Have you ever noticed that as soon as people begin to publish papers in academic journals, their protectiveness over a thus far long forgotten middle initial suddenly assumes unprecedented significance? Personally, my middle name was primarily a source of embarrassment before I began to insist my name appeared as ‘James B Maurice’ on papers, however […]
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Yellowish lesion in the colon
An 82-year-old woman with a history of eosinophilic granulomatosis with polyangiitis treated with 4 mg/day prednisolone underwent a colonoscopy because of a positive fecal occult blood test. This revealed a 2-mm slightly elevated yellowish lesion in the transverse colon (figure 1). Narrow-band imaging showed intact pits of the colonic mucosa (figure 2). Physical examination was […]
A blushing ulcer?
An elderly lady was admitted to hospital following recurrent episodes of malaena. She had an oesophagoduodenoscopy which revealed a large bleeding gastric ulcer (50mm) near the lesser curvature of the stomach (Forrest III). (Figure 1). The vessel was clipped and spray applied with haemospray. She had a repeat CT angiogram the next day. (Figure 2). […]
Thoracic and abdominal pain in a 28-year old woman with a failing kidney transplant
A 28-year old woman with a failing kidney transplant due to rejection (on high dose Prednisolone and Alemtuzumab) presented with increasing right-sided thoracic pain and abdominal discomfort. Physical examination revealed no abnormalities. Laboratory results showed a normal white blood cell count, low serum C-reactive protein, normal level of liver enzymes and electrolytes, an elevated serum […]
When food gets stuck…?
An 86-year-old woman with a background of ischaemic heart disease presented with dysphagia and odynophagia while eating toast for breakfast followed by sudden onset severe sharp retrosternal and epigastric pain radiating to her back and 3 episodes of coffee-ground vomiting. There were no reported episodes of melaena or syncope. She remained haemodynamically stable. Her blood […]
#FGdebate: Gastroenterology and hepatology training: time for a divorce?
Date: Monday 9th October Time: 8-9pm GMT Guest: Dr Ahmed Elsharkawy @aelsharkawy75 Dr Ahmed Elsharkawy was appointed as a Consultant Hepatologist in March 2012. He qualified from Southampton in 1999 before doing his core medical training in Nottingham followed by registrar training on both the Wessex and Northern Deanery schemes. His PhD was in the […]
An unusual cause of intestinal failure
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 […]
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 […]