Case Reports in Gastroenterology最新文献_第2页

Filgotinib to Treat Acute Severe Refractory Ulcerative Colitis: A Case Report and Review of the Literature. 非戈替尼治疗急性严重难治性溃疡性结肠炎1例报告及文献复习。

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Case Reports in Gastroenterology Pub Date : 2025-04-25 eCollection Date: 2025-01-01 DOI: 10.1159/000545263

Giuliana Vespere, Silvia Sedda, Pasquale Madonna, Roberta Abete, Alfredo D'Avino, Manuela Maione, Marina Lugarà, Antonietta Tazza, Franco Scaldaferri, Giuseppe Vitiello, Leonardo De Luca

{"title":"Filgotinib to Treat Acute Severe Refractory Ulcerative Colitis: A Case Report and Review of the Literature.","authors":"Giuliana Vespere, Silvia Sedda, Pasquale Madonna, Roberta Abete, Alfredo D'Avino, Manuela Maione, Marina Lugarà, Antonietta Tazza, Franco Scaldaferri, Giuseppe Vitiello, Leonardo De Luca","doi":"10.1159/000545263","DOIUrl":"https://doi.org/10.1159/000545263","url":null,"abstract":"Introduction: Acute severe ulcerative colitis (ASUC) is a serious complication affecting 9%-15% of patients with UC within 3 months of diagnosis and up to 28% of patients during the course of the disease. Despite the use of infliximab and calcineurin inhibitors, the rate of colectomy remains high both during the hospitalization and in the 5 years after an acute episode. We present a case of ASUC that was unresponsive to conventional therapies but was successfully treated with filgotinib.Case presentation: A 21-year-old male with a recent diagnosis of UC presented to our hospital with a severe flare. He received rescue therapy of high-dose intravenous steroids and 10 mg/kg infliximab. We observed little clinical and biochemical benefits. The patient declined the surgical option. Therefore, we decided to start a second rescue therapy with a new and rapid-acting Janus kinase inhibitor, filgotinib, due to its characteristics and pharmacokinetic profile of rapid absorption and metabolism. The patient showed an immediate clinical and biochemical response at 48 h, an endoscopic response at week 3, and an endoscopic remission at week 10. No recurrence was observed after 12 months of follow-up. The patient is in clinical remission with a good quality of life.Conclusion: Filgotinib may be an effective second-line therapy in an emergency setting such as ASUC in patients unresponsive to conventional therapy.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"289-297"},"PeriodicalIF":0.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986140","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

Jejunal Lipoma-Induced Intussusception Mimicking Crohn's Disease: A Case Report. 空肠脂肪瘤诱导肠套叠模拟克罗恩病1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-23 eCollection Date: 2025-01-01 DOI: 10.1159/000545297

Naveena Luke, Tianyu She, Divya Roy, Toyooki Sonoda, Seymour Katz

{"title":"Jejunal Lipoma-Induced Intussusception Mimicking Crohn's Disease: A Case Report.","authors":"Naveena Luke, Tianyu She, Divya Roy, Toyooki Sonoda, Seymour Katz","doi":"10.1159/000545297","DOIUrl":"https://doi.org/10.1159/000545297","url":null,"abstract":"Introduction: Chronic gastrointestinal bleeding in patients with Crohn's disease presents diagnostic challenges. Adult intussusception is rare and typically caused by a pathological lead point, such as a tumor or inflammatory lesion. Lipomas, though benign, can lead to obstruction and bleeding, requiring differentiation from inflammatory causes for appropriate management.Case presentation: A 70-year-old male with Crohn's disease and chronic anemia presented with recurrent obscure gastrointestinal bleeding. Initial endoscopy was unremarkable, but capsule endoscopy identified a bleeding jejunal lesion. Double-balloon enteroscopy and imaging confirmed a jejunal lipoma causing intermittent intussusception. Due to persistent anemia, the patient underwent laparoscopic resection, with pathology confirming an ulcerated lipoma. His anemia resolved postoperatively.Conclusion: This case underscores the importance of considering structural lesions like lipomas in patients with chronic bleeding and Crohn's disease. A multimodal approach, including advanced imaging and enteroscopy, is crucial for accurate diagnosis and management. Surgical resection remains the preferred treatment for symptomatic small bowel lipomas.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"282-288"},"PeriodicalIF":0.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965167","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

Erratum. 勘误表。

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Case Reports in Gastroenterology Pub Date : 2025-04-16 eCollection Date: 2025-01-01 DOI: 10.1159/000545535

引用次数: 0

Primary Eosinophilic Panniculitis of the Greater Omentum in a Young Girl: A Case Report. 年轻女孩原发性大网膜嗜酸性泛膜炎1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-07 eCollection Date: 2025-01-01 DOI: 10.1159/000544861

Masayuki Shintaku, Tokiko Okunobo, Hiroki Nakamura, Takashi Doi, Akira Tanaka, Koji Tsuta

{"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":"Introduction: 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.Case presentation: 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.Conclusion: 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.","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}

引用次数: 0

Endoscopic Clot Removal Is an Effective Method for Treating Massive Ruptured Esophageal Hematoma: A Case Report. 内镜下血块清除是治疗食管大量破裂血肿的有效方法：1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-07 eCollection Date: 2025-01-01 DOI: 10.1159/000544787

Jie Li, Manli Cui, Hua Wen, Jie Zhang, Mingxin Zhang

引用次数: 0

Spontaneous Intramural Oesophageal Dissection following Intramural Oesophageal Haematoma: A Case Report. 食管壁内血肿后自发性食管壁内夹层1例报告。

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Case Reports in Gastroenterology Pub Date : 2025-04-03 eCollection Date: 2025-01-01 DOI: 10.1159/000544766

Georgia Sun, Joshua Haron Abasszade, Elizabeth Low, Lee Shien Low, Angel I Y Wu, Darcy Quinn Holt

引用次数: 0

Coexisting Collagenous Sprue and Celiac Disease: A Case Report. 胶原性口疮与乳糜泻共存1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-02 eCollection Date: 2025-01-01 DOI: 10.1159/000543939

Tyler M Selig, Ayesha Siddique, John L Reagan, Edward R Feller, Samir A Shah

{"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":"Introduction: 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.Case presentation: 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.Conclusion: 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.","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}

引用次数: 0

Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspected Locoregional Rectal Cancer Localizations: A Valuable Tool. 内镜下超声引导下细针抽吸对疑似局部直肠癌的定位：一种有价值的工具。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-02 eCollection Date: 2025-01-01 DOI: 10.1159/000544767

Frank Ter Borg, Shira H de Bie, A Koen Talsma

{"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":"Introduction: 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).Case presentations: 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.Conclusion: 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.","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}

引用次数: 0

A Case Report: Cryptogenic Multifocal Ulcerative Stenosing Enteritis - A Diagnostic Challenge Mimicking Crohn's Disease. 一例报告：隐源性多灶性溃疡性狭窄性肠炎-模拟克罗恩病的诊断挑战。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI: 10.1159/000544941

Naveena Luke, Inna Carmela De Leon, Shayan Azizi, Seymour Katz

{"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":"Introduction: 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.Case presentation: 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.Conclusion: 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.","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}

引用次数: 0

Bronchoesophageal Fistula following Radiotherapy: A Case Report. 放疗后支气管食管瘘1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-04-01 eCollection Date: 2025-01-01 DOI: 10.1159/000544975

Eyad Jamileh, Yaeesh Khan, Usamah Hijazi, Mohammad Abusheikha

{"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":"Introduction: 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.Case presentation: 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.Conclusion: 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.","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}

引用次数: 0