A 62 year old man with well controlled type 2 diabetes presented with abdominal symptoms, significant weight loss and night blindness. He was vitamin A deficient, had marked peripheral oedema and a serum albumin of 12g/l, requiring TPN. Stool culture and testing for HIV and TB were negative. Immunoglobulin levels were normal. Computed tomography showed […]
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A rare cause of gastric outflow obstruction
A 78-year old lady with a previous history of oesophagectomy for adenocarcinoma, was referred with symptoms of epigastric pain, post-prandial vomiting and weight loss. OGD after a prolonged fast revealed erosions in the gastric conduit (image A) and the impression of external indentation at the antrum but no stenoses. Biopsies revealed chronic inflammation with no […]
#FGDebate: Liver Biopsy is Critical for Managing Fatty Liver Disease
Liver Biopsy is Critical for Managing Fatty Liver Disease Date: Tuesday 25th July Time: 8-9pm GMT Guest: Professor Rob Goldin @robdgol Rob Goldin is Professor of Gastro-intestinal and Liver Pathology at Imperial College and the Clinical Lead for Gastro-intestinal Pathology in the North-West London Pathology Group. He also works at the Ludwig Institute for Cancer Research in […]
A Macroscopic Sign of an Often Unseen Diagnosis
A 72 year old lady presented with new, non-bloody diarrhoea. She was intermittently using Ibuprofen and had a family history of colorectal cancer. She underwent colonoscopy. What is the classical feature observed at the ceacum? How can the diagnosis be confirmed? How should this be treated? Submitted by PR Harvey, RA Boulton. Department of […]
An unusual cause for hyperamylasaemia
A 79-year-old man with an extensive previous heart history was admitted electively for investigation of weight loss and deterioration of renal function. Whilst an inpatient he developed severe epigastric pain and an initial blood test revealed an acutely raised amylase (> 2000) and deranged liver function tests. A non-contrast CT scan was done. What is […]
A simple IBD flare?
33 year old male with ulcerative colitis presents with a 5-day history of fever, night sweats, abdominal pain and increased stool frequency. Medications include mesalazine M/R 1g once daily, 6-mercaptopurine 75mg once daily and a two week course of prednisolone 40mg once daily. Bloods revealed a leukopenia and c-reactive protein of 23. Based on the […]
Another portal vein thrombosis?
Figure 1 Figure 2 A 62 year old male was undergoing antiviral therapy for HCV cirrhosis. He was asymptomatic with normal liver function tests and a normal alpha fetoprotein level. Routine liver ultrasound suggested a new portal vein thrombosis. CT imaging (figure1) and subsequent pathology specimen (figure 2) demonstrate a unique lesion. What’s in […]
Case of the month: Jelly belly?
Case of the month: A 75 year old man presents with a 2 month history of abdominal distension and lethargy. Clinical examination demonstrates shifting dullness and investigations reveal he has a microcytic anaemia with raised tumour markers (CA19-9-208 U/ml , CEA-88 µg/L) Ascitic aspiration yields a gelatinous fluid, the coronal section of his abdominal CT scan […]
#FGDebate GI Consequences of Cancer
GI Consequences of Cancer: Cancer cured – all back to normal now?’ Date: Tuesday 4th October 2016 Time: 8-9 BST Guest: Dr Ana Wilson @GIWolfsonunit Dr Ana (Ignjatovic) Wilson BA(Hons) MD MRCP Consultant Gastroenterologist and Endoscopist Dept: Wolfson Unit for Endoscopy Tel: 020 8869 5277 Email: smita.patel5@nhs.net Dr Ana Wilson is out featured guest for this […]
Case of the month-A scalp lesion with anaemia?
A 79 year old man underwent a upper GI endoscopy for dark stools and anaemia (top left), histology from lesions (top right) is presented. Further examination revealed a scalp lesion (bottom left), which was also biopsied (bottom right). What is the unifying diagnosis? Submitted by GJ Webb. […]