Revista Espanola De Enfermedades Digestivas最新文献

{"title":"Abdominal bloating frequency and clinical burden in irritable bowel syndrome classified using an operationalized Rome V algorithm.","authors":"Sukunya Thongchuenjit, Xingyang Luo, Hui Yuan, Qian Li, Xiaomei Zhang, Xiaowei Liu, Jie Wu","doi":"10.17235/reed.2026.12014/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12014/2026","url":null,"abstract":"<p><strong>Introduction: </strong>abdominal bloating is common in irritable bowel syndrome (IBS), but its frequency and clinical associations remain incompletely characterized. We aimed to evaluate abdominal bloating frequency and its association with clinical burden in IBS classified using an operationalized Rome V algorithm.</p><p><strong>Methods: </strong>in a prospectively recruited sample, we conducted cross-sectional analyses of baseline associations. Consecutive patients with IBS completed validated questionnaires assessing gastrointestinal symptoms, psychological comorbidities, and health-related quality of life. Patients were classified by bloating frequency (≥ 1 day/week vs. < 1 day/week). Between-group comparisons and multivariable logistic regression were performed.</p><p><strong>Results: </strong>among 443 patients classified using the operationalized Rome V algorithm, 211 (47.6 %) reported abdominal bloating ≥1 day/week. Compared with those with less frequent bloating, these patients had greater IBS symptom severity and more frequent functional dyspepsia overlap and food-related symptoms (all p < 0.05). They also showed higher psychological comorbidity across five domains (anxiety, depression, gastrointestinal-specific anxiety, somatic symptom, and perceived stress, all p < 0.001), poorer quality of life (p < 0.001), and more gastroenterology clinic and emergency department visits (p < 0.001 and p = 0.022, respectively). On multivariable logistic regression, functional dyspepsia overlap and higher gastrointestinal, anxiety, and somatic symptom burden were independently associated with weekly bloating. Sensitivity analyses restricted to patients meeting the Rome IV criteria yielded similar findings.</p><p><strong>Discussion: </strong>abdominal bloating ≥1 day per week affects nearly half of patients with operationalized Rome V IBS and is associated with greater symptom severity, higher psychological burden, poorer quality of life, and increased healthcare utilization. Assessing bloating frequency may help identify patients with greater clinical burden.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follicular cholangitis: beyond tumour mimicry.","authors":"Miguel Ángel Lorente Martínez, Miguel Ángel Martín Navas, Eduardo Adán Baute Trujillo, Aida Selfa Muñoz","doi":"10.17235/reed.2026.12137/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12137/2026","url":null,"abstract":"<p><p>Follicular cholangitis is a rare entity that may closely mimic cholangiocarcinoma, leading to high-impact therapeutic decisions. We report the case of a 50-year-old woman with asymptomatic cholestatic liver enzyme abnormalities whose imaging studies were initially interpreted as infiltrating intrahepatic cholangiocarcinoma. However, histopathological examination of the surgical specimen established the diagnosis of follicular cholangitis. Persistence of cholestatic liver enzyme abnormalities after surgery prompted the initiation of immunosuppressive therapy, resulting in a favourable clinical and biochemical response. This case highlights the diagnostic challenges posed by follicular cholangitis and suggests that the inflammatory process may extend beyond the macroscopically identifiable lesion.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophagogastric intramural hematoma mimicking varices and a gastric fundal mass.","authors":"Ai Guo, Ruxi Lv","doi":"10.17235/reed.2026.12136/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12136/2026","url":null,"abstract":"<p><p>Esophagogastric intramural hematoma is rare and may mimic varices or an upper gastrointestinal neoplasm. We report a hemodynamically stable patient receiving long-term aspirin therapy who developed melena after gastroscopy and colonoscopy at a referring hospital. Contrast-enhanced computed tomography showed a continuous hyperattenuating mural lesion extending approximately 16 cm from the distal esophagus across the esophagogastric junction into the cardia and gastric fundus, with a 3.8 × 2.6 cm mass-like fundal component and no active contrast extravasation, perforation or radiological evidence of portal hypertension. Endoscopy revealed bluish, varix-like submucosal bulging. Conservative treatment and temporary aspirin withdrawal resulted in substantial hematoma regression within six days, with subsequent ulcer formation in the distal esophagus and cardia. Biopsy of the cardial ulcer showed no evidence of malignancy. No recurrent bleeding or related symptoms occurred during one-month follow-up.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset severe sinusoidal obstruction syndrome following adjuvant CAPOX: clinicoradiological diagnosis and favourable outcome after treatment with defibrotide.","authors":"Aurora Soldado-Serrano, Elena Zamorano-García, Pedro Alberto Alarcón-Blanco, Lucía Ochoa Vallejo, Daniel Maroto-Morales, Encarnación González-Flores","doi":"10.17235/reed.2026.12068/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12068/2026","url":null,"abstract":"<p><p>Sinusoidal obstruction syndrome (SOS) is an uncommon hepatic vascular complication classically associated with haematopoietic stem cell transplantation, although it may also occur following oxaliplatin-based chemotherapy. We report the case of a 52-year-old woman with stage III colon adenocarcinoma treated with adjuvant CAPOX who developed jaundice, ascites, rapid weight gain, thrombocytopenia, and severe liver dysfunction three weeks after completing chemotherapy. After other causes of acute liver injury had been excluded, Doppler ultrasound demonstrated reversal of portal venous flow and signs of portal hypertension consistent with SOS. Given the severity and rapid progression of the condition, treatment with defibrotide was initiated alongside supportive care, resulting in rapid clinical, biochemical, and radiological improvement. This case highlights that SOS may occur early, even after limited exposure to oxaliplatin in the adjuvant setting. Early recognition and assessment with hepatic Doppler ultrasound are essential to establish the diagnosis and initiate prompt treatment.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minor-papilla rescue stenting for pancreatic duct disruption presenting as massive pancreatic ascites.","authors":"Lianqiang Song, Ruihua Zhang","doi":"10.17235/reed.2026.12145/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12145/2026","url":null,"abstract":"<p><p>Pancreatic duct disruption may cause massive pancreatic ascites and mimic malignant or inflammatory peritoneal disease. A 57-year-old man developed progressive abdominal distension after blunt upper-abdominal trauma. Ascitic-fluid amylase was markedly elevated, whereas magnetic resonance cholangiopancreatography showed only mild pancreatic duct dilatation without a visible leak. After approximately 20 days of unsuccessful conservative treatment, endoscopic retrograde pancreatography was performed. Following failed major-papilla cannulation, access through the minor papilla demonstrated a partial pancreatic duct disruption at the pancreatic neck. The guidewire was advanced into the upstream pancreatic duct, and a 5-Fr × 7-cm single-pigtail plastic stent was placed across the leak. Ascitic-fluid amylase rapidly decreased and the ascites markedly improved. The stent was removed 3 months later, and no recurrent ascites occurred during the subsequent 6-month follow-up. Minor-papilla access may provide a rescue route for bridging pancreatic duct disruptions when conventional access fails.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bulky cecal lymphoma mimicking colorectal cancer.","authors":"Jorge Lillo-Díez, Jorge Cuevas González, Henar Núñez Rodríguez, Pedro Enrile Sánchez, Pilar Díez Redondo","doi":"10.17235/reed.2026.12133/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12133/2026","url":null,"abstract":"<p><p>Colonic involvement by non-Hodgkin lymphoma is uncommon and can closely mimic colorectal adenocarcinoma on endoscopic and radiological grounds. We report the case of a 56-year-old woman presenting with abdominal pain and anemia, in whom colonoscopy revealed a large cecal mass extending into the ascending colon. Histological and immunohistochemical evaluation confirmed diffuse large B-cell lymphoma of non-germinal center phenotype. Staging studies revealed extensive nodal involvement, including supradiaphragmatic lymphadenopathy, establishing stage IV disease inconsistent with a strictly primary colorectal lymphoma. Systemic immunochemotherapy (R-CHOP) was initiated; after four cycles, a partial response was observed on analytical and radiological grounds, without the need for surgery to date. This case highlights the diagnostic challenge posed by bulky cecal masses mimicking colorectal cancer and underscores the importance of adequate biopsy, immunophenotypic characterization, and complete staging to guide appropriate multidisciplinary management.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should coronary artery calcification assessment with low-dose thoracic computed tomography be extended to non-smoking liver transplant recipients?","authors":"Manuel Martínez-Sellés","doi":"10.17235/reed.2026.12147/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12147/2026","url":null,"abstract":"<p><p>We read with great interest the article by Caballeros Lam et al. The authors show that low-dose thoracic computed tomography (CT) enables the detection of severe coronary artery calcifications in liver transplant recipients. As expected, severe coronary artery calcifications were associated with adverse cardiovascular events. The authors conclude that low-dose CT should be performed for lung cancer screening and for cardiovascular risk stratification in liver transplant recipients who smoke. Their findings are similar to the recently published from the Danish Comorbidity in Liver Transplant Recipients (DACOLT) study, although DACOLT used coronary CT angiography and these examinations are not interchangeable. DACOLT data show that living with a transplanted liver is associated with higher odds of any coronary atherosclerosis (odds ratio [OR]: 2.2), obstructive coronary atherosclerosis (OR: 2.7), and obstructive-extensive coronary atherosclerosis (OR: 3.9). Moreover, among individuals with any coronary atherosclerosis, liver transplant recipients had higher odds of having high-risk plaque than population control subjects (OR: 2.1). DACOLT investigators were unable to find an association of tobacco with coronary atherosclerosis, although this was probably related to limited power and confounding factors. Koshy et al. were also unable to find a significant association between tobacco consumption and progression of coronary atherosclerosis, although this could be expected due to the low number of liver transplant recipients they studied (n=30).</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic submucosal dissection of an anal canal condyloma with a high-grade squamous intraepithelial lesion.","authors":"Lang Yang, Xianzong Ma, Yuan Lv, Junfeng Du","doi":"10.17235/reed.2025.11395/2025","DOIUrl":"10.17235/reed.2025.11395/2025","url":null,"abstract":"<p><p>A 40-year-old woman underwent colonoscopy and a whitish lesion detected at anal canal at local hospital, the histology of biopsy showed squamous cell high-grade dysplasia. The patient was transferred to our center for treatment because of concerning invasive disease. The test for human immunodeficiency virus was negative. Colonoscopy showed an isolated whitish, slightly elevated lesion with estimated size of 10 × 4 mm on anal canal.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"483-484"},"PeriodicalIF":4.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of intestinal mucosa-associated lymphoid tissue (MALT) lymphoma characterized by diffuse capillary hyperplasia nodules with hemorrhage.","authors":"Ming Zhong, Wei Wei, Tingyu Wang, Huang Zhong, Hang Gong","doi":"10.17235/reed.2025.11381/2025","DOIUrl":"10.17235/reed.2025.11381/2025","url":null,"abstract":"<p><p>A 52-year-old man presented to our department, complaining of recurrent episodes of hematochezia for half a month. Colonoscopy showed diffuse nodular mucosal eminences of approximately 2-3 mm in size in the colorectum and terminal ileum, presenting a \"cobblestone\" appearance, with visible capillary hyperplasia that are prone to rupture and bleeding upon light touch. Narrow-band imaging (NBI) showed that the hyperplastic capillaries presented \"root-like\" branching. We performed deep biopsies in areas with dense capillary networks or prone-to-bleeding regions at the nodules of the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, ileocecal region, and terminal ileum. Histopathological examination of all biopsy specimens revealed moderate-to-severe chronic mucosal inflammation with activity (+) and prominent lymphoid hyperplasia. Immunohistochemical staining demonstrated that the tumor cells were positive for CD20, CD79a, Bcl-2, Ki67 (20%), CD43. Combined with the morphological features of HE-stained sections, the findings suggested extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (indolent).</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"482-483"},"PeriodicalIF":4.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab as maintenance therapy in steroid-dependent eosinophilic enteritis: a multidisciplinary approach.","authors":"Íñigo Roa Esparza, Irene Arteagoitia Casero, Mario Salvador Argueta Valdez, Ainara Torralba Gallego, Pilar Pazo Meijide, Luis Dueña Bartolomé, Javier Sánchez de Vicente","doi":"10.17235/reed.2026.11809/2025","DOIUrl":"10.17235/reed.2026.11809/2025","url":null,"abstract":"<p><p>Eosinophilic enteritis is a rare immune-mediated disorder for which systemic corticosteroids remain the mainstay of treatment during acute flares, although no standardized maintenance therapy exists and some patients develop recurrent disease requiring repeated steroid courses. We report the case of a 27-year-old man with steroid-dependent eosinophilic enteritis characterized by recurrent flares with abdominal pain, diarrhea, ascites, and peripheral eosinophilia. After exclusion of alternative causes of eosinophilia through a multidisciplinary evaluation, off-label dupilumab was initiated, allowing complete corticosteroid withdrawal, with good tolerability. After one year of follow-up, he maintained remission and was able to reintroduce previously restricted foods, supporting its potential role as a steroid-sparing maintenance therapy in selected patients with eosinophilic enteritis.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"486-487"},"PeriodicalIF":4.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}