Case Reports in Gastroenterology最新文献

Neoadjuvant Chemotherapy after Plasmapheresis in Borderline Resectable Pancreatic Cancer: A Case Report. 临界可切除胰腺癌血浆置换后新辅助化疗1例报告。

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Case Reports in Gastroenterology Pub Date : 2026-08-24 eCollection Date: 2026-01-01 DOI: 10.1159/000553338

Yoshihiro Uehara, Tatsunori Satoh, Shinya Kawaguchi, Eri Asahina, Shinya Endo, Kazuya Ohno

{"title":"Neoadjuvant Chemotherapy after Plasmapheresis in Borderline Resectable Pancreatic Cancer: A Case Report.","authors":"Yoshihiro Uehara, Tatsunori Satoh, Shinya Kawaguchi, Eri Asahina, Shinya Endo, Kazuya Ohno","doi":"10.1159/000553338","DOIUrl":"10.1159/000553338","url":null,"abstract":"Introduction: Persistent jaundice may occasionally occur even after technically successful biliary drainage, posing a considerable challenge in patients requiring early systemic therapy. In borderline resectable pancreatic cancer (BR-PC), timely initiation of neoadjuvant chemotherapy (NAC) is critical for optimizing treatment outcomes, but hyperbilirubinemia often delays therapy. Although plasmapheresis has been reported as a potential option for refractory hyperbilirubinemia, its use for facilitating initiation of NAC in BR-PC has not been well described.Case presentation: We present a case of a 65-year-old man with BR-PC who underwent endoscopic biliary drainage with metallic stent placement. Despite successful drainage, his serum bilirubin concentrations remained markedly elevated, preventing initiation of NAC. Plasmapheresis was performed, which resulted in a steady decline in bilirubin concentrations and allowed NAC with gemcitabine plus nab-paclitaxel to begin 21 days after plasmapheresis. There was no recurrence of jaundice during treatment, NAC was completed without interruption, and pancreaticoduodenectomy was subsequently performed.Conclusion: This case highlights the potential role of plasmapheresis as an adjunctive strategy in managing persistent jaundice following biliary drainage, particularly when early induction of chemotherapy is required in patients with BR-PC.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"342-350"},"PeriodicalIF":0.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811971","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

A Case Suggestive of Intrathoracic Rupture of a Nonparasitic Hepatic Cyst in Polycystic Liver Disease: A Case Report. 多囊性肝病非寄生性肝囊肿胸内破裂1例报告。

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Case Reports in Gastroenterology Pub Date : 2026-08-07 eCollection Date: 2026-01-01 DOI: 10.1159/000553232

Minoru Shimizu, Tomoaki Fujikawa, Shogo Iwabuchi, Yasuhiro Nakazaki, Hiroyuki Tanemura

{"title":"A Case Suggestive of Intrathoracic Rupture of a Nonparasitic Hepatic Cyst in Polycystic Liver Disease: A Case Report.","authors":"Minoru Shimizu, Tomoaki Fujikawa, Shogo Iwabuchi, Yasuhiro Nakazaki, Hiroyuki Tanemura","doi":"10.1159/000553232","DOIUrl":"10.1159/000553232","url":null,"abstract":"Introduction: Rupture of nonparasitic hepatic cysts is rare and usually occurs into the peritoneal cavity, whereas intrathoracic rupture has only rarely been described.Case presentation: We report the case of a 61-year-old woman with polycystic liver disease (PCLD) who presented with right-sided chest pain and dyspnea, suggesting intrathoracic rupture of a hepatic cyst. Computed tomography revealed unilateral pleural effusion and reduction with deformation of a large subdiaphragmatic hepatic cyst compared with prior imaging. Thoracentesis revealed transudative pleural fluid without evidence of infection or malignancy but markedly elevated levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). Based on these findings, intrathoracic rupture of a nonparasitic hepatic cyst was considered the most likely etiology. The patient subsequently underwent surgical deroofing because of cyst enlargement and symptoms; however, no definitive rupture site was identified intraoperatively, and the diagnosis therefore remained presumptive. To our knowledge, this represents a very rare presentation of intrathoracic rupture of a nonparasitic hepatic cyst in PCLD.Conclusion: This case highlights the importance of comparison with prior imaging and suggests that measurement of pleural CEA and CA19-9 levels may provide limited adjunctive information when intrathoracic rupture of a hepatic cyst is suspected, although these markers are nonspecific.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"288-296"},"PeriodicalIF":0.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697142","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

Prolonged Retention of a Spontaneously Dislodging Pancreatic Duct Stent in a Patient with Surgically Altered Anatomy: A Case Report. 手术改变解剖结构的患者自发性移位胰管支架的长期保留：一例报告。

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Case Reports in Gastroenterology Pub Date : 2026-08-04 eCollection Date: 2026-01-01 DOI: 10.1159/000553188

Toji Murabayashi, Hirofumi Okuda, Shinya Sugimoto

{"title":"Prolonged Retention of a Spontaneously Dislodging Pancreatic Duct Stent in a Patient with Surgically Altered Anatomy: A Case Report.","authors":"Toji Murabayashi, Hirofumi Okuda, Shinya Sugimoto","doi":"10.1159/000553188","DOIUrl":"10.1159/000553188","url":null,"abstract":"Introduction: Spontaneously dislodging pancreatic duct stents are generally expected to pass within several days. We report a rare case of markedly prolonged retention of such a stent in a patient with surgically altered anatomy.Case presentation: A 78-year-old man with a history of distal gastrectomy with Roux-en-Y reconstruction underwent single-balloon enteroscopy-assisted ERCP for choledocholithiasis. After successful biliary cannulation using pancreatic guidewire assistance, stone extraction was performed following a small sphincterotomy and papillary balloon dilation. A 5-Fr × 5-cm spontaneously dislodging pancreatic duct stent without an internal flange was prophylactically placed. The postoperative course was uneventful; however, spontaneous stent dislodgement was not observed on follow-up imaging. Because of the technical burden of repeat endoscopy in surgically altered anatomy, careful observation was initially selected. The stent remained in place for 104 days and was ultimately removed endoscopically using a single-balloon enteroscope without adverse events.Conclusion: This case illustrates that markedly prolonged retention of a spontaneously dislodging pancreatic duct stent may occur in patients with surgically altered anatomy. Careful follow-up, including imaging to confirm spontaneous stent passage, is important, and endoscopic removal should be considered when the stent remains in place, even if repeat endoscopy is technically challenging.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"276-281"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673066","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

Rectal Metastasis from Breast Cancer: A Case Report and Review of Literature. 乳腺癌直肠转移1例报告及文献复习。

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Case Reports in Gastroenterology Pub Date : 2026-07-15 eCollection Date: 2026-01-01 DOI: 10.1159/000550604

Felix-Antoine Coutu, Hamila Hagh-Doust, Chelsea Rose Maedler-Kron, Jamil Asselah, Talat Bessissow

{"title":"Rectal Metastasis from Breast Cancer: A Case Report and Review of Literature.","authors":"Felix-Antoine Coutu, Hamila Hagh-Doust, Chelsea Rose Maedler-Kron, Jamil Asselah, Talat Bessissow","doi":"10.1159/000550604","DOIUrl":"https://doi.org/10.1159/000550604","url":null,"abstract":"Introduction: Metastatic spread of breast cancer to the gastrointestinal (GI) tract is very uncommon (<1% of all metastases), but it is disproportionately higher in invasive lobular carcinoma (ILC) compared to invasive ductal carcinoma. Its presentation can mimic primary rectal malignancy, often leading to delayed diagnosis.Case presentation: We describe a 40-year-old woman with metastatic, hormone receptor-positive classic ILC who developed rectal obstruction 2 years after her breast cancer diagnosis. Initial colonoscopy with superficial biopsies was negative. One year later, pelvic magnetic resonance imaging (MRI) demonstrated smooth, concentric thickening of the rectal wall; repeat biopsies confirmed metastatic lobular carcinoma.Conclusion: This case illustrates the diagnostic challenges posed by rectal metastasis from ILC, especially negative superficial rectal biopsies. Endoscopic and radiologic features often mimic primary rectal pathology, underscoring the importance of deep biopsy and imaging in establishing the diagnosis. New lower-GI symptoms in any breast-cancer survivor, especially one with ILC, should prompt pelvic MRI and deep tissue sampling to exclude metastatic disease if superficial biopsies are negative.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"311-328"},"PeriodicalIF":0.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788652","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

Cytomegalovirus Gastrointestinal Disease Masquerading as Inflammatory Bowel Disease in a Patient with Occult HIV Infection Receiving Biologics: A Case Report. 隐匿性HIV感染患者接受生物制剂后，巨细胞病毒胃肠道疾病伪装成炎症性肠病：1例报告。

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Case Reports in Gastroenterology Pub Date : 2026-07-10 eCollection Date: 2026-01-01 DOI: 10.1159/000553395

Bashar Roumia, Manon Transleau

{"title":"Cytomegalovirus Gastrointestinal Disease Masquerading as Inflammatory Bowel Disease in a Patient with Occult HIV Infection Receiving Biologics: A Case Report.","authors":"Bashar Roumia, Manon Transleau","doi":"10.1159/000553395","DOIUrl":"https://doi.org/10.1159/000553395","url":null,"abstract":"Introduction: Biologic and targeted synthetic therapies can obscure underlying immunodeficiency and opportunistic infections, leading to diagnostic challenges in patients with presumed autoimmune disease.Case presentation: A 51-year-old man with ankylosing spondylitis and presumed ulcerative colitis experienced progressive systemic decline, including 40 lb. weight loss and encephalopathy, while receiving etanercept and upadacitinib. Clinical deterioration prompted reassessment, revealing advanced HIV/AIDS (CD4 count 21 cells/µL) and biopsy-confirmed cytomegalovirus esophagitis. Discontinuation of Janus kinase inhibition and initiation of antiretroviral therapy resulted in clinical stabilization.Conclusion: This case highlights the dangers of diagnostic momentum and demonstrates how opportunistic infections can mimic autoimmune pathology, emphasizing the need for diagnostic reassessment and objectivity in patients receiving potent immunomodulatory therapies.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"297-303"},"PeriodicalIF":0.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758041","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

Adult-Onset Hyperammonemia: Case Report and Review of Literature. 成人高氨血症：病例报告及文献回顾。

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Case Reports in Gastroenterology Pub Date : 2026-07-10 eCollection Date: 2026-01-01 DOI: 10.1159/000553356

Zehra Naseem, Amala Alenchery, Sarah Yuann Kim, Omar T Sims, Kadakkal Radhakrishnan, Sobia Nasir Laique

引用次数: 0

Neuroendocrine Tumor of Unknown Origin Leading to the Diagnosis of Advanced Celiac Disease: A Case Report Exploring a Possible Association. 来源不明的神经内分泌肿瘤导致晚期乳糜泻的诊断：一个病例报告探讨可能的关联。

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Case Reports in Gastroenterology Pub Date : 2026-07-10 eCollection Date: 2026-01-01 DOI: 10.1159/000553396

Hussam Almasri, Maram Albandak, Shahem Abbarh, Adnan Humam Hajjar, Ashraf I Ahmed, Abdelrahman A Karen, Yusuf Hallak, Bisher Sawaf, Mohammed Elbadri

{"title":"Neuroendocrine Tumor of Unknown Origin Leading to the Diagnosis of Advanced Celiac Disease: A Case Report Exploring a Possible Association.","authors":"Hussam Almasri, Maram Albandak, Shahem Abbarh, Adnan Humam Hajjar, Ashraf I Ahmed, Abdelrahman A Karen, Yusuf Hallak, Bisher Sawaf, Mohammed Elbadri","doi":"10.1159/000553396","DOIUrl":"https://doi.org/10.1159/000553396","url":null,"abstract":"Introduction: Celiac disease (CD), if left untreated, can predispose a wide range of intestinal malignancies including enteric lymphoma and adenocarcinoma. On rare occasions, intestinal neuroendocrine tumors (NETs) were reported. We present a case of metastatic NET that led to the diagnosis of CD.Case presentation: A 58-year-old woman presented with a lump in the left axilla without fever or weight loss. Physical examination showed a single tender and rubbery lymph node (LN) of 2.5 cm in size in the left axilla. Laboratories showed mild iron-deficiency anemia. An excisional LN biopsy showed well-differentiated NET, grade 3. A gallium Ga-68 DOTATATE-integrated positron emission tomography (PET)-computed tomography scan showed nonspecific homogenous duodenal and small bowel uptake without apparent signs of fluorodeoxyglucose (FDG)-avid malignancy. Upper endoscopy with push enteroscopy with small bowel biopsies were consistent with CD. The serum tissue transglutaminase-immunoglobulin test was positive. The patient was started on a gluten-free diet and managed with clinical observation. A follow-up FDG-PET scan after 6 months showed no abnormal uptake, and the patient continued to be asymptomatic beyond 1 year of follow-up.Conclusion: This case highlights the possible rare coexistence of CD with an atypical neoplastic process, particularly in patients presenting with unexplained iron-deficiency anemia. While CD is associated with an increased risk of certain rare gastrointestinal malignancies, its relationship with NETs remains poorly defined. Larger studies are needed to further explore any potential association between CD and NETs.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"304-310"},"PeriodicalIF":0.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760015","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

Ascites Decompensation in a Patient without Liver Disease: A Case Report. 无肝病患者腹水失代偿一例报告

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Case Reports in Gastroenterology Pub Date : 2026-06-19 eCollection Date: 2026-01-01 DOI: 10.1159/000552879

Alejandra Maria Peñuela-Romero, Peter Studer, Carolin Wagener, Felix Stickel

引用次数: 0

Hyperammonemia after Liver Surgery: A Case Report of an Unanticipated Postoperative Challenge. 肝脏手术后高氨血症：一例意外的术后挑战报告。

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Case Reports in Gastroenterology Pub Date : 2026-06-11 eCollection Date: 2026-01-01 DOI: 10.1159/000552943

Dan Koning, Nathanja Schep, Jeroen Hagendoorn, Jelmer Oor, Maaike A Sikma

引用次数: 0

Anticoagulation-Amplified Recurrent Esophageal Hemorrhage in Triple-Positive Antiphospholipid Syndrome: The Inescapable Anticoagulation Dilemma. 抗磷脂三阳性综合征的抗凝放大复发性食管出血：不可避免的抗凝困境。

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Case Reports in Gastroenterology Pub Date : 2026-06-05 eCollection Date: 2026-01-01 DOI: 10.1159/000552878

Akram Alnounou, Chelsea Zambrano, Arghyadeep Ganguly, Harry Boamah

{"title":"Anticoagulation-Amplified Recurrent Esophageal Hemorrhage in Triple-Positive Antiphospholipid Syndrome: The Inescapable Anticoagulation Dilemma.","authors":"Akram Alnounou, Chelsea Zambrano, Arghyadeep Ganguly, Harry Boamah","doi":"10.1159/000552878","DOIUrl":"10.1159/000552878","url":null,"abstract":"Introduction: Antiphospholipid syndrome (APS) is an acquired thrombophilia. Triple-positive APS, defined by lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein I antibody positivity, usually requires long-term vitamin K antagonist therapy; direct oral anticoagulants are discouraged, and low-molecular-weight heparin is reserved for selected situations.Case presentation: A 52-year-old female with systemic lupus erythematosus and triple-positive APS on warfarin (International Normalized Ratio [INR] 2.9) presented with massive hematemesis requiring intubation. Serial esophagogastroduodenoscopy showed extensive esophageal clot burden followed by circumferential friability, sloughing, and necrotic/exudative esophagitis without varices or gastric/duodenal bleeding. Hemostatic powder was applied, fresh frozen plasma partially corrected the INR to 1.8, and anticoagulation was held. Therapeutic heparin bridging on hospital day 8 was followed by recurrent melena, hemoglobin decline from 8.3 to 5.5 g/dL, and gross hematuria; INR at rebleeding was 2.2. Hematology evaluation showed factor VIII activity 87% and negative Bethesda assay, arguing against acquired hemophilia A. Repeat endoscopy showed Los Angeles grade C esophagitis with clean-based linear ulcers and a 7-cm sliding hiatal hernia.Conclusion: Severe diffuse esophageal mucosal injury can cause recurrent major bleeding when anticoagulation is resumed before mucosal recovery. In high-risk APS, anticoagulation resumption should be individualized with hematology and gastroenterology input, and repeat endoscopy may help guide timing.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"266-275"},"PeriodicalIF":0.7,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577044","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