Case Reports in Gastroenterology最新文献

{"title":"Eosinophilic Gastritis with Localized Eosinophilic Infiltration Presenting as a Solitary Deep-Penetrating Gastric Ulcer Refractory to Potassium-Competitive Acid Blocker.","authors":"Kakeru Miyashita, Manabu Takeuchi, Takahiro Taguchi","doi":"10.1159/000552248","DOIUrl":"10.1159/000552248","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic gastritis (EoG) is a rare disease characterized by eosinophilic infiltration of the gastric wall. The endoscopic findings of EoG are diverse.</p><p><strong>Case presentation: </strong>We report a rare case of EoG in a 60-year-old woman presenting with a solitary deep-penetrating gastric ulcer accompanied by fold convergence. The lesion was resistant to potassium-competitive acid blocker therapy. Histopathological examination revealed dense eosinophilic infiltration (approximately 300 cells/high-power field) confined exclusively to the ulcer margin, with the surrounding gastric mucosa and other gastrointestinal sites showing no significant eosinophilic infiltration. EoG was diagnosed after excluding other possible causes. Corticosteroid therapy resulted in ulcer healing and an improvement in eosinophil infiltration.</p><p><strong>Conclusion: </strong>This case represents a rare instance of EoG presenting as a solitary gastric ulcer. EoG should be considered among the differential diagnoses for refractory gastric ulcer, even in the absence of diffuse mucosal eosinophilic infiltration.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"182-189"},"PeriodicalIF":0.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390023","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":"Intermittent Upper Gastrointestinal Bleeding Associated with a Hemorrhagic Pancreatic Pseudocyst and Transient Cyst-Duodenal Fistula: A Case Report.","authors":"Mohamed H Fadul, Yousef Yahia, Mohamed S Elmahadi, Girisha Balaraju","doi":"10.1159/000552379","DOIUrl":"10.1159/000552379","url":null,"abstract":"<p><strong>Introduction: </strong>Upper gastrointestinal bleeding (UGIB) is an uncommon complication of pancreatitis and may be challenging to diagnose when bleeding is intermittent and routine investigations are inconclusive. We report a case of intermittent UGIB associated with a hemorrhagic pancreatic pseudocyst and transient cystoduodenal fistula.</p><p><strong>Case presentation: </strong>A 29-year-old woman with biliary pancreatitis complicated by necrotizing pancreatitis and recurrent pancreatic collections presented with recurrent pancreatitis and intermittent UGIB. Imaging revealed a hemorrhagic pancreatic pseudocyst. During hospitalization, she experienced three discrete bleeding episodes over 10 days, including hematemesis, coffee ground emesis, and maroon-colored stools, with a hemoglobin nadir of 7.5 g/dL, requiring transfusion. Esophagogastroduodenoscopy revealed a duodenal bulb mucosal defect consistent with a cyst-duodenal fistula, which healed spontaneously. Repeated computed tomography angiography revealed no active bleeding or evidence of a pseudoaneurysm. Subsequent evaluation revealed pancreatic duct disruption with contrast leakage into a persistent pancreatic collection. Pancreatic duct stenting was performed, after which no further bleeding occurred.</p><p><strong>Conclusion: </strong>This case highlights transient cyst-duodenal fistulization as an underrecognized mechanism of intermittent UGIB in complicated pancreatitis and emphasizes that negative angiography does not exclude the pancreatic source of bleeding.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"190-195"},"PeriodicalIF":0.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435197","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":"Intussusception in Neonates: Uncommon Causes and Diagnostic Dilemmas in Two Case Reports.","authors":"Salma Mani, Lamiri Rachida, Amine Ksia, Lassaad Sahnoun, Amani N Alansari","doi":"10.1159/000552199","DOIUrl":"10.1159/000552199","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal intussusception (NI), although a rare cause of bowel obstruction, presents significant diagnostic challenges due to its clinical heterogeneity. This report describes two cases of NI, both presenting with vomiting and hematochezia. In both instances, the initial radiological evaluations led to a misdiagnosis, delaying timely treatment. Surgical intervention ultimately confirmed the diagnosis in both cases, highlighting the limitations of imaging modalities in neonates.</p><p><strong>Case presentations: </strong>In the first case, a full-term female neonate presented with bilious vomiting and rectal bleeding on day one of life. Despite suspicion of an intestinal duplication on ultrasonography, the definitive diagnosis was made intraoperatively, where ileocecal intussusception and colonic duplication were identified. In the second case, a full-term male neonate exhibited similar symptoms but with signs suggestive of volvulus on imaging. Surgical exploration revealed an ileocolonic intussusception, which was reduced manually without ischemia or necrosis.</p><p><strong>Conclusion: </strong>These cases emphasize the rarity of NI and the importance of considering it in differential diagnoses of neonates presenting with acute gastrointestinal symptoms, particularly when radiological findings are inconclusive. Timely surgical intervention remains critical for definitive diagnosis and optimal outcomes. Pediatric surgeons and clinicians must maintain a high index of suspicion for this rare condition to ensure timely diagnosis and minimize associated morbidity and mortality.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"196-203"},"PeriodicalIF":0.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403733","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":"Sequential Pancreatic Ascites and Hemosuccus Pancreaticus from an Identical Rupture Site in Branch-Duct Intraductal Papillary Mucinous Neoplasm: A Case Report.","authors":"Seiya Sasakura, Masayoshi Ko, Takato Maeda, Shohei Igarashi, Koji Shimaya, Norihiro Hanabata, Hiroshi Numao, Masaki Munakata","doi":"10.1159/000552311","DOIUrl":"10.1159/000552311","url":null,"abstract":"<p><strong>Introduction: </strong>A 68-year-old man with branch-duct intraductal papillary mucinous neoplasm (IPMN) in the pancreatic head presented with pancreatic ascites due to main duct rupture in the pancreatic body without typical pancreatitis symptoms.</p><p><strong>Case presentation: </strong>Although the serum amylase level was elevated, the amylase level in the ascitic fluid was markedly higher. We hypothesize that mucin-induced downstream obstruction may have contributed to elevated intraductal pressure and upstream rupture. After conservative management, the patient developed delayed hemorrhage of approximately 4 months from the same site.</p><p><strong>Conclusion: </strong>Based on a PubMed literature search, this appears to be the first reported case of pancreatic ascites followed by delayed hemorrhage from the same site associated with branch-duct IPMN.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"175-181"},"PeriodicalIF":0.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367091","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":"Retrievable Silicone-Covered Esophageal Stent-Assisted Endoscopic Extraction of a High-Risk Clasp-Retained Denture Impacted at the Aortic Arch Level of the Esophagus: A Case Report.","authors":"Jing Liu, Yisheng Wei","doi":"10.1159/000552200","DOIUrl":"10.1159/000552200","url":null,"abstract":"<p><strong>Introduction: </strong>Clasp-retained dentures are high-risk esophageal foreign bodies that carry a substantial risk of severe esophageal injury. Reliable protection strategies are therefore critical for safe endoscopic extraction. We present a case of successful endoscopic removal of a clasp-retained denture impacted at the aortic arch level using a retrievable silicone-covered esophageal stent as a protection device.</p><p><strong>Case presentation: </strong>A 50-year-old man with hypertension and coronary stent implantation was admitted with retrosternal pain and dysphagia for 4 h after accidental ingestion of a broken denture. Computed tomography confirmed a 1.3 × 2.0 × 4.7 cm foreign body impacted at the aortic arch level. The foreign body was successfully removed under general anesthesia with tracheal intubation, and no intraoperative complications occurred. Postoperative recovery was uneventful. Telephone follow-up at 1 week, 1 month, and 3 months showed that the patient had a normal diet with no discomfort, and the patient declined endoscopic reexamination.</p><p><strong>Conclusion: </strong>This case confirms that a retrievable silicone-covered esophageal stent is a safe and feasible protection device for endoscopic extraction of high-risk dentures at the aortic arch level, with favorable short- and medium-term outcomes. It provides a valuable clinical reference for managing such life-threatening foreign bodies.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"167-174"},"PeriodicalIF":0.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366985","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":"Successful Treatment of Refractory Pruritus in Primary Sclerosing Cholangitis with Upadacitinib: A Case Report.","authors":"Huzaifa Nadeem, Peter L Lakatos, Hamila Hagh-Doust, Jonathan M Wyse, Hamza Nadeem, Talat Bessissow","doi":"10.1159/000552074","DOIUrl":"10.1159/000552074","url":null,"abstract":"<p><strong>Introduction: </strong>Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease that is often complicated by severe pruritus, which can profoundly impair quality of life. In select cases, intractable pruritus is an independent indication for liver transplantation (LT) even in the absence of advanced liver disease, recurrent cholangitis, or malignancy. Conventional pharmacological and endoscopic therapies frequently provide only partial or transient relief, highlighting the need for mechanism-based treatments.</p><p><strong>Case presentation: </strong>We report the case of a 32-year-old man with long-standing PSC and Crohn's disease (CD) who developed severe treatment-refractory pruritus despite multiple conventional pharmacologic therapies and endoscopic biliary interventions. In the absence of advanced liver disease or malignancy, he underwent LT evaluation primarily due to debilitating pruritus significantly impairing quality of life, with secondary consideration given to medically and endoscopically challenging but manageable recurrent dominant common bile duct stricture and episodes of acute cholangitis. Upadacitinib, a selective Janus kinase 1 (JAK1) inhibitor, was initiated for a CD flare, after which pruritus completely resolved within 48-72 h. Maintenance therapy with upadacitinib 30 mg daily has sustained symptom-free status for over 27 months, markedly improving quality of life and allowing the patient to remain inactive on the liver transplant waitlist.</p><p><strong>Conclusion: </strong>This case demonstrates the rapid and durable resolution of PSC-associated pruritus with JAK1 inhibition. Effective symptom control allowed deferral of LT driven primarily by quality-of-life impairment, with the patient remaining inactive on the waitlist. To our knowledge, this is the first reported case of successful treatment of PSC-associated pruritus with upadacitinib, supporting further investigation of JAK1 inhibition as a potential therapeutic strategy for cholestatic pruritus.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"157-166"},"PeriodicalIF":0.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343967","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":"Erratum.","authors":"","doi":"10.1159/000551337","DOIUrl":"10.1159/000551337","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000549436.].</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"84"},"PeriodicalIF":0.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643998","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":"Spontaneous Pneumomediastinum Associated with Semaglutide Therapy: A Case Report.","authors":"Johanna Diebold, Christoph Gubler, Fritz Ruprecht Murray","doi":"10.1159/000551669","DOIUrl":"10.1159/000551669","url":null,"abstract":"<p><strong>Introduction: </strong>The seemingly harmless side effects of semaglutide, such as vomiting, may rarely lead to serious complications. This case is unique in highlighting spontaneous pneumomediastinum (SPM) as a potential consequence of unsupervised semaglutide use, adding new insight to the literature on the safety profile of weight-loss medications.</p><p><strong>Case presentation: </strong>We report the case of a 26-year-old woman who developed SPM shortly after the self-administered use of semaglutide purchased online for weight loss. The patient presented with vomiting, chest and neck pain, and progressive facial swelling. Imaging revealed extensive pneumomediastinum and cervicothoracic emphysema. Oesophago-gastro-duodenoscopy was performed to rule out oesophageal perforation and showed no abnormalities. The patient was managed conservatively with spontaneous recovery.</p><p><strong>Conclusion: </strong>This case highlights the importance of distinguishing SPM from life-threatening conditions such as Boerhaave's syndrome and raises concerns regarding the unsupervised use of injectable weight-loss medications, emphasizing the need for patient education and careful monitoring.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"149-156"},"PeriodicalIF":0.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249309","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":"De novo Crohn's Disease Treated with Ustekinumab in a Pediatric Liver Transplant Recipient with Tyrosinemia: A Case Report.","authors":"Saray Mesonero-Cavia, Marta Freixas-Bermejo, Marina Álvarez-Beltran, Susana Redecillas-Ferreiro, Vanessa Cabello-Ruiz, Judith Raya-Muñoz, Maria Mercadal-Hally, Andrea Martin-Nalda, Oscar Segarra-Cantón","doi":"10.1159/000551716","DOIUrl":"10.1159/000551716","url":null,"abstract":"<p><strong>Introduction: </strong>De novo inflammatory bowel disease (IBD) is more frequent in transplant recipients than in the general population and should be considered in the differential diagnosis of chronic diarrhea. In pediatric liver transplant recipients, an incidence of 206 vs. 20 cases per 100,000 patient-years has been reported, suggesting an underrecognized complication of immunosuppression.</p><p><strong>Case presentation: </strong>We report an 11-year-old girl with tyrosinemia type 1 who underwent liver transplantation and later developed de novo Crohn's disease. Despite maintenance therapy with tacrolimus, methylprednisolone, and everolimus, she presented with chronic diarrhea, weight loss, and elevated inflammatory markers after several episodes of <i>Clostridioides difficile</i> infection treated with oral vancomycin and only transient improvement. Initial inflammatory markers were only mildly elevated but showed a progressive rise over 18 months despite antibiotic therapy, alongside positive ASCA IgG and ASCA IgA with negative pANCA at the time of formal evaluation. Colonoscopy showed patchy aphthous and serpiginous ulcers with a cobblestone appearance, and histology revealed cryptitis and a mixed lymphoplasmacytic infiltrate without granulomas. Magnetic resonance enterography demonstrated ileocolic inflammation with wall thickening and mesenteric vessel engorgement. Infectious and drug-induced colitis and Epstein-Barr virus-related disease were excluded, and de novo ileocolic Crohn's disease (Paris A1b L3 B1 G1) was diagnosed. Ustekinumab (260 mg intravenously, then 90 mg subcutaneously every 4 weeks) was added to baseline immunosuppression, inducing clinical remission with normalization of C-reactive protein and a decrease in fecal calprotectin to 10 µg/g by week 20, sustained at 18 months with preserved graft function.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic challenges of de novo Crohn's disease in pediatric liver transplant recipients with metabolic liver disease and supports ustekinumab as a safe and effective option when other biologics are limited by prior infectious or lymphoproliferative.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"138-148"},"PeriodicalIF":0.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210257","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":"Rectal Neuroendocrine Tumor Presenting as Refractory Chronic Pruritus Ani: A Case Report.","authors":"Theodore Mobasser Tran, Rebecca Doan, Hoon Justin Seok, Lily Xia, Madelyn Robinson, Mario Matabele, Maziar Ghodsian","doi":"10.1159/000551349","DOIUrl":"10.1159/000551349","url":null,"abstract":"<p><strong>Introduction: </strong>Primary neuroendocrine tumors (NETs) of the rectum are rare and often present with nonspecific gastrointestinal symptoms, making early diagnosis challenging.</p><p><strong>Case presentation: </strong>We report the case of a 42-year-old male with persistent pruritus ani and mild rectal bleeding refractory to conventional treatment, ultimately diagnosed with a well-differentiated grade 1 rectal NET.</p><p><strong>Conclusion: </strong>This case underscores the importance of maintaining clinical suspicion for rare malignancies when evaluating persistent anorectal symptoms and highlights the critical role of endoscopic evaluation in achieving early diagnosis and favorable outcomes.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"20 1","pages":"132-137"},"PeriodicalIF":0.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197528","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}