Case Reports in Gastroenterology最新文献

{"title":"Primary Eosinophilic Panniculitis of the Greater Omentum in a Young Girl: A Case Report.","authors":"Masayuki Shintaku, Tokiko Okunobo, Hiroki Nakamura, Takashi Doi, Akira Tanaka, Koji Tsuta","doi":"10.1159/000544861","DOIUrl":"10.1159/000544861","url":null,"abstract":"<p><strong>Introduction: </strong>Primary (or idiopathic) panniculitis involving the intra-abdominal adipose tissue is rare, and its pathogenesis remains unknown. A case of primary eosinophilic panniculitis that involved the greater omentum of a girl is reported.</p><p><strong>Case presentation: </strong>The patient, an 11-year-old girl, complained of dull periumbilical pain and nausea, and radiological examination showed a mass lesion in the abdomino-pelvic cavity. On laparoscopy, a plaque-like, flat mass was seen in the greater omentum, and laparoscopic omental resection was performed. On histopathological examination, the interlobular fibrous septa of omental adipose tissue were widened by inflammatory edema, prominent infiltration of eosinophils, and loose proliferation of myofibroblasts. Dense lymphocytic infiltration was also noted around small veins. Inflammatory changes were mild in the fat lobules, and fat necrosis and infiltration of lipid-laden macrophages were absent. Findings of obliterative phlebitis or arteritis were not seen.</p><p><strong>Conclusion: </strong>Isolated involvement of the omentum by a panniculitic process is rare, and the pathogenesis of eosinophilic septal panniculitis found in the present case remains unknown, but involvement of a hypersensitivity reaction against some unknown stimuli is presumed, based on the histopathological resemblance of the omental lesions to erythema nodosum or eosinophilic panniculitis of the skin. We should keep in mind the possibility that the omental lesion in this patient is a harbinger of more serious immunological disorders. Careful, long-term follow-up and monitoring of the patient are needed.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"268-275"},"PeriodicalIF":0.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802585","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}

{"title":"Endoscopic Clot Removal Is an Effective Method for Treating Massive Ruptured Esophageal Hematoma: A Case Report.","authors":"Jie Li, Manli Cui, Hua Wen, Jie Zhang, Mingxin Zhang","doi":"10.1159/000544787","DOIUrl":"10.1159/000544787","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic clot removal in complex huge esophageal hematoma is a rare clinical entity.</p><p><strong>Case presentation: </strong>A 48-year-old male patient presented to our hospital with vomiting blood with black stool for 1 day after drinking alcohol. Esophageal hematoma was diagnosed after chest CT and EGD. After conservative treatment with intravenous fluids, the patient's symptoms of vomiting blood persisted and the hemoglobin decreased significantly. We decided to perform another EGD: the huge hematoma had ruptured. We performed endoscopic hemostasis and blood clot removal. Long-term postoperative follow-up shows the mucosa heals well.</p><p><strong>Conclusion: </strong>Endoscopic clot removal is an effective method of treating esophageal huge hematoma accompanied by rupture.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"276-280"},"PeriodicalIF":0.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802584","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}

{"title":"Coexisting Collagenous Sprue and Celiac Disease: A Case Report.","authors":"Tyler M Selig, Ayesha Siddique, John L Reagan, Edward R Feller, Samir A Shah","doi":"10.1159/000543939","DOIUrl":"10.1159/000543939","url":null,"abstract":"<p><strong>Introduction: </strong>Collagenous sprue (CS) is an extremely rare enteropathy of unknown etiology and if untreated, can lead to substantial morbidity and mortality. CS often copresents with celiac disease. The presence of a subepithelial collagen band on histology differentiates CS from celiac disease, as both have villous blunting. The management of the two diseases is different, and thus it is critical that the proper diagnosis of CS is made promptly to prevent complications.</p><p><strong>Case presentation: </strong>We present a case report of CS in an elderly male who was initially diagnosed with celiac disease alone before returning to care years later with unresolved gastrointestinal symptoms.</p><p><strong>Conclusion: </strong>Clinicians must verify that CS has been ruled out following a celiac disease diagnosis. In regard to CS's mechanism, CS's high frequency of comorbid autoimmune conditions and its robust response to corticosteroids support an immune-mediated process. Future research should continue to aim to elucidate the mechanism as it would allow for a more targeted approach to treatment, such as anti-fibrotic or specific immunomodulator therapy.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"246-252"},"PeriodicalIF":0.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771447","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}

{"title":"Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspected Locoregional Rectal Cancer Localizations: A Valuable Tool.","authors":"Frank Ter Borg, Shira H de Bie, A Koen Talsma","doi":"10.1159/000544767","DOIUrl":"10.1159/000544767","url":null,"abstract":"<p><strong>Introduction: </strong>Organ-preserving treatment for rectal cancer using local excision (LE) and/or chemoradiotherapy (CRT) is increasingly used. Locoregional metastasis precludes LE and locoregional regrowth, recurrence, or persistence after LE or chemoradiation (CRT) may prompt total mesorectal excision (TME). We believe that the time has passed to make such life-changing treatment decisions without pathological confirmation and investigated the use of linear endoscopic ultrasound with fine-needle aspiration (EUS-FNA).</p><p><strong>Case presentations: </strong>We report 8 cases of suspected locoregional tumor growth (LRTG) on MRI: adjacent or in the rectal wall, within the mesorectal fascia, high presacral region, and obturator foramen. MRI images were studied thoroughly before and during EUS to identify the target lesion using rectal EUS-FNA. Patients were prepared using an enema. The procedure was performed on an outpatient basis without conscious sedation. FNA was performed using a 25G needle. The patient received a 3-day course of ciprofloxacin after the procedure to prevent infection of the perirectal space. Identification of the target was the most difficult part of EUS but was successful in all cases. FNA revealed adenocarcinoma in 7 cases. Five cases were confirmed by TME results: 1 patient died before the operation, and 1 patient was treated with CRT. One patient with a suspected node in the obturator foramen was free of tumors on FNA. The TME resection specimen contained 31 lymph nodes without metastasis. All procedures were well tolerated, and no complications were observed.</p><p><strong>Conclusion: </strong>Suspected LRTG on MRI can be confirmed using EUS-FNA. In the era of organ-preserving treatment for rectal cancer, EUS-FNA may play a supportive role when considering TME or CRT.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"253-261"},"PeriodicalIF":0.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771449","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}

{"title":"A Case Report: Cryptogenic Multifocal Ulcerative Stenosing Enteritis - A Diagnostic Challenge Mimicking Crohn's Disease.","authors":"Naveena Luke, Inna Carmela De Leon, Shayan Azizi, Seymour Katz","doi":"10.1159/000544941","DOIUrl":"10.1159/000544941","url":null,"abstract":"<p><strong>Introduction: </strong>Cryptogenic multifocal ulcerative stenosing enteritis (CMUSE) is a rare and underrecognized small bowel disorder that often mimics Crohn's disease, leading to delays in diagnosis and misdirected treatment. Given its relapsing nature and resistance to conventional inflammatory bowel disease (IBD) therapies, CMUSE presents significant diagnostic and therapeutic challenges.</p><p><strong>Case presentation: </strong>We present the case of a 41-year-old male with chronic anemia, fatigue, weight loss, and intermittent abdominal pain with melena, who remained undiagnosed for 9 years despite extensive evaluations. Imaging and endoscopy failed to identify a definitive cause, and management with TNF inhibitors and IL-12/IL-23 blockade provided only temporary relief. The patient required multiple surgical resections due to recurrent strictures. Pathological examination consistently revealed multifocal jejunal ulceration with stenosis but lacked granulomas, vasculitis, or systemic inflammatory markers, ultimately confirming CMUSE. Given its distinct pathology and treatment resistance, differentiating CMUSE from Crohn's disease is essential. The patient's ongoing management includes upadacitinib, a JAK1 inhibitor, which may help modulate immune pathways contributing to ulcer formation and stricture development.</p><p><strong>Conclusion: </strong>This case underscores the need for heightened clinical recognition of CMUSE, particularly in patients with unexplained small bowel strictures and ulceration unresponsive to standard IBD therapies. Genetic testing may aid in distinguishing CMUSE from Crohn's disease, preventing unnecessary immunosuppressive treatments. Further research is necessary to establish effective, targeted therapies and improve outcomes for patients with this rare condition.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"238-245"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763164","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}

{"title":"Bronchoesophageal Fistula following Radiotherapy: A Case Report.","authors":"Eyad Jamileh, Yaeesh Khan, Usamah Hijazi, Mohammad Abusheikha","doi":"10.1159/000544975","DOIUrl":"10.1159/000544975","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchoesophageal fistulas (BOF) have predominantly been found to result in a decreased quality of life and an increased rate of mortality, particularly due to their severe complications and difficult treatment.</p><p><strong>Case presentation: </strong>This report discusses the case of a 71-year-old female who presented with shortness of breath and a continuous cough secondary to a fistula between the oesophagus and right bronchus on the background of squamous cell carcinoma (SCC). This patient was seen by oncologists for the treatment of her lung cancer after right middle and lower lobe lobotomies, which was then treated with radiotherapy. On admission, a computed tomography scan revealed that the patient had a BOF due to therapeutic radiotherapy for SCC. She underwent intervention from the gastrointestinal and respiratory physicians to treat the BOF. Oesophageal stent placement was performed for treatment; however, the BOF remained patent, so a bronchial stent was considered for insertion. While the patient was awaiting the bronchial stent, she died.</p><p><strong>Conclusion: </strong>This case highlights the complexities and challenges of BOFs, emphasising the need for further research and documentation to improve treatment strategies. More studies are needed to determine when oesophageal stenting is preferred over bronchial stenting and to evaluate the suitability and safety of dual stenting in both the oesophagus and bronchus.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"225-231"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763165","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}

{"title":"Primary Peritoneal Clear Cell Carcinoma Presenting with Nonspecific Gastrointestinal Symptoms in a 39-Year-Old Woman: A Case Report.","authors":"Ramya Vasireddy, Thilini Delungahawatta, Greeshma Gaddipati, Jeffrey Iding, Bryan Szeto, Christopher J Haas","doi":"10.1159/000544883","DOIUrl":"10.1159/000544883","url":null,"abstract":"<p><strong>Introduction: </strong>Primary peritoneal clear cell carcinoma (PPCCC) is a rare abdominal tumor, affecting 7 out of every million people. Its vague presenting signs and symptoms often lead to delayed diagnosis and poor prognosis. We present a case involving a young woman with anemia and abdominal discomfort who on further investigation had a 26-cm abdominal tumor identified to be PPCCC. Multimodal therapy with tumor debulking and chemotherapy was pursued. Given the aggressive nature of PPCCC, any clinical suspicion of peritoneal carcinoma should prompt thorough diagnostic evaluation.</p><p><strong>Case presentation: </strong>A 39-year-old woman with menorrhagia and peptic ulcer disease presented with abdominal discomfort of 2 days duration. She initially had headaches managed with ibuprofen. Following this, she had generalized abdominal pain with bloating that worsened with food and had no relief with use of stool softeners. She had associated dizziness with palpitations, chest pressure, and exertional dyspnea. In the emergency department, the patient was mildly tachycardic but otherwise stable. On exam, she had a distended abdomen with generalized tenderness and normoactive bowel sounds. Labs showed normocytic anemia with a hemoglobin of 5.2 mg/dL. Electrocardiogram and abdominal and chest X-rays were normal. A non-contrast computed tomography of the abdomen and pelvis showed a fibroid uterus and posterior displacement of multiple bowel loops by a large septate cystic mass (13.5 × 26.0 × 26.7 cm) occupying the entire abdominal cavity. Elevated CA 125 and CA 19-9 were also noted. She underwent exploratory laparotomy with mass resection, partial omentectomy, left colectomy (given extension into transverse colon), appendectomy, and total abdominal hysterectomy with bilateral salpingectomy. Biopsy and immunohistochemical staining (positive for PAX-8, ER, P53, P16, Napsin A and negative for PR and WT-1) confirmed mass as stage IIIB PPCCC. There was no evidence of malignancy in other tissue samples. The patient was discharged with a plan for outpatient chemotherapy and genetic counseling.</p><p><strong>Conclusion: </strong>Given the rarity of PPCCC, our case highlights how increased clinical vigilance and prompt multidisciplinary efforts are essential for an accurate diagnosis, especially in younger patients to not delay management. Currently, there are no established management guidelines; however, initial treatment with surgical debulking followed by chemotherapy is often practiced.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"198-203"},"PeriodicalIF":0.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708670","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}

{"title":"Aseptic Abscess Syndrome: A Case Report of a Rare Extraintestinal Manifestation of Inflammatory Bowel Disease.","authors":"Clive Jude Miranda, Nariman Hossein-Javaheri, Gina Marie Sparacino, Yousef Soofi, Farhan Azad, Nikki Duong","doi":"10.1159/000543761","DOIUrl":"10.1159/000543761","url":null,"abstract":"<p><strong>Introduction: </strong>Aseptic hepatic abscesses are a highly uncommon phenomenon and even more rare in the spectrum of extraintestinal manifestations of inflammatory bowel disease. Part of the spectrum of \"neutrophilic disease,\" both the pathogenesis and the optimal management of these aseptic abscesses remain unclear. In the context of inflammatory bowel disease, sometimes these abscesses appear despite normal endoscopic findings.</p><p><strong>Case presentation: </strong>We describe a highly uncommon case of aseptic hepatic abscess formation in a patient with inflammatory bowel disease.</p><p><strong>Conclusion: </strong>In doing so, we investigated the concept of \"aseptic abscess syndrome\" as it relates to similar autoimmune conditions.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"120-126"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522667","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}

{"title":"An Intra-Abdominal Desmoid Tumor with Edematous Loose Collagen Fibers.","authors":"Mao Iino, Shoji Oura","doi":"10.1159/000543498","DOIUrl":"10.1159/000543498","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnostic physicians tend to judge a low-dense area on computed tomography (CT) as central necrosis when it has no contrast enhancement and locates in the center of large tumors.</p><p><strong>Case presentation: </strong>An 80-year-old woman was referred to our hospital due to the detection of an abdominal mass on ultrasound (US). CT showed a well-demarcated oval mass, 11 cm in size, with a central low-density area. US showed high internal echoes and enhanced posterior echoes. Magnetic resonance imaging (MRI) showed the low-density area on CT to be hypo-intense on T1-weighted images and hyper-intense on T2-weighted images. MRI further showed the central part of the tumor to be hyper-intense both on diffusion-weighted images and apparent diffusion coefficient images. Under the tentative diagnosis of a gastrointestinal stromal tumor with central necrosis, the patient underwent tumor resection, revealing the tumor to be a jejunal submucosal tumor. Pathological study showed collagen fibers with heterogeneous density and sparse proliferation of spindle cells. The center of the tumor had marked edema in addition to sparse collagen fibers. Immunostaining showed that the atypical cells were diffusely positive for β catenin and negative for S100 protein, desmin, and DOG1, leading to the diagnosis of desmoid tumor (DT).</p><p><strong>Conclusions: </strong>Physicians should note that intra-abdominal DT can have edematous loose collagen fibers and may show central necrosis-like findings on CT.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"107-112"},"PeriodicalIF":0.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11857155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499369","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}

{"title":"Drug-Induced Liver Injury Associated with Turmeric and Piperine: A Case and Review.","authors":"Atul Shrestha, Sarah Elliott, Joshua Haron Abasszade, Kyle Wu, Thomas Worland, Ian Simpson, Anouk Dev","doi":"10.1159/000543679","DOIUrl":"10.1159/000543679","url":null,"abstract":"<p><strong>Introduction: </strong>Turmeric is a common spice used in traditional Chinese and Ayurvedic medicine for a variety of purported health benefits. Recent concerns have arisen regarding turmeric-induced liver injury linked to formulations with enhanced bioavailability, often including piperine found in black pepper.</p><p><strong>Case presentation: </strong>We explore a case of a 40-year-old female with increasing fatigue, pruritus, and dark urine following consumption of turmeric and black pepper \"wellness shots\" leading to a significant drug-induced liver injury.</p><p><strong>Conclusion: </strong>This case underscores the critical need to recognise herbal remedies, such as turmeric, as potential sources of hepatotoxicity. Despite a reputation of safety, limited regulation and testing of turmeric may mean potential adverse effects are under-recognised. Understanding the mechanisms behind turmeric and black pepper's hepatotoxicity, including the role of potential genetic predispositions, requires further investigation for its safe use.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"96-106"},"PeriodicalIF":0.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490900","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}