News from the AGA

Top AGA Community patient cases


 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

In case you missed it, here are the most popular clinical discussions shared in the forum recently:

1. Active colitis in a patient with previous colon cancer

This popular conversation centers around next steps for a 39-year-old previously treated for a large malignant tumor with a right hemicolectomy and chemotherapy. She was referred for a chromoendoscopy, which revealed four areas of nonpolypoid abnormal mucosa with indistinct borders and abnormal dye uptake. Biopsies also revealed low-grade dysplasia and minimally active colitis.

2. IBD in remission

A 66-year-old female with a history of Crohn’s disease is currently asymptomatic and in remission, but with low Remicade trough. The debate among physicians in the forum questions the need for further action or follow-up insight. 3. Eosinophilic esophagitis and duodenitis (http://ow.ly/kja130mRoDV)

This 40-year-old patient was originally seen for food bolus. The physician prescribed proton pump inhibitors (PPI) after a scope showed typical eosinophilic esophagitis (EoE) findings. Although he had symptoms of obstruction since he was 15, this was his first upper endoscopy. Biopsies following successful scopes showed eosinophilic duodenitis and the patient had no signs of eosinophilia in the stomach.

4. Eosinophilic esophagitis and gastric sleeve

A physician noted no established absolute contraindication for a 50-year-old patient who was seen for a presleeve gastrectomy. Others contributing to this thread shared concerns for the risk for gastroesophageal reflux disease (GERD) post-surgery and committing the patient to long-term steroids.

More clinical cases and discussions are at https://community.gastro.org/discussions.

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