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  1. Article: Stone-Induced Purulent Choledocoduodenal Fistula Presenting with Ascending Cholangitis.

    Shams, Christienne / Cannon, Michael / Bortman, Jared / Hakim, Seifeldin

    ACG case reports journal

    2018  Volume 5, Page(s) e60

    Abstract: A biliary enteric fistula (BEF) is a rare, abnormal communication between any segment of the biliary tree with any portion of the small or large intestine. BEF is more frequently diagnosed with the increasingly widespread use of endoscopic retrograde ... ...

    Abstract A biliary enteric fistula (BEF) is a rare, abnormal communication between any segment of the biliary tree with any portion of the small or large intestine. BEF is more frequently diagnosed with the increasingly widespread use of endoscopic retrograde cholangiopancreatography. Different theories have been postulated regarding the etiology of this fistula formation, with the most likely cause being gallstones. Treatment modalities, ranging from conservative management to surgical reconstruction, show varying levels of success. We present a case of BEF secondary to large common bile duct stones, successfully treated with endoscopic sphincterotomy (EST) followed by papillary balloon dilatation, and we briefly discuss large stone retrieval in the setting of atypical anatomy.
    Language English
    Publishing date 2018-08-29
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2814825-3
    ISSN 2326-3253
    ISSN 2326-3253
    DOI 10.14309/crj.2018.60
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Case report and systematic literature review of a novel etiology of sinistral portal hypertension presenting with UGI bleeding: Left gastric artery pseudoaneurysm compressing the splenic vein treated by embolization of the pseudoaneurysm.

    Hakim, Seifeldin / Bortman, Jared / Orosey, Molly / Cappell, Mitchell S

    Medicine

    2017  Volume 96, Issue 13, Page(s) e6413

    Abstract: Introduction: A novel case is reported of upper gastrointestinal (UGI) bleeding from sinistral portal hypertension, caused by a left gastric artery (LGA) pseudoaneurysm (PA) compressing the splenic vein (SV) that was successfully treated with PA ... ...

    Abstract Introduction: A novel case is reported of upper gastrointestinal (UGI) bleeding from sinistral portal hypertension, caused by a left gastric artery (LGA) pseudoaneurysm (PA) compressing the splenic vein (SV) that was successfully treated with PA embolization.
    Case report: A 41-year-old man with previous medical history of recurrent, alcoholic pancreatitis presented with several episodes of hematemesis and abdominal pain for 48 hours. Physical examination revealed a soft abdomen, with no abdominal bruit, no pulsatile abdominal mass, and no stigmata of chronic liver disease. The hemoglobin declined acutely from 12.3 to 9.3 g/dL. Biochemical parameters of liver function and routine coagulation profile were entirely within normal limits. Abdominal CT revealed a 5-cm-wide peripancreatic mass compressing the stomach and constricting the SV. Esophagogastroduodenoscopy showed blood oozing from portal hypertensive gastropathy, small nonbleeding gastric cardial and fundal varices, gastric compression from the extrinsic mass, and no esophageal varices. MRCP and angiography showed that the mass was vascular, arose from the LGA, compressed the mid SV without SV thrombosis, and caused sinistral portal hypertension. At angiography, the PA was angioembolized and occluded. The patient has been asymptomatic with no further bleeding and a stable hemoglobin level during 8 weeks of follow-up.
    Discussion: Literature review of the 14 reported cases of LGA PA revealed that this report of acute UGI bleeding from sinistral portal hypertension from a LGA PA constricting the SV is novel; one previously reported patient had severe anemia without acute UGI bleeding associated with sinistral portal hypertension from a LGA PA.
    Conclusion: A patient presented with UGI bleeding from sinistral portal hypertension from a LGA PA compressing the SV that was treated by angiographic obliteration of the PA which relieved the SV compression and arrested the UGI bleeding. Primary therapy for this syndrome should be addressed to obliterate the PA and not the secondarily constricted SV.
    MeSH term(s) Adult ; Aneurysm, False/complications ; Aneurysm, False/diagnostic imaging ; Aneurysm, False/therapy ; Embolization, Therapeutic ; Hematemesis/etiology ; Humans ; Hypertension, Portal/diagnostic imaging ; Hypertension, Portal/etiology ; Male ; Splenic Vein/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2017-03-28
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review ; Systematic Review
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000006413
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Ileocolonic tuberculosis clinically, endoscopically, and radiologically mimicking Crohn's disease: disseminated infection after treatment with infliximab.

    Cappell, Mitchell S / Saad, Abdulhassan / Bortman, Jared S / Amin, Mitual

    Journal of Crohn's & colitis

    2014  Volume 8, Issue 6, Page(s) 560–562

    MeSH term(s) Antibodies, Monoclonal/adverse effects ; Antibodies, Monoclonal/therapeutic use ; Colonic Diseases/chemically induced ; Colonic Diseases/diagnosis ; Colonic Diseases/diagnostic imaging ; Colonic Diseases/etiology ; Colonic Diseases/microbiology ; Crohn Disease/diagnosis ; Crohn Disease/drug therapy ; Diagnosis, Differential ; Female ; Gastrointestinal Agents/adverse effects ; Gastrointestinal Agents/therapeutic use ; Humans ; Ileal Diseases/chemically induced ; Ileal Diseases/diagnosis ; Ileal Diseases/diagnostic imaging ; Ileal Diseases/etiology ; Ileal Diseases/microbiology ; Infliximab ; Radiography ; Tuberculosis, Gastrointestinal/chemically induced ; Tuberculosis, Gastrointestinal/diagnosis ; Tuberculosis, Gastrointestinal/diagnostic imaging ; Tuberculosis, Gastrointestinal/etiology ; Young Adult
    Chemical Substances Antibodies, Monoclonal ; Gastrointestinal Agents ; Infliximab (B72HH48FLU)
    Language English
    Publishing date 2014-06
    Publishing country England
    Document type Case Reports ; Letter
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1016/j.crohns.2013.11.022
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  4. Article ; Online: Noncirrhotic Portal Hypertension due to Nodular Regenerative Hyperplasia Treated with Surgical Portacaval Shunt.

    Louwers, Lisa M / Bortman, Jared / Koffron, Alan / Stecevic, Veslav / Cohn, Steven / Raofi, Vandad

    Case reports in medicine

    2012  Volume 2012, Page(s) 965304

    Abstract: Nodular regenerative hyperplasia (NRH) is an uncommon condition, but an important cause of noncirrhotic intrahepatic portal hypertension (NCIPH), characterized by micronodules of regenerative hepatocytes throughout the liver without intervening fibrous ... ...

    Abstract Nodular regenerative hyperplasia (NRH) is an uncommon condition, but an important cause of noncirrhotic intrahepatic portal hypertension (NCIPH), characterized by micronodules of regenerative hepatocytes throughout the liver without intervening fibrous septae. Herein, we present a case of a thirty-seven-year-old female with systemic lupus erythematosus (SLE) who was discovered to have significant esophageal varices on endoscopy for dyspepsia. Her labs revealed a slight elevation in the alkaline phosphatase and mild thrombocytopenia. Abdominal MRI revealed seven focal hepatic masses, splenomegaly, no ascites, and a patent portal vein. Ultrasound-guided core biopsy was reported as focal nodular hyperplasia. However, her varices persisted despite treatment with beta-blockers and four additional upper endoscopies with banding. She was subsequently referred for a surgical opinion. At that time, given her history of SLE, azathioprine use, and portal hypertension, suspicion for NRH was raised. Given her normal synthetic function and lack of parenchymal liver disease, the patient was offered surgical shunting. During shunt surgery, a liver wedge biopsy was also performed and this confirmed NRH. An upper endoscopy six weeks after shunting verified complete resolution of varices. Currently, fifteen months after surgery duplex ultrasonography demonstrates shunt patency and the patient is without recurrence of her portal hypertension.
    Language English
    Publishing date 2012-08-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2502642-2
    ISSN 1687-9635 ; 1687-9627
    ISSN (online) 1687-9635
    ISSN 1687-9627
    DOI 10.1155/2012/965304
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center.

    Jacob, Abraham / Robinson, Lawrence L / Bortman, Jared S / Yu, Lianbo / Dodson, Edward E / Welling, D Bradley

    The Laryngoscope

    2007  Volume 117, Issue 12, Page(s) 2087–2092

    Abstract: Objective: To determine nerve of origin, tumor size, hearing preservation rates, and facial nerve outcomes in a retrospective cohort study of patients undergoing translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) ... ...

    Abstract Objective: To determine nerve of origin, tumor size, hearing preservation rates, and facial nerve outcomes in a retrospective cohort study of patients undergoing translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) approaches to vestibular schwannomas (VS).
    Study design: Retrospective.
    Methods: Chart review.
    Results: Patient charts from 231 TL, 70 MCF, 53 SO, and 5 combined TL/SO procedures for VS were evaluated in 356 patients. The inferior vestibular nerve (IVN) was the nerve of origin in 84 of 359 cases (23.3%), while the superior vestibular nerve (SVN) was the nerve of origin in 36 patients (10%). In 239 of 359 cases (66.6%), the nerve of origin was not identified. Forty patients undergoing hearing preservation surgery had hearing results and nerve of origin data available for review. Functional hearing (<50dB PTA and >50% speech discrimination) was preserved in 10 of 15 patients (75%) with SVN tumors, while only 7 of 25 patients (28%) with IVN tumors retained functional hearing. Facial nerve outcomes and nerve of origin were recorded simultaneously in 109 patients. Seventy-one of 74 patients (95%) patients with IVN tumors achieved a House-Brackmann (HB) grade I-III, while 35 of 35 patients (100%) with SVN tumors retained HB I-III facial function. Looking at tumor size versus hearing preservation, functional hearing was preserved in 22 of 49 patients (45%) with <1-cm tumors, and 4 of 20 patients (20%) with 1- to 1.5-cm tumors. For all cases with documented facial nerve function, HB I-III were achieved in 96% of SO, 94% of MCF, and 88% of TL procedures.
    Conclusions: Our retrospective data indicated that IVN tumors were twice as common as SVN tumors. The nerve of origin did not affect facial nerve outcomes but did impact hearing preservation rates. Patients with tumors <1 cm in size had the best chance for hearing preservation. Overall facial nerve preservation was excellent with >90% achieving HB 1 to 3 function at final follow-up.
    MeSH term(s) Academic Medical Centers ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Audiometry, Pure-Tone ; Auditory Threshold/physiology ; Child ; Facial Nerve/pathology ; Facial Nerve/physiopathology ; Facial Paralysis/diagnosis ; Facial Paralysis/etiology ; Facial Paralysis/prevention & control ; Female ; Follow-Up Studies ; Hearing/physiology ; Hearing Loss, Sensorineural/diagnosis ; Hearing Loss, Sensorineural/etiology ; Hearing Loss, Sensorineural/prevention & control ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neuroma, Acoustic/diagnosis ; Neuroma, Acoustic/physiopathology ; Neuroma, Acoustic/surgery ; Otologic Surgical Procedures/methods ; Postoperative Complications/prevention & control ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Vestibulocochlear Nerve/pathology ; Vestibulocochlear Nerve/physiopathology
    Language English
    Publishing date 2007-12
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1097/MLG.0b013e3181453a07
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    Ul II Zs.82: Show issues Location:
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  6. Article: Does packing the eustachian tube impact cerebrospinal fluid rhinorrhea rates in translabyrinthine vestibular schwannoma resections?

    Jacob, Abraham / Bortman, Jared S / Robinson, Lawrence L / Yu, Lianbo / Dodson, Edward E / Welling, D Bradley

    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

    2007  Volume 28, Issue 7, Page(s) 934–938

    Abstract: Objective: To calculate cerebrospinal fluid (CSF) leak rates for translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) craniotomies performed for removal of vestibular schwannoma (VS) and analyze whether packing the ... ...

    Abstract Objective: To calculate cerebrospinal fluid (CSF) leak rates for translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) craniotomies performed for removal of vestibular schwannoma (VS) and analyze whether packing the eustachian tube (ET) in TL VS resections impacts CSF rhinorrhea rates.
    Study design: Retrospective.
    Setting: Tertiary care center.
    Methods: Chart review.
    Results: Three hundred fifty-nine VS resections were reviewed in 356 patients ranging from 10 to 86 years of age. Two hundred thirty-one TL, 70 MCF, 53 SO, and 5 combined TL/SO procedures were analyzed. Total CSF leak rates (incisional, otorrhea, and rhinorrhea) were 14.2% for TL, 11.4% for MCF, and 13.2% for SO approaches. Differences in overall CSF leak rates were not statistically significant. For those who underwent TL craniotomies, 2 groups of patients were identified based on whether their ETs were packed during surgery. In 1 group, the incus was removed, the aditus enlarged, the ET packed, and the middle ear filled with muscle. In the second group, the aditus, epitympanum and middle ear were packed without removing the incus, and the ET was not packed. Of 148 patients who had their ET packed, 12 developed CSF rhinorrhea (8.1%). The CSF rhinorrhea rate for patients who did not have ET packing was 5.9% (3 of 51 patients). This difference was not statistically significant (p = 0.80). When Proplast was used to pack the ET (121 patients), the CSF rhinorrhea rate was 5.8%. Unfortunately, this material extruded in 4 of 121 patients (3.3%) and presented clinically as delayed purulent otorrhea.
    Conclusion: Cerebrospinal fluid leak rates were similar in patients undergoing TL, SO, and MCF approaches, and CSF rhinorrhea was not decreased by ET packing. Patients whose ETs are packed with Proplast are at risk for extrusion and otorrhea years after their initial VS resection.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bandages ; Cerebrospinal Fluid Rhinorrhea/epidemiology ; Cerebrospinal Fluid Rhinorrhea/etiology ; Child ; Cohort Studies ; Cranial Nerve Neoplasms/complications ; Cranial Nerve Neoplasms/surgery ; Craniotomy ; Eustachian Tube ; Female ; Humans ; Male ; Middle Aged ; Neuroma, Acoustic/complications ; Neuroma, Acoustic/surgery ; Otologic Surgical Procedures ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Vestibulocochlear Nerve Diseases/complications ; Vestibulocochlear Nerve Diseases/surgery
    Language English
    Publishing date 2007-10
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2036790-9
    ISSN 1537-4505 ; 1531-7129
    ISSN (online) 1537-4505
    ISSN 1531-7129
    DOI 10.1097/MAO.0b013e31814619bd
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Patient safety event reporting expectation: does it influence residents' attitudes and reporting behaviors?

    Boike, Justin R / Bortman, Jared S / Radosta, Jonathan M / Turner, Crescent L / Anderson-Shaw, Lisa / Centomani, Nikki M / Chamberlin, William H / Mayer, David / McDonald, Timothy / Goldstein, Jay L

    Journal of patient safety

    2013  Volume 9, Issue 2, Page(s) 59–67

    Abstract: Background: Internal Medicine resident (IMR) physician reporting of patient safety events (PSEs) is suboptimal and may be related to poor attitudes toward reporting.: Purpose: The objective was to evaluate the impact of a PSE reporting expectation on ...

    Abstract Background: Internal Medicine resident (IMR) physician reporting of patient safety events (PSEs) is suboptimal and may be related to poor attitudes toward reporting.
    Purpose: The objective was to evaluate the impact of a PSE reporting expectation on the rates of reporting among IMRs.
    Methods: In this prospective cohort study, IMRs were informed of an expectation to submit 1 or more PSE report per month based on the ACGME core competencies. The PSE reports were collected over 9 months and compared with a 4-month baseline before the expectation. Report quality and IMRs' attitudes were also evaluated.
    Results: There was a significant and initial increase in the total number of reports. However, the number of IMRs meeting the expectation of 1 or more report per month initially rose but was not sustained over the 9-month observational period. Report quality and IMRs attitudes toward reporting were positive but unchanged over time.
    Conclusions: Although a reporting expectation increased the total number of reports, the majority of IMRs did not maintain a 1 or more PSE report per month despite positive attitudes.
    MeSH term(s) Attitude of Health Personnel ; Disclosure ; Female ; Humans ; Internal Medicine/education ; Internship and Residency ; Male ; Patient Safety ; Program Evaluation ; Prospective Studies
    Language English
    Publishing date 2013-06
    Publishing country United States
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0b013e3182676e53
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