Case Reports in Gastrointestinal Medicine最新文献

{"title":"Bleeding From a Lateral Duodenal Diverticulum Complicated by a Retroperitoneal Perforation After Endoscopic Clipping.","authors":"Páll Guðjónsson, Hallgrímur Guðjónsson, Einar Stefán Bjornssön","doi":"10.1155/crgm/9493004","DOIUrl":"10.1155/crgm/9493004","url":null,"abstract":"<p><p>Duodenal diverticula (DD) are commonly encountered in the periampullary region but rarely on the lateral wall of the duodenum. They can develop complications such as diverticulitis, bleeding, and perforation. A 69-year-old healthy woman presented with melena due to a bleeding lesion in a lateral DD that was treated with hemoclipping. Two days later, she developed fever, hypotension, and an elevated CRP with mild abdominal pain and had no signs of peritonitis. A CT scan with oral contrast showed a large diverticulum at the junction of the descending and horizontal part of the duodenum and a perforation with minimal clinical symptoms that was successfully treated conservatively. Although causality could not be established, a retroperitoneal perforation following endoscopic hemostasis was a suspected complication of hemostatic clipping. Physicians should have a low threshold for a CT scan in the case of raised fever or inflammatory markers following endoscopic management of DD.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"9493004"},"PeriodicalIF":0.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216972","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}

{"title":"Inferior Vena Cava Syndrome due to Giant Hepatic Cyst After Blunt Trauma.","authors":"Akinori Sekizawa, Yosuke Ono, Takuto Kaji, Tatsuto Shimizu, Yuta Kawahara, Kazuki Kobayashi, Takazumi Tsunenari, Hiroshi Takazaki, Takahiro Einama, Yasuhiro Obuchi, Kenichi Hashimoto, Yoji Kishi, Nobutaka Hirooka","doi":"10.1155/crgm/8238996","DOIUrl":"https://doi.org/10.1155/crgm/8238996","url":null,"abstract":"<p><p>A 78-year-old woman presented with sudden-onset lower extremity edema, abdominal pain, and loss of appetite that developed the day after she fell off her bicycle. Computed tomography showed a simple hepatic cyst, 17 cm in diameter, compressing the inferior vena cava (IVC). Her symptoms resolved following laparoscopic deroofing. Notably, the cyst had remained stable at 12 cm 2 and 4 years prior, without any evidence of IVC compression. Although many guidelines for asymptomatic simple hepatic cysts published to date do not recommend treatment or follow-up regardless of size, our experience suggests the importance of monitoring simple hepatic cysts larger than 12 cm.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"8238996"},"PeriodicalIF":0.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171099","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}

{"title":"Retroperitoneal Hibernoma Presenting as a Gastrointestinal Surgical Diagnostic Challenge: A Rare Benign Lipomatous Tumor and Literature Review.","authors":"Gilton Marques Fonseca, Luiz Guilherme Cernaglia Aureliano de Lima, Marcel Cerqueira Cesar Machado","doi":"10.1155/crgm/7500074","DOIUrl":"https://doi.org/10.1155/crgm/7500074","url":null,"abstract":"<p><strong>Background: </strong>Hibernoma is an uncommon benign adipocytic neoplasm showing differentiation toward brown fat. Although it usually occurs in anatomical sites where residual brown adipose tissue persists, retroperitoneal involvement is particularly uncommon, with fewer than 60 cases reported.</p><p><strong>Case presentation: </strong>A 54-year-old man was found to have a retroperitoneal mass incidentally during a routine physical examination. CT and MRI demonstrated a 15-cm homogeneous fat-containing lesion without radiological evidence of local invasion. Complete surgical excision was performed. Histopathological examination showed univacuolated and multivacuolated adipocytic cells without atypia. The tumor was positive for S-100 and CD10, and fluorescence in situ hybridization showed no MDM2 amplification, supporting the diagnosis of hibernoma. Recovery was uneventful, and the patient was discharged on Postoperative Day 7.</p><p><strong>Discussion: </strong>Retroperitoneal hibernoma can be difficult to distinguish radiologically from other lipomatous neoplasms, including atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL). Diagnosis therefore relies on the integration of morphology with ancillary immunohistochemical and, when indicated, molecular findings. The decision between preoperative core needle biopsy and upfront resection should be individualized according to the radiological differential diagnosis, tumor vascularity and resectability, expected surgical morbidity, and whether tissue confirmation would alter management.</p><p><strong>Conclusion: </strong>Hibernoma should be included in the differential diagnosis of retroperitoneal fat-containing masses. Accurate diagnosis is fundamental, as complete surgical excision is curative, with no need for additional treatment.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"7500074"},"PeriodicalIF":0.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116277","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}

{"title":"Schistosomal Rectal Polyposis Mimicking Colorectal Cancer: A Case Report of a 60-mm Polyp in a Young Ethiopian Man Treated at Firoomsis General Hospital.","authors":"Alemayehu Abebe Guji, Birhanu Gudeta Geleta, Gashahun Mekonnen Dissassa, Mohammed Merga Ayana, Melese Abere Gizaw, Kedir Negesso Tukeni","doi":"10.1155/crgm/5589986","DOIUrl":"10.1155/crgm/5589986","url":null,"abstract":"<p><strong>Background: </strong><i>Schistosomiasis</i> is a major public health problem in endemic regions, affecting over 250 million individuals globally, with <i>Schistosoma mansoni</i> frequently causing intestinal and hepatosplenic disease. Chronic infection may lead to rectal polyposis, which can mimic colorectal malignancy and create diagnostic and therapeutic challenges. Addressing these intersecting diagnostic and therapeutic issues necessitates a comprehensive multidisciplinary approach that integrates increased clinical vigilance in endemic populations, accurate histopathological assessment, focused endoscopic treatment, and antiparasitic therapy. This strategy aims to prevent patients from undergoing unnecessary and debilitating radical surgery.</p><p><strong>Case presentation: </strong>We report a 25-year-old man from rural Ethiopia who presented with abdominal pain, hematochezia, anemia, and weight loss. Colonoscopy revealed a large pedunculated rectal polyp measuring 60 mm, along with multiple smaller sessile polyps. Histopathology confirmed <i>Schistosoma mansoni</i> ova with intense eosinophilic infiltration and no dysplasia. The patient was treated with praziquantel and iron supplementation; the smaller polyps were completely removed with cold snare polypectomy, and the largest polyp was removed by piecemeal resection with hot snare polypectomy.</p><p><strong>Outcome: </strong>At the 3-month follow-up, hemoglobin levels improved, stool microscopy was negative for <i>S. mansoni ova</i>, and colonoscopy demonstrated complete mucosal healing with no recurrent polyps.</p><p><strong>Conclusion: </strong><i>Schistosomal</i> rectal polyposis closely resembles colorectal cancer, particularly in endemic regions. Histopathological and parasitological confirmation is essential to avoid unnecessary radical surgeries. Early diagnosis, appropriate antiparasitic therapy, and endoscopic management can achieve favorable outcomes, while follow-up colonoscopy ensures long-term disease control.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"5589986"},"PeriodicalIF":0.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082287","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}

{"title":"Refractory Post-TIPS Hepatic Encephalopathy Complicated by Small Bowel Obstruction: A Therapeutic Dilemma.","authors":"Ammar Ismail, Amira Alnakeb, Saba Altarawneh, Joseph Depasquale","doi":"10.1155/crgm/3799217","DOIUrl":"10.1155/crgm/3799217","url":null,"abstract":"<p><strong>Introduction: </strong>Refractory hyperammonemic encephalopathy in cirrhosis presents a therapeutic challenge, particularly in post-TIPS patients or with contraindications to standard therapies. We report a fatal case complicated by small bowel obstruction (SBO), highlighting the limitations of current management strategies.</p><p><strong>Case presentation: </strong>A 69-year-old male with decompensated NASH cirrhosis and recent TIPS revision for shunt stenosis developed SBO. He presented with severe encephalopathy (GCS 5), seizures, and MRI-confirmed cerebral edema. Due to SBO, lactulose and rifaximin were not effective. Despite aggressive dialysis with continuous venovenous hemodialysis (CVVHD) reducing ammonia from 447 to 160 μmol/L, he progressed to irreversible cerebral edema and met brain death criteria.</p><p><strong>Discussion: </strong>Post-TIPS hyperammonemia carries high mortality, especially when compounded by SBO. CVVHD effectively lowers ammonia but may fail to prevent neurologic injury if initiated late.</p><p><strong>Conclusion: </strong>This case underscores the need for proactive RRT and novel ammonia-lowering strategies in high-risk patients, especially when gut decontamination is not feasible.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"3799217"},"PeriodicalIF":0.6,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076094","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}

{"title":"Metastasis of Pancreatic Intraductal Oncocytic Papillary Neoplasm to the Ovaries.","authors":"Emily Fronk, Jamie McDowell, Natalia Yanchenko, Hani Katerji, Ashlee Smith","doi":"10.1155/crgm/9926744","DOIUrl":"10.1155/crgm/9926744","url":null,"abstract":"<p><strong>Objectives: </strong>Intraductal oncocytic papillary neoplasm (IOPN) is a digestive system tumor typically found in the head of the pancreas. Most often, they remain confined to the pancreas; it is rare that they develop into an invasive carcinoma or metastasize.</p><p><strong>Methods: </strong>This paper presents the case of a 63-year-old postmenopausal female with a past medical history notable for BRCA1 mutation and exploratory laparotomy with pancreatoduodenectomy who underwent risk-reducing laparoscopic bilateral salpingo-oophorectomy.</p><p><strong>Results: </strong>Postoperative pathology revealed metastatic oncocytic papillary neoplasm involving the bilateral ovaries. She was ultimately referred to gastrointestinal medical oncology for further management.</p><p><strong>Conclusions: </strong>This is the first report to our knowledge of pancreatic IOPN metastasizing to the ovaries. It is essential for cases to be reported for guidance of treatment regimens.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"9926744"},"PeriodicalIF":0.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009189","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}

{"title":"A Case of Clinically Suspected Epidermolysis Bullosa With Oesophageal Stricture Successfully Managed by Savary-Gilliard Dilatation.","authors":"Mohammad Abu Faisal, Sara Tasnim Mahpara","doi":"10.1155/crgm/1227580","DOIUrl":"https://doi.org/10.1155/crgm/1227580","url":null,"abstract":"<p><strong>Background: </strong>Epidermolysis bullosa (EB) comprises a heterogeneous group of inherited blistering disorders characterized by skin and mucosal fragility. Oesophageal involvement, though uncommon, is a recognized and potentially debilitating complication.</p><p><strong>Case presentation: </strong>A 10-year-old girl presented with progressive dysphagia to solid foods of one-and-a-half months duration, against a lifelong history of recurrent bullous skin lesions healing with scarring and nail dystrophy; a younger sibling had similar skin lesions. Upper gastrointestinal endoscopy revealed oesophageal strictures from 18 cm to 22 cm from the incisors (combined length approximately 5 cm), which could not be traversed by the scope. Barium swallow confirmed a tight upper-thoracic stricture with pre- and poststenotic dilatation. Skin biopsy showed a subepidermal vesiculobullous disorder with eosinophils, with direct immunofluorescence negative for IgA, IgG, and C3; genetic testing, immunomapping, and electron microscopy were unavailable. Based on the lifelong cutaneous phenotype, family history and histopathological findings, a diagnosis of clinically suspected inherited EB was made, with the oesophageal stricture considered to be occurring in this context. The patient underwent fluoroscopy-guided, guidewire-assisted Savary-Gilliard bougie dilatation (7, 9, and 11 mm dilators) in a single session, with immediate improvement in swallowing and no procedural complications; Follow-up at 2 weeks demonstrated sustained clinical improvement, and endoscopic follow-up is planned.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering inherited blistering disorders in children with chronic skin fragility and progressive dysphagia and illustrates that careful, staged bougie dilatation can safely relieve EB-associated oesophageal stricture.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"1227580"},"PeriodicalIF":0.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991825","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}

{"title":"Kissing Rectal Ulcers With Associated Occult Rectal Mucosal Prolapse: A Distinct Endoscopic Presentation of Solitary Rectal Ulcer Syndrome in an HIV Positive Patient With Comprehensive Infectious Exclusion.","authors":"Nakul Ganju, Sneha Rao Adidam, Naga Sai Shravan Turaga, Lakshmi Chirumamilla, Suryanarayana Challa Reddy, Rabia Zafar, Angesom Kibreab","doi":"10.1155/crgm/4644258","DOIUrl":"10.1155/crgm/4644258","url":null,"abstract":"<p><p>Solitary rectal ulcer syndrome (SRUS) is a rare benign disorder of the rectum strongly associated with chronic straining and rectal mucosal prolapse, which may be overt or occult. Its endoscopic appearance is highly variable, and atypical presentations can create significant diagnostic challenges, particularly in immunocompromised patients in whom infectious etiologies must be systematically excluded. We report a case of SRUS presenting as simultaneous contralateral kissing rectal ulcers in an HIV positive patient. Histopathology demonstrated the characteristic triad of fibromuscular obliteration of the lamina propria, smooth muscle extension between distorted crypts, and muscularis mucosae hypertrophy, establishing occult internal mucosal prolapse as the underlying mechanism. Comprehensive infectious evaluation including targeted testing for cytomegalovirus, herpes simplex virus, Neisseria gonorrhoeae, and Chlamydia trachomatis including lymphogranuloma venereum serovars was entirely negative. The patient achieved complete symptomatic resolution on conservative therapy with psyllium fiber supplementation at 2-month follow-up. This case illustrates an uncommon endoscopic presentation of SRUS, the diagnostic importance of histopathology in the absence of visible mucosal prolapse, and a systematic infectious exclusion approach in an HIV positive patient that may serve as a clinical reference for similar presentations.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"4644258"},"PeriodicalIF":0.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913449","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}

{"title":"A Novel Case of Sarcoidosis-Lymphoma Syndrome.","authors":"Mario Tavakoli, Alexander Pan, Sam Papasotiriou","doi":"10.1155/crgm/8829729","DOIUrl":"10.1155/crgm/8829729","url":null,"abstract":"<p><p>Sarcoidosis-lymphoma syndrome (SLS) is a rare condition that elucidates the association between sarcoidosis and the development of lymphoma. It is believed that the chronic active inflammation from sarcoidosis increases the risk of malignant transformation of lymphoid cells. There are only 4 documented cases of mucosa-associated lymphoid tissue (MALT) lymphoma in patients with sarcoidosis, and we present the first reported case of a patient with <i>Helicobacter pylori</i> (<i>H. pylori</i>)-negative gastric MALT lymphoma preceding the diagnosis of gastric sarcoidosis.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"8829729"},"PeriodicalIF":0.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819933","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}

{"title":"Spontaneous Migration of a Postcholecystectomy Surgical Clip From the Common Bile Duct to the Cecum Nineteen Years After Surgery: A Case Report.","authors":"Marina Takawy, Tausif Syed, Mostafa Najim, Richard Alweis, Jason Gutman","doi":"10.1155/crgm/7768285","DOIUrl":"10.1155/crgm/7768285","url":null,"abstract":"<p><p>Postcholecystectomy clip migration (PCCM) is a rare but recognized complication following cholecystectomy. The clinical presentation of PCCM often mimics that of choledocholithiasis, with symptoms including right upper quadrant pain and obstructive jaundice. Although the exact mechanisms underlying clip migration remain unclear, several theories have been proposed in the literature. While most cases occur shortly after the procedure, with clips migrating to the common bile duct (CBD) or, less commonly, to the duodenum; some instances may occasionally present much later, such as the case described here. An 85-year-old female presented with symptoms consistent with CBD obstruction, and the initial imaging revealed a clip in the CBD. Endoscopic retrograde cholangiopancreatography (ERCP) was planned; however, subsequent imaging showed that the clip had disappeared. Three days later, the clip was found in the cecum, and the patient's symptoms had improved. Given the patient's clinical progress, conservative management was pursued, allowing the clip to pass naturally without further intervention. While clip migration can lead to serious complications such as CBD obstruction or cholangitis, requiring procedural or surgical management, spontaneous resolution with conservative care, although rare, has been reported. The factors contributing to clip migration may include procedural factors early after surgery or chronic inflammatory changes and tissue necrosis that develop years after the cholecystectomy. Emerging techniques such as clipless surgery and the use of absorbable sutures are under development to reduce the risk of clip migration. In conclusion, despite its rarity, PCCM should be considered in patients with a history of cholecystectomy who present with symptoms suggestive of CBD obstruction. Although uncommon, clip migration may occur without significant complications and can resolve spontaneously, as demonstrated in this case. Conservative management may be an appropriate approach in select cases, particularly when the patient is clinically improving.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"7768285"},"PeriodicalIF":0.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799369","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}