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Massive upper gastrointestinal hemorrhage due to invasive hepatocellular carcinoma and hepato-gastric fistula

World Journal of Gastroenterology 2013年第42期19卷 7472-7475页

作者： Hari Sayana Osama Yousef wendell k clarkston Section of Gastroenterology and Hepatology Department of Internal MedicineUniversity of Missouri Kansas CityKansas CityMO 64108-2640United States

A 36-year-old male Asian immigrant with a history of hepatitis B and hepatitis C related unresectable hepatocellular carcinoma in the left lobe of the liver presented with hematemesis and severe *** was diagnosed with a liver mass that was resected 8 years ago described as a benign tumor in his home *** had received trans-arterial chemoembolization(TACE)four months ago after subsequent diagnosis of unresectable hepatoma,and currently was receiving chemotherapy with *** resuscitation,a contrast enhanced computerized tomography was performed which showed fistulization of hepatocellular carcinoma into adjacent *** finding was confirmed during endoscopy with direct visualization of the fistulous *** carcinoma(HCC)invading the gastrointestinal(GI)tract is *** present a case and literature review of HCC with local invasion of the stomach causing massive upper GI bleeding after receiving TACE.

关键词： Hepatocellular carcinoma Hepatogastric fistula Fistula Upper gastrointestinal bleeding

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Jejunoileal bypass:A surgery of the past and a review of its complications

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World Journal of Gastroenterology 2009年第18期15卷 2277-2279页

作者： Dushyant Singh Alexandra S Laya wendell k clarkston Mark J Allen Department of Gastroenterology and Hepatology University of Missouri Kansas CityKansas City MO 64111United States

Jejunoileal bypass(JIB),popular in the 1960s and 1970s,had remarkable success in achieving weight loss by creating a surgical short bowel *** patient had an unusual case of liver disease and provided no history of prior bariatric ***,it was recognized that he had a JIB in the 1970s,which was also responsible for the gamut of his *** with JIB are often not recognized,as they died of complications,or underwent reversal of their surgery or a liver-kidney *** identification with prompt reversal,and the recognition and treatment of the life-threatening consequences play a critical role in the management of such patients.

关键词： Jejunoileal bypass Bariatric surgery Weightloss Obesity Morbid obesity

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Achalasia after bariatric Roux-en-Y gastric bypass surgery reversal

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World Journal of Gastroenterology 2017年第37期23卷 6902-6906页

作者： Mouhanna Abu Ghanimeh Ayman Qasrawi Omar Abughanimeh Sakher Albadarin wendell clarkston Division of Gastroenterology Henry Ford Hospital Department of Internal Medicine University of Missouri-Kansas City Division of Gastr-oenterology Saint Luke’s Hospital of Kansas City

Achalasia is a rare esophageal motility disorder that is characterized by a loss of peristalsis in the distal esophagus and failure of lower esophageal sphincter relaxation. The risk of developing esophageal motility disorders, including achalasia, following bariatric surgery is controversial and differs based on the type of surgery. Most of the reported cases occurred with laparoscopic adjustable gastric banding. To our knowledge, there are only three reported cases of achalasia after Roux-en-Y gastric bypass and no reported cases after revision of the surgery. We present a case of a 70-year-old female who had a previous history of Roux-en-Y gastric bypass with revision. She presented with persistent nausea and regurgitation for one month. Esophagogastroduodenoscopy showed a dilated esophagus without strictures or stenosis. A barium study was performed after the endoscopy and was suggestive of achalasia. Those findings were confirmed by a manometry. The patient was referred for laparoscopic Heller's myotomy.

关键词： Esophagus Bariatric Gastric band Bypass surgery Achalasia Esophagogastroduodenoscopy Heller's myotomy Motility disorder

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