Clinical Journal of Gastroenterology最新文献_第10页

Massive lower gastrointestinal bleeding in a young adult due to Meckel's diverticulum without ectopic gastric mucosa. 年轻成人梅克尔憩室引起大量下消化道出血，无胃粘膜异位。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-09-25 DOI: 10.1007/s12328-025-02228-6

Naoto Osugi, Akira Doi, Kengo Matsumoto, Masashi Yamamoto, Koji Fukui, Kotoe Akagi, Yozo Suzuki, Hiromi Tamura, Tsutomu Nishida

{"title":"Massive lower gastrointestinal bleeding in a young adult due to Meckel's diverticulum without ectopic gastric mucosa.","authors":"Naoto Osugi, Akira Doi, Kengo Matsumoto, Masashi Yamamoto, Koji Fukui, Kotoe Akagi, Yozo Suzuki, Hiromi Tamura, Tsutomu Nishida","doi":"10.1007/s12328-025-02228-6","DOIUrl":"10.1007/s12328-025-02228-6","url":null,"abstract":"Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in approximately 2% of the general population. However, symptomatic cases in adults are uncommon, and bleeding is usually caused by ulceration resulting from the ectopic gastric mucosa. Here, we report a case of massive lower gastrointestinal bleeding in a 22-year-old woman with Meckel's diverticulum without ectopic gastric mucosa. The patient presented with hematochezia and significant anemia. Initial endoscopic evaluation and contrast-enhanced computed tomography failed to identify the bleeding source. Transanal double-balloon enteroscopy revealed a tubular structure 35 cm proximal to the ileocecal valve, with a circumferential ulcer at its opening. Although active bleeding was not observed, contact with the endoscope induced oozing. Laparoscopic segmental resection was performed, and histopathology confirmed the presence of a true diverticulum without ectopic tissue. The patient's postoperative course was uneventful, with no recurrence of bleeding observed during the 3-month follow-up period. This case highlights that a Meckel's diverticulum can cause clinically significant bleeding, even in the absence of ectopic mucosa, and emphasizes the diagnostic value of enteroscopy.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"35-40"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary epithelioid angiosarcoma of the liver. 原发性肝上皮样血管肉瘤。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-10-22 DOI: 10.1007/s12328-025-02235-7

Minori Nishiya, Keito Suzuki, Miyako Murakawa, Shun Kaneko, Tsubasa Nobusawa, Kei Onodera, Yuko Kinowaki, Morito Kurata, Yasuhiro Asahina, Ryuichi Okamoto

引用次数: 0

Transient response to cisplatin-etoposide chemotherapy for early postoperative recurrence of large cell neuroendocrine carcinoma of the distal bile duct: a case report. 顺铂-依托泊苷化疗治疗胆管远端大细胞神经内分泌癌术后早期复发的短暂反应1例。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-12-15 DOI: 10.1007/s12328-025-02264-2

Taiki Sunakawa, Masashi Kudo, Tomoyuki Satake, Motokazu Sugimoto, Shin Kobayashi, Naoto Gotohda

{"title":"Transient response to cisplatin-etoposide chemotherapy for early postoperative recurrence of large cell neuroendocrine carcinoma of the distal bile duct: a case report.","authors":"Taiki Sunakawa, Masashi Kudo, Tomoyuki Satake, Motokazu Sugimoto, Shin Kobayashi, Naoto Gotohda","doi":"10.1007/s12328-025-02264-2","DOIUrl":"10.1007/s12328-025-02264-2","url":null,"abstract":"Background: Large cell neuroendocrine carcinoma (LCNEC) arising from the extrahepatic bile duct is a highly uncommon and aggressive malignancy. Due to the absence of an established standard and a lack of detailed reports on effective chemotherapy for recurrent biliary LCNEC, we present a case that demonstrated a temporary response to cisplatin and etoposide.Case presentation: A Japanese man in his 70 s presented with jaundice and weight loss. Imaging studies identified a tumor in the distal bile duct, and a biopsy of the bile duct confirmed a neuroendocrine tumor. The patient underwent a radical pancreaticoduodenectomy with regional lymph node dissection. Histopathology confirmed LCNEC with a Ki-67 index of 60% and metastases in the regional lymph nodes. Despite the initial surgical treatment, multiple liver metastases appeared 3 months after surgery. Systemic chemotherapy using cisplatin and etoposide was initiated and produced a short-term partial response. However, after six cycles, the disease progressed, and subsequent therapy with amrubicin was ineffective. The patient passed away 14 months after the operation.Conclusions: This case underscores the aggressive behavior of biliary LCNEC and the limited success of current treatments. To our knowledge, this is the first reported case of biliary LCNEC with recurrent liver metastases demonstrating a radiologically confirmed partial response to cisplatin and etoposide therapy. A review of previously published cases revealed comparable outcomes, underscoring the need for further investigation to develop effective therapeutic strategies for LCNEC of the extrahepatic bile duct.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"282-290"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of encapsulating peritoneal sclerosis associated with tuberculous peritonitis. 包封性腹膜硬化合并结核性腹膜炎1例。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-11-18 DOI: 10.1007/s12328-025-02254-4

Hiroshi Naito, Kosuke Maehara, Kazuki Hirano, Daisuke Hattori, Yoshiki Sato, Tetsuo Tamura, Rikako Koyama, Mizuki Haraguchi, Hideki Araoka, Tsunao Imamura

{"title":"A case of encapsulating peritoneal sclerosis associated with tuberculous peritonitis.","authors":"Hiroshi Naito, Kosuke Maehara, Kazuki Hirano, Daisuke Hattori, Yoshiki Sato, Tetsuo Tamura, Rikako Koyama, Mizuki Haraguchi, Hideki Araoka, Tsunao Imamura","doi":"10.1007/s12328-025-02254-4","DOIUrl":"10.1007/s12328-025-02254-4","url":null,"abstract":"We report a case of encapsulating peritoneal sclerosis (EPS) associated with tuberculous peritonitis. A man in his 50s presented with fever, anorexia, and abdominal distension and was urgently hospitalized because computed tomography (CT) revealed ascites. Despite hospitalization for 1 month, the diagnosis remained unclear and his condition worsened; therefore, the patient was transferred to our hospital. At our hospital, his fever reached approximately 38 °C and an upper abdominal mass was palpable. Contrast-enhanced CT revealed encapsulated ascites and extensive peritoneal thickening with adhesions, resulting in a diagnosis of EPS. Mycobacterium tuberculosis complex was detected in the ascitic fluid culture, thus confirming EPS secondary to tuberculous peritonitis. CT revealed rapid bowel dilatation, suggesting a high risk of ileus. We initiated treatment comprising four antituberculosis drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol) and prednisolone (60 mg/day). The fever resolved rapidly and inflammatory markers improved. CT revealed resolution of ascites and bowel dilation. Therefore, the steroid dose was tapered. On day 28, the patient was discharged. This case highlights that tuberculosis should be considered as a cause of EPS in patients without a history of peritoneal dialysis, and that early steroid therapy is necessary to prevent EPS progression to ileus.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"211-216"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of budesonide and vedolizumab for IBD-U associated with Muckle-Wells syndrome. 布地奈德和维多单抗治疗与Muckle-Wells综合征相关的IBD-U的疗效。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-10-11 DOI: 10.1007/s12328-025-02234-8

Yuzo Kawata, Kentaro Tominaga, Daisuke Kobayashi, Annenkov Alexey, Kosuke Kojima, Osamu Shibata, Yuichi Kojima, Kazuya Takahashi, Hiroteru Kamimura, Shuji Terai

{"title":"Efficacy of budesonide and vedolizumab for IBD-U associated with Muckle-Wells syndrome.","authors":"Yuzo Kawata, Kentaro Tominaga, Daisuke Kobayashi, Annenkov Alexey, Kosuke Kojima, Osamu Shibata, Yuichi Kojima, Kazuya Takahashi, Hiroteru Kamimura, Shuji Terai","doi":"10.1007/s12328-025-02234-8","DOIUrl":"10.1007/s12328-025-02234-8","url":null,"abstract":"Cryopyrin-associated periodic syndrome (CAPS) is a rare, autosomal dominant inflammatory disorder linked to interleukin (IL)-1β dysregulation. Muckle-Wells syndrome (MWS) is a clinical subtype of CAPS that is often managed with canakinumab, an anti-IL-1β monoclonal antibody. Canakinumab has been approved for all phenotypes of CAPS, with no age restrictions, since 2011. Despite its efficacy in controlling systemic inflammation, its gastrointestinal side effects remain unclear. This report presents the case of a 28 year-old man who developed abdominal pain and diarrhea during treatment with canakinumab for MWS. Colonoscopy revealed findings suggestive of inflammatory bowel disease, and a diagnosis of IBD-unclassified (IBD-U) was made after exclusion of other conditions. Treatment with oral budesonide and vedolizumab led to marked clinical and endoscopic improvements, maintaining remission after budesonide discontinuation. Although the usefulness of systemic prednisolone and anti-TNFα antibody preparations for treating IBD-U in patients with MWS has been previously reported, to the best of our knowledge, this is the first report to highlight the therapeutic effects of budesonide and vedolizumab. Therefore, IBD-U should be considered in the differential diagnosis of patients with CAPS who develop gastrointestinal symptoms. Considering their favorable side-effect profiles, budesonide and vedolizumab may serve as promising treatment alternatives in the future.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"78-83"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of ulcerative colitis relapse in a diverted colon after rectal cancer surgery: efficacy of carotegrast methyl. 直肠癌术后转移结肠溃疡性结肠炎复发一例：甲胡萝卜素的疗效。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-11-06 DOI: 10.1007/s12328-025-02243-7

Takanori Igarashi, Kentaro Tominaga, Yuichi Kojima, Mai Nakamura, Takafumi Tonouchi, Nobutaka Takeda, Tomoaki Yoshida, Yuzo Kawata, Akira Sakamaki, Shuji Terai

{"title":"A rare case of ulcerative colitis relapse in a diverted colon after rectal cancer surgery: efficacy of carotegrast methyl.","authors":"Takanori Igarashi, Kentaro Tominaga, Yuichi Kojima, Mai Nakamura, Takafumi Tonouchi, Nobutaka Takeda, Tomoaki Yoshida, Yuzo Kawata, Akira Sakamaki, Shuji Terai","doi":"10.1007/s12328-025-02243-7","DOIUrl":"10.1007/s12328-025-02243-7","url":null,"abstract":"This case presents a rare instance of ulcerative colitis (UC) relapse in the functionally isolated left colon following surgery for rectal cancer associated with UC. A 62-year-old man, suspected of having cancer based on positron emission tomography (PET)-computed tomography (CT) findings and elevated carcinoembryonic antigen levels, underwent robot-assisted low anterior resection and temporary transverse colostomy. Postoperatively, leakage and infection made it difficult to administer conventional local treatments or corticosteroids; however, remission was achieved with the oral α4-integrin inhibitor, carotegrast methyl, allowing for stoma closure. To our knowledge, this report is the first to describe the use of carotegrast methyl for recurrent UC in a diverted colon. This case demonstrates that carotegrast methyl may serve as an effective steroid-sparing option for UC relapse in complex postoperative anatomical contexts. It also highlights the potential utility of PET-CT as an adjunctive diagnostic tool for UC-associated cancer.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"137-143"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From pain relief to organ protection: epidural analgesia in acute pancreatitis-a narrative review of its evolving role. 从疼痛缓解到器官保护：急性胰腺炎的硬膜外镇痛-其演变作用的叙述性回顾。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-08-22 DOI: 10.1007/s12328-025-02204-0

Rajendran Theakarajan, Subramanian Ashuvanth, Govindarajan Rajagopalan

{"title":"From pain relief to organ protection: epidural analgesia in acute pancreatitis-a narrative review of its evolving role.","authors":"Rajendran Theakarajan, Subramanian Ashuvanth, Govindarajan Rajagopalan","doi":"10.1007/s12328-025-02204-0","DOIUrl":"10.1007/s12328-025-02204-0","url":null,"abstract":"Background: Acute pancreatitis (AP) is a potentially life-threatening inflammatory condition with a wide clinical spectrum. In severe acute pancreatitis (SAP), impaired pancreatic microcirculation contributes to necrosis and multiorgan dysfunction. Despite advances in supportive care, therapeutic strategies that directly target pancreatic perfusion remain limited.Objectives: This narrative review explores the evolving role of epidural analgesia (EA) in SAP, examining its physiological basis, experimental evidence, and clinical outcomes.Methods: Literature was reviewed on the pathophysiology of pancreatitis, pancreatic microcirculation, and the use of EA in both animal models and human trials. Data from randomized controlled trials, meta-analyses, and cohort studies were synthesized.Results: EA exerts beneficial effects by blocking thoracic sympathetic outflow, thereby improving splanchnic vasodilation and pancreatic perfusion. Animal studies demonstrated enhanced microcirculatory flow, reduced necrosis, and improved survival. Early clinical studies showed EA reduced enzyme levels, improved pain scores, and enhanced organ function. A recent systematic review and meta-analysis found EA to be safe, associated with reduced mortality and ventilatory requirements. However, the EPIPAN trial, a multicenter RCT, found no significant benefit in ventilator-free days and noted a longer duration of mechanical ventilation in EA recipients.Conclusions: EA appears to be a safe adjunct modality in SAP management, offering analgesia and potential organ-protective effects. However, heterogeneity in study designs and outcomes necessitates larger, high-quality trials to clarify its role in routine practice.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combined diffusion-weighted MRI and contrast-enhanced ultrasonography in diagnosing small hepatic MALT lymphoma mimicking hepatocellular carcinoma. MRI弥散加权与超声造影联合诊断肝小细胞MALT淋巴瘤。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-10-01 DOI: 10.1007/s12328-025-02230-y

Sounosuke Yamato, Takaaki Sugihara, Takuya Kihara, Emiko Kanemura, Yoshiki Hoshino, Takakazu Nagahara, Yudai Ota, Kyohei Okuda, Satoshi Kuwamoto, Hajime Isomoto

引用次数: 0

Minimally invasive repeat liver resection in a patient with situs inversus totalis: report of a challenging case. 微创重复肝切除术治疗完全性倒位患者：一个具有挑战性的病例报告。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-12-08 DOI: 10.1007/s12328-025-02253-5

Marco Colella, Federico Gaudenzi, Taiga Wakabayashi, Yu Teshigahara, Yusuke Nie, Malek Alomari, Kohei Mishima, Go Wakabayashi

引用次数: 0

Diagnosis of peritoneal pseudomyxoma using endoscopic ultrasound-guided fine-needle aspiration. 超声内镜引导下细针穿刺诊断腹膜假性粘液瘤。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-11-07 DOI: 10.1007/s12328-025-02240-w

Mayu Kawabata, Reiko Yamada, Takamitsu Tanaka, Kenji Nose, Yoshifumi Nakamura, Tetsuro Miwata, Jyunya Tsuboi, Hayato Nakagawa

引用次数: 0