BMC Gastroenterology最新文献

{"title":"A gut vascular barrier damage-based scoring system predicts postoperative outcomes in Crohn's disease.","authors":"Xiao-Jun Chen, Yi Guo, Hui Peng, Hu-Fei Zhang, Yi-Nan Zhang, Zi-Meng Liu, Xu-Yu Zhang","doi":"10.1186/s12876-026-04892-5","DOIUrl":"https://doi.org/10.1186/s12876-026-04892-5","url":null,"abstract":"<p><strong>Background: </strong>The gut vascular barrier (GVB) is essential for maintaining intestinal homeostasis. However, its role in patients undergoing surgery for Crohn's disease (CD) remains unclear. Thus, our study aimed to explore the association between GVB and disease severity and postoperative outcomes in CD patients, as well as to develop a scoring system to predict postoperative prognosis.</p><p><strong>Methods: </strong>Endothelial plasmalemma vesicle-associated protein (PV-1) is a typical biomarker of GVB dysfunction. The expression of PV-1 was measured in intestinal mucosa of patients with Crohn's disease (CD) and controls scheduled for surgery. The correlation between PV-1 expression and clinical data was analyzed. Moreover, a scoring system based on PV-1 was developed to predict the postoperative outcomes.</p><p><strong>Results: </strong>GVB damage was detected in CD patients. Levels of intestinal PV-1 expression were markedly higher in inflamed parts of CD patients than in non-inflamed parts and in control patients (both P < 0.05). Levels of PV-1 were positively correlated with preoperative disease activity indexes and postoperative clinical outcomes. Importantly, a new scoring system based on PV-1 was established to predict an adverse total postoperative prognosis or a longer length of stay, and it showed better discrimination (Areas under the receiver operating characteristic curves (AUCs) = 0.808, 0.902, P < 0.001).</p><p><strong>Conclusion: </strong>GVB damage was found in CD patients and was associated with the severity of disease and postoperative outcomes. A scoring system based on GVB damage is promising in predicting poor postoperative outcomes.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reactive nodular fibrous pseudotumor of the omentum: a rare case report and literature review.","authors":"Xiujuan Sun, Chengyu Hu, Sisi Wang, Weihua Gong","doi":"10.1186/s12876-026-04888-1","DOIUrl":"https://doi.org/10.1186/s12876-026-04888-1","url":null,"abstract":"<p><strong>Background: </strong>Reactive nodular fibrous pseudotumor is a rare benign fibroinflammatory lesion of the gastrointestinal tract and mesentery that can closely mimic malignant disease on clinical examination and imaging. Most reported cases are associated with prior abdominal surgery, trauma, or inflammation. Omental involvement is particularly uncommon, and preoperative diagnosis remains difficult because of its rarity and the limited description of multimodality imaging findings. We report a rare case of omental reactive nodular fibrous pseudotumor in a young man without any history of abdominal surgery, trauma, or abdominal discomfort, highlighting its unusual presentation and diagnostic features.</p><p><strong>Case presentation: </strong>A 31-year-old man presented with a palpable abdominal mass that had been present for more than 1 month. He had no previous abdominal surgery, trauma, or gastrointestinal symptoms. Contrast-enhanced computed tomography revealed multiple well-defined solid masses in the greater omentum with scattered calcifications. The lesions were similar in attenuation to skeletal muscle on unenhanced images and showed mild progressive enhancement after contrast administration. Magnetic resonance imaging demonstrated low signal intensity on both T1-weighted and T2-weighted images with a similar gradual enhancement pattern. Ultrasound and contrast-enhanced ultrasound showed hypoechoic lesions with limited enhancement. Because malignancy could not be excluded radiologically, surgical resection was performed. Histopathological examination demonstrated spindle cell proliferation within dense hyalinized collagenous stroma with focal chronic inflammatory infiltrates. Immunohistochemical findings supported the diagnosis of reactive nodular fibrous pseudotumor. The patient recovered well after surgery and remained recurrence-free during more than 4 years of follow-up.</p><p><strong>Conclusions: </strong>This case indicates that reactive nodular fibrous pseudotumor should be included in the differential diagnosis of solid omental masses, even in patients without a history of abdominal surgery or inflammation. Multimodality imaging may provide important clues to its fibrous nature, but definitive diagnosis still depends on histopathological confirmation. Greater awareness of this rare entity may reduce misdiagnosis and help avoid unnecessary aggressive treatment.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectivity and safety of TAF in CHB patients with concurrent MASLD: a real-world study.","authors":"Haifeng Zhang, Yong Zhou, Jun Yu, Qingxi Wang, Xiaoyu Wang, Jing Chen, Jiaqi Yu, Bing Qiao, Zhensheng Liu","doi":"10.1186/s12876-026-04886-3","DOIUrl":"https://doi.org/10.1186/s12876-026-04886-3","url":null,"abstract":"<p><strong>Background and aim: </strong>The overlapping prevalence of chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) is high, increasing the risk of liver complications. However, data on whether antiviral therapy influences lipid profiles are limited. Therefore, this study aimed to investigate the efficacy and safety of tenofovir alafenamide (TAF) in treatment-naïve CHB patients with MASLD.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 96 treatment-naïve CHB patients with MASLD who received TAF monotherapy. Clinical data were collected at baseline and at 12, 24, 36, and 48 weeks after treatment initiation. Changes in HBV DNA, ALT, AST, HBsAg, TBIL, ALB, liver stiffness measurement (LSM), controlled attenuation parameter (CAP), lipid biomarkers (HDL, LDL, TG, TC), and renal markers (BUN, Cr, β2-microglobulin) were compared before and after treatment.</p><p><strong>Results: </strong>A total of 96 treatment-naïve CHB patients with MASLD (56 males and 40 females) were eligible and enrolled. The mean age was 50.69 ± 10.89 years, with ALT and AST levels of 90.54 ± 17.76 U/L and 74.01 ± 15.09 U/L, respectively. The rates of undetectable HBV DNA at 12, 24, 36, and 48 weeks were 67.71%, 72.92%, 91.67%, and 96.88%, respectively, all significantly different from baseline (P < 0.001). After 48 weeks of TAF treatment, ALT levels decreased significantly from 90.54 ± 17.76 U/L to 30.81 ± 16.06 U/L (P = 0.001), and AST levels decreased from 74.01 ± 15.09 U/L to 24.78 ± 14.95 U/L (P = 0.002). HBsAg quantification decreased from 6061.29 ± 972.96 IU/mL to 3621.11 ± 699.54 IU/mL (P = 0.047). LSM decreased from 6.53 ± 1.52 kPa to 5.96 ± 1.67 kPa (P = 0.01), and CAP decreased from 299.09 ± 26.44 dB/m to 290.04 ± 28.38 dB/m (P = 0.023). No significant changes were observed in TBIL, ALB, lipid biomarkers (HDL, LDL, TG, TC), or renal function markers (BUN, Cr, β2-microglobulin) throughout the treatment period.</p><p><strong>Conclusion: </strong>TAF treatment in treatment-naïve CHB patients with MASLD effectively suppressed viral replication, showed a trend toward improving liver stiffness, and has no adverse effects on lipid profiles or renal function.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of intracranial hemorrhage in critically ill ACLF patients: a retrospective single center cohort study.","authors":"Miriam Dibos, Maja Wossnig, Silke Wunderlich, Roland M Schmid, Ulrich Mayr, Tobias Lahmer, Julian Triebelhorn","doi":"10.1186/s12876-026-04875-6","DOIUrl":"https://doi.org/10.1186/s12876-026-04875-6","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients with liver cirrhosis present numerous challenges in clinical evaluation of bleeding risk. Their deficiencies in both pro- and anticoagulant factors result in a particularly fragile hemostatic system and bleeding complications. While the risk of the particular bleeding complication of intracerebral hemorrhage (ICH) is a major clinical concern, the question of whether ICH occurs more frequently in patients with acute-on-chronic liver failure (ACLF) compared to a control group and which parameters predict cerebral bleeding, remain unresolved and was the aim of this study.</p><p><strong>Methods: </strong>One hundred two critically ill ACLF patients and 166 patients in the control group were included retrospectively. Clinical parameters and occurrence of spontaneous ICH were compared to controls.</p><p><strong>Results: </strong>Cerebral computer tomography detected ICH in 15 out of 102 patients (14.7%) in the ACLF group compared to 16 out of 166 patients (9.6%) in the control group. While patients in the ACLF group exhibited prolonged prothrombin time (pTT) (median [IQR]: (57 [45-71] s vs. 42 [35-52] s, p < 0.001) and higher INR values (1.9 [1.5-2.4] vs. 1.2 [1.1-1.4], p < 0.001), significantly lower platelet count compared to control group (43 [24-64] × 10³/µL vs. 87 [39-159] × 10³/µL, p < 0.001) as risk factors for cerebral bleeding, statistical analysis revealed a trend towards a higher incidence among patients in the ACLF group compared to controls (OR: 1.61, chi-square-test, p-value = 0.24).</p><p><strong>Conclusions: </strong>Although statistical analysis showed a tendency to a higher incidence of ICH in the ACLF group compared to controls, ICH did not occur significantly more frequently in patients with ACLF. While no correlation was shown between the occurrence of ICH and high systolic blood pressure or dysregulated INR and pTT, low platelet counts were associated with spontaneous ICH in both groups.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple white flat lesions on upper endoscopy: a systematic review and meta-analysis of the association with proton pump inhibitor exposure.","authors":"Liang Zhang, Jian Liu, Yali Wang","doi":"10.1186/s12876-026-04771-z","DOIUrl":"https://doi.org/10.1186/s12876-026-04771-z","url":null,"abstract":"<p><strong>Background: </strong>Recognition of multiple white flat lesions (MWFLs), or white flat elevated mucosa (WFEM), is increasing. Their tendency to mimic gastric intestinal metaplasia often leads to unwarranted biopsies. To address this, we reviewed existing evidence covering their endoscopic characteristics, relationship with H. pylori, detection frequencies, and longitudinal course, including the observational association with proton pump inhibitor (PPI) therapy.</p><p><strong>Methods: </strong>From 1 January 2010 to 30 November 2025, we searched PubMed, Embase, Web of Science, Scopus, CENTRAL, and East Asian databases without language restrictions. We screened the reference lists of included studies. We pooled study-reported multivariable-adjusted odds ratios (ORs) for PPI exposure using a random-effects model wherever possible. Detection frequencies were reported descriptively, as pooling was not appropriate given the ascertainment heterogeneity.</p><p><strong>Results: </strong>We retained five observational studies (N = 5,065). Pooling was feasible for three studies contributing cross-sectional exposure-outcome estimates (k = 3; Japan n = 2, China n = 1; N = 2,907) reporting multivariable-adjusted ORs. In this limited exploratory synthesis, PPI exposure, however defined, was associated with higher odds of MWFLs (pooled adjusted OR 2.91, 95% CI 1.98-4.29; I²=16.9%). As all studies were at moderate risk of bias, residual confounding and detection bias cannot be excluded. Study-level detection frequencies in four unselected cohorts (N = 4,902) ranged from 3.0% to 10.4% (these are detection frequencies, not population prevalence estimates). Regardless of how variables were defined, MWFLs were typically associated with H. pylori-negative or post-eradication status rather than active infection. Longitudinal evidence was inadequate to determine malignant potential or whether biopsy can be safely deferred.</p><p><strong>Conclusions: </strong>Uncertainty regarding the malignant potential of typical MWFLs precludes any conclusion on the safety of biopsy omission. In the limited available cross-sectional evidence, PPI exposure was associated with higher MWFL odds, but this estimate should be viewed as hypothesis-generating rather than causal. Careful description of suspected MWFLs, best achieved with image-enhanced endoscopy, is essential while prospective, protocol-driven investigations resolve questions regarding their natural history, malignant potential, and the resolution of diagnostic uncertainty.</p><p><strong>Registration: </strong>PROSPERO CRD420251248816.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma YAP1 as a biomarker for the prediction of occurrence, progression, and outcomes of sepsis-associated liver injury: a prospective observational study.","authors":"Jun Shao, Lulu Zhou, Haoran Wang, Xiaohua Gu, Tianwei Wang, Tingting Yu, Jichao Zhai, Aipeng Hu, Yuanyuan Zhu, Wei Lei, Hailong Yu, Nianfang Lu, Ruiqiang Zheng","doi":"10.1186/s12876-026-04889-0","DOIUrl":"https://doi.org/10.1186/s12876-026-04889-0","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated liver injury (SALI) is an independent risk factor for multiple organ dysfunction and high mortality in septic patients, which is often associated with a poor prognosis. Currently, there is still a lack of early diagnostic biomarkers of Sepsis-Associated Liver Injury in clinical practice. YAP1 (Yes1 Associated Transcriptional Regulator) has been demonstrated to correlate with hepatic inflammation, nevertheless, its exact function and mechanism in sepsis-associated liver injury have not been conclusively determined.</p><p><strong>Methods: </strong>Clinical data of septic patients in the ICU of Northern Jiangsu People's Hospital (Oct. 2023 - Dec. 2025) were reviewed. Patients were classified into sepsis non-liver injury (SNLI) and SALI groups according to the presence or absence of liver injury at admission. Logistic regression was used to identify independent risk factors for SALI. Receiver operating characteristic (ROC) analysis assessed predictive performance. Patients were stratified by plasma YAP1 quartiles to evaluate its association with disease progression, and significant variables were further analyzed by logistic regression. Correlations were examined using Spearman analysis. A Cox proportional hazards model was applied to assess the association between YAP1 and 28-day mortality in SALI patients.</p><p><strong>Results: </strong>A total of 199 patients were included (SNLI, n = 121; SALI, n = 78). Plasma YAP1 was an independent protective factor for SALI (OR = 0.97, P < 0.001), while BMI (OR = 1.35, P = 0.015) and day 1 lactate (OR = 1.48, P = 0.002) were independent risk factors. YAP1 showed good predictive performance (AUC = 0.86). Higher YAP1 levels were independently associated with 72-hour SOFA score reduction (OR = 7.55, P = 0.009), indicating improved early organ function. No significant association was found between YAP1 and 28-day mortality.</p><p><strong>Conclusion: </strong>Plasma YAP1 is inversely associated with SALI occurrence and demonstrates good predictive performance. Higher YAP1 levels are associated with early organ function improvement but not with 28-day mortality.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated clinicopathological model versus TNM for predicting survival in resected hepatocellular carcinoma: a retrospective cohort study.","authors":"Gia Anh Pham, Trung Nghia Bui, Tien Cong Bui, Manh Thau Cao, Hong Son Trinh, Thi Huyen Trang Vo, Thanh Tung Pham, Thi Thu Hang Nguyen, Thanh Lam Phan, Thu Hang Nong, Thi Ngoc Tran","doi":"10.1186/s12876-026-04895-2","DOIUrl":"https://doi.org/10.1186/s12876-026-04895-2","url":null,"abstract":"<p><strong>Objective: </strong>To explore prognostic factors of postoperative hepatocellular carcinoma (HCC) and compare the prognostic performance of the tumor-node-metastasis (TNM) system with an integrated clinicopathological model.</p><p><strong>Methods: </strong>We conducted a cohort study evaluating 249 patients with HCC who underwent radical liver resection between January 2015 and December 2024. Overall survival (OS) was the primary endpoint. Independent prognostic factors were determined using the Cox proportional hazards model. Model performance was assessed using the correlation index (C-index) with bootstrap internal validation. Time-dependent receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration plots were used to assess discrimination, clinical utility, and agreement between predicted and observed outcomes.</p><p><strong>Results: </strong>In multivariable analysis, TNM stage, microvascular invasion (MVI), resection margin status, and albumin-bilirubin (ALBI) grade were independent predictors of OS. For recurrence-free survival (RFS), independent predictors included hepatitis status, ALBI grade, TNM stage, and MVI. The integrated model demonstrated improved discrimination compared with TNM alone, with a higher optimism-corrected C-index (0.676 vs. 0.647). Time-dependent ROC analysis showed significantly higher AUC values for the integrated model at 1 year (0.725 vs. 0.669, p = 0.046), 3 years (0.703 vs. 0.657, p = 0.024), and 5 years (0.684 vs. 0.649, p = 0.031). DCA indicated greater net benefit across clinically relevant thresholds, and calibration plots showed good agreement between predicted and observed survival probabilities.</p><p><strong>Conclusion: </strong>An integrated clinicopathological model incorporating TNM stage, MVI, ALBI grade, and resection margin status improves prognostic performance compared with TNM alone in patients undergoing curative resection for HCC. This model may support more accurate postoperative risk stratification.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in upper GI pathology over 18 years: a retrospective cross-sectional study.","authors":"Yahya Kemal Çalışkan, Olgun Erdem, Tolga Canbak, Aylin Acar, Fatih Başak, Hüsna Tosun, Aykut Angı, İlyas Kudaş","doi":"10.1186/s12876-026-04896-1","DOIUrl":"https://doi.org/10.1186/s12876-026-04896-1","url":null,"abstract":"<p><strong>Background: </strong>Upper gastrointestinal (GI) pathologies, such as peptic ulcers and gastroesophageal reflux disease (GERD), are common causes of gastrointestinal discomfort. This study investigates the trends in the prevalence and demographic patterns of several upper GI conditions over an 18-year period (2007-2024) at a tertiary care center.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using data from endoscopic procedures performed between 2007 and 2024. The data included diagnoses of gastritis, peptic ulcers, GERD, bulbitis, hiatal hernia, LES insufficiency, esophagitis, duodenitis, and malignancies. We evaluated the trends in the number of cases and the average age of patients diagnosed with these conditions. Additionally, the male-to-female ratio was analyzed for each pathology. Statistical analysis included time-series analysis to detect trends over the study period.</p><p><strong>Results: </strong>A total of 6,188 endoscopic procedures were analyzed. Gastritis was the most prevalent condition, accounting for 60.8% of cases, followed by peptic ulcers (22.8%) and GERD (14.5%). Time-series analysis revealed a steady decline in the incidence of gastritis and peptic ulcers over the years (p < 0.05), while GERD exhibited a bimodal distribution with an increase after 2018. The average age of patients varied across conditions, with GERD showing a significant increase in the average age over time. Gender distribution was relatively balanced for most conditions, although GERD showed a higher prevalence in females.</p><p><strong>Conclusion: </strong>This study highlights significant trends in the prevalence of upper GI pathologies, with a decrease in gastritis and peptic ulcers and a rising trend in GERD. The findings suggest that the demographic landscape of upper GI pathologies is shifting, with GERD becoming more prominent in the later years of the study.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration of a Hem-O-Lok clip into the cecal lumen following laparoscopic appendectomy: a case report.","authors":"Runjie Hou, Jing Guo, Mingyue Du, Zhilong Zhang, Jijun Wang","doi":"10.1186/s12876-026-04841-2","DOIUrl":"https://doi.org/10.1186/s12876-026-04841-2","url":null,"abstract":"<p><strong>Background: </strong>Hem-O-Lok clips are widely used in laparoscopic appendectomy (LA). Although postoperative clip migration is rare, it is a clinically significant complication. Previous reports have mainly focused on clip migration after cholecystectomy and urologic surgery. To the best of our knowledge, there have been no reports of clip migration into the intestinal lumen after LA. This report suggests that such migration may occur after LA, highlights an important potential device-related complication, and adds to the relevant literature.</p><p><strong>Case presentation: </strong>A 44-year-old male experienced persistent dull right lower abdominal pain for three days, two months after LA. Physical examination showed tenderness at McBurney's point, while laboratory tests revealed no abnormalities. The patient had received two Hem-O-Lok clips during surgery two months prior. Abdominal computed tomography (CT) revealed a high-density shadow in the ileocecal region. Colonoscopy confirmed a Hem-O-Lok clip embedded at the appendiceal orifice within the cecal lumen. The patient refused endoscopic removal, opting for conservative observation. At the six-month follow-up, the patient's pain had completely resolved.</p><p><strong>Clinical discussion: </strong>The mechanism of this complication remains unclear and may involve the combined effects of local inflammation and foreign body-related reaction. CT may serve as an initial screening tool, and endoscopy is helpful for establishing the diagnosis. As there is currently no standardized treatment strategy, conservative observation, endoscopic intervention, and surgical treatment may all be considered as options, depending on the individual situation. In clinical practice, attention should also be paid to the standardized use of clips in order to reduce the risk of similar complications.</p><p><strong>Conclusion: </strong>This case highlights the potential risk of Hem-O-Lok clip migration after LA. Clinicians should increase their awareness of this rare complication.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal adenoma recurrence: an analysis of risk factors and gut microbiota characteristics.","authors":"Yujie Chen, Xueru Gao, Li Wang, Chunlin Zhang, Yuhai Fang","doi":"10.1186/s12876-026-04878-3","DOIUrl":"https://doi.org/10.1186/s12876-026-04878-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colorectal adenoma (CRA) is precancerous lesion of colorectal cancer (CRC). Early detection and endoscopic resection of CRA are the most effective methods for preventing CRC, yet there is a significant recurrence risk. We aim to analyze the risk factors for CRA recurrence and explore the gut microbiota characteristics in individuals with recurrent CRA, in order to provide new insights for risk stratification and intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recruited 30 participants with recurrent CRA and 15 participants without CRA recurrence. Demographic information, baseline characteristics of adenomas, and other clinical data were collected from each participant. Univariate analysis and Firth Logistic regression analysis were used to analyze the risk factors for CRA recurrence. Meanwhile, fecal samples were collected from all participants and 16s rRNA sequencing was performed to analyze the composition, structure, and taxonomic differences of the gut microbiota, as well as to predict potential functional capacities. Correlation analysis is employed to explore the associations between differential gut microbiota and functional pathways.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Univariate analysis revealed that there were statistically significant differences (p &lt; 0.05) between the two groups in terms of age, body mass index (BMI), diabetes, smoking history, adenoma size, adenoma number, and advanced adenomas. Firth Logistic analysis indicated that adenoma number and smoking history were independent clinical risk factors for CRA recurrence. Microbiomic analysis showed no significant difference (p &gt; 0.05) in the α-diversity and β-diversity of the gut microbiota between the two groups. Taxonomic analysis revealed the abundances of potential pathogenic bacteria such as Escherichia-Shigella and Klebsiella were significantly increased in the recurrence group, while the abundances of Bacteroides and Faecalibacterium were significantly reduced. Furthermore, Linear Discriminant Analysis Effect Size (LEfSe) analysis indicated that the non-recurrence group was enriched with genera such as Megasphaera. Functional prediction analysis suggested that pathways related to fatty acid metabolic and biosynthetic process were more active in the non-recurrence group. Correlation analysis uncovered the genera enriched in the recurrence group were positively correlated with the functional pathways of styrene degradation and fat digestion and absorption, whereas the genera with reduced abundance were positively correlated with fat digestion and absorption and MicroRNAs in cance pathways.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study not only elucidates the clinical risk factors for CRA recurrence but also reveals that CRA recurrence may be closely associated with the gut microbiota dysbiosis. Combining clinical risk factors with gut microbial biomarkers is expected to construct a more precise predictive model for adenoma recurrence and provid","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}