Clinical Journal of Gastroenterology最新文献_第4页

PTEN negative adenocarcinoma developed in a gastric hamartoma polyp of a Cowden syndrome patient. PTEN阴性腺癌发展为胃错构瘤息肉科登综合征患者。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-03 DOI: 10.1007/s12328-026-02389-y

Jumpei Suzuki, Bunichiro Kato, Hiro-O Matsushita, Kenjiro Yoshikawa, Haruka Yorozu, Takeya Edagawa, Hiroki Koshiishi, Takuo Tokairin, Masayuki Yoshida, Katsuhiko Enomoto

{"title":"PTEN negative adenocarcinoma developed in a gastric hamartoma polyp of a Cowden syndrome patient.","authors":"Jumpei Suzuki, Bunichiro Kato, Hiro-O Matsushita, Kenjiro Yoshikawa, Haruka Yorozu, Takeya Edagawa, Hiroki Koshiishi, Takuo Tokairin, Masayuki Yoshida, Katsuhiko Enomoto","doi":"10.1007/s12328-026-02389-y","DOIUrl":"10.1007/s12328-026-02389-y","url":null,"abstract":"Cowden syndrome (CS) is an autosomal dominant genetic cancer predisposition disease caused by mutation of the germline phosphatase and tensin homolog (PTEN) gene. A 60s-year-old man who has been diagnosed as CS at our hospital 10 years ago due to his medical history of Lhermitte-Duclos disease (LDD), thyroid medullary carcinoma and gastrointestinal polyposis. He was regularly followed up by the endoscopic examination of gastrointestinal polyps at our hospital. A recent routine examination revealed a surface irregular and hemorrhagic gastric polyp at the lower body of stomach. As a biopsy report showed a high possibility of carcinoma, an endoscopic mucosal resection (EMR) was performed. Histopathological examination of the EMR specimen revealed well-differentiated tubular adenocarcinoma developed in a hamartoma polyp. Immunohistochemical staining using anti-PTEN antibody showed that PTEN expression was completely deficient in the nuclei of carcinoma cells as well as majority of hamartoma cells, whereas a part of hamartoma cells showed PTEN nuclear expression. Furthermore, we applied the specimen to gene panel analysis and confirmed pGly127Arg (c379G > A) mutation present in PTEN gene. Helicobacter pylori (H. pylori) infection in the biopsied gastric specimen and immunohistochemically high expression of p16INK4a and p53 in cancer cells were detected. In addition to PTEN mutation, these changes may contribute to the gastric carcinogenesis of this patient. Although only few cases of gastric carcinoma in CS patients were reported, our case highlights the importance of regular and careful endoscopic observation of hamartoma polyps to detect early-gastric carcinoma in those with CS.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1063-1068"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374732","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

Severe pancreatic exocrine insufficiency presenting with hypoalbuminemia, anasarca, and pulmonary edema in a patient with prior gastrectomy and suspected immunoglobulin G4-related pancreatobiliary disease. 曾行胃切除术并疑似免疫球蛋白g4相关胰胆管疾病的患者出现严重胰腺外分泌功能不全，表现为低白蛋白血症、贫血和肺水肿。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-23 DOI: 10.1007/s12328-026-02404-2

Naoya Fujita, Kenichi Hashimoto, Akinori Sekizawa, Hiroshi Takazaki, Yosuke Ono, Yasuhiro Obuchi, Nobutaka Hirooka, Yuji Tanaka

{"title":"Severe pancreatic exocrine insufficiency presenting with hypoalbuminemia, anasarca, and pulmonary edema in a patient with prior gastrectomy and suspected immunoglobulin G4-related pancreatobiliary disease.","authors":"Naoya Fujita, Kenichi Hashimoto, Akinori Sekizawa, Hiroshi Takazaki, Yosuke Ono, Yasuhiro Obuchi, Nobutaka Hirooka, Yuji Tanaka","doi":"10.1007/s12328-026-02404-2","DOIUrl":"10.1007/s12328-026-02404-2","url":null,"abstract":"A 55-year-old man with prior subtotal gastrectomy was admitted with generalized edema, 16-kg weight gain, dyspnea, and frequent watery pale stools. Laboratory tests revealed severe hypoalbuminemia (1.0 g/dL), anemia, elevated myogenic enzymes, liver dysfunction, and markedly decreased pancreatic enzyme levels. Computed tomography showed bilateral pleural effusion, pulmonary edema, ascites, diffuse soft tissue edema, and marked pancreatic atrophy. Stool Sudan III staining was positive, and urinary para-aminobenzoic acid excretion was reduced. Although cardiac, renal, and hepatic disorders were considered, they did not adequately explain the presentation. Pancreatic exocrine insufficiency was diagnosed. Serum immunoglobulin G4 was elevated at 199 mg/dL, and previous imaging showed poor visualization of the hilar bile duct, gallbladder wall thickening, and gallbladder atrophy. Therefore, possible immunoglobulin G4-related pancreatobiliary disease was considered the leading possible etiology of pancreatic atrophy and exocrine insufficiency, with prior gastrectomy as a modifying factor. Treatment with albumin, diuretics, and pancrelipase (1,800 mg/day) rapidly improved the overall condition of the patient. This case highlights that pancreatic exocrine insufficiency can present with severe third-space fluid shift, pulmonary edema, and compartment syndrome-like findings, highlighting the need to assess multifactorial causes.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1264-1272"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560944","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

First-line systemic therapy for advanced or metastatic esophageal squamous cell carcinoma: clinical implications for treatment selection after KEYNOTE-590, CheckMate 648, and RATIONALE-306. 晚期或转移性食管鳞状细胞癌的一线全身治疗：KEYNOTE-590、CheckMate 648和RATIONALE-306后治疗选择的临床意义

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-09-08 DOI: 10.1007/s12328-026-02447-5

Tamotsu Sagawa, Hiroyuki Nagashima, Koshi Fujikawa

{"title":"First-line systemic therapy for advanced or metastatic esophageal squamous cell carcinoma: clinical implications for treatment selection after KEYNOTE-590, CheckMate 648, and RATIONALE-306.","authors":"Tamotsu Sagawa, Hiroyuki Nagashima, Koshi Fujikawa","doi":"10.1007/s12328-026-02447-5","DOIUrl":"10.1007/s12328-026-02447-5","url":null,"abstract":"First-line systemic therapy for unresectable advanced or metastatic esophageal squamous cell carcinoma (ESCC) has been reshaped by PD-1 blockade, but treatment selection remains complex because the pivotal trials differ in chemotherapy backbone and PD-L1 scoring methodology. KEYNOTE-590 enrolled both ESCC and adenocarcinoma and established pembrolizumab plus chemotherapy as a durable chemoimmunotherapy standard across histologic subtypes. CheckMate 648, focused on ESCC, showed that nivolumab plus chemotherapy and nivolumab plus ipilimumab both improve overall survival (OS), although the patterns of benefit are distinct: progression-free survival (PFS) benefit was observed with nivolumab plus chemotherapy but not with nivolumab plus ipilimumab. RATIONALE-306 subsequently added tislelizumab plus chemotherapy as another evidence-based first-line option in ESCC. Accordingly, clinically relevant treatment selection is better framed by the need for rapid disease control, tolerance for chemotherapy, toxicity profile, histology, and biomarker context than by a simple comparison of individual antibodies. Interpretation of PD-L1 also requires caution because KEYNOTE-590 used combined positive score (CPS), CheckMate 648 used tumor-cell PD-L1 expression, and RATIONALE-306 used Tumor Area Positivity (TAP). This review summarizes the evidence supporting current first-line treatment selection and its implications for daily clinical practice. Key issues addressed include practical distinctions between chemoimmunotherapy and dual immune checkpoint blockade, harmonization of PD-L1 assessment, platinum-backbone selection, and the optimization of treatment sequencing after first-line immunotherapy.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1009-1017"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910943","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

Extremely large solid pseudopapillary neoplasm of the pancreas. 胰腺中巨大的实性假乳头状肿瘤。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-06-15 DOI: 10.1007/s12328-026-02377-2

Richi Nakatake, Hiroaki Kitade, Hidesuke Yanagida, Morihiko Ishizaki, Tetsuya Okuyama, Yoshiko Uemura, Sohei Satoi

{"title":"Extremely large solid pseudopapillary neoplasm of the pancreas.","authors":"Richi Nakatake, Hiroaki Kitade, Hidesuke Yanagida, Morihiko Ishizaki, Tetsuya Okuyama, Yoshiko Uemura, Sohei Satoi","doi":"10.1007/s12328-026-02377-2","DOIUrl":"10.1007/s12328-026-02377-2","url":null,"abstract":"Background: Solid pseudopapillary neoplasms (SPNs) are rare pancreatic tumors with low malignant potential. Although SPNs often grow slowly and may reach a large size before detection, tumors > 20 cm in diameter are extremely rare.Case presentation: A 45-year-old asymptomatic woman was incidentally found to have a large abdominal mass during a routine health examination. Serum CEA and CA19-9 levels were within normal limits. Contrast-enhanced CT revealed a well-encapsulated cystic mass measuring approximately 20 cm, with heterogeneous internal density and focal mural thickening. MRI demonstrated a predominantly cystic lesion with high signal intensity on T2-weighted images and restricted diffusion in the solid components. Complete surgical resection was performed, with an operative time of 4 h 9 min and blood loss of 42 mL. Pathological examination confirmed a 22 × 22-cm SPN with typical histological and immunohistochemical features. Postoperative portal vein thrombosis was successfully treated with anticoagulation therapy. The patient was discharged on postoperative day 17 and remains recurrence-free 5 years after surgery.Conclusion: This case demonstrates that even extremely large SPNs can be safely resected with excellent long-term outcomes, and tumor size alone should not be considered an indicator of aggressive biological behavior.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1193-1198"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249352","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

Duodenoesophageal fistula as a rare complication following emergency total gastrectomy for caustic injury. 十二指肠食管瘘是急诊全胃切除术后罕见的并发症。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-20 DOI: 10.1007/s12328-026-02405-1

Papawee Chennavasin, Thitiporn Chobarporn, Chadin Tharavej, Dudsadee Mesiri

{"title":"Duodenoesophageal fistula as a rare complication following emergency total gastrectomy for caustic injury.","authors":"Papawee Chennavasin, Thitiporn Chobarporn, Chadin Tharavej, Dudsadee Mesiri","doi":"10.1007/s12328-026-02405-1","DOIUrl":"10.1007/s12328-026-02405-1","url":null,"abstract":"Duodenoesophageal fistula (DEF) has not been previously reported. We present a case of DEF connecting the duodenal stump and the intra-abdominal esophageal stump following an emergency total gastrectomy without reconstruction due to caustic injury. Additionally, we describe our experience with one-stage surgical management of the fistula, along with digestive tract reconstruction. The patient underwent emergency surgery approximately 6 months prior at another hospital and was subsequently referred to our center for esophageal reconstruction. Preoperative investigations revealed the presence of DEF along with jejunal obstruction at the site of feeding jejunostomy (FJ) placement, as well as caustic strictures of the esophagus. Thoracoscopic esophagectomy, detachment of the FJ with segmental small bowel resection, duodenoesophageal fistulectomy with resection of the duodenal stump defect, and colonic interposition were successfully performed. In this report, we present a rare condition and describe the successful surgical management of DEF. To the best of our knowledge, this type of fistula formation following emergency total gastrectomy for caustic injury and its management have not been previously described in the literature.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1116-1125"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520071","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

Salvage pancreaticoduodenectomy for localized recurrence after resection of ascending colon cancer: a case report. 补救性胰十二指肠切除术治疗升结肠癌术后局部复发1例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-08-14 DOI: 10.1007/s12328-026-02420-2

Rihito Nagata, Nobuyuki Takemura, Masahiko Komagome, Michio Kogure, Ryosuke Satake, Natsuko Takayanagi, Yasuhiro Nunokawa, Akira Maki, Yoshifumi Beck

{"title":"Salvage pancreaticoduodenectomy for localized recurrence after resection of ascending colon cancer: a case report.","authors":"Rihito Nagata, Nobuyuki Takemura, Masahiko Komagome, Michio Kogure, Ryosuke Satake, Natsuko Takayanagi, Yasuhiro Nunokawa, Akira Maki, Yoshifumi Beck","doi":"10.1007/s12328-026-02420-2","DOIUrl":"10.1007/s12328-026-02420-2","url":null,"abstract":"A 66-year-old man underwent right hemicolectomy for ascending colon cancer with direct invasion of gallbladder. Numerous aberrant proliferative vessels from the duodenum were noted. The pathological diagnosis was T4bN0M0, Stage IIC, with a KRAS G12D mutation. He received four cycles of adjuvant chemotherapy. Four months later, a mass approximately 3 cm in diameter involving the duodenum and ileum was identified and diagnosed as localized recurrence with no evidence of distant metastasis. After administration of two cycles of chemotherapy, contrast-enhanced computed tomography demonstrated tumor shrinkage. A pancreaticoduodenectomy was performed, including resection of the involved ileum, and the short segment of transverse colon. Pathological examination revealed adenocarcinoma proliferation extending across the adhesion plane between the duodenum and ileum, infiltrating the muscularis propria of both intestinal walls without intraluminal exposure. These findings suggested that the tumor originated from residual cancer cells at the dissection plane of the initial surgery. No postoperative adjuvant chemotherapy was administered, in accordance with the patient's wishes. The patient has remained disease-free for more than 7 years after the pancreaticoduodenectomy.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1169-1177"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758294","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

Sustained normalization of hydrogen-positive small intestinal bacterial overgrowth after polyethylene glycol bowel preparation. 聚乙二醇肠道准备后氢阳性小肠细菌过度生长的持续正常化。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-26 DOI: 10.1007/s12328-026-02412-2

Kunihiko Yokoyama, Kentaro Tominaga, Yuichi Kojima, Yuzo Kawata, Naruhiro Kimura, Toru Setsu, Akira Sakamaki, Shuji Terai

{"title":"Sustained normalization of hydrogen-positive small intestinal bacterial overgrowth after polyethylene glycol bowel preparation.","authors":"Kunihiko Yokoyama, Kentaro Tominaga, Yuichi Kojima, Yuzo Kawata, Naruhiro Kimura, Toru Setsu, Akira Sakamaki, Shuji Terai","doi":"10.1007/s12328-026-02412-2","DOIUrl":"10.1007/s12328-026-02412-2","url":null,"abstract":"Small intestinal bacterial overgrowth (SIBO) is a frequent complication of chronic liver disease with portal hypertension that often persists or recurs despite standard treatments. Polyethylene glycol (PEG)-based bowel preparations are routinely used before colonoscopy; however, their effects on SIBO have not yet been systematically evaluated. We report the case of a 44-year-old man with metabolic dysfunction-associated steatohepatitis, complicated by intrahepatic portal vein thrombosis and esophagogastric varices. Before colonoscopy, hydrogen and methane breath testing revealed hydrogen-positive and methane-negative SIBO, while the gastrointestinal symptoms were mild, with a Gastrointestinal Symptom Rating Scale score of 15. Subsequently, the patient underwent a standard bowel preparation using a PEG electrolyte solution. No antibiotics, probiotics, laxatives, or dietary interventions were administered before or after the procedure. Follow-up breath tests performed 1 week after bowel preparation demonstrated normalization of both hydrogen and methane levels. Importantly, repeat testing at 6 weeks confirmed sustained negativity without any additional interventions. This case highlights a previously unreported phenomenon, suggesting that transient luminal interventions, such as bowel preparation, may influence small intestinal microbial dynamics in selected high-risk patients. This observation should be considered hypothesis-generating, and no conclusions regarding therapeutic efficacy can be drawn from this single case.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1147-1151"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590833","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

HER2-positive rectal adenocarcinoma metastatic to the pancreas complicated by obstructive pancreatitis and an infected pseudocyst: a case report. her2阳性直肠腺癌转移至胰腺并发阻塞性胰腺炎和感染假性囊肿1例报告

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-15 DOI: 10.1007/s12328-026-02353-w

Hiroumi Akita, Hideaki Miyamoto, Kazuki Kobayashi, Shinya Yamaga, Sayoko Tayama, Hajime Iwasaki, Motohiro Yoshinari, Yasuhito Tanaka

{"title":"HER2-positive rectal adenocarcinoma metastatic to the pancreas complicated by obstructive pancreatitis and an infected pseudocyst: a case report.","authors":"Hiroumi Akita, Hideaki Miyamoto, Kazuki Kobayashi, Shinya Yamaga, Sayoko Tayama, Hajime Iwasaki, Motohiro Yoshinari, Yasuhito Tanaka","doi":"10.1007/s12328-026-02353-w","DOIUrl":"10.1007/s12328-026-02353-w","url":null,"abstract":"Pancreatic metastasis is uncommon and difficult to distinguish from primary pancreatic cancer based on imaging alone, although accurate diagnosis is essential because treatment strategies differ by tumor origin. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has become an important diagnostic tool, and molecular profiling may identify therapeutic opportunities. A man in his 60s presented with cerebellar masses, and positron emission tomography-computed tomography (PET-CT) revealed hypermetabolic lesions in the rectum and pancreas. Histopathological and molecular analyses confirmed HER2-positive and RAS/BRAF wild-type rectal adenocarcinoma. The pancreatic lesion was complicated by obstructive pancreatitis and an infectious pancreatic pseudocyst. EUS-TA of the pancreatic mass demonstrated metastatic colorectal adenocarcinoma, consistent with pancreatic metastasis from rectal cancer. Following infection control with antibiotics, cytotoxic chemotherapy was considered high risk; therefore, dual HER2-targeted therapy with trastuzumab plus pertuzumab was initiated. After four cycles, tumor marker levels decreased, and radiologic regression of the pancreatic metastasis with improvement of the pseudocyst was observed. This case highlights the diagnostic value of EUS-TA in differentiating pancreatic metastasis from primary pancreatic cancer and suggests that HER2-targeted therapy may be a safe and effective option for HER2-positive metastatic colorectal cancer in situations where cytotoxic chemotherapy is contraindicated because of infectious complications.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1029-1035"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444776","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

Potentially fatal hemorrhagic duodenal ulcers caused by cytomegalovirus infection complicating autoimmune hepatitis with acute liver failure, successfully treated with multiple interventional radiology procedures. 巨细胞病毒感染合并自身免疫性肝炎并发急性肝衰竭引起的潜在致命性出血性十二指肠溃疡，通过多次介入放射治疗成功。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-08-01 DOI: 10.1007/s12328-026-02413-1

Satoshi Sato, Yusuke Matsuoka, Hidezumi Kikuchi, Chikara Iino, Kenta Yoshida, Taka Asari, Tetsuya Tatsuta, Daisuke Chinda, Yui Akemoto, Hirotake Sakuraba

{"title":"Potentially fatal hemorrhagic duodenal ulcers caused by cytomegalovirus infection complicating autoimmune hepatitis with acute liver failure, successfully treated with multiple interventional radiology procedures.","authors":"Satoshi Sato, Yusuke Matsuoka, Hidezumi Kikuchi, Chikara Iino, Kenta Yoshida, Taka Asari, Tetsuya Tatsuta, Daisuke Chinda, Yui Akemoto, Hirotake Sakuraba","doi":"10.1007/s12328-026-02413-1","DOIUrl":"10.1007/s12328-026-02413-1","url":null,"abstract":"Cytomegalovirus (CMV)-associated gastrointestinal disease can precipitate life-threatening hemorrhages; therefore, heightened vigilance is warranted in patients administered immunosuppressive agents. Moreover, acute liver failure compromises cellular immunity by disrupting immune regulatory mechanisms. Herein, we describe a case of duodenal ulcer caused by CMV reactivation during treatment for autoimmune hepatitis (AIH), complicated by acute liver failure. The patient was admitted with acute-onset AIH and steroid pulse therapy was initiated; however, progression to acute liver failure followed. Although acute liver failure improved after plasma exchange and continuous hemodiafiltration, multiple duodenal ulcers developed owing to CMV reactivation following the introduction of azathioprine. Subsequently, the patient developed a microperforation, which resolved with conservative management. However, gastrointestinal bleeding occurred at multiple sites, making endoscopic hemostasis difficult. As the patient's general condition was poor, and surgical intervention was deemed infeasible, interventional radiology (IVR) was conducted thrice within a single day, successfully achieving hemostasis and ultimately saving the patient's life. Although immunosuppressive therapy is indispensable for AIH management, caution regarding CMV reactivation is required during the development of acute liver failure. Furthermore, IVR is a minimally invasive modality that can be performed repeatedly, making it an effective therapeutic option for managing gastrointestinal bleeding.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1152-1160"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653137","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

Intraventricular mechanical factors: subtle triggers of takotsubo syndrome following gastric endoscopic interventions. 脑室内机械因素：胃内窥镜干预后takotsubo综合征的微妙触发因素。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2026-10-01 Epub Date: 2026-07-13 DOI: 10.1007/s12328-026-02400-6

Kenan Yalta

引用次数: 0