Clinical Journal of Gastroenterology最新文献_第2页

Fatal rebleeding of a residual duodenal varix caused by portal hemodynamic redistribution after selective embolization. 选择性栓塞后门静脉血流动力学再分布所致残余十二指肠静脉曲张的再出血。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-06 DOI: 10.1007/s12328-026-02453-7

Mayumi Ehara, Takanori Matsuura, Naoki Shinmaru, Tatsuya Sakane, Yuta Inoue, Jun Kitadai, Toshifumi Tada, Tomoharu Yamanaka, Akihiro Umeno, Yuzo Kodama

{"title":"Fatal rebleeding of a residual duodenal varix caused by portal hemodynamic redistribution after selective embolization.","authors":"Mayumi Ehara, Takanori Matsuura, Naoki Shinmaru, Tatsuya Sakane, Yuta Inoue, Jun Kitadai, Toshifumi Tada, Tomoharu Yamanaka, Akihiro Umeno, Yuzo Kodama","doi":"10.1007/s12328-026-02453-7","DOIUrl":"https://doi.org/10.1007/s12328-026-02453-7","url":null,"abstract":"Duodenal varices are a rare form of ectopic varices that develop as a consequence of portal hypertension and may cause life-threatening gastrointestinal bleeding. Due to complex portosystemic collateral pathways, optimal treatment strategies have yet to be established. We herein report a fatal case of ruptured duodenal varices in a man in his 50s with decompensated liver cirrhosis. The patient presented with hematochezia and hemorrhagic shock. Endoscopic hemostasis was unsuccessful, and emergency transileocolic venous obliteration (TIO) was performed. Contrast-enhanced computed tomography revealed three duodenal varices located in the horizontal portion of the duodenum, supplied by the superior mesenteric vein and draining into the right testicular vein, forming a high-flow portosystemic shunt. Selective embolization of two of the bleeding varices using coils and N-butyl-2-cyanoacrylate was successfully achieved, while the third varix was intentionally preserved to avoid an excessive elevation in portal pressure. Portal vein thrombosis (PVT) subsequently developed, which may have contributed to the redistribution of portal venous flow toward the remaining untreated varix. Coil exposure and bacteremia due to Streptococcus anginosus were also observed during the clinical course. The residual varix ultimately ruptured and caused massive rebleeding. Despite additional treatment, the patient developed hepatic failure followed by multiple organ failure and died on day 47. Selective embolization of ectopic varices may change portal hemodynamics and increase pressure in residual varices, potentially leading to fatal rebleeding. This case highlights the importance of anticipating hemodynamic redistribution and considering early portal decompression strategies in the management of duodenal varices.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104962","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

An unresectable cholangiolocarcinoma diagnosed by integrating biopsy-based histopathology and genomic findings with clinical and imaging data. 一种不可切除的胆管癌，通过结合以活检为基础的组织病理学和基因组学发现以及临床和影像学数据诊断。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-05 DOI: 10.1007/s12328-026-02445-7

Yukinari Yoshida, Norikazu Iwata, Yasushi Sasaki, Yoshifumi Ishii, Yasuyo Adachi, Yasushi Adachi, Takao Endo, Shigeru Sasaki, Hiroshi Nakase, Akira Gotoh

{"title":"An unresectable cholangiolocarcinoma diagnosed by integrating biopsy-based histopathology and genomic findings with clinical and imaging data.","authors":"Yukinari Yoshida, Norikazu Iwata, Yasushi Sasaki, Yoshifumi Ishii, Yasuyo Adachi, Yasushi Adachi, Takao Endo, Shigeru Sasaki, Hiroshi Nakase, Akira Gotoh","doi":"10.1007/s12328-026-02445-7","DOIUrl":"https://doi.org/10.1007/s12328-026-02445-7","url":null,"abstract":"Cholangiolocarcinoma is a rare malignant liver tumor typically diagnosed on pathological evaluation of surgically resected specimens. Establishing a definitive diagnosis in unresectable cases is therefore challenging. A case of a large unresectable liver tumor, extending across the hepatic hilum into both lobes, is presented. Despite the advanced stage, the patient's serum total bilirubin and carbohydrate antigen 19-9 levels remained within normal ranges. On dynamic computed tomography, characteristic imaging features of CLC, including intrahepatic vessel penetration, were seen. Histopathologically, the biopsied specimen demonstrated the typical architecture of CLC, with tubular or cord-like glands with an antler-like anastomosing pattern within abundant fibrous stroma. Next-generation sequencing performed postmortem identified a somatic mutation in the isocitrate dehydrogenase 1 (IDH1) gene, previously reported to be enriched in CLC. Although the liver tumor was unresectable, integration of histopathological, genomic, clinical, and imaging findings strongly supported a diagnosis of CLC.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105005","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 β-catenin-activated hepatocellular adenoma with inflammatory features: diagnostic challenges of integrating imaging and biopsy findings. 具有炎症特征的β-连环蛋白激活的肝细胞腺瘤：综合影像学和活检结果的诊断挑战。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-05 DOI: 10.1007/s12328-026-02440-y

Riku Nakashima, Haruki Uojima, Satoshi Narahara, Hiroki Inada, Etsuko Iio, Katsuya Nagaoka, Hiroko Setoyama, Keita Kai, Yoshiki Mikami, Yasuhito Tanaka

{"title":"A β-catenin-activated hepatocellular adenoma with inflammatory features: diagnostic challenges of integrating imaging and biopsy findings.","authors":"Riku Nakashima, Haruki Uojima, Satoshi Narahara, Hiroki Inada, Etsuko Iio, Katsuya Nagaoka, Hiroko Setoyama, Keita Kai, Yoshiki Mikami, Yasuhito Tanaka","doi":"10.1007/s12328-026-02440-y","DOIUrl":"https://doi.org/10.1007/s12328-026-02440-y","url":null,"abstract":"Hepatocellular adenoma (HCA) is a rare, benign liver tumor classified into molecular subtypes based on immunohistochemical and genetic features, some of which are associated with an increased risk of malignant transformation. However, increasing evidence suggests an overlap among these subtypes, indicating that strict classification may not always reflect the biological complexity of these tumors. We report the case of a 75-year-old man with a slowly enlarging hepatic lesion identified during follow-up after treatment for diffuse large B-cell lymphoma. Magnetic resonance imaging showed low signal intensity on T1-weighted images, mildly hyperintense signal on T2-weighted images, persistent enhancement on dynamic phases, hypointensity on the hepatobiliary phase, and a relatively high apparent diffusion coefficient value. These findings suggested inflammatory HCA, although overlap with other hepatic tumors was considered. A percutaneous liver biopsy revealed hepatocellular proliferation with minimal atypia and inflammatory cell infiltration. Immunohistochemistry demonstrated diffuse glutamine synthetase positivity and nuclear β-catenin expression, consistent with β-catenin-activated HCA. In contrast, C-reactive protein and serum amyloid A expression were only focal. These findings suggest a phenotypic overlap between inflammatory and β-catenin-activated HCA. This case highlights the limitations of biopsy-based subtype classification and underscores the importance of integrating imaging, histopathological, immunohistochemical, and molecular findings.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104971","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

Muir-Torre syndrome in a patient with advanced duodenal carcinoma. 晚期十二指肠癌患者的Muir-Torre综合征。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-05 DOI: 10.1007/s12328-026-02455-5

Ryoma Taketo, Kohei Shibata, Ryota Ishijima, Takuya Noguchi, Masafumi Inomata

{"title":"Muir-Torre syndrome in a patient with advanced duodenal carcinoma.","authors":"Ryoma Taketo, Kohei Shibata, Ryota Ishijima, Takuya Noguchi, Masafumi Inomata","doi":"10.1007/s12328-026-02455-5","DOIUrl":"https://doi.org/10.1007/s12328-026-02455-5","url":null,"abstract":"Muir-Torre syndrome (MTS) is a rare autosomal dominant disorder characterized by sebaceous neoplasms and visceral malignancies and is regarded as a phenotypic variant of Lynch syndrome. Although colorectal and genitourinary cancers are the most common visceral malignancies in MTS, duodenal cancer is extremely rare. We report a case of advanced duodenal cancer associated with MTS treated with multidisciplinary therapy. A 62-year-old man with a history of multiple colorectal cancers and sebaceous carcinomas presented with vomiting and epigastric pain. Upper gastrointestinal endoscopy revealed a circumferential tumor with stenosis in the fourth portion of the duodenum, and a biopsy showed moderately differentiated adenocarcinoma. Computed tomography suggested peritoneal dissemination, and the tumor was considered unresectable. Systemic chemotherapy with 5-fluorouracil and oxaliplatin resulted in tumor regression and disappearance of the suspected dissemination. Conversion surgery with partial duodenectomy and lymph node dissection was subsequently performed, achieving R0 resection. Genetic testing revealed microsatellite instability-high status and a pathogenic MSH2 mutation, confirming MTS. Although postoperative lymph node recurrence occurred, the disease has been controlled with immunotherapy and radiotherapy, and the patient remains alive two years after surgery. This case highlights the potential role of multidisciplinary treatment and the importance of recognizing MTS and implementing appropriate surveillance.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105085","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

Recurrent rupture of a pancreatic mucinous cystic neoplasm with suspected main pancreatic duct communication, presenting with a mediastinal pancreatic pseudocyst, pancreatic pleural effusion, and pericardial effusion. 胰腺粘液囊性肿瘤复发性破裂，怀疑与主胰管相通，表现为纵隔胰腺假性囊肿、胰腺胸膜积液和心包积液。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-05 DOI: 10.1007/s12328-026-02433-x

Makiko Kinoshita, Shunsuke Omoto, Hideaki Sakata, Masako Iwamoto, Shogo Hirata, Hironao Yasuoka, Ikuharu Kinoshita

{"title":"Recurrent rupture of a pancreatic mucinous cystic neoplasm with suspected main pancreatic duct communication, presenting with a mediastinal pancreatic pseudocyst, pancreatic pleural effusion, and pericardial effusion.","authors":"Makiko Kinoshita, Shunsuke Omoto, Hideaki Sakata, Masako Iwamoto, Shogo Hirata, Hironao Yasuoka, Ikuharu Kinoshita","doi":"10.1007/s12328-026-02433-x","DOIUrl":"https://doi.org/10.1007/s12328-026-02433-x","url":null,"abstract":"Spontaneous rupture of pancreatic mucinous cystic neoplasm (MCN) is rare, particularly outside pregnancy, and mediastinal extension has not been reported. We report a 34-year-old woman with a pancreatic tail MCN demonstrating continuity with the main pancreatic duct on computed tomography (CT), suggesting ductal communication. The neoplasm ruptured dorsally, and cyst fluid extended through the aortic hiatus, resulting in a mediastinal pancreatic pseudocyst, pancreatic pleural effusion, and pericardial effusion. Pleural fluid amylase was 1541 IU/L. Endoscopic ultrasonography showed a cyst-in-cyst architecture, and a preoperative diagnosis of MCN was made. After conservative treatment, the mediastinal lesion regressed; subsequently, symptoms recurred on day 5, and CT on day 7 showed a second rupture at a distinct site. Distal pancreatectomy with splenectomy was performed on day 58. Histologically, the lesion was an MCN with low-grade dysplasia, and the ovarian-type stroma was positive for estrogen and progesterone receptors. Epithelial denudation and ulceration extended well beyond the rupture sites, indicating diffuse inner-wall injury. These findings suggest that persistent inflow of pancreatic juice through the suspected communication may have contributed to recurrent rupture and mediastinal extension. Early surgical resection may be warranted when imaging suggests such communication. The patient has remained recurrence-free for 10 years postoperatively.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105052","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

Undifferentiated carcinoma of the pancreas arising from intraductal papillary mucinous neoplasm: a case report. 导管内乳头状黏液性肿瘤引起的胰腺未分化癌1例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-03 DOI: 10.1007/s12328-026-02461-7

Nagomi Mankawa, Yuki Yamauchi, Koji Kitamura

{"title":"Undifferentiated carcinoma of the pancreas arising from intraductal papillary mucinous neoplasm: a case report.","authors":"Nagomi Mankawa, Yuki Yamauchi, Koji Kitamura","doi":"10.1007/s12328-026-02461-7","DOIUrl":"https://doi.org/10.1007/s12328-026-02461-7","url":null,"abstract":"A 75-year-old woman was referred for evaluation of a pancreatic cystic lesion. Serum tumor markers were normal. Contrast-enhanced computed tomography revealed a 35 mm cystic lesion in the pancreatic body with a 7 mm enhancing mural nodule. Magnetic resonance imaging showed slight T1 hyperintensity, T2 hypointensity, and diffusion restriction of the nodule. Contrast-enhanced endoscopic ultrasound demonstrated a broad-based mural nodule with a slightly irregular surface, heterogeneous internal echogenicity, and persistent enhancement from the early to late phases. The lesion was preoperatively diagnosed as branch-duct intraductal papillary mucinous neoplasm (IPMN) with high-risk stigmata, and middle pancreatectomy was performed. Histopathological examination showed that the cystic lesion was a gastric-type IPMN. The mural nodule consisted primarily of pleomorphic and spindle-shaped atypical cells in a hyalinized stroma with focal multinucleated giant cells. Transition from adenocarcinoma to undifferentiated carcinoma identified in the superficial layer led to the final diagnosis of spindle cell-type undifferentiated carcinoma arising from IPMN. This rare case suggests that even a small mural nodule in a pancreatic cystic lesion may exhibit histologically aggressive features. However, preoperative diagnosis of undifferentiated carcinoma of the pancreas remains challenging. Therefore, when a mural nodule is detected in a pancreatic cystic lesion, the treatment strategy, including the surgical procedure, should be carefully considered.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105053","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

Long-term disease control of GP2-NTRK1 fusion-positive pancreatic adenocarcinoma with liver metastases using sequential tyrosine receptor kinase inhibitors. 序贯酪氨酸受体激酶抑制剂对GP2-NTRK1融合阳性胰腺腺癌伴肝转移的长期疾病控制

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-07 DOI: 10.1007/s12328-026-02388-z

Sho Tazuma, Takeshi Sudo, Kenta Baba, Takashi Onoe, Tatsuaki Sumiyoshi, Kazuya Kuraoka, Kenichiro Uemura, Shinya Takahashi, Hirotaka Tashiro, Yosuke Shimizu

引用次数: 0

Immune checkpoint inhibitor-based chemotherapy for granulocyte-colony stimulating factor-producing advanced esophageal squamous cell carcinoma: a report of three cases. 基于免疫检查点抑制剂的化疗治疗粒细胞集落刺激因子产生的晚期食管鳞状细胞癌：附3例报告

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-23 DOI: 10.1007/s12328-026-02406-0

Kohei Suto, Akiharu Kimura, Etsuko Hisanaga, Takahiro Shirakura, Tatsuro Maehara, Makoto Sakai, Akihiko Sano, Nobuhiro Nakazawa, Ken Shirabe, Hiroshi Saeki

{"title":"Immune checkpoint inhibitor-based chemotherapy for granulocyte-colony stimulating factor-producing advanced esophageal squamous cell carcinoma: a report of three cases.","authors":"Kohei Suto, Akiharu Kimura, Etsuko Hisanaga, Takahiro Shirakura, Tatsuro Maehara, Makoto Sakai, Akihiko Sano, Nobuhiro Nakazawa, Ken Shirabe, Hiroshi Saeki","doi":"10.1007/s12328-026-02406-0","DOIUrl":"10.1007/s12328-026-02406-0","url":null,"abstract":"Introduction: Granulocyte-colony stimulating factor (G-CSF)-producing esophageal squamous cell carcinoma (ESCC) is a rare and highly aggressive malignancy. Currently, no specific treatment approach has been established for G-CSF-producing tumors, including those in the lungs, esophagus, and other organs. Here, we present three cases of advanced G-CSF-producing ESCC treated with immune checkpoint inhibitor (ICI) combination chemotherapy.Case presentation: Case 1: A 52-year-old man was diagnosed with G-CSF-producing ESCC with multiple lymph node and lung metastases. First-line chemotherapy with fluorouracil (5-FU), cisplatin, and pembrolizumab (FP + PEM) led to significant tumor regression and normalization of inflammatory marker levels. The regimen was de-escalated to 5-FU and pembrolizumab, and the disease remains stable. Case 2: A 69-year-old man was diagnosed with G-CSF-producing ESCC with multiple lymph node metastases. FP + PEM therapy initially reduced the tumor burden, but disease progression occurred after four treatment cycles. The patient was switched to second-line weekly paclitaxel. Case 3: A 62-year-old man was diagnosed with G-CSF-producing ESCC with bone metastasis. FP + PEM therapy achieved partial response in the primary tumor, but bone metastasis progressed, requiring radiation and a switch to paclitaxel.Conclusions: We report three cases of advanced G-CSF-producing ESCC treated with ICI combination chemotherapy. Although ICIs show promise, treatment resistance remains a challenge. Further research and additional case accumulation are needed to better understand their efficacy and optimize treatment strategies.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1107-1115"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560951","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 a pancreatic pseudocyst associated with alcoholic chronic pancreatitis that mimicked a mucinous cystic neoplasm. 胰脏假性囊肿合并酒精性慢性胰腺炎，模仿粘液囊性肿瘤。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-17 DOI: 10.1007/s12328-026-02409-x

Koji Takao, Hiromitsu Maehira, Haruki Mori, Nobuhito Nitta, Takeru Maekawa, Katsushi Takebayashi, Masatsugu Kojima, Sachiko Kaida, Toru Miyake, Masaji Tani

{"title":"A case of a pancreatic pseudocyst associated with alcoholic chronic pancreatitis that mimicked a mucinous cystic neoplasm.","authors":"Koji Takao, Hiromitsu Maehira, Haruki Mori, Nobuhito Nitta, Takeru Maekawa, Katsushi Takebayashi, Masatsugu Kojima, Sachiko Kaida, Toru Miyake, Masaji Tani","doi":"10.1007/s12328-026-02409-x","DOIUrl":"10.1007/s12328-026-02409-x","url":null,"abstract":"Distinguishing true cysts from pseudocysts can be challenging in clinical practice. We report a patient with a pancreatic pseudocyst secondary to alcoholic chronic pancreatitis that closely mimicked a mucinous cystic neoplasm. A 64-year-old woman with a medical history of alcoholic liver cirrhosis had a progressively enlarging pancreatic cyst in the pancreas body associated with elevated serum carbohydrate antigen 19 - 9 levels. Computed tomography indicated a multilocular cystic lesion with calcification, thickened septa, and protruded lesion. Endoscopic ultrasonography revealed a protruded lesion within the cyst showing detectable blood flow and the cystic lesion had no communication with the main pancreatic duct. Endoscopic ultrasonography showed honeycombing lobularity and strand-like hyperechoic structures in the pancreatic parenchyma. We determined a mucinous cystic neoplasm diagnosis, which cannot rule out malignancy. Distal pancreatectomy with splenectomy was performed. The histopathological examination revealed fibrosis within the pancreatic parenchyma surrounding the cyst as well as fibrin and material suggestive of pancreatic stones along the inner wall. The pancreatic duct was communicated with the cyst and epithelial lining of the cyst wall was not identified, leading to a pancreatic pseudocyst diagnosis. Even when MCN-like features are present in patients with chronic pancreatitis as an underlying disease, it is difficult to completely rule out pancreatic pseudocysts.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1273-1279"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469282","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

Successful transition to mirikizumab following hepatic abscess during adalimumab therapy in a patient with ulcerative colitis. 溃疡性结肠炎患者在阿达木单抗治疗期间肝脓肿后成功过渡到米rikizumab。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-26 DOI: 10.1007/s12328-026-02397-y

Kazuya Miyaguchi, Hisashi Matsumoto, Rie Shiomi, Yoshikazu Tsuzuki, Hiroyuki Imaeda

{"title":"Successful transition to mirikizumab following hepatic abscess during adalimumab therapy in a patient with ulcerative colitis.","authors":"Kazuya Miyaguchi, Hisashi Matsumoto, Rie Shiomi, Yoshikazu Tsuzuki, Hiroyuki Imaeda","doi":"10.1007/s12328-026-02397-y","DOIUrl":"10.1007/s12328-026-02397-y","url":null,"abstract":"Ulcerative colitis (UC) is associated with an increased risk of infectious complications, particularly during anti-tumor necrosis factor (anti-TNF) therapy. Pyogenic hepatic abscess is a rare but potentially life-threatening extraintestinal complication of UC. Optimal biologic management following deep infection during anti-TNF therapy remains unclear. Mirikizumab, a selective interleukin-23 p19 inhibitor, may have a more favorable infectious safety profile than anti-TNF agents. We report the case of a 19-year-old woman with pancolitis-type UC who developed persistent fever, worsening diarrhea, hematochezia, and subsequent right upper quadrant abdominal pain during maintenance therapy with adalimumab. Contrast-enhanced computed tomography revealed active colitis complicated by hepatic abscess. Adalimumab was discontinued, and intravenous ceftriaxone plus metronidazole therapy was initiated. After confirmation of infection control and abscess regression, induction therapy with mirikizumab was initiated for active UC. Clinical symptoms rapidly improved, and the patient achieved sustained clinical and endoscopic remission without recurrence of the hepatic abscess during long-term follow-up. This case suggests that mirikizumab can be successfully administered after adequate infection control in a patient with UC complicated by hepatic abscess during anti-TNF therapy. However, larger studies are needed to determine the optimal biologic option as a second-line treatment for patients requiring treatment reintroduction after deep infection.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1087-1091"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0