Raosaheb Rathod - Academia.edu (original) (raw)
Papers by Raosaheb Rathod
World journal of transplantation, Mar 18, 2024
ACG Case Reports Journal, May 1, 2019
A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive ... more A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive care unit with respiratory distress, acute kidney injury, and hypercalcemia, was referred for evaluation of upper gastrointestinal (GI) bleed. The patient was on mechanical ventilation with fresh blood aspirated using the Ryles tube. On investigation, hemoglobin was 7.6 g/dL and platelets were 63,000/mm 3 with international normalized ratio 1.3. Bedside upper GI endoscopy showed diffuse erythema with thickening and nodularity involving the entire stomach, without any ulceration or active bleeding (Figure 1). Biopsies were taken from the stomach for evaluation. There was suspicion of fungal pneumonia on thorax computed tomography. Differential diagnoses included infective gastropathy and gastric involvement by amyloidosis. The
PubMed, Jul 1, 2018
Introduction: Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (D... more Introduction: Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (DAH) and glomerulonephritis (GN), occurring simultaneously. It has high mortality and dialysis dependence at one year, if not timely diagnosed and aggressively treated. Objectives: To study etiology and short term outcome of PRS in India. Materials and methods: This study included patients of PRS seen in a tertiary care center in Mumbai, by one consultant from 1997- 2013, analyzed retrospectively and from January 2014 to December 2015 collected prospectively from six medical units, intensive care unit, nephrology and respiratory units. Patients with DAH (haemoptysis, breathlessness and x-ray chest with bilateral alveolar shadows with sparing of apices) and glomerulonephritis (Proteinuria, heamaturia, hypertension with or without raised serum Creatinine) were included in the study after carefully excluding other causes of haemoptysis and breathless like tuberculosis, pulmonary oedema, pneumonia, ARDS. During prospective enrollment of patients, in all admitted patients with haemoptysis, urine examination was carried out to specifically look for proteinuria and red blood cells in urine, same was also followed in those admitted for breathlessness with chest x-ray suggestive of alveolar haemorrhage. Patients were extensively investigated for etiology and were treated with steroids and pulse cyclophosphamide (after ruling out infectious etiology). Supportive care with ventilator or dialysis was given as per usual indications. Palsmapheresis was initiated in those with serum Creatinine ≥ 5.7mg/dl. Rituximab was used in refractory cases, as per treating physicians' choice. Final outcome was death or discharge. Results: There were 25 patients of PRS (13 retrospective, 12 prospective), with following etiology : Granulomatosis with polyangiitis (GPA) 7, Microscopic polyangiitis (MPO) 4, Churg Strauss Syndrome (EGPA) 1, Goodpasture's syndrome 1, lupus 5, leptospirosis 5, dengue 2. All were given steroids, 18 (72%) were given pulse Cyclophosphamide (barring those with leptospirosis and dengue), ventilator support in 14 (56%) patients (8 invasive, 6 non-invasive), haemodialysis 3, plasmapheresis 1, Rituximab 2. Seventeen (68%) patients survived, mortality was high in those requiring invasive ventilator. Conclusion: Most common etiology of PRS is ANCA positive vasculitis in India. With high degree of suspicion for DAH in patients presenting with haemoptysis, breathlessness and alveolar opacities in chest x-ray and carefully investigating by simple urine examination for evidence of GN, timely diagnosis of PRS can be made. With timely appropriate treatment survival is 68%. Patients with PRS due to leptospirosis or dengue have features suggestive of underlying disease (like icterus with raised bilirubin but < 200U SGOT/SGPT, subconjunctival haemorrhage, typical rash of dengue with thrombocytopenia).
Indian Journal of Medical Research, 2020
Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in... more Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in patients with cancer is recommended by all major hepatology and oncology societies. This study was aimed to determine the screening practices for hepatitis B among oncologists from India and their experience with hepatitis B reactivation. Methods: A questionnaire-based survey was conducted among oncologists attending the Evidence-Based Medicine Conference at Tata Memorial Centre, Mumbai, India. The questionnaire was developed in keeping with the recent guidelines for hepatitis B reactivation on chemotherapy, with questions regarding demographics, years in practice and hepatitis B screening practices and management. There was 78 per cent response rate to the questionnaire. Results: Most respondents were <35 yr of age (69%), with < five years of experience (39%), practicing in an academic institution (81%). Seventy four per cent respondents always screened their patients with cancer for hepatitis prior to chemotherapy, whereas 19 per cent in special settings and seven per cent never screened; 96 per cent respondents used hepatitis B surface antigen (HBsAg) as a screening test, while 17 per cent also used antibody to hepatitis B core antigen. Sixty one per cent respondents used entecavir or tenofovir for prophylaxis; 70 per cent continued prophylaxis till 6-12 months after completion of chemotherapy, while 21 per cent continued only till the end of chemotherapy. Interpretation & conclusions: More than 25 per cent of the oncologists were not screening their patients with cancer for viral hepatitis prior to cancer-directed therapy, and only 17 per cent of the oncologists used the recommended tests for screening. Better training of oncologists regarding viral hepatitis screening and management is needed.
Journal of Digestive Endoscopy
Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for pall... more Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for palliation of malignant colonic obstruction. We analyzed outcomes of patients who underwent colonic SEMS placement for palliation at a tertiary care oncology center in Western India. Methods Retrospective review of the endoscopy database was done for patients who underwent colonic SEMS placement at our center between January 2013 and September 2021. Demographic details, intent of stent placement, site of obstruction, length of stricture, technical success of stenting, clinical success, and complications (both immediate and long term) were noted. Results Sixty-one patients underwent colonic SEMS placement during the study period (mean age 53.6 years, 50.7% men). Obstruction was due to primary colonic malignancy in 43 (70.5%) patients and extracolonic malignancies in 18 (29.5%) patients. Most common extracolonic malignancy was gallbladder cancer in 8 (44.4%) patients. Most common site of obstr...
Online Journal of Health & Allied Sciences, 2013
Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with ... more Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with a stratified growth pattern but without destructive stromal invasion. Little is known about the histological subtypes and outcome, role of fertility sparing surgery and role of postoperative therapy in advanced stage in Indian scenario. While there is ample data in the world literature about this disease, prognosis in Indian patients is largely unknown due to dearth of studies in our setting. Objective: To study the demographic profile, clinical features, imaging, treatment and outcome of borderline ovarian tumors. Methods: This is a retrospective study of eighty seven patients with pathologically proven diagnosis of borderline ovarian tumor, diagnosed and treated from January 2006 to October 2011 at our institution. Most patients underwent surgical staging which incuded total abdominal hysterectomy and bilateral salphingo-oophorectomy, infracolic omentectomy, bilateral pelvic and para a...
Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, hyperlipid... more Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, hyperlipidemia and edema. It can affect any age group.Nephrotic syndrome is a comparatively rare but form major manifestation of kidney disease. Nephrotic syndrome has an occurrence of three new cases per 100000 each year in adults. Management of nephrotic syndrome according to modern science varies with different stages of the disease. The purpose of treatment is to relieve symptoms, prevent complications, and delay kidney damage.Patient with primary nephrotic syndrome needs corticosteroids but many times they may have relapse or become steroid dependent or resistant to it. Then alternative agents like cyclophosphamide, cyclosporine, levamisole which may be used in a combination. According to Ayurveda, there are number of drugs which can be used in nephrotic syndrome but Guduchi (Tinospora cordifolia) plays a specific role in nephrotic syndrome. It belongs to family Menispermaceae. Guduchi is sai...
The Journal of the Association of Physicians of India, 2018
Introduction Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (DA... more Introduction Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (DAH) and glomerulonephritis (GN), occurring simultaneously. It has high mortality and dialysis dependence at one year, if not timely diagnosed and aggressively treated. Objectives To study etiology and short term outcome of PRS in India. Materials and Methods This study included patients of PRS seen in a tertiary care center in Mumbai, by one consultant from 1997- 2013, analyzed retrospectively and from January 2014 to December 2015 collected prospectively from six medical units, intensive care unit, nephrology and respiratory units. Patients with DAH (haemoptysis, breathlessness and x-ray chest with bilateral alveolar shadows with sparing of apices) and glomerulonephritis (Proteinuria, heamaturia, hypertension with or without raised serum Creatinine) were included in the study after carefully excluding other causes of haemoptysis and breathless like tuberculosis, pulmonary oedema, pneumon...
Clinical Gastroenterology, 2021
within endoscopic reach, both > 2 cm in diameter & > 5 cm in length. There were no deaths due to ... more within endoscopic reach, both > 2 cm in diameter & > 5 cm in length. There were no deaths due to FB ingestion. Conclusions This is the largest study of Endoscopic FB removal from Western India. This study showed that the majority of the FB were ingested by children. Even those with injury to the bowel were asymptomatic. Since the size of FB did not determine it being within the reach of the endoscope and Groups S, NS & C FBs are associated with injury to the bowel; we propose an attempt at removal should be made in all patients, whether symptomatic or not.
Indian Journal of Medical Research, 2020
Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in... more Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in patients with cancer is recommended by all major hepatology and oncology societies. This study was aimed to determine the screening practices for hepatitis B among oncologists from India and their experience with hepatitis B reactivation. Methods: A questionnaire-based survey was conducted among oncologists attending the Evidence-Based Medicine Conference at Tata Memorial Centre, Mumbai, India. The questionnaire was developed in keeping with the recent guidelines for hepatitis B reactivation on chemotherapy, with questions regarding demographics, years in practice and hepatitis B screening practices and management. There was 78 per cent response rate to the questionnaire. Results: Most respondents were <35 yr of age (69%), with < five years of experience (39%), practicing in an academic institution (81%). Seventy four per cent respondents always screened their patients with cancer for hepatitis prior to chemotherapy, whereas 19 per cent in special settings and seven per cent never screened; 96 per cent respondents used hepatitis B surface antigen (HBsAg) as a screening test, while 17 per cent also used antibody to hepatitis B core antigen. Sixty one per cent respondents used entecavir or tenofovir for prophylaxis; 70 per cent continued prophylaxis till 6-12 months after completion of chemotherapy, while 21 per cent continued only till the end of chemotherapy. Interpretation & conclusions: More than 25 per cent of the oncologists were not screening their patients with cancer for viral hepatitis prior to cancer-directed therapy, and only 17 per cent of the oncologists used the recommended tests for screening. Better training of oncologists regarding viral hepatitis screening and management is needed.
ACG Case Reports Journal, 2019
A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive ... more A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive care unit with respiratory distress, acute kidney injury, and hypercalcemia, was referred for evaluation of upper gastrointestinal (GI) bleed. The patient was on mechanical ventilation with fresh blood aspirated using the Ryles tube. On investigation, hemoglobin was 7.6 g/dL and platelets were 63,000/mm 3 with international normalized ratio 1.3. Bedside upper GI endoscopy showed diffuse erythema with thickening and nodularity involving the entire stomach, without any ulceration or active bleeding (Figure 1). Biopsies were taken from the stomach for evaluation. There was suspicion of fungal pneumonia on thorax computed tomography. Differential diagnoses included infective gastropathy and gastric involvement by amyloidosis. The
Saudi Journal of Gastroenterology, 2016
Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an attractive option for patients who c... more Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an attractive option for patients who cannot undergo conventional endoscopic retrograde cholangiopancreatography (ERCP) and do not want surgery or percutaneous drainage procedures. We present the use of EUS-antegrade (EUS-AG) insertion of a self-expandable metal stent (SEMS) in a patient with a common hepatic duct cholangiocarcinoma, as well as a huge gastric lipoma, after recurrent biliary obstruction of a prior SEMS inserted via ERCP in the same session as a duodenal stent insertion for gastric outlet obstruction.
World journal of transplantation, Mar 18, 2024
ACG Case Reports Journal, May 1, 2019
A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive ... more A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive care unit with respiratory distress, acute kidney injury, and hypercalcemia, was referred for evaluation of upper gastrointestinal (GI) bleed. The patient was on mechanical ventilation with fresh blood aspirated using the Ryles tube. On investigation, hemoglobin was 7.6 g/dL and platelets were 63,000/mm 3 with international normalized ratio 1.3. Bedside upper GI endoscopy showed diffuse erythema with thickening and nodularity involving the entire stomach, without any ulceration or active bleeding (Figure 1). Biopsies were taken from the stomach for evaluation. There was suspicion of fungal pneumonia on thorax computed tomography. Differential diagnoses included infective gastropathy and gastric involvement by amyloidosis. The
PubMed, Jul 1, 2018
Introduction: Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (D... more Introduction: Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (DAH) and glomerulonephritis (GN), occurring simultaneously. It has high mortality and dialysis dependence at one year, if not timely diagnosed and aggressively treated. Objectives: To study etiology and short term outcome of PRS in India. Materials and methods: This study included patients of PRS seen in a tertiary care center in Mumbai, by one consultant from 1997- 2013, analyzed retrospectively and from January 2014 to December 2015 collected prospectively from six medical units, intensive care unit, nephrology and respiratory units. Patients with DAH (haemoptysis, breathlessness and x-ray chest with bilateral alveolar shadows with sparing of apices) and glomerulonephritis (Proteinuria, heamaturia, hypertension with or without raised serum Creatinine) were included in the study after carefully excluding other causes of haemoptysis and breathless like tuberculosis, pulmonary oedema, pneumonia, ARDS. During prospective enrollment of patients, in all admitted patients with haemoptysis, urine examination was carried out to specifically look for proteinuria and red blood cells in urine, same was also followed in those admitted for breathlessness with chest x-ray suggestive of alveolar haemorrhage. Patients were extensively investigated for etiology and were treated with steroids and pulse cyclophosphamide (after ruling out infectious etiology). Supportive care with ventilator or dialysis was given as per usual indications. Palsmapheresis was initiated in those with serum Creatinine ≥ 5.7mg/dl. Rituximab was used in refractory cases, as per treating physicians' choice. Final outcome was death or discharge. Results: There were 25 patients of PRS (13 retrospective, 12 prospective), with following etiology : Granulomatosis with polyangiitis (GPA) 7, Microscopic polyangiitis (MPO) 4, Churg Strauss Syndrome (EGPA) 1, Goodpasture's syndrome 1, lupus 5, leptospirosis 5, dengue 2. All were given steroids, 18 (72%) were given pulse Cyclophosphamide (barring those with leptospirosis and dengue), ventilator support in 14 (56%) patients (8 invasive, 6 non-invasive), haemodialysis 3, plasmapheresis 1, Rituximab 2. Seventeen (68%) patients survived, mortality was high in those requiring invasive ventilator. Conclusion: Most common etiology of PRS is ANCA positive vasculitis in India. With high degree of suspicion for DAH in patients presenting with haemoptysis, breathlessness and alveolar opacities in chest x-ray and carefully investigating by simple urine examination for evidence of GN, timely diagnosis of PRS can be made. With timely appropriate treatment survival is 68%. Patients with PRS due to leptospirosis or dengue have features suggestive of underlying disease (like icterus with raised bilirubin but < 200U SGOT/SGPT, subconjunctival haemorrhage, typical rash of dengue with thrombocytopenia).
Indian Journal of Medical Research, 2020
Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in... more Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in patients with cancer is recommended by all major hepatology and oncology societies. This study was aimed to determine the screening practices for hepatitis B among oncologists from India and their experience with hepatitis B reactivation. Methods: A questionnaire-based survey was conducted among oncologists attending the Evidence-Based Medicine Conference at Tata Memorial Centre, Mumbai, India. The questionnaire was developed in keeping with the recent guidelines for hepatitis B reactivation on chemotherapy, with questions regarding demographics, years in practice and hepatitis B screening practices and management. There was 78 per cent response rate to the questionnaire. Results: Most respondents were <35 yr of age (69%), with < five years of experience (39%), practicing in an academic institution (81%). Seventy four per cent respondents always screened their patients with cancer for hepatitis prior to chemotherapy, whereas 19 per cent in special settings and seven per cent never screened; 96 per cent respondents used hepatitis B surface antigen (HBsAg) as a screening test, while 17 per cent also used antibody to hepatitis B core antigen. Sixty one per cent respondents used entecavir or tenofovir for prophylaxis; 70 per cent continued prophylaxis till 6-12 months after completion of chemotherapy, while 21 per cent continued only till the end of chemotherapy. Interpretation & conclusions: More than 25 per cent of the oncologists were not screening their patients with cancer for viral hepatitis prior to cancer-directed therapy, and only 17 per cent of the oncologists used the recommended tests for screening. Better training of oncologists regarding viral hepatitis screening and management is needed.
Journal of Digestive Endoscopy
Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for pall... more Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for palliation of malignant colonic obstruction. We analyzed outcomes of patients who underwent colonic SEMS placement for palliation at a tertiary care oncology center in Western India. Methods Retrospective review of the endoscopy database was done for patients who underwent colonic SEMS placement at our center between January 2013 and September 2021. Demographic details, intent of stent placement, site of obstruction, length of stricture, technical success of stenting, clinical success, and complications (both immediate and long term) were noted. Results Sixty-one patients underwent colonic SEMS placement during the study period (mean age 53.6 years, 50.7% men). Obstruction was due to primary colonic malignancy in 43 (70.5%) patients and extracolonic malignancies in 18 (29.5%) patients. Most common extracolonic malignancy was gallbladder cancer in 8 (44.4%) patients. Most common site of obstr...
Online Journal of Health & Allied Sciences, 2013
Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with ... more Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with a stratified growth pattern but without destructive stromal invasion. Little is known about the histological subtypes and outcome, role of fertility sparing surgery and role of postoperative therapy in advanced stage in Indian scenario. While there is ample data in the world literature about this disease, prognosis in Indian patients is largely unknown due to dearth of studies in our setting. Objective: To study the demographic profile, clinical features, imaging, treatment and outcome of borderline ovarian tumors. Methods: This is a retrospective study of eighty seven patients with pathologically proven diagnosis of borderline ovarian tumor, diagnosed and treated from January 2006 to October 2011 at our institution. Most patients underwent surgical staging which incuded total abdominal hysterectomy and bilateral salphingo-oophorectomy, infracolic omentectomy, bilateral pelvic and para a...
Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, hyperlipid... more Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, hyperlipidemia and edema. It can affect any age group.Nephrotic syndrome is a comparatively rare but form major manifestation of kidney disease. Nephrotic syndrome has an occurrence of three new cases per 100000 each year in adults. Management of nephrotic syndrome according to modern science varies with different stages of the disease. The purpose of treatment is to relieve symptoms, prevent complications, and delay kidney damage.Patient with primary nephrotic syndrome needs corticosteroids but many times they may have relapse or become steroid dependent or resistant to it. Then alternative agents like cyclophosphamide, cyclosporine, levamisole which may be used in a combination. According to Ayurveda, there are number of drugs which can be used in nephrotic syndrome but Guduchi (Tinospora cordifolia) plays a specific role in nephrotic syndrome. It belongs to family Menispermaceae. Guduchi is sai...
The Journal of the Association of Physicians of India, 2018
Introduction Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (DA... more Introduction Pulmonary Renal Syndrome (PRS), is characterized by diffuse alveolar haemorrhage (DAH) and glomerulonephritis (GN), occurring simultaneously. It has high mortality and dialysis dependence at one year, if not timely diagnosed and aggressively treated. Objectives To study etiology and short term outcome of PRS in India. Materials and Methods This study included patients of PRS seen in a tertiary care center in Mumbai, by one consultant from 1997- 2013, analyzed retrospectively and from January 2014 to December 2015 collected prospectively from six medical units, intensive care unit, nephrology and respiratory units. Patients with DAH (haemoptysis, breathlessness and x-ray chest with bilateral alveolar shadows with sparing of apices) and glomerulonephritis (Proteinuria, heamaturia, hypertension with or without raised serum Creatinine) were included in the study after carefully excluding other causes of haemoptysis and breathless like tuberculosis, pulmonary oedema, pneumon...
Clinical Gastroenterology, 2021
within endoscopic reach, both > 2 cm in diameter & > 5 cm in length. There were no deaths due to ... more within endoscopic reach, both > 2 cm in diameter & > 5 cm in length. There were no deaths due to FB ingestion. Conclusions This is the largest study of Endoscopic FB removal from Western India. This study showed that the majority of the FB were ingested by children. Even those with injury to the bowel were asymptomatic. Since the size of FB did not determine it being within the reach of the endoscope and Groups S, NS & C FBs are associated with injury to the bowel; we propose an attempt at removal should be made in all patients, whether symptomatic or not.
Indian Journal of Medical Research, 2020
Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in... more Background & objectives: Screening for hepatitis B prior to the initiation of chemotherapy in patients with cancer is recommended by all major hepatology and oncology societies. This study was aimed to determine the screening practices for hepatitis B among oncologists from India and their experience with hepatitis B reactivation. Methods: A questionnaire-based survey was conducted among oncologists attending the Evidence-Based Medicine Conference at Tata Memorial Centre, Mumbai, India. The questionnaire was developed in keeping with the recent guidelines for hepatitis B reactivation on chemotherapy, with questions regarding demographics, years in practice and hepatitis B screening practices and management. There was 78 per cent response rate to the questionnaire. Results: Most respondents were <35 yr of age (69%), with < five years of experience (39%), practicing in an academic institution (81%). Seventy four per cent respondents always screened their patients with cancer for hepatitis prior to chemotherapy, whereas 19 per cent in special settings and seven per cent never screened; 96 per cent respondents used hepatitis B surface antigen (HBsAg) as a screening test, while 17 per cent also used antibody to hepatitis B core antigen. Sixty one per cent respondents used entecavir or tenofovir for prophylaxis; 70 per cent continued prophylaxis till 6-12 months after completion of chemotherapy, while 21 per cent continued only till the end of chemotherapy. Interpretation & conclusions: More than 25 per cent of the oncologists were not screening their patients with cancer for viral hepatitis prior to cancer-directed therapy, and only 17 per cent of the oncologists used the recommended tests for screening. Better training of oncologists regarding viral hepatitis screening and management is needed.
ACG Case Reports Journal, 2019
A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive ... more A 59-year-old man, diagnosed with relapsed multiple myeloma, admitted currently in the intensive care unit with respiratory distress, acute kidney injury, and hypercalcemia, was referred for evaluation of upper gastrointestinal (GI) bleed. The patient was on mechanical ventilation with fresh blood aspirated using the Ryles tube. On investigation, hemoglobin was 7.6 g/dL and platelets were 63,000/mm 3 with international normalized ratio 1.3. Bedside upper GI endoscopy showed diffuse erythema with thickening and nodularity involving the entire stomach, without any ulceration or active bleeding (Figure 1). Biopsies were taken from the stomach for evaluation. There was suspicion of fungal pneumonia on thorax computed tomography. Differential diagnoses included infective gastropathy and gastric involvement by amyloidosis. The
Saudi Journal of Gastroenterology, 2016
Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an attractive option for patients who c... more Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an attractive option for patients who cannot undergo conventional endoscopic retrograde cholangiopancreatography (ERCP) and do not want surgery or percutaneous drainage procedures. We present the use of EUS-antegrade (EUS-AG) insertion of a self-expandable metal stent (SEMS) in a patient with a common hepatic duct cholangiocarcinoma, as well as a huge gastric lipoma, after recurrent biliary obstruction of a prior SEMS inserted via ERCP in the same session as a duodenal stent insertion for gastric outlet obstruction.