{"title":"COVID-19 Challenges in Autoimmune Hepatitis Management: A Successful Outcome With Intravenous Immune Globulin (IVIg).","authors":"Amirali Mashhadiagha, Parnian Khalili, Maryam Ataollahi, Fereshteh Karbasian, Ali Arman, Bita Geramizadeh","doi":"10.1155/crgm/4446896","DOIUrl":"https://doi.org/10.1155/crgm/4446896","url":null,"abstract":"<p><p><b>Background:</b> Several autoimmune diseases, such as autoimmune hepatitis (AIH), can arise or become decompensated following COVID-19 infection or vaccination; however, there is a lack of data regarding the management of concurrent COVID-19 infection and autoimmune diseases. <b>Case Summary:</b> In this paper, we present a case of a 9-year-old boy with yellowish discoloration of the skin and sclera, abnormal liver function test, followed by positive qRT-PCR for SARS-CoV-2 and progressive bicytopenia. After a lack of response to corticosteroids, intravenous immune globulin (IVIg) was administrated and a decline in liver enzymes, total bilirubin, and direct bilirubin was observed. <b>Result and Discussion:</b> This case illustrates how IVIg significantly improved the AIH symptoms in the patient with positive qRT-PCR for the SARS-CoV-2 test. We hope our report encourages further research on therapeutic approaches for AIH concomitant with COVID-19.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"4446896"},"PeriodicalIF":0.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029673","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":"Gallstone Ileus in a 25-Year-Old Female With Cyclin-Dependent Kinase-Like 5 Deficiency Disorder: A Case Report.","authors":"Hikaru Onoda, Mami Kuroda, Ryo Takeguchi, Ryosuke Tanaka, Daisuke Ishii, Hisayuki Miyagi, Masatoshi Hirasawa, Satoru Takahashi","doi":"10.1155/crgm/4901433","DOIUrl":"10.1155/crgm/4901433","url":null,"abstract":"<p><p>Gallstone ileus is an uncommon complication of cholelithiasis and the delayed diagnosis may be associated with increased risk of mortality. When gallstones block the cystic duct, they can lead to cholecystitis. If a fistula forms between the inflamed gallbladder and the adjacent intestine, the gallstones may pass into the intestinal tract and cause obstruction in the intestine. We report a case of 25-year-old female with developmental and epileptic encephalopathy who was intraoperatively diagnosed with gallstone ileus during surgery for small bowel obstruction of unknown origin. The patient had potential risk factors enhancing the formation of cholesterol gallstones, including long-term use of phenobarbital, vagus nerve injury in open gastrostomy and laparoscopic fundoplication, and tube feeding; however, the patient's gallstone had been undiagnosed for a long time. Computed tomography of the abdomen showed small bowel obstruction and pneumobilia. The presence of pneumobilia in a patient without a surgical history of the biliary system should raise suspicion of a bilioenteric fistula. The awareness of this complication of cholelithiasis is important to make an early diagnosis and to initiate the appropriate treatment.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"4901433"},"PeriodicalIF":0.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754936","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}
Ahmad F Alenezi, Haitham Jahrami, Yonca Kanber, Talat Bessissow
{"title":"Gastrointestinal Tract Perineuriomas and Benign Fibroblastic Polyps: Case Report and Comprehensive Systematic Review.","authors":"Ahmad F Alenezi, Haitham Jahrami, Yonca Kanber, Talat Bessissow","doi":"10.1155/crgm/1636142","DOIUrl":"https://doi.org/10.1155/crgm/1636142","url":null,"abstract":"<p><p><b>Background:</b> Perineurioma is a rare benign peripheral nerve sheath tumor that can arise in various body locations. In the gastrointestinal (GI) tract, perineuriomas are uncommon and have only been reported in case reports and case series. In addition, a new classification suggests reclassifying benign fibroblastic polyps as perineurioma when they show positive markers of perineurial differentiation. <b>Objective:</b> This study aims to enhance understanding of GI tract perineuriomas by presenting a new case and conducting a systematic literature review. <b>Methods:</b> We described a new case of colonic perineurioma and systematically reviewed all case reports and case series on GI perineuriomas and benign fibroblastic polyps with perineurial markers. We searched ScienceDirect, PubMed/MEDLINE, and Web of Science up to May 2024. <b>Results:</b> A total of 148 cases were analyzed, and most of the cases were published in the last decade (2014-2024). The majority were females (59.46%), with a mean age of 51 years (standard deviation [SD] ±14.87). Most GI perineuriomas (87.5%) were in the distal colon, predominantly in the sigmoid/rectosigmoid (56%) and rectum (14%). Outside the colon, the stomach was the most affected site (7 of 10 cases), with fewer cases in the small intestine and esophagus. The two most commonly performed stains were for epithelial membrane antigen (EMA) and glucose transporter 1 (GLUT-1), at 75% and 56% of cases, respectively. Noncolonic perineuriomas were generally larger and more symptomatic than colonic ones. Submucosal polyps were more likely symptomatic than mucosal polyps. <b>Conclusion:</b> Perineurioma in the GI tract is a rare benign polyp mainly identified in the distal colon. Its rarity and limited follow-up data restrict our understanding of recurrence rates. We recommend reporting uncommon polyp locations, detailing polyp morphologies, and using at least two markers for classification.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"1636142"},"PeriodicalIF":0.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034154","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":"Reexamining Multisystem Desmoid Tumors Linked to Gardner's Syndrome: A Clinical Case.","authors":"Haijia Zhang, Yongjie Wu, Xiushan Dong, Jie An","doi":"10.1155/crgm/6882566","DOIUrl":"https://doi.org/10.1155/crgm/6882566","url":null,"abstract":"<p><p>A variation of familial adenomatous polyposis (FAP), known as Gardner's syndrome (GS), can manifest as extraintestinal tumors, such as desmoid tumors (DTs). A key part in the diagnosing process is played by the clinician. Because DT frequently occurs before intestinal polyposis develops, doctors can identify the underlying illness early by looking for DT's telltale signs. Nevertheless, in this instance, the patient's failure to recognize the illness promptly following the excision of the tumor in the abdomen wall caused a delay in the diagnosis and impacted the disease's course.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6882566"},"PeriodicalIF":0.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057501","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}
Sévérine De Bruijn, Annick De Weerdt, Glenn Broeckx, Maarten Spinhoven, Rudi De Paep, Dominique Robert, Niels Komen, Philippe G Jorens
{"title":"Multimodal Treatment of a Spontaneously Ruptured Echinococcus Cyst of the Spleen and Its Complications.","authors":"Sévérine De Bruijn, Annick De Weerdt, Glenn Broeckx, Maarten Spinhoven, Rudi De Paep, Dominique Robert, Niels Komen, Philippe G Jorens","doi":"10.1155/crgm/6657981","DOIUrl":"10.1155/crgm/6657981","url":null,"abstract":"<p><p><b>Introduction:</b> Cystic echinococcosis, also known as hydatid cyst, is a parasitic infection of mammals that can affect any organ. Although the diagnosis of primary splenic echinococcosis is challenging, especially in nonendemic areas, it can be life-saving because an anaphylactic shock may occur when the cyst ruptures. Recommendations regarding optimal treatment options after rupture are scarce, and the overall prognosis remains poor. <b>Case Presentation:</b> A patient with a spontaneous rupture of an isolated splenic hydatid cyst was treated with splenectomy and peritoneal lavage with a hypertonic salt solution. The patient survived despite rapidly progressive hypernatremia, which was treated with conventional therapy along with continuous venovenous hemofiltration with gradient sodium replacement. <b>Discussion:</b> When the decision is made to treat a patient with a spontaneously ruptured splenic echinococcus cyst, splenectomy is the only surgical option. Hypernatremia is a complication to be expected when hypertonic saline is used to rinse the splenic and abdominal cavities. <b>Conclusion:</b> This case highlights the importance of prompt surgical intervention and the management of hypernatremia in patients with ruptured splenic hydatid cysts.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6657981"},"PeriodicalIF":0.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524973","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}
Evghenii Gutu, Dumitru Casian, Roman Smolnitchi, Vasile Culiuc, Andrei Scureac
{"title":"Splenic Artery Embolization for Upper Gastrointestinal Bleeding Caused by Hemosuccus Pancreaticus.","authors":"Evghenii Gutu, Dumitru Casian, Roman Smolnitchi, Vasile Culiuc, Andrei Scureac","doi":"10.1155/crgm/6149221","DOIUrl":"10.1155/crgm/6149221","url":null,"abstract":"<p><p>Hemosuccus pancreaticus (HP) is a rare but potentially life-threatening condition, characterized by upper gastrointestinal bleeding from the ampulla of Vater, often originating from a ruptured pseudoaneurysm of the peripancreatic arteries. Despite its rarity, HP presents a diagnostic and therapeutic challenge due to its elusive clinical presentation and complex underlying pathophysiology. In this case report, we presented a compelling instance of HP, diagnosed in a 48-year-old man, complicated with gastrointestinal bleeding and severe anemia successfully managed with urgent endovascular intervention. We highlighted the importance of early recognition, prompt intervention, and interdisciplinary collaboration in achieving favorable outcomes in patients afflicted by this distinctly unusual condition.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6149221"},"PeriodicalIF":0.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524974","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":"Incidentally Discovered Duodenal Gastrointestinal Stromal Tumour (GIST): Operative Treatment and Problems After Surgery-A Case Report and Literature Review.","authors":"Peter Lüthje, Ilona Nurmi-Lüthje","doi":"10.1155/crgm/5493240","DOIUrl":"10.1155/crgm/5493240","url":null,"abstract":"<p><p><b>Background:</b> Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours of the digestive tract that can involve any part of the tract. The tumours can be harmless or life-threatening. <b>Materials and Methods:</b> A case report of a surgeon who fell in a Finnish sauna, and he immediately felt that some ribs were broken. Magnetic resonance imaging and ultrasound showed three fractured ribs and an intrasplenic haematoma. Contrast-enhanced computed tomography (CT) demonstrated a small intrasplenic anomaly but no haematoma. Incidentally, an incidentaloma in the left adrenal gland was diagnosed. Three months later, a control CT scan was performed. The radiological findings on the adrenal gland and laboratory examinations matched those of a benign adenoma. Incidentally, a small duodenal tumour was diagnosed. At the same time, anaemia (haemoglobin: 104 g/L) and iron deficiency (ferritin: 8 μg/L) were noticed. An esophagogastroduodenoscopy showed an intramural tumour localised after the bulb-descending junction. Because the tumour was submucosal, the pathological diagnosis failed. Three months later, a radical surgical resection of the tumour with a resection margin of 2 mm and primary closing of the duodenum was performed. Pathological examination showed a well-circumscribed submucosal mesenchymal tumour with spindle cells. A tumour-free margin was uncertain. Immunohistochemistry findings showed a GIST. Due to the uncertain margin, an esophagogastroduodenoscopy control was planned at 2 years postoperatively. The patient disagreed with the decision and ordered a private control CT 3 months after the operation. The new CT found no local recurrence or metastasis. The patient contacted the head surgeon of the clinic, who ordered a 1-year postoperative CT. The 1-year follow-up CT finding agreed with the previous findings. <b>Conclusion:</b> The aftertreatment of a radical-operated GIST is extremely important if histologic examination of the tumour-free margin is uncertain. In that case, CT controls should be considered once a year for at least 3 years.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"5493240"},"PeriodicalIF":0.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484523","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}
Quintin Solano, Sarah Uttal, Peter D R Higgins, Jeffrey A Berinstein
{"title":"Disseminated Chickenpox Following Live Varicella Vaccination in a Crohn's Disease Patient on Combination Immunosuppression.","authors":"Quintin Solano, Sarah Uttal, Peter D R Higgins, Jeffrey A Berinstein","doi":"10.1155/crgm/6088333","DOIUrl":"10.1155/crgm/6088333","url":null,"abstract":"<p><p>Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement. To improve safety, healthcare facilities should develop protocols that use electronic medical records enhanced with clinical decision support systems to identify and protect immunocompromised patients from inappropriate live vaccinations.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6088333"},"PeriodicalIF":0.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053727","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":"Typhoid Fever as a Cause of Liver Failure in the United States: A Case Report.","authors":"Syed Mujtaba Baqir, Neha Sharma, Aruge Lutaf, Monica Ghitan, Yu Shia Lin","doi":"10.1155/crgm/3087201","DOIUrl":"10.1155/crgm/3087201","url":null,"abstract":"<p><p><b>Background:</b> Typhoid fever is a multisystemic illness caused by <i>Salmonella typhi</i> and <i>Salmonella paratyphi</i>, transmitted fecal orally through contaminated water and food. It is a rare diagnosis in the US, with most cases reported in returning travelers. Hepatitis and cholestasis are rare sequelae of <i>salmonella</i> infection. However, acute liver failure (ALF) is exceptionally uncommon. We report a case of typhoid fever in a returning traveler to the US progressing to ALF. <b>Case Presentation:</b> A 48-year-old man presented with high-grade fever, abdominal pain, vomiting, acholic stools, dark urine, and yellowish discoloration of skin and sclera for one week. He was immune to hepatitis A and B, with no recent change in medications. He had no history of alcohol consumption. On presentation, the patient was tachycardic but well perfused with diffuse abdominal tenderness. Laboratory results showed leukocytosis, elevated creatinine, mixed hepatocellular and cholestatic pattern of raised liver enzymes, elevated ammonia levels, and negative hemolytic parameters. Viral, autoimmune, and metabolic causes of hepatitis were negative. Ultrasound of the abdomen revealed a normal biliary system and a computerized tomography (CT) scan of the abdomen showed multiple liver cysts, mesenteric and porta-hepatis lymphadenopathy, and mild thickening of the terminal ileum. Intravenous (IV) ceftriaxone and metronidazole were initiated. Blood cultures grew <i>S</i>. <i>typhi</i>. The patient clinically deteriorated and developed altered mental status, respiratory distress, and an up-trending Model for End-Stage Liver Disease (MELD) score and was upgraded to the intensive care unit. IV meropenem was initiated, resulting in clinical recovery and negative repeat blood cultures. The patient completed 2 weeks of meropenem and was discharged. <b>Conclusion:</b> Typhoid fever can cause life-threatening liver failure which is rare. Clinicians should be aware of this due to the rapid progression and life-threatening clinical course, as well as the rise of multidrug-resistant and extensively drug-resistant typhoid causing delays in starting the right antibiotic.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"3087201"},"PeriodicalIF":0.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013339","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}
Ammad Javaid Chaudhary, Abdulmalik Saleem, Muhammad Shahzil, Nosheen Hafeez, Taher Jamali, Brian Ginnebaugh
{"title":"A Rare Case of Colorectal Cancer With Delayed Metastasis to the Duodenum.","authors":"Ammad Javaid Chaudhary, Abdulmalik Saleem, Muhammad Shahzil, Nosheen Hafeez, Taher Jamali, Brian Ginnebaugh","doi":"10.1155/crgm/6679555","DOIUrl":"10.1155/crgm/6679555","url":null,"abstract":"<p><p>Colorectal cancer (CRC) continues to be a significant global health issue contributing to a high mortality rate. Despite advancements in treatment, the risk of recurrence remains due to inherent mutations and the rapid turnover of intestinal mucosa. We present an exceptionally rare case of CRC metastasis to the duodenum in a 42-year-old female who has been compliant with postsurgical surveillance. Despite previous negative surveillance results, elevated CEA levels and a 3-cm mesenteric mass were detected, raising concerns for carcinoma, which was later confirmed by biopsy. The tumor board deemed her ineligible for surgery due to vascular involvement, leading to palliative care and an attempt at neoadjuvant therapy. Vigilant monitoring is crucial for early detection and intervention.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2025 ","pages":"6679555"},"PeriodicalIF":0.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012972","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}