Acta gastro-enterologica Belgica最新文献

{"title":"Belgian protocol for indication and selection of patients with unresectable colorectal cancer liver metastases eligible for liver transplantation.","authors":"G Rasschaert, M Vandermeulen, M Van den Eynde, H Eker, T Vandamme, B Bracke, X Verhelst, J Verbeek, H Van Vlierberghe, H Topal, V Labille, D Monbaliu, B Op de Beeck, T Gustot, M Sainz Barriga, F Sclafani, V Vandecaveye, T Vanwolleghem, C Amicone, V Lucidi, C Verslype, K Geboes, G Dahlqvist, J Pirenne, O Detry, L Coubeau","doi":"10.51821/89.3.14956","DOIUrl":"https://doi.org/10.51821/89.3.14956","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colorectal cancer (CRC) is common in Western countries, about 50% of patients develop liver metastases (CLM). While local CLM therapies can achieve 5-year survival up to 60%, most patients eventually become unresectable (uCLM) and have poor outcomes with systemic treatment alone. Prospective studies, including SECA I and II and the TransMet trial, showed that in carefully selected patients, liver transplantation (LTx) can achieve survival outcomes comparable to standard LTx indications. The aim of this work was to develop a harmonized national consensus protocol for the indication and selection of uCLM patients eligible for LTx.</p><p><strong>Patients and methods: </strong>Under the coordination of the Belgian Liver & Intestine Advisory Committee (Be-LIAC), all six Belgian transplant centers delegated a transplant surgeon, an oncologist and an hepatologist to a working group that performed a literature review and drafted preliminary criteria. Three successive national meetings and a structured voting refined these criteria in the current protocol.</p><p><strong>Results: </strong>Consensus was reached on inclusion and exclusion criteria for LTx in uCLM. Two key conditions are liver-only disease and technically uCLM. Strict requirements include a six months disease stability or response on systemic therapy and an obligatory eight-week treatment holiday. Absolute CEA levels and specific somatic mutations are not excluded. A national Be-LIAC governance model was established, combining local prospective decision-making with central auditing and registry-based evaluation.</p><p><strong>Conclusions: </strong>A harmonized national protocol for LTx inuCLM has been established, ensuring consistent patient selection across all Belgian centers. Stricter criteria and a national governance model aim to optimize outcomes while maintaining ethical allocation of donor organs.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 3","pages":"483-492"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178803","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":"The effectiveness of transcutaneous nerve stimulation in treating children with functional constipation.","authors":"F Vander Vennet, J Desmytter, S Van Biervliet, B De Muynck, B Samijn, S Vande Velde","doi":"10.51821/89.3.15203","DOIUrl":"https://doi.org/10.51821/89.3.15203","url":null,"abstract":"<p><strong>Background and study aims: </strong>Functional constipation (FC) is a prevalent condition in paediatric populations and while standard therapies, including laxatives and toilet training are commonly used, a substantial proportion of children exhibit an inadequate response. This study aimed to evaluate the effectiveness of transcutaneous nerve stimulation (TENS) as a non-invasive treatment for FC in children.</p><p><strong>Patients and methods: </strong>Children diagnosed with FC according to the Rome IV criteria and treated with TENS were included in this retrospective cohort study. Data were collected in two Belgian hospitals between 2018 and 2024. Primary outcome measures included stool frequency, stool retention behaviour, faecal incontinence, and stool size. Statistical analyses incorporated post hoc comparison with Bonferroni correction.</p><p><strong>Results: </strong>A total of 36 children were included (median age 7.5 years, range 3-15 years; 61% male) of whom approximately one-third had a concomitant diagnosis of a neurodevelopmental disorder (NDD). Improvements were observed in faecal incontinence (p = 0.016), retentive behaviour (p = 0.001), stool frequency (<2 bowel movements/week) (p = 0.035), and abdominal pain (p = 0.006). After applying a Bonferroni correction, only the effect on retentive behaviour remained statistically significant. Side effects were limited to mild erythema in two patients, which did not necessitate discontinuation.</p><p><strong>Conclusion: </strong>TENS appears to be a promising and well-tolerated treatment for children with FC and it may be considered as an early intervention within the therapeutic management pathway as the beneficial effects seem particularly evident in children with more severe forms.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 3","pages":"475-481"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178398","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":"PKHD1 biallelic defects caused Severe Hepatic Fibrosis and polycystic kidney: Identification of a novel pathogenic variant in a Chinese family.","authors":"G Zheng, H Feryel, J Si, M Liu, Xuan Shang","doi":"10.51821/89.3.15087","DOIUrl":"https://doi.org/10.51821/89.3.15087","url":null,"abstract":"<p><strong>Background: </strong>Autosomal recessive polycystic kidney disease (ARPKD) is a rare hereditary ciliopathy, clinically characterized by fibrocystic changes in the kidneys and liver. The disease is manifested by hepatic fibrosis and significantly enlarged, echogenic kidneys with fusiform dilation of the collecting ducts. ARPKD is predominantly associated with homozygous or compound heterozygous mutations in the PKHD1 gene, which encodes the protein fibrocystin.</p><p><strong>Clinical case: </strong>In this study, we report a case involving a young Chinese female who presented with recurrent upper gastrointestinal bleeding, abdominal distension, and hepatosplenomegaly. Imaging studies revealed portal hypertension and bilateral renal involvement, while a liver biopsy indicated portal fibrosis with ductal plate malformation. Genetic analysis identified her as a compound heterozygote for a known pathogenic variant, c.2107G>A (p.D703N), and a novel variant, c.4820A>G (p.Y1607C), in the PKHD1 gene.</p><p><strong>Conclusion: </strong>Family-based studies have shown that individuals carrying the novel variant exhibit a hepatic abnormal phenotype. Bioinformatics analysis suggests that this novel mutation may impact the protein structure by altering hydrogen bond interactions with other amino acids.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 3","pages":"503-507"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178250","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":"Therapeutic challenges in the multidisciplinary approach of liver transplant-associated biliary tract complications in Roux-en-Y gastric bypass patients.","authors":"J L Nuñez-Pizarro, G Dahlqvist, L Monino, P Deprez, P Goffette, E Bonaccorsi Riani, L Coubeau, O Ciccarelli, T Moreels","doi":"10.51821/89.2.15150","DOIUrl":"10.51821/89.2.15150","url":null,"abstract":"<p><strong>Introduction: </strong>This case series addresses the available non-surgical approaches for the management of biliary tract complications in liver transplant (LT) patients with a history of Roux-en-Y gastric bypass (RYGB).</p><p><strong>Methods: </strong>Descriptive single center case series of endoscopic and radiological treatments of biliary tract complications in LT recipients with a history of RYGB.</p><p><strong>Results: </strong>Balloon enteroscopy-assisted-ERCP (BE-ERCP), endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE), percutaneous transhepatic biliary drainage (PTBD), or a combination of these procedures are used according to the clinical indication or the surgical biliary reconstruction (duct-to-duct anastomosis vs hepaticojejunostomy) in conjunction with RYGB. Case 1 was treated with PTBD, followed by BE-ERCP; case 2 with BE-ERCP, followed by EDGE; case 3 with PTBD, followed by EDGE; and case 4 with BE-ERCP.</p><p><strong>Conclusion: </strong>Both BE-ERCP, EDGE and PTBD in different combinations are reliable non-surgical therapeutic approaches for treating LT-associated biliary tract complications in RYGB patients.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"407-411"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403353","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":"Helicobacter pylori infection and pregnancy-related issues: literature review.","authors":"E Lam, K Kotilea, P Bontems, R Garces Duran, B Hauser, V Y Miendje, R Ntounda, F Mana, The Bhmsg","doi":"10.51821/89.2.14953","DOIUrl":"10.51821/89.2.14953","url":null,"abstract":"<p><p>Helicobacter pylori (H. pylori) is a gram-negative bacterium that infects approximately half of the worldwide population. Although asymptomatic in most people, it can cause non-ulcer dyspepsia, gastro-duodenal ulcer disease and gastric cancer. H. pylori infection has also been correlated with extra-intestinal diseases like unexplained iron-deficiency anemia, immune thrombocytopenia and vitamin B12 deficiency. Its impact on pregnancy issues has also been studied, but the relationship is less clear. Recently, multiple meta-analyses found that H. pylori infection is correlated with gestational diabetes mellitus, preeclampsia, nausea and hyperemesis gravidarum, and adverse birth outcomes such as birth defects and fetal growth restriction. There is no recommendation for treating H. pylori infection during pregnancy according to the Maastricht VI consensus. This article aims to state the current knowledge about H. pylori infection and pregnancy-related diseases.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"367-371"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403243","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":"From theory to practice: a Belgian consensus on minimal monitoring strategies for patients with IBD treated with advanced therapies.","authors":"M Truyens, A Cremer, A Jauregui-Amezaga, B Verstockt, J Sabino, L Pouillon, The Bird Group, T Lobatón","doi":"10.51821/89.2.14879","DOIUrl":"10.51821/89.2.14879","url":null,"abstract":"<p><strong>Background and study aims: </strong>Inflammatory bowel diseases (IBD) are chronic conditions requiring lifelong management, often involving advanced therapies. To harmonize the current heterogeneity in monitoring practices we developed a Belgian Standard of Care (SOC) guidance for patients with IBD treated with these advanced therapies.</p><p><strong>Methods: </strong>A multistep approach was adopted. First, a core team of IBD clinicians conducted a national survey to evaluate current practices and identify gaps. Next, a SOC guidance document was drafted and reviewed by multiple stakeholders, including physicians and IBD nurses from the Belgian IBD Research and Development (BIRD) group and patient organizations. Feedback was then incorporated to develop a consensus-based framework tailored to current Belgian clinical practices.</p><p><strong>Results: </strong>This SOC guidance outlines minimal follow-up requirements across treatment phases, emphasizing clinical, biochemical, endoscopic and cross-sectional assessments, while also discussing additional relevant outcomes such as quality of life.</p><p><strong>Conclusions: </strong>The SOC guidance document offers a comprehensive, consensus-based framework to homogenize the monitoring of patients with IBD receiving advanced therapies. By standardizing monitoring practices, it aims to enhance quality of care, safety and long-term outcomes, ensuring alignment with international standards while addressing specific national requirements and availabilities.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"315-323"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403245","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":"Auto-immune hepatitis following COVID-19 Vaccination and SARS-COV2 infection : A narrative Review.","authors":"M Bendoumou, P Langlet, T Gustot","doi":"10.51821/89.2.15138","DOIUrl":"10.51821/89.2.15138","url":null,"abstract":"<p><strong>Background and objectives: </strong>Since the onset of the COVID-19 pandemic, both SARS-CoV-2 infection and vaccination have been implicated as potential triggers for de novo autoimmune hepatitis (AIH). This review summarizes published cases, outlining clinical and biological features, treatment approaches, and outcomes.</p><p><strong>Methods: </strong>A PubMed search identified reports of new-onset AIH following SARS-CoV-2 infection or COVID-19 vaccination up to February 1, 2025. Inclusion criteria encompassed case reports, series, and reviews. Data were extracted on demographics, vaccine type, onset timing, laboratory findings, histology, treatments, and outcomes.</p><p><strong>Results: </strong>A total of 74 post-vaccination AIH cases and 22 post-infection cases were included. Post-vaccination AIH predominantly affected older women (median age 62) and occurred mainly after mRNA vaccines, with a median onset of 14 days. Most patients showed marked transaminase elevation, high IgG, and positive ANA (74.3%). Liver biopsies (performed in 92% of cases) showed features compatible with AIH. A total of 80% of the 50 cases of our study with available serology and liver histology were classified as probable / definite AIH, according to the simplified AIH score. Corticosteroid therapy was effective in most cases (survival 95.9%). Post-infection AIH cases showed similar features but affected younger individuals (median age 47), with uniformly favorable responses to immunosuppression.</p><p><strong>Conclusions: </strong>New-onset AIH can occur following both SARS-CoV-2 infection or vaccination. Although these events remain rare, recognition of this association is essential for timely diagnosis and management.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"341-354"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403270","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":"Significance of leptin, Galectin-1 and Galectin-3 in tumor lymphangiogenesis.","authors":"S M Petrovic, B Simovic Markovic, I Jovanovic, A Jevtovic, J Pantic, G D Radosavljevic","doi":"10.51821/89.2.14594","DOIUrl":"10.51821/89.2.14594","url":null,"abstract":"<p><strong>Background and study aims: </strong>Leptin, Galectin-1 and Galectin-3 are essential players in tumorigenesis, angiogenesis, and metastasis, but their lymphangiogenic role is unclear. Here, the associations of leptin, Galectin-1 and Galectin-3 with markers of lymphangiogenesis were evaluated in colorectal cancer (CRC).</p><p><strong>Patients and methods: </strong>A total of 120 patients with CRC were included in the study. The expressions of leptin, Galectin-1, Galectin-3, and vascular endothelial growth factor- C (VEGF-C) were analyzed in CRC tissue and compared with lymphatic vessel density (LVD). Also, the concentrations of Galectin-1 and Galectin-3 were determined in the sera of CRC patients (n=38).</p><p><strong>Results: </strong>LVD positively correlated with the intensity of leptin or Galectin-1 expression (as defined by intensity score, IS) in tissues. Although there was no significant association between tissue expression of Galectin-3 and LVD, serum Galectin-3 concentrations were markedly decreased in patients with high LVD. The positive correlation was observed between intensity of VEGF-C and leptin expressions. No significant relationship was found between VEGF-C and Galectin-1 expression, while the intensity of VEGF-C expression positively correlated with Galectin-3 expression in tumor tissue. Further, high leptin expression, determined by a total score (sum of percentage score (PS) and IS) > 4, was related to regional lymph node metastasis and TNM stages, indicating a more aggressive CRC phenotype.</p><p><strong>Conclusions: </strong>The results suggest that leptin and Galectin-1 are involved in the formation of new lymphatic vessels in tumor, either dependently or independently of VEGF-C. It seems that high leptin expression reflects regional metastases and progression of CRC.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"285-294"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403298","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":"Guideline on Pelvic Floor Disorders: consensus on Obstructed Defecation Syndrome (ODS).","authors":"C Van de Bruaene, H De Schepper, M Surmont, D Van de Putte, S Van den Broeck, G Bislenghi, K Boon, P Casteels, J -B Cornille, D De Looze, M A Denis, A François, I Gijsen, J Geldof, B Van Geluwe, I Geraerts, M Hanssens, S Kindt, N Komen, D Meerhout, S Nullens, N Poortmans, P Pletinckx, K Raymenants, H Ruymbeke, A Segaert, S Stockman, J Stijns, T Van Aggelpoel, L Vandenplas, P Roelandt","doi":"10.51821/89.2.15231","DOIUrl":"10.51821/89.2.15231","url":null,"abstract":"<p><strong>Background and aims: </strong>Obstructed defecation syndrome (ODS) is a multifactorial condition that significantly impairs quality of life and presents diagnostic and therapeutic challenges due to the interaction of functional and anatomical factors. This initiative aimed to develop a Belgian consensus and a diagnostic-therapeutic algorithm to support effective clinical management of ODS.</p><p><strong>Methods: </strong>A Belgian steering group of gastroenterologists and colorectal surgeons (n=6) conducted a Delphi consensus process. Based on a structured literature review, 82 statements were drafted and discussed during three online voting rounds. Consensus was defined as ≥80% agreement, and evidence strength was graded using the GRADE system.</p><p><strong>Results: </strong>Thirty-one experts participated, including gastroenterologists, colorectal surgeons, gynecologists, and physiotherapists. Sixty-two final statements were formulated, of which 46 were endorsed. ODS was defined as a disorder of anorectal evacuation, with functional and structural components often coexisting. Symptoms overlap with functional constipation, IBS-C, and fecal incontinence, and quality of life is substantially impaired. Diagnosis requires multimodal evaluation, including digital rectal examination and anorectal testing. First-line treatment consists of conservative measures such as lifestyle optimization, laxatives, and pelvic floor re-education. Surgery is reserved for selected patients with refractory symptoms and significant anatomical abnormalities. Tailored surgical approaches are supported for rectocele, rectal prolapse, and pelvic organ prolapse, whereas sacral nerve stimulation is not routinely recommended.</p><p><strong>Conclusion: </strong>These consensus statements provide practical guidance for the diagnosis and management of ODS. Conservative therapy remains the cornerstone, with surgery reserved for selected cases. Areas lacking consensus warrant further research.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"385-405"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403222","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":"Gastric Trichobezoars in Children and Adolescents: A Single-Center Case Series.","authors":"J Chami, H Reusens, V Weeda, P Lingier, P Bontems, K Kotilea","doi":"10.51821/89.2.15484","DOIUrl":"10.51821/89.2.15484","url":null,"abstract":"<p><strong>Background: </strong>Trichobezoars are masses composed of ingested hair, typically affecting children and adolescents with trichotillomania and trichophagia. Their nonspecific presentation often delays diagnosis and may result in complications such as malnutrition or gastric perforation. This study describes our experience in managing pediatric trichobezoars at a tertiary pediatric center in Europe.</p><p><strong>Methods: </strong>Retrospective single-center case series of gastric trichobezoar cases in children treated at a tertiary pediatric hospital in Brussels, Belgium, between 2020 and 2025. Data extracted from electronic medical records included demographic, clinical presentation, comorbidities, imaging findings, therapeutic approach, complications, and outcomes.</p><p><strong>Results: </strong>Five pediatric patients (four females; age 6-15 years) were diagnosed with gastric trichobezoars. Recurrent vomiting, abdominal pain, early satiety, and constipation were the most common symptoms. Psychiatric or behavioral comorbidities were present in all cases, including trichotillomania, trichophagia, anxiety, or autism with pica. Ultrasound and plain radiography were unhelpful in all cases. CT raised suspicion of a bezoar in each patient, leading to endoscopic confirmation in three; however, the size of the trichobezoars prevented endoscopic removal. All patients underwent gastrotomy for bezoar extraction, performed via laparotomy in four cases and a laparoscopy-assisted approach in one. Postoperative complications occurred in two patients, including wound infection in two cases and postoperative pneumoperitoneum requiring re-exploration in one case. All patients received psychiatric follow-up, and clinical outcomes were favorable.</p><p><strong>Conclusions: </strong>Pediatric trichobezoar is a cause of recurrent vomiting that needs invasive intervention. Nonspecific symptoms and psychiatric comorbidities often delay recognition, and CT imaging is needed to establish the diagnosis, which can then be confirmed by endoscopy. Multidisciplinary management involving pediatrics, gastroenterology, and psychiatry is essential to prevent recurrence.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"413-418"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403268","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}