Scandinavian Journal of Gastroenterology最新文献

{"title":"HCC-surveillance is associated with improved HCC-related mortality in patients with cirrhosis - a case-control study.","authors":"Hannes Hegmar, Bonnie Bengtsson, Sofia Ullman, Ian A Rowe, Per Stål, Hannes Hagström","doi":"10.1080/00365521.2025.2517208","DOIUrl":"https://doi.org/10.1080/00365521.2025.2517208","url":null,"abstract":"<p><strong>Background and aims: </strong>Surveillance for hepatocellular carcinoma (HCC) with ultrasound screening is recommended by guidelines. However, there are conflicting data whether HCC-surveillance reduces HCC-related mortality in patients with cirrhosis. The aim of this study was to validate previous findings that found no association between HCC-surveillance and decreased HCC-related mortality.</p><p><strong>Methods: </strong>This was a case-control study in patients with cirrhosis from Stockholm County, Sweden. Cases died from HCC between 2004 and 2020. Controls did not die from HCC, and were matched to cases based on age, sex, etiology of cirrhosis, year of cirrhosis diagnosis, hospital site, MELD, and Child-Pugh scores. An adjusted logistic regression model was used to compare exposure to screening ultrasounds 2 years prior to HCC diagnosis between cases and controls. An odds ratio below one would suggest an association between HCC surveillance and decreased HCC-related mortality.</p><p><strong>Results: </strong>A total of 1272 patients with cirrhosis and HCC died during follow-up, and 516 of these were excluded as potential cases due to a diagnosis of HCC near the cirrhosis diagnosis. From the potential cases 72 cases and 72 controls were matched. The adjusted odds ratio was 0.33 (95% Confidence Interval [CI] = 0.14-0.78).</p><p><strong>Conclusions: </strong>HCC surveillance was associated with decreased HCC-related mortality, indicating that HCC surveillance should continue as recommended in guidelines. However, many patients who died from HCC were diagnosed with HCC close to the cirrhosis diagnosis, suggesting that identifying patients with cirrhosis earlier is highly important for improving HCC-related mortality.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317847","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":"Multi-omic analysis identifies cholesterol metabolism related protein ARV1 as a novel biomarker for Colon adenocarcinoma patients with adenomatous polyposis.","authors":"Yu-Cheng Zhu, Jun Zhang, Kun Liu, Ya-Bin Cheng, Wei Jiang","doi":"10.1080/00365521.2025.2518461","DOIUrl":"https://doi.org/10.1080/00365521.2025.2518461","url":null,"abstract":"<p><strong>Objectives: </strong>Familial adenomatous polyposis (FAP) is typically characterized by numerous adenomatous polyps that will inevitably progress to adenocarcinomas. To enhance the clinical management of colon adenocarcinoma (COAD), a deeper understanding of the molecular mechanisms driving malignant transformation in pre-cancerous adenomatous polyposis, as well as the identification of predictive biomarkers, is essential.</p><p><strong>Methods: </strong>In the present study, clinical samples were collected from rare patients with COAD and FAP, and metabolomic and proteomic analyses were performed to elucidate the mechanisms of canceration in FAP patients.</p><p><strong>Results: </strong>The multi-omics analysis showed that cholesterol metabolism is highly activated in COAD tissue and identified 64 genes that are highly expressed in COAD and significantly correlated with prognosis. Improved <i>in situ</i> sequencing (IISS) identified <i>ARV1</i> (ACAT related enzyme 2 required for viability 1) as a critical regulator of cholesterol metabolism. Finally, bioinformatics analysis using the HPA database showed that <i>ARV1</i> expression is negatively correlated with COAD TNM stage; thus, indicating that <i>ARV1</i> might play a role as a tumor suppressor in colon cancer.</p><p><strong>Conclusions: </strong>Overall, cholesterol metabolism was found to be involved in colon adenocarcinoma tumorigenesis and <i>ARV1</i> was identified as a key factor in the early stage of FAP transformation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317822","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":"Immunogenicity of the Comirnaty Omicron XBB.1.5 booster COVID-19 mRNA vaccine in patients with cirrhosis.","authors":"Samer Al-Dury, Sigrun Einarsdottir, Ellen Fridriksson, Linn Dahlsten Andius, Hao Wang, Sinan Sharba, Amin Mountagui, Johan Waern, Johan Ringlander, Jesper Waldenström, Anna Martner, Kristoffer Hellstrand, Martin Lagging","doi":"10.1080/00365521.2025.2518466","DOIUrl":"https://doi.org/10.1080/00365521.2025.2518466","url":null,"abstract":"<p><p><b>Objective:</b> : To evaluate the durability of immune responses following prior COVID-19 vaccinations and assess the immunogenicity of a fifth mRNA-based COVID-19 booster dose in patients with liver cirrhosis.</p><p><p><b>Materials and Methods</b>: In this longitudinal cohort study, 33 patients with liver cirrhosis received a fifth booster dose of the Comirnaty Omicron XBB.1.5® (Pfizer-BioNTech) mRNA vaccine. Peripheral blood samples were collected prior to and four weeks after vaccination. Humoral immunity was assessed by measuring serum antibodies against the receptor-binding domain of spike (anti-RBD-S1) and nucleocapsid proteins. Cellular immunity was evaluated by quantifying ex vivo Spike 1 (S1)-specific T-cell responses, specifically IL-2 release.</p><p><p><b>Results</b>: The fifth mRNA vaccine dose led to a significant increase in anti-RBD-S1 antibody levels and S1-induced IL-2 release, indicating enhanced humoral and cellular immune responses. The optimal interval for booster administration to maintain elevated antibody titers was identified as 10-12 months. Additionally, a history of prior COVID-19 infection significantly influenced post-booster antibody responses.</p><p><p><b>Conclusions</b>: A fifth mRNA-based COVID-19 booster dose significantly augments both humoral and cellular immunity in patients with liver cirrhosis. These findings support the use of a single annual booster dose to maintain adequate immune protection in this vulnerable population.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317848","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":"Lipofuscinosis as a novel discriminating feature for drug-induced liver injury from autoimmune hepatitis.","authors":"Sabine Weber, Franziska Erhardt, Jens Neumann, Julian Allgeier, Didem Saka, Nirali Donga, Izabel Mircheva, Rochell Balakumar, Christian M Lange, Alexander L Gerbes","doi":"10.1080/00365521.2025.2517207","DOIUrl":"https://doi.org/10.1080/00365521.2025.2517207","url":null,"abstract":"<p><strong>Background and objective: </strong>Differentiating drug-induced liver injury (DILI) and autoimmune hepatitis (AIH) is a diagnostic challenge. Liver biopsy is recommended in unclear cases, however, clear distinguishing patterns are unknown. We therefore aimed to further identify histopathological features that can discriminate DILI from AIH.</p><p><strong>Methods: </strong>The clinical and histological data of well-characterised 136 DILI and 43 AIH patients from our prospective cohort on patients with acute liver injury and potential drug-related cause were analysed. Logistic binary regression was performed to identify models that could differentiate both two entities.</p><p><strong>Results: </strong>Histopathological findings showed high overlaps between DILI and AIH, and overall concordance between histological and clinical diagnosis was low (48.9%). While interface hepatitis, plasma cell infiltration, and portal-intralobular infiltration were favouring AIH, relevant proportions of DILI patients also presented with those features (44.1%, 46.3% and 29.2%, respectively). Interestingly, on multivariate analysis, lipofuscinosis was the only independent predictor of DILI diagnosis, showing a strong association with DILI diagnosis (odds ratio [OR] 10.8; positive predictive value [PPV] 96.2%). Moreover, logistic regression analysis showed that a model combining different histopathological features (lack of interface hepatitis, fibrosis and eosinophils together with presence of cholestasis, steatosis and lipofuscinosis) could differentiate DILI from AIH with an accuracy of 76.5% and a strikingly high sensitivity of 94.9%.</p><p><strong>Conclusions: </strong>DILI and AIH showed similar histological patterns, however lipofuscinosis was identified as a novel distinctive feature for DILI with an extraordinarily high PPV. Moreover, a model combining a variety of histological features could differentiate both entities with high sensitivity.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302809","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":"Periodontitis is associated with increased disease activity in a Swedish cohort of patients with inflammatory bowel disease.","authors":"Gorm Roager Madsen, Kristina Bert, Amanda Wåhlin, Daniel Najjar, Nikolaos Pandis, Andreas Stavropoulos, Johan Burisch","doi":"10.1080/00365521.2025.2517217","DOIUrl":"https://doi.org/10.1080/00365521.2025.2517217","url":null,"abstract":"<p><strong>Background: </strong>Periodontitis and inflammatory bowel disease (IBD) are chronic, progressive inflammatory diseases with shared aetiopathogenetic mechanisms. Research suggests that IBD patients are at increased risk of developing periodontitis, which may, in turn, exacerbate IBD activity and disability. This study examines whether periodontitis is associated with increased IBD activity, severity, disability and reduced quality of life.</p><p><strong>Methods: </strong>An online survey was distributed to Swedish IBD patients, covering demographics, oral health, and IBD characteristics. Validated tools were used where possible, and data were combined with a similar Danish study.</p><p><strong>Results: </strong>A total of 786 IBD patients (371 Crohn's disease [CD] and 415 ulcerative colitis [UC]) completed the survey. Self-reported severe periodontitis was significantly associated with poorer IBD disability scores [coef. 5.07 (1.86; 8.27)], more self-reported active disease [OR 1.72 (1.19; 2.49)], higher self-reported disease activity in the preceding 12 months [OR 1.44 (1.05; 1.98)], and reduced quality of life [Coef. -1.45 (-3.01; 0.10)]. Self-reported tooth loss also correlated with poorer disability scores [Coef. 4.47 (0.71; 8.22)] and showed a trend toward greater self-reported disease severity [OR 1.57 (0.97; 2.52)]. Combined Danish-Swedish analysis confirmed these findings.</p><p><strong>Conclusions: </strong>This study, although based purely on self-reported data at a single timepoint, reinforces associations between periodontitis, tooth loss and worse IBD outcomes, emphasizing the need for greater focus on oral health in IBD management.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294895","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":"Enhanced liver fibrosis test improves diagnostic efficiency and reduces testing costs for advanced liver fibrosis in steatotic liver disease.","authors":"Christel Pussinen, Anni Kelkka, Kari Pulkki, Anna Lempiäinen, Fredrik Åberg","doi":"10.1080/00365521.2025.2517219","DOIUrl":"https://doi.org/10.1080/00365521.2025.2517219","url":null,"abstract":"<p><strong>Objective: </strong>We performed cost-analysis to evaluate the most economic testing approach for diagnosing compensated advanced chronic liver disease in low- and high-prevalence populations in the Finnish healthcare system.</p><p><strong>Materials and methods: </strong>In a simulated analysis of 1000 individuals at risk of (low prevalence) or diagnosed (high prevalence) with metabolic dysfunction-associated steatotic liver disease or alcohol-related liver disease, we compared five different testing strategies for compensated advanced chronic liver disease based on costs and incremental diagnostic accuracy, The Fibrosis-4 index, enhanced liver fibrosis test, and liver stiffness measurements were performed in various combinations.</p><p><strong>Results: </strong>In the low-prevalence setting, the least costly testing strategy for compensated advanced chronic liver disease detection was fibrosis-4 index, followed by enhanced liver fibrosis test if fibrosis-4 index > 1.30, and liver stiffness measurement if the enhanced liver fibrosis test score was > 9.8. In the high-prevalence setting, the most economic testing strategy was fibrosis-4 index, followed by enhanced liver fibrosis test if fibrosis-4 index was 1.30-2.67, and/or liver stiffness measurement if fibrosis-4 index > 2.67 or enhanced liver fibrosis test score > 9.8.</p><p><strong>Conclusions: </strong>Integration of the enhanced liver fibrosis test in the diagnostic testing strategy for compensated advanced chronic liver disease in individuals with risk factors for or a diagnosis of metabolic dysfunction-associated steatotic/alcohol-related liver disease can decrease costs by reducing unnecessary referrals to secondary care and limiting the need for liver stiffness measurements, while maintaining good diagnostic accuracy.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275866","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":"Predicting severe inflammatory bowel disease: a risk matrix model based on the IBSEN III inception cohort.","authors":"Vibeke Strande, Milada Hagen, Charlotte Lund, Øyvind Asak, May-Bente Bengtson, Raziye Boyar, Trond Espen Detlie, Svein Oskar Frigstad, Magne Henriksen, Kristina I Aass Holten, Øistein Hovde, Gert Huppertz-Hauss, Ole Høie, Ingunn Johansen, Asle W Medhus, Bjørn Christian Olsen, Randi Opheim, Gøri Perminow, Petr Ricanek, Roald Torp, Jørgen Valeur, Simen Vatn, Tone Bergene Aabrekk, Bjørn Moum, Marte Lie Høivik, Vendel A Kristensen","doi":"10.1080/00365521.2025.2512591","DOIUrl":"https://doi.org/10.1080/00365521.2025.2512591","url":null,"abstract":"<p><strong>Background and aims: </strong>Identifying patients at risk of developing severe inflammatory bowel disease (IBD) can aid treatment decisions. However, predicting disease course remains challenging. We aimed to identify predictive factors associated with severe disease course in the first year after IBD diagnosis.</p><p><strong>Methods: </strong>Newly diagnosed adult (≥18 years) patients with IBD were recruited from a population-based inception cohort (IBSEN III study). Preselected baseline factors were tested for associations with severe disease course, defined as IBD-related hospitalisation, surgery, treatment with ≥2 steroid courses, >2 biologics and/or new event of complication (stricture, fistula, abscess only applicable Crohn's disease (CD)). From a best fitted multivariable logistic regression model stratified by diagnosis and age (18-40/>40 years), probability of severe disease for given combinations of predictive factors was summarised in prediction matrices.</p><p><strong>Results: </strong>At one-year follow-up, 90/559 (16%) patients with ulcerative colitis (UC) and 74/312 (24%) with CD had severe disease. Treatment with systemic steroids, vitamin D deficiency, Simple Clinical Colitis Activity Index >2, and hypoalbuminemia at diagnosis were all significantly associated with severe disease in UC patients. CD patients with stricturing or penetrating disease behaviour, systemic steroids and hypoalbuminemia at diagnosis were associated with severe disease course. The least favourable combination of these factors increased the probability of severe disease from 3% (95%CI[0-5%]) to 72% (95%CI[66-79%]) for UC and from 8% (95%CI[3-13%]) to 88% (95%CI[84-93%]) for CD.</p><p><strong>Conclusions: </strong>Our study identified predictive factors associated with severe disease the first year after diagnosis. The probability of severe disease summarised in matrices enables easy risk stratification.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249442","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 ultrasound with tissue acquisition of lymph nodes in patients with resectable distal cholangiocarcinoma.","authors":"David M de Jong, Sanne van de Vondervoort, Roy S Dwarkasing, Michail Doukas, Rogier P Voermans, Robert C Verdonk, Wojciech G Polak, Jeroen de Jonge, Bas Groot Koerkamp, Marco J Bruno, Lydi M J W van Driel","doi":"10.1080/00365521.2025.2506143","DOIUrl":"https://doi.org/10.1080/00365521.2025.2506143","url":null,"abstract":"<p><strong>Background: </strong>Lymph node (LN) involvement is a negative prognostic factor for patients with distal cholangiocarcinoma (dCCA). Therefore, preoperative assessment of the LN status could potentially aid therapy decision making. Endoscopic ultrasound (EUS) is often used to obtain a tissue diagnosis of the primary tumor, but can also be used to sample suspicious LN. The aim of this study was to evaluate the impact of EUS for suspicious LN in patients with presumed resectable dCCA.</p><p><strong>Patients and methods: </strong>In this multicenter cohort study, patients with potentially resectable dCCA who underwent preoperative EUS between 2010 and 2020 were retrospectively included. Impact of EUS was defined as the percentage of patients who were precluded from surgical exploration due to pathologically confirmed LN metastasis found with EUS tissue acquisition (EUS-TA).</p><p><strong>Results: </strong>A total of 149 patients were included. In the 187 EUS procedures performed, a total of 58 LN among 43 patients were described. Among five patients (3.6%), EUS-TA of LN confirmed malignancy in six of the 20 LN (30%). In four patients (2.7%), surgical exploration was withheld due to nodal involvement (extraregional in two, regional in two). Finally, 109 patients (73.2%) underwent surgical exploration. During exploration or at surgical pathology specimens, malignant regional LN was identified in 58 patients (53.2%).</p><p><strong>Conclusion: </strong>Preoperative EUS had a limited but clinically important yield for nodal staging in patient with presumed resectable dCCA but was not executed in systematic fashion. Further prospective studies should investigate whether systematic nodal staging with EUS could improve preoperative decision making.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235034","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":"Pathological reevaluation of gastric neoplasms with differentiation into the fundic gland.","authors":"Tetsuya Suwa, Tadakazu Shimoda, Masao Yoshida, Daisuke Aizawa, Noboru Kawata, Takashi Sugino, Hiroyuki Ono","doi":"10.1080/00365521.2025.2515428","DOIUrl":"https://doi.org/10.1080/00365521.2025.2515428","url":null,"abstract":"<p><strong>Objectives: </strong>In the original classification, oxyntic gland neoplasms (OGNs) are classified as carcinoma based on the submucosal (SM) involvement and differentiation into MUC5AC- and MUC6-positive cells. Some cases without structural or nuclear atypia or desmoplastic reaction (DR) in the SM layer, which is essential for typical carcinoma, are also categorized as carcinoma of OGNs. To address potential overdiagnoses, we conducted a histopathological review of OGNs to propose a clinically relevant reevaluation.</p><p><strong>Methods: </strong>Forty-one OGNs diagnosed pathologically in our institution between 2010 and 2022 were included. We defined carcinoma based on the structural or nuclear atypia of the tumor cells and evaluated DR in cases of SM involvement. Furthermore, our novel classification was compared to the original one.</p><p><strong>Results: </strong>Among 41 OGNs, 10 were classified as carcinoma and 31 as adenoma. Carcinoma had a significantly larger endoscopic and pathological tumor size (<i>p</i> = 0.03, <i>p</i> < 0.01) and more MUC5AC/MUC6 co-expression than adenoma (<i>p</i> < 0.01). All cases of SM involvement with DR were recognized in nine carcinoma (90%), and all 20 cases without DR were adenoma (65%). According to the original classification, 47% (14/30) of OGNs were categorized as noncurative endoscopic resection according to the Japanese guidelines, which recommended additional gastrectomy; however, no cases of lymph node metastasis and recurrence were observed.</p><p><strong>Conclusion: </strong>Our definition of carcinoma could categorize all cases of SM involvement with DR and lymphatic invasion as carcinoma. This novel classification for OGNs may be possible to overcome the issue of overdiagnosis caused by the original classification.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235035","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":"<i>Clostridioides difficile</i> enteritis: a targeted review of current literature.","authors":"Lefika Bathobakae, Rammy Bashir, Atang Koodirile, Katrina Villegas, Islam Rajab, Edgar W Perez, Yana Cavanagh, Abraham El-Sedfy, Jin S Suh","doi":"10.1080/00365521.2025.2515423","DOIUrl":"https://doi.org/10.1080/00365521.2025.2515423","url":null,"abstract":"<p><p><i>Clostridioides difficile</i> enteritis (CDE) is a rare but clinically significant form of <i>Clostridioides difficile</i> infection (CDI) affecting the small intestine. CDE poses a diagnostic challenge owing to its rarity, complexity, and nonspecific presentation. The current data is retrospective in the form of case reports and conference proceedings. The lack of widespread awareness and limited literature on CDE often result in diagnostic delays, contributing to increased morbidity. This targeted narrative review sought to consolidate the current knowledge on the epidemiology, pathophysiology, clinical presentation, and management of CDE, addressing a critical gap in the existing literature. Electronic databases, including PubMed, Embase, and Web of Science, were searched for published cases from inception to April 2024. The initial search yielded 2,120 articles, which were filtered using study design, English language, and human subjects. After screening for duplicates and excluding irrelevant articles, 44 articles comprising 49 patients were included in the final review. Of the 49 individual cases reviewed, 25 (51%) were male and 24 (49%) were female. The patients' <b>ages</b> ranged from 16 to 91 years, with a mean age of 53.4 years. Abdominal pain and diarrhea were the chief complaints reported in 37/49 (76%) and 35/49 (71%) cases, respectively. About 42/49 (86%) cases were effectively treated with antibiotics, while some cases required fecal microbiota transplantation or surgical exploration. Given its <b>grave</b> course, CDE warrants prompt and appropriate treatment to prevent complications such as fulminant enteritis, compartment syndrome, and bowel perforation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249441","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}