Frontiers in Medicine最新文献

{"title":"Pulmonary cryptococcosis in the setting of immunosuppression by methylprednisolone monotherapy for oral pemphigus: a case report and literature review.","authors":"Hongxia Mei, Pengchen Bao, Yongxu Wang, Zhijing Wei, Qin Yang, Chen Chen, Yakai Sun, Xinming Su, Jian Kang, WenYang Li","doi":"10.3389/fmed.2025.1569949","DOIUrl":"https://doi.org/10.3389/fmed.2025.1569949","url":null,"abstract":"<p><p><i>Cryptococcosis</i> is an opportunistic and potentially fatal fungal infectious disease. Pemphigus diseases are characterized by blistering of the cutaneous and mucous membranes. We report a case of pulmonary <i>cryptococcosis</i> (PC) following methylprednisolone treatment for pemphigus vulgaris. Additionally, we analyzed a case series of PC infections recorded in PUBMED from 2013 to 2023. A total of 229 cases of PC were included. The median age was 54 years, with 66.4% of patients being male. Those with previous use of corticosteroids or immunosuppressives accounted for 38.4% of cases. Underlying conditions included solid organ transplantations (25.7%), respiratory diseases (6.6%), malignant tumors (6.1%), rheumatoid arthritis (5.7%), hematological malignancies (4.4%), among others. The main source of infection was exposure to birds, poultry, and their feces (12.7%). <i>Cryptococcus neoformans</i> was most frequently isolated (76.4%). Overall mortality was 14.8%. Previous use of corticosteroids or immunosuppressants was a risk factor for disseminated <i>cryptococcus</i> (<i>p</i> < 0.05). Age, underlying disease, dissemination, and no antifungal therapy were independently associated with increased mortality (<i>p</i> < 0.05). Co-occurrence of pemphigus and PC is rare. Prompt diagnosis and appropriate treatment of PC are essential to prevent fatal consequences. Corticosteroids or immunosuppressive therapy are associated with the development of disseminated cryptococcal infection. Age, underlying disease, and dissemination are related to increased mortality. Timely antifungal therapy can improve prognosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1569949"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving OSA screening efficiency with subjective questionnaires: integrating STOP-Bang, ESS, and Berlin.","authors":"Riken Chen, Yuan Zhang, Weilong Ye, Zhaojun Chen, Weifeng Liao, Huizhao Liao, Tingting Sun, Huan Li, Junfen Cheng, Wang Liu, Weimin Yao, Yitian Yang","doi":"10.3389/fmed.2025.1581904","DOIUrl":"https://doi.org/10.3389/fmed.2025.1581904","url":null,"abstract":"<p><strong>Objective: </strong>To compare the predictive value of the STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), and the Berlin questionnaire, while evaluating the combined application of these tools in a three-step screening strategy for obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>From September 1, 2016, to October 31, 2020, at the Sleep Medicine Center of the First Affiliated Hospital of Guangzhou Medical University, 2,208 suspected OSA patients completed the ESS, STOP-Bang, and Berlin questionnaires and underwent polysomnography (PSG). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) curves were calculated for each questionnaire, and the accuracy and predictive value of combining the STOP-Bang, ESS, and Berlin questionnaires for OSA screening were analyzed.</p><p><strong>Results: </strong>Among the individual scales, the Berlin questionnaire had the highest area under the curve (AUC), demonstrating the best diagnostic performance and the highest PPV. The ESS had the smallest AUC and the highest specificity, but the lowest sensitivity and NPV. The STOP-Bang had the highest sensitivity and NPV but the lowest specificity and PPV. When the scales were combined, the AUCs of all combinations were less than 0.7, indicating that the diagnostic performance of the combined scales slightly decreased compared to the individual scales. However, among the combined scales, the AUC of the three-scale combination was higher than that of the two-scale combinations. After combining the questionnaires, specificity and PPV increased, but sensitivity and NPV decreased. Among the two-questionnaire combinations, the sensitivity and NPV of the ESS and STOP-Bang combination were higher than those of the ESS and Berlin questionnaire combination, while specificity and PPV were lower. The combination of all three questionnaires resulted in the highest specificity and PPV, but the lowest sensitivity and NPV.</p><p><strong>Conclusion: </strong>As the number of scales increases, sensitivity and NPV decrease, while specificity and PPV increase. Therefore, we recommend a three-step strategy, combining a STOP-Bang score of 3, an ESS score of 9, and the Berlin questionnaire to improve the specificity and PPV in screening for OSA.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1581904"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of estimated glucose disposal rate with risk of future metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases: a prospective cohort study.","authors":"Yan Li, Xi Ye, Xiaoyu Chen","doi":"10.3389/fmed.2025.1589245","DOIUrl":"https://doi.org/10.3389/fmed.2025.1589245","url":null,"abstract":"<p><strong>Background: </strong>The incidence of insulin resistance, as determined by estimated glucose disposal rate (eGDR), is associated with various morbidities. The relationship between eGDR and chronic liver diseases remains to be explored. This study examined the association between eGDR and the risk of future metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, liver cancer, and liver-related mortality.</p><p><strong>Method: </strong>We analyzed data from UK Biobank participants with no history of liver diseases. We calculated the eGDR values for each participant and divided them into four quartile groups based on these values. The primary outcome was MASLD, whereas the secondary outcomes included cirrhosis, liver cancer, and liver-related mortality. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression models. We used restricted cubic splines models to detect potential non-linear relationships.</p><p><strong>Results: </strong>This study included data from 290,397 UK Biobank participants who had no history of liver diseases, and the magnetic resonance imaging (MRI)-derived liver proton density fat fraction (PDFF) analysis included 25,810 individuals. Over a median follow-up period of 15.69 years, we identified 3,926 cases of MASLD, 1,553 cases of cirrhosis, 167 cases of liver cancer, and 120 cases of liver-related mortality. After adjusting for multiple variables, higher eGDR levels were significantly associated with a lower risk of MASLD (HR: 0.91, 95% CI: 0.90-0.93), cirrhosis (HR: 0.89, 95% CI: 0.86-0.92), and liver cancer (HR: 0.91, 95% CI: 0.83-1.00). Comparing participants between the lowest and highest quartiles (Q1 and Q4) of eGDR, Q4 had a 47% lower risk of MASLD (HR: 0.53; 95% CI: 0.45-0.63), with similar results for cirrhosis. Moreover, high eGDR levels were associated with a low risk of MASLD based on MRI-derived liver PDFF > 5% (odds ratio: 0.98, 95% CI: 0.97-0.98).</p><p><strong>Conclusion: </strong>We found a significant inverse correlation between eGDR and MASLD, cirrhosis, and liver cancer. Incorporating eGDR into clinical decision-making can improve the long term follow-up of patients with MASLD.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1589245"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autosomal recessive woolly hair/hypotrichosis caused by LIPH mutations: a case report.","authors":"Ying Xie, Sha Luo, Yumei Yang, Xin Zou, Shuying Lv, Meijiao Du, Yonglong Xu, Xiaojuan Song, Changjie Qi, Nuo Li, Dingquan Yang","doi":"10.3389/fmed.2025.1563299","DOIUrl":"https://doi.org/10.3389/fmed.2025.1563299","url":null,"abstract":"<p><strong>Objective: </strong>To report the clinical characteristics of a case of Autosomal recessive woolly hair/ hypotrichosis(ARWH/HT, OMIM:278150/604379) in a child, analyze and identify the causative gene and mutation site. A review of related research at home and abroad was conducted to summarize the current progress in the diagnosis and treatment of ARWH.</p><p><strong>Methods: </strong>Clinical data were collected, and exome sequencing was performed on blood samples from the patient and parents to screen for mutations. Sanger sequencing validated suspected pathogenic variants. A summary analysis of previously published woolly hair cases was also conducted.</p><p><strong>Results: </strong>The family was found to have mutations in the LIPH gene, with the patient's sample showing two heterozygous mutations: <i>c.1101del</i> (maternal) and <i>c.736 T > A</i> (paternal). These compound heterozygous mutations are responsible for the ARWH phenotype.</p><p><strong>Conclusion: </strong>The compound heterozygous mutations <i>c.1101del</i> and <i>c.736 T > A</i> in the LIPH gene are the pathogenic mutations causing the clinical phenotype of autosomal recessive woolly hair in the child. The <i>c.1101del</i> mutation is a newly discovered frameshift mutation, enriching the mutation spectrum of LIPH-associated autosomal recessive woolly hair with hypotrichosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1563299"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myopia and daylight-A combination of factors.","authors":"Richard Hobday, Mariëlle Aarts, Christian Cajochen, Lenka Maierova, Mirjam Münch, Werner Osterhaus, Oliver Stefani, Katharina Wulff","doi":"10.3389/fmed.2025.1481209","DOIUrl":"https://doi.org/10.3389/fmed.2025.1481209","url":null,"abstract":"<p><p>The incidence of myopia among school children has risen markedly over the last three decades. In urban areas of South and East Asia, as many as 80-90% of young adults are now myopic. This trend is occurring elsewhere around the world. During the COVID-19 lockdowns, children in many countries were confined indoors and spent an undue amount of time exposed to television screens, computers, and mobile devices. This resulted in an acceleration in the incidence and progression of the condition. Myopia is a significant public health issue as it is a leading cause of blindness and other vision problems. Yet the underlying mechanisms that produce the condition remain elusive. Pseudomyopia has recently been proposed as an independent risk factor for myopia. We hypothesize that pseudomyopia induced by prolonged close work, stress, and anxiety combines and is further amplified by chronically low ambient light levels. If time spent outdoors in daylight is restricted, the effects worsen and together may play a significant part in myopia epidemics.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1481209"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Successful application of endoscopic biliary accessories in a patient with complete esophageal stricture.","authors":"Junjun Yan, Qiangming Liao, Bin Ding","doi":"10.3389/fmed.2025.1540103","DOIUrl":"https://doi.org/10.3389/fmed.2025.1540103","url":null,"abstract":"<p><p>The endoscopic treatment of complete esophageal stricture presents a huge challenge. In instances where the esophageal lumen is nearly obliterated, preventing the passage of a dilating guide wire, conventional endoscopic bougie dilation is often difficult to perform. We report a case of patients with nearly complete esophageal stricture due to esophageal cancer surgery, leading to severe dysphagia and weight loss. Our strategy began with the achievement of anterograde esophageal access, facilitated by a biliary intubation method and aided by a 0.35-inch guidewire. Subsequently, we sequentially applied biliary dilators and balloon dilators, progressing along the guidewire to incrementally dilate the esophageal lumen up to the site of complete stenosis. The stenosis was successfully penetrated and dilated, and eventually the patient's dysphagia was completely relieved. This case underscores the efficacy of the novel endoscopic treatment for biliary appendices in patients with refractory esophageal anastomotic stricture, offering a new therapeutic approach for clinical management.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1540103"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the diagnostic spectrum of malignant otitis externa: a case report of proteus infection in a non-immunosuppressed patient.","authors":"Fabián Darío Arias Rodríguez, Mercedes Larenas, Santiago Paredes, Guillermina Giuliano, Andrés López-Cortés, Juan S Izquierdo-Condoy","doi":"10.3389/fmed.2025.1577525","DOIUrl":"https://doi.org/10.3389/fmed.2025.1577525","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant otitis externa (MOE) is a severe and potentially life-threatening infection of the external auditory canal, most frequently caused by <i>Pseudomonas aeruginosa</i>. Although typically seen in immunocompromised individuals-especially those with diabetes mellitus-up to 45% of cases have been reported in non-diabetic patients, highlighting the importance of recognizing atypical presentations. Rare pathogens, such as <i>Proteus mirabilis</i>, have been identified in only a few documented cases. Early diagnosis and prompt intervention are essential to prevent serious complications, including osteomyelitis and intracranial extension.</p><p><strong>Objectives: </strong>This report describes a really uncommon case of malignant otitis externa caused by <i>P. mirabilis</i> in a non-diabetic, immunocompetent patient.</p><p><strong>Case presentation: </strong>A 53-year-old male with no relevant medical history presented with a four-month history of left-sided otorrhea, otalgia, and preauricular pain. Examination and imaging revealed purulent discharge and bone erosion, suggestive of MOE. Empirical treatment with amoxicillin/clavulanic acid was ineffective. Culture identified <i>Proteus mirabilis</i>, resistant to multiple antibiotics but sensitive to piperacillin/tazobactam, which was administered with supportive care. After 17 days of intravenous therapy, the patient improved and was discharged on oral ciprofloxacin to complete a three-month course. Follow-up confirmed clinical resolution without recurrence.</p><p><strong>Conclusion: </strong>This case report highlights an exceptionally rare occurrence of MEO caused by <i>P. mirabilis</i> in an immunocompetent, non-diabetic patient. It emphasizes the need to consider uncommon pathogens and atypical clinical profiles in MOE. Early diagnosis, microbiological confirmation, and tailored antimicrobial therapy were critical for favorable outcomes.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1577525"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria in China: a discourse-historical perspective.","authors":"Peng Miao","doi":"10.3389/fmed.2025.1590518","DOIUrl":"https://doi.org/10.3389/fmed.2025.1590518","url":null,"abstract":"<p><p>The translation, transmission, and re-conceptualization of malaria in late Qing and Republican China exemplifies how knowledge on an ancient disease is reshaped through linguistic and cultural mediation. This article analyzes diverse textual medical sources, namely English-Chinese dictionaries (1830s-1900s) and vernacular newspapers and periodicals, to trace and observe the lexical journey of \"ague\" and \"malaria\" into the Chinese domain as \"nueji\" (/) and \"zhangqi\" (/). Three phases of conceptual transfer are identified: first, early missionary dictionaries (1822-1860s) prioritized symptom-based translations (e.g., faleng /, chills); second, the 1870s-1920s witnessed terminological competition between nueji and zhangqi, reflecting clashes between traditional Chinese etiology and western theories; third, by the 1930s-1940s, nueji became dominant through institutional standardization, while western parasitological frameworks were selectively assimilated, as \"<i>Plasmodium</i>\" was lexicalized as \"nueyuanchong\" (/), yet the mechanism of \"immunity\" remained unexplained in Chinese medical discourse. This process was formed by intra-medical debates: while western-trained practitioners weaponized microscopy to validate <i>Plasmodium</i> as a pathogen, traditional healers reframed it through local cosmology. Newspaper and periodicals served as contested epistemic spaces, where terms like \"weichong\" (/) and \"jishengchong\" (/) mirrored public struggles to reconcile western knowledge with local beliefs. This article demonstrates that disease introduction transcends lexical substitution, acting as a battlefield for different medical discourses in China's medical modernization.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1590518"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging tradition and innovation: a constitution-guided framework for personalized blood pressure management in acute ischemic stroke.","authors":"Xuran Zhang, Kegang Cao, Li Zhou, Jinxian Liu, Yufeng Ding","doi":"10.3389/fmed.2025.1602274","DOIUrl":"https://doi.org/10.3389/fmed.2025.1602274","url":null,"abstract":"<p><strong>Background: </strong>Elevated blood pressure (BP) in acute ischemic stroke (AIS) significantly impacts clinical outcomes, yet optimal BP management remains contentious due to patient heterogeneity. Traditional Chinese medicine (TCM) constitution theory categorizes individuals into distinct physiological patterns, offering a novel framework to address this variability. This study integrates TCM constitutional theory into modern AIS care to propose a personalized BP management ‌hypothesis.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted across nine databases, including PubMed, Web of Science, Scopus, the Cochrane Library, ScienceDirect, the Chinese National Knowledge Infrastructure, Wanfang Data, VIP Database, and China Biology Medicine, covering publications up to January 2025. We analyzed TCM constitution distributions in AIS, hypertension, hypotension, AIS with hypertension, ischemic stroke (IS) with hypertension, and ischemic cerebrovascular disease with hypoperfusion, correlating constitutional types with clinical outcomes. We employed the Agency for Healthcare Research and Quality (AHRQ) checklist to evaluate the methodological quality of cross-sectional studies and utilized the Newcastle-Ottawa Scale (NOS) for quality assessment of cohort and case-control studies. Subgroup and sensitivity analyses were performed, and publication bias was assessed. A constitution-guided framework for BP management was developed through evidence synthesis.</p><p><strong>Results: </strong>Fifty-four studies were included in the study, with the majority being of moderate-to-high quality. The findings demonstrated that Phlegm-dampness, Qi-deficiency, Yin-deficiency, and Blood-stasis constitutions predominated in AIS patients with hypertension. Subgroup and sensitivity analyses confirmed the robustness of the results. Most analyses demonstrated no evidence of publication bias. Although several analyses indicated potential publication bias, the primary conclusions withstood the trim-and-fill adjustment and remained robust. A TCM constitution-based BP management hypothesis was proposed: patients with Phlegm-dampness or Blood-stasis constitutions may benefit from intensive BP control, whereas Qi-deficiency and Yin-deficiency types may require conservative strategies to mitigate hypoperfusion risks.</p><p><strong>Conclusion: </strong>This integration of TCM constitutional theory into AIS BP management provides a potential framework for advancing precision care to improve clinical outcomes in AIS patients. Further validation in multicenter cohorts and mechanistic exploration is warranted to enhance clinical applicability (Registration information: https://www.crd.york.ac.uk/PROSPERO2/view/CRD420250655689).</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1602274"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful endoscopic mechanical lithotripsy for post-ERCP gallstone ileus: a case report.","authors":"Jing Wang, Zhe Luan, Bin Yan, Gang Sun","doi":"10.3389/fmed.2025.1604835","DOIUrl":"https://doi.org/10.3389/fmed.2025.1604835","url":null,"abstract":"<p><p>Gallstone ileus is a rare but severe complication of gallstone disease and is typically caused by the formation of a fistula between the biliary and gastrointestinal systems. The conventional treatment approach is enterolithotomy with stone removal. However, for elderly patients or those with underlying comorbidities, surgical intervention poses significant risks. Therefore, exploring minimally invasive, nonsurgical treatment strategies holds critical clinical value. A 63-year-old female was admitted to the hospital due to abdominal pain, chills, and high fever. She was diagnosed with a large common bile duct stone (diameter 3.9 cm). During endoscopic retrograde cholangiopancreatography (ERCP), as the stone was too large to be removed directly, endoscopic sphincterotomy (EST) combined with the placement of a biliary plastic stent was performed. On the 7th postoperative day, the patient developed nausea, vomiting, and constipation. Laboratory tests revealed elevated inflammatory marker, pancreatic enzyme, bile enzyme, and bilirubin levels. Imaging studies revealed intestinal dilatation and a high-density shadow within the intestinal lumen, leading to the diagnosis of gallstone ileus. On postoperative day 11, biliary and pancreatic stents were placed. On postoperative day 16, endoscopic stone extraction was attempted, successfully relieving the obstruction. The patient recovered well postoperatively and experienced no recurrence during the 2-month follow-up. This case report describes the successful treatment of post-ERCP gallstone ileus using endoscopic stone extraction and fragmentation techniques.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1604835"},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}