Browsing by Author "Kesar, Varun"

Now showing 1 - 6 of 6
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    An Alarming Mimicry of Intra-Abdominal Infections: Acute Appendiceal Diverticulitis
    Kim, Youseung; Kesar, Varun; Grider, Douglas J.; Chitnavis, Maithili V. (Hindawi, 2021-11-12)
    A 65-year-old woman presented with three days of colicky abdominal pain. Abdominal imaging illustrated small bowel enteritis, ascites in both paracolic gutters, and incidental hepatic steatosis. Although ascites fluid demonstrated high neutrophil count consistent with peritonitis and the patient received adequate antibiotics, she clinically deteriorated. Subsequent exploratory laparotomy revealed necrotic appendix and multiple intra-abdominal abscesses. Histopathology showed acute suppurative appendicitis with multiple other intact small diverticula, indicating likely perforation of inflamed appendiceal diverticula with subsequent abscess formation and abdominal peritonitis. This case highlights the importance of ascites fluid analysis and continued clinical correlation, especially in cases of rare entities with atypical presentations.
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    Bleeding Gastric Lipoma Resected by Endoscopic Submucosal Dissection
    Mir, Adil Shamim; Kesar, Varun; Sageer, Mohamed; Grider, Douglas J.; Chitnavis, Vikas (2020-06-29)
    Gastric lipomas are slow-growing benign lesions of the stomach that are often detected incidentally. Most cases are asymptomatic but larger lesions may become symptomatic, thereby requiring treatment. Multiple endoscopic modalities have been used for resection in the past. We present the case of a 67-year-old patient who presented with upper GI bleeding secondary to a gastric lipoma, which was successfully resected by endoscopic submucosal dissection.
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    Endoscopic management of a chronic anastomotic leak after a Billroth II procedure
    Wasserman, Reid D.; Abel, William F.; Salzberg, Arnold; Kesar, Vivek; Yeaton, Paul; Kesar, Varun (Georg Thieme, 2024-01-30)
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    Massive infected pancreatic necrosis in an 8-year-old: Endoscopic management
    Abel, William F.; Kesar, Varun; Wasserman, Reid D.; Kumar, Manoj; Patel, Vishal; Yeaton, Paul; Kesar, Vivek (Wiley, 2024-02-14)
    Pancreatitis is a condition much more commonly found in adults, but when diagnosed in the pediatric population, is often due to medications, congenital pathology, and critical illness. This patient had previously undergone treatment with 6-mercaptopurine and presented with pancreatitis that eventually worsened to a walled-off necrotic collection with paracolic extensions reaching the pelvis. Given clinical worsening with development of shock, procedural options for source control were weighed with gastroenterology, pediatric surgery, and interventional radiology, before pancreatic necrosectomy was determined to be the treatment of choice, given the adjacency of the collection to the stomach. A total of three separate endoscopic pancreatic necrosectomy procedures were performed and the patient s clinical status improved greatly, with vast improvement later seen on outpatient imaging. This successful treatment course argues for the efficacy of pancreatic necrosectomy even in very large walled off collections, and most importantly, lead to a positive outcome in this young patient.
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    A Rare Case of Eosinophilic Gastroenteritis Isolated in the Muscularis Propria of the Small Bowel
    Kim, Seo Hyun; Kesar, Varun; Grider, Douglas; Nguyen, Vu (Cureus, 2021-10-14)
    Eosinophilic gastroenteritis (EG) is an autoimmune disorder that involves infiltration of eosinophils in the bowel wall of the stomach and/or intestine, resulting in various gastrointestinal symptoms. The majority of cases are diagnosed by findings of increased eosinophils on mucosal biopsies. We describe a rare type of eosinophilic gastroenteritis with eosinophilic infiltration involving only the muscularis propria layer. This elusive diagnosis was made after a full-thickness intestinal wall biopsy. This predominantly muscular type eosinophilic gastroenteritis can cause intestinal obstruction or perforation. Similar to the predominantly mucosal type eosinophilic gastroenteritis, this type of eosinophilic gastroenteritis responds to low-dose or topical corticosteroids.
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    Unusual cause of colonic mucosal ulceration and gastrointestinal bleeding
    Kim, Youseung; Kesar, Varun; LeBel, David (BMJ, 2021-06-14)