Case Reports in Gastroenterology最新文献_第4页

Management of Refractory Esophageal Variceal Bleeding when TIPSS Is Not Possible: Review of a Challenging Case. 当TIPSS不可能时难治性食管静脉曲张出血的处理：回顾一个具有挑战性的病例。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-02-13 eCollection Date: 2025-01-01 DOI: 10.1159/000543537

Abdulrahman Qatomah, Ali Bessissow, Yen-I Chen, Talat Bessissow, Amine Benmassaoud

引用次数: 0

Anaphylaxis to a Vedolizumab Infusion following Drug Holiday in a Patient with Ulcerative Colitis: A Case Report. 溃疡性结肠炎患者在药物假期后对Vedolizumab输注的过敏反应：1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-02-12 eCollection Date: 2025-01-01 DOI: 10.1159/000543387

Jadon Karp, Henry Shen, Thomas Goodwin, Miles P Sparrow

{"title":"Anaphylaxis to a Vedolizumab Infusion following Drug Holiday in a Patient with Ulcerative Colitis: A Case Report.","authors":"Jadon Karp, Henry Shen, Thomas Goodwin, Miles P Sparrow","doi":"10.1159/000543387","DOIUrl":"10.1159/000543387","url":null,"abstract":"Introduction: Vedolizumab is a commonly prescribed biologic agent due to its safety profile and clinical efficacy. Severe infusion-related reactions are exceedingly rare, with no previously documented cases of anaphylaxis to vedolizumab infusion following a drug holiday.Case presentation: We report the case of a 65-year-old male with ulcerative colitis who had a severe anaphylactic reaction to the first re-induction infusion of vedolizumab following a 30-month drug holiday. No pre-infusion prophylactic medication was administered. Upon commencement of the infusion, the patient developed anaphylactic symptoms including airway compromise that required intensive care unit admission and treatment with an adrenaline infusion.Conclusion: Anaphylactic reactions to vedolizumab after a drug holiday can occur. As is done for infliximab, we recommend administration of an antipyretic, antihistamine, and corticosteroid prior to vedolizumab re-induction infusions when it is given after a drug holiday.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"62-66"},"PeriodicalIF":0.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11820661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467042","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

Successful Pregnancy in a Patient with Crohn's Disease and Short Bowel Syndrome: Off Total Parenteral Nutrition and On Teduglutide, a Glucagon-Like Peptide-2 Analog - A Case Report. 克罗恩病和短肠综合征患者成功怀孕：脱离全肠外营养并服用胰高血糖素样肽-2类似物泰度鲁肽--病例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-02-04 eCollection Date: 2025-01-01 DOI: 10.1159/000543291

Maria M Dahar, MacKenzie Both, Linda M Lord, Carly Densmore, Lawrence J Saubermann

{"title":"Successful Pregnancy in a Patient with Crohn's Disease and Short Bowel Syndrome: Off Total Parenteral Nutrition and On Teduglutide, a Glucagon-Like Peptide-2 Analog - A Case Report.","authors":"Maria M Dahar, MacKenzie Both, Linda M Lord, Carly Densmore, Lawrence J Saubermann","doi":"10.1159/000543291","DOIUrl":"10.1159/000543291","url":null,"abstract":"Introduction: Patients with short bowel syndrome (SBS) on conventional oral diets often face nutritional deficiencies and dehydration, a challenge further compounded during pregnancy. This case report describes the use of a glucagon-like peptide-2 (GLP-2) analog in the nutritional management of an SBS patient dependent on total parenteral nutrition (TPN).Case presentation: A 29-year-old woman with a significant medical history of Crohn's disease leading to SBS was traditionally dependent on TPN for sustenance. During her pregnancy, she was successfully managed with a GLP-2 analog, which enabled her to wean off TPN. This successful management underscores the therapeutic potential of GLP-2 analogs in effectively altering the nutritional landscape for SBS patients, including during the physiologically demanding period of pregnancy.Conclusion: GLP-2 analogs helped with the nutritional management of patients with SBS during pregnancy and helped them wean off TPN. There is a need for further research and exploration into GLP-2 analogs as viable alternatives to conventional treatments such as TPN in the care and management of SBS patients during pregnancy.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"57-61"},"PeriodicalIF":0.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188412","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

Colonic Dieulafoy Lesion as a Rare Cause of Lower Gastrointestinal Bleeding. 结肠十二指肠病变是下消化道出血的罕见病因。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-01-31 eCollection Date: 2025-01-01 DOI: 10.1159/000542790

Mohamed Farag, Yordanka Diaz, Harish Patel

{"title":"Colonic Dieulafoy Lesion as a Rare Cause of Lower Gastrointestinal Bleeding.","authors":"Mohamed Farag, Yordanka Diaz, Harish Patel","doi":"10.1159/000542790","DOIUrl":"10.1159/000542790","url":null,"abstract":"Introduction: Dieulafoy lesion is one of the most under-recognized sources of gastrointestinal (GI) bleeding (GI), typically manifesting as acute upper gastrointestinal bleeding; endoscopy is usually the first diagnostic and therapeutic modality utilized to handle these lesions by employing a variety of procedures.Case report: This is a case of an 81-year-old female who was being assessed after experiencing repeated bouts of melena with hemoglobin drop. The patient had multiple comorbidities but no history of gastrointestinal bleeding. Esophagogastroduodenoscopy (EGD) revealed only Erythematous duodenopathy without active bleeding; the initial colonoscopy revealed a large amount of blood without identifying the source of bleeding; a second colonoscopy revealed classic Dieulafoy lesions in the splenic flexure, which were injected and clipped, and the bleeding ceased.Conclusion: Dieulafoy lesions are most frequently found in the stomach and gastroesophageal junction, but they have also been documented in other parts of the gastrointestinal tract. In this particular instance, the lesions were identified in the colon, which is an unusual location for them, and they were treated endoscopically by clipping and injecting. In conclusion, colonic Dieulafoy lesions, although rare, have the potential to cause life-threatening bleeding and should be included in the differential diagnosis of lower gastrointestinal bleeding.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"52-56"},"PeriodicalIF":0.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077916","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

Rare Encounter: A Case Report of Hepatic Perivascular Epithelioid Cell Tumor - An Uncommon Mesenchymal Tumor in the Liver. 罕见病例：肝脏血管周围上皮样细胞瘤1例——一种罕见的肝脏间充质肿瘤。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-01-24 eCollection Date: 2025-01-01 DOI: 10.1159/000543018

Diogo Paula, Maria João Amaral, Joana Madeira, João Simões, André Lázaro, Nuno Silva, José Guilherme Tralhão

{"title":"Rare Encounter: A Case Report of Hepatic Perivascular Epithelioid Cell Tumor - An Uncommon Mesenchymal Tumor in the Liver.","authors":"Diogo Paula, Maria João Amaral, Joana Madeira, João Simões, André Lázaro, Nuno Silva, José Guilherme Tralhão","doi":"10.1159/000543018","DOIUrl":"10.1159/000543018","url":null,"abstract":"Introduction: Perivascular epithelioid cell tumor (PEComa) is a rare neoplastic mesenchymal tumor, more frequently found in the uterus, although it can occur in different organs. Hepatic PEComa is extremely rare, with only a few cases described in the literature.Case presentation: We present a case report of a 33-year-old female patient with a history of macroprolactinoma. She was initially referred to our Department due to a 9-mm hepatic nodule incidentally diagnosed in an abdominal ultrasound in 2018. She was asymptomatic. Follow-up ultrasound showed a growth from 9 mm to 16 mm in 2019 and 30 mm in a liver magnetic resonance imaging (MRI) scan in 2022. The case was discussed in a multidisciplinary team meeting, and since malignant transformation or hepatocellular carcinoma could not be ruled out, the decision was to undergo hepatic resection. An open hepatic subsegmentectomy of segment 5 was performed, with uneventful postoperative period. The definitive diagnosis was hepatic PEComa.Conclusion: Hepatic PEComas are rare liver tumors, and their preoperative diagnosis is challenging due to the lack of specific radiological features. In most cases, the diagnosis is only confirmed through histopathological and immunohistochemical studies. Resection of the lesion appears to be the curative treatment; however, due to the rarity of the condition, there are no studies comparing surgical treatment with other options. In our case, the hypervascular lesion was initially misdiagnosed as an adenoma. PEComas should be considered as a differential diagnosis in liver nodules with well-defined margins and increased uptake in the arterial phase in computed tomography or MRI scan. Surgical resection was curative, and no recurrence was detected during the patient's follow-up.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"43-51"},"PeriodicalIF":0.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467048","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

Colitis-Induced Pancreatic Fistula with Pancreatic Ascites. 结肠炎诱发胰瘘伴胰腹水。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-01-16 eCollection Date: 2025-01-01 DOI: 10.1159/000543007

Evan Winrich, Ethan Steele, Amal Shine, Dipendra Parajuli

引用次数: 0

Jackhammer Esophagus as a Complication of Tonsillectomy and Adenoidectomy: A Case Report. 钻锤式食管作为扁桃体和腺样体切除术的并发症：1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2025-01-14 eCollection Date: 2025-01-01 DOI: 10.1159/000542891

W Michael McDonnell, Alison Tewnion

引用次数: 0

Risankizumab and Certolizumab Pegol Dual-Targeted Therapy for Crohn's Disease and Axial Spondyloarthritis: A Case Report. Risankizumab和Certolizumab Pegol双靶向治疗克罗恩病和轴性脊椎关节炎：1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2024-12-24 eCollection Date: 2025-01-01 DOI: 10.1159/000542759

Anouk Lehmann, Juerg Vosbeck, Diego Kyburz, Petr Hruz, Jan Hendrik Niess

{"title":"Risankizumab and Certolizumab Pegol Dual-Targeted Therapy for Crohn's Disease and Axial Spondyloarthritis: A Case Report.","authors":"Anouk Lehmann, Juerg Vosbeck, Diego Kyburz, Petr Hruz, Jan Hendrik Niess","doi":"10.1159/000542759","DOIUrl":"10.1159/000542759","url":null,"abstract":"Introduction: Treatment of Crohn's disease (CD) and axial spondyloarthritis (axSpA) is challenging, with CD refractory to anti-TNF antibodies. Here, we present for the first time a case treated with dual-targeted therapy (DTT) using the anti-IL-23 monoclonal risankizumab and the anti-TNF antibody certolizumab pegol.Case presentation: Our patient initially presented with axSpA at the age of 27. Nine years later, CD was diagnosed by the age of 36. One year after the diagnosis of CD, a spontaneous ileal perforation occurred as part of a disease course refractory to multiple anti-TNF antibodies and intolerance to immunomodulators. However, the axSpA showed a response to the anti-TNF certolizumab pegol. After stopping certolizumab pegol, we enrolled the patient into the M15-991 induction trial (MOTIVATE) and the maintenance trial (FORTIFY) testing the anti-IL-23 antibody risankizumab versus placebo in CD with failure to prior biological therapy. As a result, risankizumab induced a CD response but failed to control the axSpA. Considering the CD refractory and the axSpA responding to anti-TNFs, we initiated a DTT with risankizumab and certolizumab pegol. Risankizumab and certolizumab pegol together improved both CD and axSpA. As adverse events, there were only two episodes of spontaneously resolving common colds during the 19-month reviewed period.Conclusion: DTT using risankizumab and certolizumab pegol is effective in CD and axSpA without serious adverse events in our patient. Combining biologicals that target specific pathways in immune-mediated diseases promises excellent potential in CD associated with extraintestinal manifestations.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"22-30"},"PeriodicalIF":0.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466976","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

Steroid-Refractory Immune-Related Hepatitis Caused by Pembrolizumab with Stage IVB Non-Small Cell Lung Cancer: A Case Report. 派姆单抗引起的类固醇难治性免疫相关性肝炎伴IVB期非小细胞肺癌1例报告

IF 0.5

Case Reports in Gastroenterology Pub Date : 2024-12-23 eCollection Date: 2025-01-01 DOI: 10.1159/000542598

Tomomi Hamaguchi, Makoto Ueno, Satoshi Kobayashi, Shun Tezuka, Manabu Morimoto, Terufumi Kato, Haruhiro Saito, Shinya Sato, Junji Furuse, Shin Maeda

{"title":"Steroid-Refractory Immune-Related Hepatitis Caused by Pembrolizumab with Stage IVB Non-Small Cell Lung Cancer: A Case Report.","authors":"Tomomi Hamaguchi, Makoto Ueno, Satoshi Kobayashi, Shun Tezuka, Manabu Morimoto, Terufumi Kato, Haruhiro Saito, Shinya Sato, Junji Furuse, Shin Maeda","doi":"10.1159/000542598","DOIUrl":"10.1159/000542598","url":null,"abstract":"Introduction: We report the case of a man in his 50s with stage IVB non-small cell lung cancer who developed severe immune-related hepatitis caused by pembrolizumab.Case presentation: He received carboplatin, pemetrexed, and pembrolizumab as first-line therapy. After four courses, each of the triplet regimen and maintenance therapy with pemetrexed and pembrolizumab, the patient developed immune-related pneumonitis and colitis. Therefore, pemetrexed and pembrolizumab were discontinued, and 0.5 mg/kg/day prednisolone was started. Despite gradual reduction of the prednisolone to 15 mg/day along with resolution of the pneumonitis and colitis, hepatic dysfunction occurred (elevated serum bilirubin and transaminase levels). We made a diagnosis of immune-related hepatitis based on liver biopsy results and negative results for other causes, such as viral infection. We increased the prednisolone dose to 2 mg/kg/day; however, the hepatic dysfunction was not resolved. Upon sequential methylprednisolone pulse therapy (1,000 mg/day), mycophenolate mofetil, and azathioprine treatment, the hepatic dysfunction plateaued but was not resolved. The patient did not respond to steroids for immune-related hepatitis, developed infectious enteritis owing to a compromised state, and died of sepsis on day 107 after diagnosis of immune-related hepatitis.Conclusion: This case highlights the importance of early diagnosis of steroid-refractory disease, prompt initiation of immunosuppressive agents, and steroid dose reduction in such cases. The changes in liver function during steroid non-response and immunosuppressive drug induction in this case are valuable as a reference for future cases of immune-related adverse event hepatitis.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"14-21"},"PeriodicalIF":0.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466978","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

Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report. Upadacitinib作为急性重度溃疡性结肠炎的序贯挽救治疗：1例报告。

IF 0.5

Case Reports in Gastroenterology Pub Date : 2024-12-23 eCollection Date: 2025-01-01 DOI: 10.1159/000542711

David Huynh, Myat Myat Khaing, Richard Gareth Fernandes, Reuben Malloy, Lei Lin, Robert Gilmore, Nicole Walker, Emi Khoo, Jakob Begun

{"title":"Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report.","authors":"David Huynh, Myat Myat Khaing, Richard Gareth Fernandes, Reuben Malloy, Lei Lin, Robert Gilmore, Nicole Walker, Emi Khoo, Jakob Begun","doi":"10.1159/000542711","DOIUrl":"10.1159/000542711","url":null,"abstract":"Introduction: Acute severe ulcerative colitis (ASUC) represents a medical emergency associated with high mortality and morbidity. While corticosteroids are the primary treatment, cases that are unresponsive often require rescue therapy with either infliximab or cyclosporine to reduce the rate of colectomy. Janus kinase inhibitors, such as tofacitinib and upadacitinib, are a highly efficacious therapy with rapid induction of clinical response in moderate to severe ulcerative colitis (UC). Limited data are available on its use on ASUC. We present the first case utilizing upadacitinib as sequential medical rescue therapy in ASUC as well as intestinal ultrasound as a useful tool for disease and response monitoring.Case presentation: A 69-year-old female who presented with corticosteroid-refractory ASUC partially responded to dose-intensified infliximab and finally achieved clinical remission with upadacitinib. This resulted in swift clinical remission and significant improvement in her mucosal inflammation on intestinal ultrasound.Conclusion: This successful intervention not only avoided colectomy but demonstrated sustained clinical and sonographic remission 16 weeks of post-treatment. Upadacitinib, with its rapid action and efficacy, shows promise in ASUC and should be supported by registration trials and real-world studies. Despite successful outcomes in this case, further validation and long-term data are necessary.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"19 1","pages":"1-6"},"PeriodicalIF":0.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466980","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