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Upadacitinib Outcomes After Tofacitinib Failure in Patients With Moderate to Severe Ulcerative Colitis. 中至重度溃疡性结肠炎患者托法替尼失败后更新阿达西替尼的疗效。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002275
Krishan Pratap, Abdulrahman Bassam A AlBassam, Neeraj Narula
{"title":"Upadacitinib Outcomes After Tofacitinib Failure in Patients With Moderate to Severe Ulcerative Colitis.","authors":"Krishan Pratap, Abdulrahman Bassam A AlBassam, Neeraj Narula","doi":"10.14309/crj.0000000000002275","DOIUrl":"10.14309/crj.0000000000002275","url":null,"abstract":"<p><p>Evidence for upadacitinib in ulcerative colitis (UC) after tofacitinib failure is limited, with unclear long-term outcomes. A single-centre retrospective case series at a Canadian tertiary hospital included adult UC patients who lost response to tofacitinib and were subsequently treated with upadacitinib (January 2016 to March 2024). Nine patients, who failed a median of four therapies, received upadacitinib. Eight completed induction, and four archived steroid-free clinical remission during maintenance, supported by endoscopic and histologic improvement. Durable remission beyond one year was observed in these four patients, suggesting that upadacitinib may be effective in a subset of patients after tofacitinib failure.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02275"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721163","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}
引用次数: 0
Vanishing Act: Spontaneous Regression of Hepatocellular Carcinoma After Hepatitis C Virus Treatment and Emergent Transjugular Intrahepatic Portosystemic Shunt Placement. 消失行为：丙型肝炎病毒治疗和紧急经颈静脉肝内门静脉系统分流放置后肝细胞癌的自发消退。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002253
Jake MacDonald, Garrett Cole, Haider Mejbel, Nader Dbouk, Thuy-Van Hang
{"title":"Vanishing Act: Spontaneous Regression of Hepatocellular Carcinoma After Hepatitis C Virus Treatment and Emergent Transjugular Intrahepatic Portosystemic Shunt Placement.","authors":"Jake MacDonald, Garrett Cole, Haider Mejbel, Nader Dbouk, Thuy-Van Hang","doi":"10.14309/crj.0000000000002253","DOIUrl":"10.14309/crj.0000000000002253","url":null,"abstract":"<p><p>We describe the case of a 71-year-old man with hepatitis C virus/alcohol-associated cirrhosis and a liver mass consistent with hepatocellular carcinoma (HCC) who experienced tumor regression after the initiation of direct acting antivirals and undergoing an emergent transjugular intrahepatic portosystemic shunt placement for variceal bleeding. Repeat imaging showed nonviable HCC despite no locoregional therapy, and liver explant pathology revealed <5% residual tumor. This is a rare instance of HCC regression potentially linked to viral eradication and portal pressure reduction. Understanding how direct acting antiviral therapy and transjugular intrahepatic portosystemic shunt influence tumor biology may offer insights into HCC management in decompensated cirrhosis.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02253"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720005","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}
引用次数: 0
Catastrophic Multiterritorial Arterial Embolization Causing Near-Total Bowel Necrosis in New-Onset Atrial Fibrillation With Thyrotoxicosis. 急性多区域动脉栓塞导致新发心房颤动伴甲状腺毒症患者近乎全肠坏死。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002259
Arshiya Shabnam, Rayees Ahmed Konduru, Nayanika Tummala
{"title":"Catastrophic Multiterritorial Arterial Embolization Causing Near-Total Bowel Necrosis in New-Onset Atrial Fibrillation With Thyrotoxicosis.","authors":"Arshiya Shabnam, Rayees Ahmed Konduru, Nayanika Tummala","doi":"10.14309/crj.0000000000002259","DOIUrl":"10.14309/crj.0000000000002259","url":null,"abstract":"<p><p>Acute mesenteric ischemia remains one of the most lethal abdominal emergencies, particularly when bowel necrosis has already occurred at the time of diagnosis. Embolic occlusion of the superior mesenteric artery is most commonly associated with atrial fibrillation. Although hyperthyroidism is a recognized trigger for atrial fibrillation, widespread systemic arterial embolization in this setting is rarely reported. We describe a 77-year-old woman with biochemical thyrotoxicosis and new-onset atrial fibrillation who developed simultaneous superior mesenteric and peripheral arterial occlusions, resulting in near-total small bowel necrosis that was not surgically survivable. Her rapid clinical deterioration underscores the aggressive nature of embolic mesenteric ischemia and the narrow window available for intervention.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02259"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727867","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}
引用次数: 0
Granulomatous Cheilitis as the Presenting Manifestation of Widespread Crohn's Disease. 肉芽肿性舌炎是广泛克罗恩病的表现。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002270
Wyatt Nice, Ekta Gupta, Marcia Wills, George Kunnackal John
{"title":"Granulomatous Cheilitis as the Presenting Manifestation of Widespread Crohn's Disease.","authors":"Wyatt Nice, Ekta Gupta, Marcia Wills, George Kunnackal John","doi":"10.14309/crj.0000000000002270","DOIUrl":"10.14309/crj.0000000000002270","url":null,"abstract":"<p><p>Granulomatous cheilitis, a localized subset of orofacial granulomatosis, can rarely be the presenting symptom of Crohn's disease. It can appear before any gastrointestinal (GI) symptoms develop. Orofacial granulomatosis has been associated with more widespread granulomatous Crohn's disease, which tends to be more aggressive. We present a case of isolated granulomatous cheilitis progressing to diffuse granulomatous involvement of multiple portions of the upper and lower GI tract with eventual secondary loss of response to initial anti-tumor necrosis factor-α therapy, underscoring the need for these patients to be monitored very closely even in the absence of GI symptoms.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02270"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720061","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}
引用次数: 0
Bite-on-Bite Near Miss: From Hemangioma to Gastrointestinal Stromal Tumors. 咬对咬：从血管瘤到胃肠道间质瘤。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002287
Olivia Reszczynski, Himesh B Zaver, Dev Patel, Christopher Farid, Steven Powell, Daniel S Strand
{"title":"Bite-on-Bite Near Miss: From Hemangioma to Gastrointestinal Stromal Tumors.","authors":"Olivia Reszczynski, Himesh B Zaver, Dev Patel, Christopher Farid, Steven Powell, Daniel S Strand","doi":"10.14309/crj.0000000000002287","DOIUrl":"10.14309/crj.0000000000002287","url":null,"abstract":"<p><p>Gastrointestinal stromal tumors (GISTs) are rare, potentially malignant mesenchymal neoplasms that can arise anywhere within the gastrointestinal tract or abdominal cavity. We present a case of an incidentally discovered duodenal subepithelial lesion that was initially endoscopically sampled using bite-on-bite biopsy technique and misdiagnosed as a benign hemangioma. Following multidisciplinary review, the patient underwent endoscopic ultrasound with fine-needle aspiration and fine-needle biopsy, which ultimately confirmed the diagnosis of GIST. This case highlights the limitations of the bite-on-bite technique for diagnosing subepithelial lesions and underscores the importance of multidisciplinary evaluation when managing potentially high-risk subepithelial lesions.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02287"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719515","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}
引用次数: 0
Zolbetuximab-Associated Gastritis in a Patient With Metastatic Gastric Adenocarcinoma. 转移性胃腺癌患者的佐仑妥昔单抗相关性胃炎
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002265
Allen Zhu, Janki Luther, Eli Aminpour, Xiuli Liu, Anas Gremida
{"title":"Zolbetuximab-Associated Gastritis in a Patient With Metastatic Gastric Adenocarcinoma.","authors":"Allen Zhu, Janki Luther, Eli Aminpour, Xiuli Liu, Anas Gremida","doi":"10.14309/crj.0000000000002265","DOIUrl":"10.14309/crj.0000000000002265","url":null,"abstract":"<p><p>We present a case report of severe gastritis and colitis in the context of recent zolbetuximab administration in a patient receiving combination chemotherapy for metastatic gastric adenocarcinoma. This case highlights the potential gastrointestinal toxicity associated with zolbetuximab, particularly in patients with previous mucosal injury from chemotherapy and tumor involvement.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02265"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719871","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}
引用次数: 0
The Evolving Digital Landscape of Gastroenterology Fellowship Recruitment. 不断发展的胃肠病学奖学金招聘数字景观。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-12 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002283
Janak Bahirwani, Madhav Changela, Pravin Kalyankar, Maulik Kaneriya, Ashish Sharma, Hareesha Rishab Bharadwaj, Hassam Ali, Dushyant Singh Dahiya
{"title":"The Evolving Digital Landscape of Gastroenterology Fellowship Recruitment.","authors":"Janak Bahirwani, Madhav Changela, Pravin Kalyankar, Maulik Kaneriya, Ashish Sharma, Hareesha Rishab Bharadwaj, Hassam Ali, Dushyant Singh Dahiya","doi":"10.14309/crj.0000000000002283","DOIUrl":"10.14309/crj.0000000000002283","url":null,"abstract":"<p><p>Social media has rapidly transformed communication, education, and professional networking within graduate medical education. Increasingly, residency and fellowship applicants rely on social media platforms to evaluate training programs, particularly to gain insights into program culture, trainee experiences, and educational environments that may not be easily conveyed through traditional program websites. The COVID-19 pandemic further accelerated the adoption of social media by both applicants and training programs, highlighting its growing role in recruitment and outreach. Gastroenterology fellowship programs are uniquely positioned to leverage these platforms given the visual and procedural nature of the specialty, which lends itself to digital content such as endoscopy demonstrations, educational discussions, and conference highlights. This editorial argues that gastroenterology fellowship programs should move beyond passive or reactive social media use toward a structured, intentional strategy, one built around 4 core pillars: recruitment transparency, educational dissemination, cultural representation, and inclusive outreach. We outline practical considerations including platform selection, content governance, and professionalism standards, while also acknowledging the risks of misrepresentation and inequity that programs must actively work to mitigate.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02283"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720534","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}
引用次数: 0
Juvenile Polyposis Syndrome in a Post-Fontan Adolescent With Tetralogy of Fallot: A Rare Association With Important Cancer Risk and Developmental Overlap. 青少年息肉病综合征后fontan青少年法洛四联症：与重要癌症风险和发育重叠的罕见关联。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-11 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002279
Jorge G Pacheco Oliva, Ninoska Meléndez Rodríguez, Abel Sánchez, Ximena Aguilar, Hugo Cardona
{"title":"Juvenile Polyposis Syndrome in a Post-Fontan Adolescent With Tetralogy of Fallot: A Rare Association With Important Cancer Risk and Developmental Overlap.","authors":"Jorge G Pacheco Oliva, Ninoska Meléndez Rodríguez, Abel Sánchez, Ximena Aguilar, Hugo Cardona","doi":"10.14309/crj.0000000000002279","DOIUrl":"10.14309/crj.0000000000002279","url":null,"abstract":"<p><p>A 14-year-old adolescent boy with repaired Tetralogy of Fallot and Fontan-type physiology presented with intermittent hematochezia and poor weight gain. Colonoscopy revealed multiple pedunculated polyps throughout the colon, including several larger than 1 cm, and upper endoscopy demonstrated gastric polyposis. Histology confirmed hamartomatous juvenile polyps without dysplasia, fulfilling diagnostic criteria for juvenile polyposis syndrome. Echocardiography showed moderate-to-severe pulmonary insufficiency, branch pulmonary artery stenosis, and mildly depressed ventricular function, consistent with residual hemodynamic compromise after complex congenital heart disease repair. Multidisciplinary management resulted in significant nutritional improvement. Although genetic testing for <i>SMAD4/BMPR1A</i> was not available, the diagnosis was fully supported by clinical, endoscopic, and histologic criteria. This case highlights the rare coexistence of juvenile polyposis syndrome and congenital heart disease and underscores the importance of early recognition and cancer-risk surveillance in complex pediatric patients.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02279"},"PeriodicalIF":0.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711004","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}
引用次数: 0
Bullous Form of Ischemic Colitis. 大泡型缺血性结肠炎。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-10 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002255
Alekhya Mannava, Deepa Patil, Jenny Jan, Resham Ramkissoon
{"title":"Bullous Form of Ischemic Colitis.","authors":"Alekhya Mannava, Deepa Patil, Jenny Jan, Resham Ramkissoon","doi":"10.14309/crj.0000000000002255","DOIUrl":"10.14309/crj.0000000000002255","url":null,"abstract":"","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02255"},"PeriodicalIF":0.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705363","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}
引用次数: 0
Breaking the Mold: A Rare Case of Invasive Colonic Aspergillosis Causing Toxic Megacolon and Perforation in a Patient Without Classic Immunosuppression. 打破霉菌：侵袭性结肠曲霉病引起中毒性巨结肠和穿孔的罕见病例，患者没有典型的免疫抑制。
IF 0.6
ACG Case Reports Journal Pub Date : 2026-08-10 eCollection Date: 2026-08-01 DOI: 10.14309/crj.0000000000002278
Katharine Hunter Cook, Jordan Woodard, Christina Leyson
{"title":"Breaking the Mold: A Rare Case of Invasive Colonic Aspergillosis Causing Toxic Megacolon and Perforation in a Patient Without Classic Immunosuppression.","authors":"Katharine Hunter Cook, Jordan Woodard, Christina Leyson","doi":"10.14309/crj.0000000000002278","DOIUrl":"10.14309/crj.0000000000002278","url":null,"abstract":"<p><p>Invasive gastrointestinal aspergillosis is rare and typically occurs in immunocompromised hosts. We present a case of a 24-year-old man with intermittent corticosteroid use presenting with diarrhea and abdominal pain found to have toxic megacolon on imaging. He developed colonic necrosis and perforation requiring emergent colectomy. Histopathology revealed invasive Aspergillus with transmural necrosis. His course was complicated by septic shock, acute kidney injury requiring dialysis, and pulmonary candidiasis. Primary colonic aspergillosis in immunocompetent patients is exceedingly uncommon. This case highlights the importance of early consideration of invasive fungal infection and prompt antifungal treatment in a patient with fulminant colitis unresponsive to standard therapy.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"13 8","pages":"e02278"},"PeriodicalIF":0.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705314","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}
引用次数: 0
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