mesylate/adverse effects , Imatinib Mesylate/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Aged, 80 and over , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic useABSTRACT
Distal intestinal obstruction syndrome (DIOS) is a common complication in patients with cystic fibrosis (CF). Patients typically present with right lower quadrant pain, nausea, abdominal distention, and failure to pass stool or flatus. It can be managed conservatively with medical interventions but some cases may require colonoscopy and even surgery. We report a rare instance in which a CF patient with a previous ileostomy developed DIOS and was successfully managed with ileoscopy after medical management failed.
ABSTRACT
Hypercoagulability is now a recognized complication of COVID-19 infection. Despite this, splenic infarction remains rare and is often found incidentally, radiologically, or at autopsy. We report a case of symptomatic splenic infarction with superimposed infection, secondary to COVID-19-induced hypercoagulability in a young patient with paradoxical emboli due to an undiagnosed patent foramen ovale (PFO). This multifactorial case should prompt a level of suspicion of the patient with unexplained abdominal pain and recent COVID-19 infection.
