BMC Gastroenterology最新文献

{"title":"The value of the serum cytokine-to-immune ratio model in predicting the progression-free survival after interventional therapy for hepatocellular carcinoma.","authors":"Jun Zhou, Bo Zhang, Jing Niu","doi":"10.1186/s12876-026-04894-3","DOIUrl":"https://doi.org/10.1186/s12876-026-04894-3","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a prognostic nomogram for predicting progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA). The model incorporates serum transforming growth factor-β1 (TGF-β1), interleukin-8 (IL-8), and the peripheral blood CD4+/CD8 + ratio to enable precise risk stratification and inform adjuvant therapy decisions.</p><p><strong>Methods: </strong>This retrospective study enrolled 138 patients with HCC who underwent initial TACE/RFA between January 2020 and December 2023. Patients were randomly divided into training (n = 97) and internal validation (n = 41) sets at a 7:3 ratio. PFS was the primary outcome. Independent prognostic factors were identified via univariate and multivariate Cox regression analyses in the training set and were used to construct a nomogram. Concurrently, random forest (RF), k-nearest neighbors, and gradient boosting models were developed, with hyperparameters optimized by ten-fold cross-validation. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). The SHAP (SHapley Additive exPlanations) framework was applied to interpret the optimal model. Patients were stratified into risk groups based on the median nomogram score; survival differences were evaluated using Kaplan-Meier curves and the log-rank test.</p><p><strong>Results: </strong>Multivariate Cox analysis confirmed tumor number, BCLC stage, serum transforming growth factor-β1 (TGF-β1), serum interleukin-8 (IL-8), and the CD4+/CD8 + ratio as independent prognostic factors for PFS (all P < 0.05). Multiple tumors, advanced BCLC stage (B/C), and elevated TGF-β1 and IL-8 levels were independent risk factors, whereas a higher CD4+/CD8 + ratio was a protective factor. Among the machine learning models, RF demonstrated superior predictive performance, with AUCs of 0.846 (95% CI: 0.742-0.949) in the training set and 0.791 (95% CI: 0.619-0.964) in the validation set. Calibration curves for the RF model indicated excellent agreement between predicted and observed outcomes. DCA showed a favorable net clinical benefit across a wide range of threshold probabilities. SHAP analysis identified serum TGF-β1 as the most influential predictor; its effect direction was consistent with the Cox model, with high TGF-β1, high IL-8, advanced BCLC stage, and multiple tumors increasing the risk score, and a high CD4+/CD8 + ratio decreasing it. A nomogram was subsequently constructed based on these factors. The risk stratification derived from the nomogram effectively distinguished patients with significantly different PFS outcomes in both cohorts (P < 0.05, log-rank test).</p><p><strong>Conclusion: </strong>The prognostic nomogram integrating TGF-β1, IL-8, CD4+/CD8 + ratio, and clinicopathological factors demonstrates robust di","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833446","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":"Diagnosis and treatment of slow-transit constipation.","authors":"Feng Yang, Qingsong Tao","doi":"10.1186/s12876-026-04784-8","DOIUrl":"https://doi.org/10.1186/s12876-026-04784-8","url":null,"abstract":"<p><p>In today's society, with changes in diet structure and living habits, drug abuse, and psychosomatic diseases, the prevalence of constipation is increasing. Currently, there is a lack of unified diagnostic criteria for constipation, and therapeutic approaches lack standardization. This often leads to an inability to select appropriate treatment methods based on the patient's specific condition. Consequently, a significant proportion of constipation patients do not achieve satisfactory therapeutic outcomes. This is particularly true for slow-transit constipation (STC), which is characterized by a protracted course of the disease and significant diagnostic challenges. Therefore, this review aims to delineate the mechanisms, diagnosis, and therapeutic advances in STC, in order to offer insights for clinical diagnosis and treatment.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833441","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":"Development and internal validation of a risk-stratification model for complicated appendicitis in the elderly: a retrospective comparative study.","authors":"Weihuan Luo, Chi Liang, Yu Chen","doi":"10.1186/s12876-026-04868-5","DOIUrl":"https://doi.org/10.1186/s12876-026-04868-5","url":null,"abstract":"<p><strong>Objective: </strong>The clinical presentation of acute appendicitis in elderly patients is often atypical, leading to delayed diagnosis and a substantially elevated risk of complicated appendicitis. This progression complicates treatment strategies and negatively impacts prognostic outcomes. Currently, there is a lack of simple and practical tools to help identify complicated appendicitis at presentation in elderly patients. The objective of this study was to investigate admission-time factors associated with complicated appendicitis in the elderly and to develop a model for admission-time identification/risk stratification.</p><p><strong>Methods: </strong>Clinical data from 288 elderly patients with acute appendicitis admitted to the General Surgery Department of Jiangsu Province (Suqian)Hospital, between January 2016 and December 2024 were retrospectively analyzed. Patients were categorized into a complicated appendicitis (CA) group (n = 117) and an uncomplicated appendicitis (UCA) group (n = 171) based on postoperative pathology. Univariate and multivariate logistic regression analyses were performed to identify independent predictors and to develop a risk-stratification model. Model performance was evaluated using the Hosmer-Lemeshow (H-L) test, calibration curves, and receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Multivariate analysis showed that white blood cell count (WBC) ≥ 12.81 × 10⁹/L (OR = 2.78), lymphocyte count ≤ 0.955 × 10⁹/L (OR = 0.27), and C-reactive protein (CRP) ≥ 56.085 mg/L (OR = 20.42) were independently associated with complicated appendicitis at admission. The constructed risk-stratification model exhibited an area under the curve (AUC) of 0.85, with a sensitivity of 81.2%, and a specificity of 84.8%. The H-L test indicated satisfactory model calibration (P = 0.933).</p><p><strong>Conclusion: </strong>The model based on admission WBC, lymphocyte count, and CRP showed good discriminatory ability for identifying complicated appendicitis in elderly patients at presentation. As an admission-time risk-stratification tool, it may assist clinical assessment and triage.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833149","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":"Association between the blood urea nitrogen to albumin ratio and all-cause mortality in critically ill patients with liver cirrhosis.","authors":"Jian Liao, Maojuan Wang, Mingyang Du, Yuan Wang, Dingyu Lu","doi":"10.1186/s12876-026-04887-2","DOIUrl":"https://doi.org/10.1186/s12876-026-04887-2","url":null,"abstract":"<p><strong>Background: </strong>The prognosis for critically ill patients with liver cirrhosis in the intensive care unit (ICU) remains uncertain. This study aimed to investigate the association between the Blood Urea Nitrogen to Albumin Ratio (BAR) at ICU admission and mortality in patients with liver cirrhosis.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the MIMIC-IV database. The primary and secondary outcomes were 28-day and 180-day all-cause mortality after ICU admission, respectively. Patients were stratified into high- and low-BAR groups based on an optimal cutoff value determined by ROC analysis. To evaluate the association between BAR and all-cause mortality, we employed multivariate Cox regression models with comprehensive covariate adjustments. The survival experience stratified by BAR was visualized using Kaplan-Meier curves. Furthermore, we utilized restricted cubic splines to examine the potential non-linear relationship between BAR and the risk of mortality, complemented by interaction and subgroup analyses to assess the consistency of this association.</p><p><strong>Results: </strong>A total of 3,268 adult patients with liver cirrhosis were included. The optimal BAR cutoff was 9.25. Compared to the low-BAR group, patients in the high-BAR group (≥ 9.25) had significantly higher 28-day (46.5% vs. 17.5%) and 180-day (54.0% vs. 24.9%) mortality rates. After multivariable adjustment, a high BAR remained independently associated with increased risks of 28-day (HR: 1.65, 95% CI: 1.42-1.92) and 180-day mortality (HR: 1.41, 95% CI: 1.21-1.64). BAR demonstrated good predictive ability for both 28-day mortality (AUC: 0.752) and 180-day mortality (AUC: 0.744), which was comparable to APS III and significantly better than SOFA, OASIS, GCS, and Charlson scores. Restricted cubic spline analyses revealed the mortality risk increased only modestly at BAR levels below approximately 9.25, but rose steeply and nonlinearly once BAR exceeded this threshold, indicating a potential threshold effect.</p><p><strong>Conclusion: </strong>The BAR is an independent predictor of short-and long-term mortality in critically ill cirrhotic patients. Its calculation at ICU admission may serve as a potential tool for early risk stratification, potentially facilitating timely clinical interventions.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833554","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":"Machine learning-driven clinical decision support for liver cirrhosis: a gut microbiome-based web prediction model with explainable AI integration.","authors":"Jianyuan Liu, Shiran He, Heng Zhang, Huanzhuo Mai, Xiaozhen Li, Hao Liang, Ping Cui, Liuyan Lan, Wenping Liao, Qianqian Huang, Huan Ning, Zhuoxin Li, Yunxiao Liang, Xing Yang, Jiegang Huang","doi":"10.1186/s12876-026-04890-7","DOIUrl":"https://doi.org/10.1186/s12876-026-04890-7","url":null,"abstract":"<p><strong>Background: </strong>Liver cirrhosis (LC) is a chronic liver disease with global prevalence. Current diagnostic methods for LC still face limitations in safety and accessibility. We aimed to develop an interpretable machine learning (ML) prediction model for LC using gut microbes and deploy it as a web-based clinical decision support tool.</p><p><strong>Methods: </strong>Data were retrieved from PubMed and BioProject databases. Bioinformatics re-analysis and discriminant analysis effect size (LEfSe) analysis was conducted to preliminarily identify key genera associated with LC. Further feature selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression. The independent datasets were combined to form an integrated dataset, which was then subjected to five-fold cross-validation and leave-one-dataset-out (LODO) analysis. Model performance was evaluated using metrics such as the area under the receiver operating characteristic curve (AUC), and the optimal model was selected. The decision mechanism of the optimal model was interpreted using SHapley Additive exPlanations (SHAP), and the model was deployed as a web application using the Streamlit framework.</p><p><strong>Results: </strong>We ultimately included 11 datasets related to LC. The genera Veillonella, Lachnospira, Romboutsia, Akkermansia, Erysipelatoclostridium, Prevotella, UCG.005, and Streptococcus were identified as key predictors distinguishing LC patients from healthy controls. The Random Forest (RF) model demonstrated the best predictive performance (AUC in five-fold cross-validation: 0.875, 95% CI: 0.823-0.905; AUC in LODO analysis: 0.793, 95% CI: 0.702-0.940) and was deployed as an online LC prediction tool.</p><p><strong>Conclusion: </strong>The interpretable RF model, along with its web-based implementation, has the potential to provide decision support for healthcare professionals and shows promise as a valuable auxiliary tool for LC screening and early clinical intervention.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833443","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":"Circulating miR-184 and miR-206 as predictive biomarkers for early recurrence in HBV-related hepatocellular carcinoma: a prospective study.","authors":"Sang-Hoon Kim, Ryunjin Lee, Eunyoung Tak, Ki-Hun Kim","doi":"10.1186/s12876-026-04871-w","DOIUrl":"https://doi.org/10.1186/s12876-026-04871-w","url":null,"abstract":"<p><strong>Background: </strong>Early recurrence after curative resection remains a major challenge in hepatocellular carcinoma (HCC), particularly in hepatitis B virus (HBV)-related cases. Liquid biopsy using circulating microRNAs (miRNAs) offers a non-invasive approach to identify molecular markers predictive of recurrence.</p><p><strong>Methods: </strong>We prospectively enrolled 30 patients with HBV-related HCC presenting with a single tumor (< 5 cm) and no vascular invasion or metastasis. Blood samples were collected preoperatively and on postoperative day 7. Expression of 20 selected miRNAs from circulating cell-free DNA/RNA and exosomes was analyzed. Participants were categorized into early recurrence (within 1 year, n = 6) and non-recurrence (n = 24) groups. Differentially expressed miRNAs were identified, and target genes of significant miRNAs were retrieved from miRTarBase. Protein-protein interaction (PPI) networks were constructed using STRING and visualized in Cytoscape. Enrichment analysis was performed using Gene Ontology and KEGG pathway databases.</p><p><strong>Results: </strong>On postoperative day 7, expression of miR-184 and miR-206 was significantly lower in the early recurrence group than in the non-recurrence group (p < 0.05). Other miRNAs showed no significant differences. Target gene analysis revealed 16 key hub proteins-CCND1, CCND2, KLF4, NOTCH3, BDNF, MET, CDK4, BCL2, AKT2, IGF1R, MYC, HDAC4, ESR1, KRAS, SMARCB1, and AGO2-enriched in cancer-related pathways and involved in HCC progression.</p><p><strong>Conclusion: </strong>Reduced postoperative expression of miR-184 and miR-206 may predict early recurrence in patients with HBV-related HCC. Their associated regulatory networks suggest possible mechanisms of recurrence and represent potential biomarkers for postoperative surveillance. Further studies are needed to validate their prognostic value.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833556","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":"Development and validation of a real-time AI model for differentiating benign and malignant gastric ulcers : a multicenter retrospective study.","authors":"Yibo Tan, Yongjun Wu, Mei Yang, Yan Li, Xiaofei Bi, Song He, Zhihang Zhou, Junyu Lu","doi":"10.1186/s12876-026-04848-9","DOIUrl":"https://doi.org/10.1186/s12876-026-04848-9","url":null,"abstract":"<p><strong>Aim: </strong>To develop and validate a deep learning-based AI system for the dynamic, real-time differentiation of benign and malignant gastric ulcers during endoscopy, with the goal of enhancing diagnostic precision.</p><p><strong>Methods: </strong>This was a multicenter, retrospective study collecting endoscopic images and videos from four tertiary hospitals in China. An improved YOLOv8 model, incorporating an illumination attention module, was developed for real-time instance segmentation and classification. The dataset comprised 9,820 benign ulcer images, 1,727 malignant ulcer images, and 15,791 normal mucosa images, split into training, testing, and validation sets at an 8:1:1 ratio. Performance was evaluated based on precision, recall, specificity, and processing latency.</p><p><strong>Results: </strong>On the validation set, the AI model achieved an overall precision, recall, and specificity of 0.91, 0.91, and 0.95, respectively. For malignant ulcer recognition specifically, the precision, recall, and specificity were 0.90, 0.91, and 0.99. The model demonstrated strong real-time performance with a latency of 8.84 ms per frame and a processing speed of 113 frames per second.</p><p><strong>Conclusion: </strong>The developed AI model enables accurate, real-time discrimination between benign and malignant gastric ulcers during endoscopy. It holds potential to augment clinical decision-making, standardize diagnostic quality, and optimize biopsy strategies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833170","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":"Peptic ulcer disease in hospitalized patients: a comprehensive risk factor analysis using a validated checklist.","authors":"Noorollah Tahery, Alireza Baghrobehbahani, Razieh Mohammadzadeh, Amirhossein Alaviyan, Rasool Paygozar, Mona Ebrahimzadeh, Mohsen Shafiee","doi":"10.1186/s12876-026-04711-x","DOIUrl":"https://doi.org/10.1186/s12876-026-04711-x","url":null,"abstract":"<p><strong>Background: </strong>Peptic ulcer disease (PUD) remains a significant public health concern globally, particularly in regions with high prevalence of risk factors such as Helicobacter pylori infection and Non-Steroidal Anti-Inflammatory Drug (NSAID) use. This study aimed to investigate the prevalence of PUD and its associated risk factors among hospitalized patients in a tertiary hospital in southwest Iran.</p><p><strong>Methods: </strong>A mixed-methods design was employed, including a comprehensive literature review, checklist development and validation via a modified Delphi process, a cross-sectional prevalence study, and a hospital-based case-control study. Data were collected from 43,324 patient records (2019-2023) at Abadan University Teaching Hospital. Risk factors were assessed using a validated 21-item checklist, and multivariate logistic regression was used to identify independent predictors of PUD.</p><p><strong>Results: </strong>Among all admissions, 6,874 cases of PUD were identified, indicating a point prevalence of 15.9% (95% CI: 15.6-16.2). NSAID use (75.3%), H. pylori infection (70.1%), smoking (46.9%), and corticosteroid use (30.2%) were highly prevalent among PUD patients. Significant independent risk factors included age ≥ 60 years (AOR: 1.65), NSAID use (AOR: 2.58), H. pylori positivity (AOR: 2.41), smoking (AOR: 1.45), and ulcer size ≥ 5 mm (AOR: 2.19). Despite the high rate of NSAID use, only 26.4% received gastroprotective therapy.</p><p><strong>Conclusions: </strong>The findings underscore the high burden of PUD in hospitalized patients in southwest Iran, with modifiable risk factors such as NSAID use, H. pylori infection, and smoking playing a critical role. Targeted interventions, including Proton Pump Inhibitor (PPI) co-prescription, H. pylori eradication, and lifestyle modifications, are essential to reduce PUD incidence and its complications.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811108","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":"EUS-guided drainage for pelvic abscesses: a Chinese single-center two-year follow-up study highlighting clinical outcomes.","authors":"Tao Yang, Yi Lu, Wenru Li, Jun Deng, Tao Liu, Yanan Liu, Min Zhi, Jiachen Sun","doi":"10.1186/s12876-026-04741-5","DOIUrl":"https://doi.org/10.1186/s12876-026-04741-5","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS)- guided drainage has emerged as a novel technique for managing pelvic abscesses. This single-center retrospective case series aims to assess the safety and efficacy of EUS-guided drainage in treating pelvic abscesses of varying etiologies from 2021 to the present.</p><p><strong>Methods: </strong>Consecutive patients with pelvic abscesses who underwent EUS-guided drainage were retrospectively reviewed. Etiologies included appendiceal abscess secondary to acute appendicitis (n = 1), pelvic abscesses resulting from anastomotic leaks following rectal cancer surgery (n = 2), and perianal abscesses associated with Crohn's disease (n = 7). The primary outcome was technical success and reduction in abscess cavity size, assessed via follow-up imaging. Clinical success was defined as significant reduction or complete resolution of the abscess cavity size on follow-up imaging at one-month post-procedure, accompanied by clinical symptom resolution and without the need for additional interventions. Secondary outcomes included post-procedural complications and resolution of the abscess without additional interventions.</p><p><strong>Results: </strong>EUS-guided drainage was technically successful in all cases. The median reduction in abscess size was statistically significant (Mean SD: 24.1 ± 11.11, p < 0.05). During follow-up, imaging results confirmed significant reduction in the size of pelvic abscesses in 9 patients, except for one case at the 1-month post-procedure. None of the patients required further surgical intervention, and 2 cases recurrences were observed in the sixth- and tenth-months post-procedure. Additionally, no procedure-related complications were reported.</p><p><strong>Conclusion: </strong>EUS-guided drainage is a safe and effective therapeutic option for managing pelvic abscesses of various etiologies. Its efficacy, particularly in Crohn's disease-related cases, and the absence of complications in this cohort, suggest significant potential for broader clinical application.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811110","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":"Laparoscopic partial hepatectomy for primary hepatic PEComa: a case report.","authors":"Bing Liang, Hongjin Shi, Qingbin Zeng, Xin Tie, Kui Long","doi":"10.1186/s12876-026-04884-5","DOIUrl":"https://doi.org/10.1186/s12876-026-04884-5","url":null,"abstract":"<p><strong>Introduction: </strong>Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors composed of cells exhibiting an epithelioid morphology. These cells typically arrange around small blood vessels (perivascular spaces) and display dual differentiation characteristics of smooth muscle cells and melanocytes. Diagnosis is challenging due to the absence of specific symptoms or tumor markers. This case features a young male patient with a large hepatic PEComa, whose imaging findings resemble those of hepatocellular carcinoma. We have detailed the entire process from diagnosis to treatment to aid in differential diagnosis and surgical planning.</p><p><strong>Case: </strong>A 31-year-old male patient with no prior medical history underwent a routine health examination 20 days prior to presentation. Although the patient was asymptomatic, ultrasound revealed an incidental hepatic lesion measuring 58 × 50 × 45 mm (maximum diameter 58 mm, or 5.8 cm). The screening center suspected a hemangioma. Subsequently, he presented to our hospital. Comprehensive imaging studies, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), revealed a 58 mm-diameter space-occupying lesion in segments V and VIII of the right hepatic lobe. Imaging findings initially raised suspicion for hepatocellular carcinoma. To minimize surgical trauma and preserve liver function, our team discussed surgical approaches and ultimately decided on a laparoscopic partial hepatectomy. During the procedure, we obtained a specimen for pathological examination. The final histopathological analysis confirmed the diagnosis of a PEComa with undetermined malignant potential. The patient recovered smoothly postoperatively and was successfully discharged.</p><p><strong>Conclusion: </strong>PEComa has an insidious onset and is rare. Early diagnosis is often challenging, and imaging studies typically show no highly specific findings. Clinical diagnosis frequently relies on biopsy. In terms of treatment, radical resection (R0 resection, i.e., negative margins) represents the definitive therapeutic approach.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811112","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}