Diagnostic and Therapeutic Challenges of Chronic Portal Vein Thrombosis Secondary to Myeloproliferative Neoplasm in Sub-Saharan Region: A Series of Cases and Literature Review.

Myeloproliferative neoplasms (MPN) are the commonest causes of non-cirrhotic abdominal vein thrombosis. MPN was observed in 30-40% with Budd Chiari Syndrome (BCS) and portal vein thrombosis (PVT), whereas this is the cause in only a minority of other types of venous thrombosis. Herein, we report 10 cases of chronic PVT secondary to Janus Kinase 2 gene (JAk 2) positive myeloproliferative neoplasm (MPN). The median age was 35 years with M:F 1:1. Portal hypertension was present at presentation in all of them. Nine patients have esophageal varices, of which 6 have bleeding at presentation. Classical MPN phenotype on complete blood count (CBC) was not present in 6 of them. Management of patients with anticoagulation was difficult with 4 patients experiencing bleeding during anticoagulation, and bleeding occurring despite the target international normalized ratio (INR) in 2 of them. Portal hypertension leading to hypersplenism and hemodilution may mask erythrocytosis and thrombocytosis, which are the main criteria used to diagnose MPN. The resulting absence of a typical MPN phenotype in routine laboratory studies alongside accessibility issues, and the need for a multidisciplinary treatment approach imparts a diagnostic as well as a therapeutic challenge for chronic PVT associated with Jak 2 positive MPN in sub-Saharan patients.

Upper GI Bleeding Due to Leech Infestation in Ethiopian Patients: A Case Series and Review of Literature.

Upper GI bleeding secondary to a live foreign body (leech) is a very rare condition, causing diagnostic and therapeutic challenges. Aquatic leeches could infest the upper gastrointestinal (GI) mucosa, resulting in bleeding and/or anemia. A history of contact with a contaminated water source is necessary to establish the diagnosis. We, herein, present two cases of upper GI bleeding caused by leech infestation and a technique for extraction of the leech.

A Case Report of Belly Dancer Dyskinesia in a 54 Years Old Female: Gastroenterology Meets Neurology.

Dyskinesia limited only to the axial musculature is very rare, and if it is localized to the anterior abdominal wall, it is called belly dancer's dyskinesia. Despite reports of variable clinical characteristics, a common feature is a myriad of involuntary, repetitive, sometimes painful, and often rhythmic movements of the anterior abdominal wall, with the majority being bilateral, resembling that of a belly dancer. As the symptom is mainly localized to the abdomen, patients could visit a gastroenterology service thinking it might be associated with underlying visceral pathology. Since the first report in 1990, only a few cases of belly dancer dyskinesia have been reported over the years. We herein report the case of a 54 years old female who presented to our OPD with a recurrent painless writhing movement of the abdomen, diagnosed as belly dancer dyskinesia and successfully treated with chlordiazepoxide.