Metastasis of Ewing Sarcoma to the Pancreas: An Exceedingly Rare Case report and Literature Review

Manuscript type: case series

Esophagogastric Fistula in an Adult Following Laparoscopic Nissen Fundoplication: A Case Report of Successful Resolution of Fistulization Through Conservative Medical TherapyKaram Karam1, Houssein Chebbo2, Sarah Saleh2, Emanuel-Youssef Dib2, Karim Zodeh3, Lamia Azizi4, Majd Rustom*5[1] Department of Gastroenterology, University of Balamand (UOB), Beirut, Lebanon. Email: karamek7@gmail.com[2] Faculty of Medicine, University of Balamand (UOB), Beirut, Lebanon. Email: Houssein.chebbo@std.balamand.edu.lb[2] Faculty of Medicine, University of Balamand (UOB), Beirut, Lebanon. Email: Sarah.saleh@std.balamand.edu.lb[2] Faculty of Medicine, University of Balamand (UOB), Beirut, Lebanon. Email: emanuelyoussef.dib@std.balamand.edu.lb[3] Department of Gastroenterology, University of Balamand (UOB), Beirut, Lebanon. Email: Karim.zodeh@std.balamand.edu.lb[4] Department of Radiology, University of Balamand (UOB), Beirut, Lebanon. Email: Lamia.azizi@std.balamand.edu.lb[5] Department of Internal Medicine, Division of Gastroenterology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University (LAU), Beirut, Lebanon. Email: majd.rustom@laumcsjh.com*CORRESPONDING AUTHOR

Hereditary Hemochromatosis Unmasked by Yersiniosis: Report of Three CasesKaram Karam1, Elias Fiani2*[1] Department of Gastroenterology, University of Balamand, Beirut, Lebanon. Email: Karamek7@gmail.com[2] Associate Professor, Department of Gastroenterology, University of Balamand, Beirut, Lebanon. Email: Elias.fiani@hotmail.com *CORRESPONDING AUTHORKey Clinical Message: Yersiniosis has a causal relationship with hereditary hemochromatosis (HH). Physicians should have a high index of suspicion for the diagnosis of HH when approaching a patient with yersiniosis in the setting of high ferritin levels and increased iron saturation. Yersiniosis serves as a precursor for the diagnosis of HH.Keywords: Hereditary Hemochromatosis; Yersinia Enterocolitica ; HFE Genetic Testing; Phlebotomy; Case Series.

Rare Presentation of Adult-Onset Still’s Disease Complicated by Acute Severe Hepatitis Refractory to Medical Treatment: A Case ReportMajed Ali1, Karam Karam2, Emanuel-Youssef Dib3, Elias Fiani4*[1] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: majed.ali@std.balamand.edu.lb[2] Department of Gastroenterology, University of Balamand, Beirut, Lebanon. Email: Karamek7@gmail.com[3] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: emanuelyoussef.dib@std.balamand.edu.lb

Eosinophilic Esophagitis Masquerading as Steakhouse Syndrome: A Case ReportEmanuel-Youssef Dib1, Jessy Fadel2, Karam Karam3, Sarah Saleh4, Houssein Chebbo5, Elias Fiani6*[1] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: emanuelyoussef.dib@std.balamand.edu.lb[2] Department of Gastroenterology, Saint George University Medical Center, Beirut, Lebanon. Email:

High grade dysplastic rectal adenoma in a young patient with Café-au-lait spots: A case reportAli Hamdan1, Razan Abou Zeid2, Jana Khalil3, Karam Karam4, Elias Fiani5*Medical Doctor, Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: ali.hamdan.dr@outlook.comMedical student, University of Balamand, Beirut, Lebanon. Email: razan.abouzeid@std.balamand.edu.lbMedical student, University of Balamand, Beirut, Lebanon. Email: jana.khalil@std.balamand.edu.lbMedical doctor, Department of Gastroenterology, University of Balamand, Beirut, Lebanon. Email: Karamek7@gmail.comAssociate Professor, Department of Gastroenterology, University of Balamand, Beirut, Lebanon. Email: Elias.fiani@hotmail.com *CORRESPONDING AUTHORKey Clinical Message: Colorectal cancer screening guidelines typically focus on familial history and age-related risk factors, yet Café-au-lait macules could serve as early indicators for tailored surveillance protocols. This case underscores the importance of considering extracolonic manifestations in young patients presenting with colorectal symptoms. We present a case of a young patient with café-au-lait spots who was diagnosed with rectal tubulo-villous dysplastic adenoma following rectal bleeding.Keywords: Café-au-lait macules; Café-au-lait spots; Tubulo-villous dysplastic adenoma; Extracolonic manifestations; Case report.

Blastocystis hominis Infection Inducing Gut Microbiome Dysbiosis and Aggravating Parkinson’s Disease Symptoms: A Case ReportEmanuel-Youssef Dib1, Karam Karam2, Lama Al Akel3, Loulewa Al Sayed4, Tala Charafeddine5, Laila Al Akel6, Serena Khoury7, Walid Abdel Khalek8*[1] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: emanuelyoussef.dib@std.balamand.edu.lb[2] Department of Gastroenterology, University of Balamand, Beirut, Lebanon. Email: Karamek7@gmail.com[3] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: lama.akel@std.balamand.edu.lb[4] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: loulewa.sayed@std.balamand.edu.lb[5] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: tala.charafeddine@std.balamand.edu.lb[6] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: laila.akel@std.balamand.edu.lb[7] Department of Internal Medicine, University of Balamand, Beirut, Lebanon. Email: serena.khoury@std.balamand.edu.lb[8] Associate professor, University of Balamand, Department of Gastroenterology, Dekweneh, Lebanon. Email: walid_ak33@hotmail.com