Case Reports In Gastroenterology[JOURNAL]
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200 papers
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.
Liu J, Wei Y
Case Rep Gastroenterol · 2026 · PMID 42389320 · Full text
INTRODUCTION: 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 extractio...
INTRODUCTION: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
Sequential Pancreatic Ascites and Hemosuccus Pancreaticus from an Identical Rupture Site in Branch-Duct Intraductal Papillary Mucinous Neoplasm: A Case Report.
Sasakura S, Ko M, Maeda T … +5 more , Igarashi S, Shimaya K, Hanabata N, Numao H, Munakata M
Case Rep Gastroenterol · 2026 · PMID 42389319 · Full text
INTRODUCTION: 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 pan...
INTRODUCTION: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
Successful Treatment of Refractory Pruritus in Primary Sclerosing Cholangitis with Upadacitinib: A Case Report.
Nadeem H, Lakatos PL, Hagh-Doust H … +3 more , Wyse JM, Nadeem H, Bessissow T
Case Rep Gastroenterol · 2026 · PMID 42368781 · Full text
INTRODUCTION: 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 prurit...
INTRODUCTION: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
Spontaneous Pneumomediastinum Associated with Semaglutide Therapy: A Case Report.
Diebold J, Gubler C, Murray FR
Case Rep Gastroenterol · 2026 · PMID 42291462 · Full text
INTRODUCTION: 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 consequ...
INTRODUCTION: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
De novo Crohn's Disease Treated with Ustekinumab in a Pediatric Liver Transplant Recipient with Tyrosinemia: A Case Report.
Mesonero-Cavia S, Freixas-Bermejo M, Álvarez-Beltran M … +6 more , Redecillas-Ferreiro S, Cabello-Ruiz V, Raya-Muñoz J, Mercadal-Hally M, Martin-Nalda A, Segarra-Cantón O
Case Rep Gastroenterol · 2026 · PMID 42266888 · Full text
INTRODUCTION: 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 liv...
INTRODUCTION: 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. CASE PRESENTATION: 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 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. CONCLUSION: 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.
Rectal Neuroendocrine Tumor Presenting as Refractory Chronic Pruritus Ani: A Case Report.
Tran TM, Doan R, Seok HJ … +4 more , Xia L, Robinson M, Matabele M, Ghodsian M
Case Rep Gastroenterol · 2026 · PMID 42256648 · Full text
INTRODUCTION: Primary neuroendocrine tumors (NETs) of the rectum are rare and often present with nonspecific gastrointestinal symptoms, making early diagnosis challenging. CASE PRESENTATION: We report the case of a 42-ye...
INTRODUCTION: Primary neuroendocrine tumors (NETs) of the rectum are rare and often present with nonspecific gastrointestinal symptoms, making early diagnosis challenging. CASE PRESENTATION: 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. CONCLUSION: 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.
Persistent Cholestatic Hepatitis after Choledocholithiasis Removal: A Rare Case of Vanishing Bile Duct Syndrome.
Leonard G, Sulaiman RA, Xie C
Case Rep Gastroenterol · 2026 · PMID 42220336 · Full text
INTRODUCTION: Vanishing bile duct syndrome (VBDS) is a rare condition involving the progressive loss of intrahepatic bile ducts. CASE PRESENTATION: A 77-year-old woman presented with cholestatic hepatitis, initially diag...
INTRODUCTION: Vanishing bile duct syndrome (VBDS) is a rare condition involving the progressive loss of intrahepatic bile ducts. CASE PRESENTATION: A 77-year-old woman presented with cholestatic hepatitis, initially diagnosed with choledocholithiasis and treated via ERCP; however, her persistent transaminase levels did not improve. A subsequent liver biopsy revealed ductopenia, consistent with VBDS. She had been on long-term amoxicillin for maintenance therapy related to recurrent infections from sacral decubitus ulcers. Amoxicillin was determined to be the most likely offending agent behind VBDS and was discontinued. After the withdrawal of the culprit medication, the case was monitored for nearly 3 years, and the patient's transaminase levels consistently trended downward with ursodeoxycholic acid before she ultimately passed away from complications arising from other comorbidities. CONCLUSION: This case served as a rare and valuable example of amoxicillin contributing to VBDS, and with cessation of the offending drug and supportive care with ursodeoxycholic acid, it can lead to gradual biochemical improvement after a prolonged follow-up course.
Safety of Argon Plasma Coagulation for Minute Synchronous Neoplasms Detected under General Anesthesia during Endoscopic Laryngopharyngeal Surgery: A Case Series.
Sugimoto S, Fuke T, Nakagawa H
Case Rep Gastroenterol · 2026 · PMID 42124862 · Full text
INTRODUCTION: Despite the use of narrow-band imaging, comprehensive endoscopic evaluation of the laryngopharynx in the endoscopy suite remains challenging because of its complex anatomical structure, limited working spac...
INTRODUCTION: Despite the use of narrow-band imaging, comprehensive endoscopic evaluation of the laryngopharynx in the endoscopy suite remains challenging because of its complex anatomical structure, limited working space, and reactions such as gagging and coughing. Consequently, minute synchronous neoplasms may occasionally be overlooked during the initial endoscopic assessment. We hypothesized that argon-plasma coagulation (APC) could serve as a minimally invasive treatment for minute synchronous neoplasms of the head and neck detected during endoscopic laryngopharyngeal surgery combined with endoscopic submucosal dissection (ELPS/ESD) for primary lesions. CASE PRESENTATION: We report three cases of pharyngeal cancer treated with ELPS/ESD under general anesthesia: an 82-year-old man, a 73-year-old man, and a 40-year-old woman. During intraoperative endoscopic observation, 9 minute lesions measuring 3-7 mm that had not been detected in the endoscopy suite were identified in 3 patients. These lesions were immediately treated with APC, a non-contact technique that uses ionized argon gas to coagulate abnormal tissue. In Cases 1, 2, and 3, the lengths of hospital stay were 10, 11, and 6 days, respectively, and the follow-up periods were 9 months, 6 months, and 6 months, respectively. Within this limited follow-up period, no post-procedural bleeding, post-procedural hoarseness, or post-procedural swallowing dysfunction was observed. CONCLUSION: Based on this small case series with limited follow-up, intraoperative APC may be a feasible adjunctive approach for the ablation of minute synchronous lesions detected during ELPS/ESD for pharyngeal cancer.
Grade 1 Hepatic Neuroendocrine Tumor with Peritoneal Metastases: Case Report - Diagnostic Reasoning and Management Challenges.
Tsai TL, Guo JW, Lin CL … +1 more , Lien HH
Case Rep Gastroenterol · 2026 · PMID 42058028 · Full text
INTRODUCTION: Neuroendocrine tumors are rare neoplasms that commonly metastasize to the liver, while peritoneal metastases occur less frequently but are associated with poorer outcomes. This report presents a rare case o...
INTRODUCTION: Neuroendocrine tumors are rare neoplasms that commonly metastasize to the liver, while peritoneal metastases occur less frequently but are associated with poorer outcomes. This report presents a rare case of concurrent liver metastasis and peritoneal metastasis from a well-differentiated neuroendocrine tumor, emphasizing the diagnostic reasoning and multidisciplinary management involved. CASE PRESENTATION: A 62-year-old woman with a history of laparoscopic cholecystectomy was incidentally found to have multiple hypoechoic liver lesions and a mesenteric mass. Contrast-enhanced computed tomography and magnetic resonance imaging revealed hepatic and peritoneal nodules consistent with metastatic disease. Laparoscopic wedge resection of hepatic segments VI and VIII and biopsy of peritoneal implants confirmed a grade 1 neuroendocrine tumor positive for chromogranin A, synaptophysin, and INSM1, with a Ki-67 index of 2-3%. The patient underwent cytoreductive debulking surgery, achieving approximately 70% tumor reduction, followed by long-acting octreotide therapy. Postoperative recovery was uneventful, and follow-up imaging demonstrated no recurrence. CONCLUSION: This case report underscores the importance of early recognition and a multidisciplinary approach in managing indolent neuroendocrine tumors with multisite metastases. Combined surgical and medical strategies, including debulking surgery and octreotide therapy, can achieve durable disease control and favorable outcomes.
Sigmoid Colon Obstruction due to Gallstone Ileus: Case Report.
Al Alawi S, Chen LK, Waschke KA
Case Rep Gastroenterol · 2026 · PMID 42016159 · Full text
INTRODUCTION: Gallstone ileus of the colon is a rare cause of large bowel obstruction, usually caused by a gallbladder-to-colon fistula allowing stone entry. The classical presentation is with episodic subacute obstructi...
INTRODUCTION: Gallstone ileus of the colon is a rare cause of large bowel obstruction, usually caused by a gallbladder-to-colon fistula allowing stone entry. The classical presentation is with episodic subacute obstruction. Contrast-enhanced CT is valuable for diagnosis, with surgery being the preferred treatment; however, endoscopic therapy has been described and may also be attempted. CASE PRESENTATION: We describe the case of an 81-year-old female with a medical history significant for atrial fibrillation and congestive heart failure. She presented with a 2-week history of constipation, abdominal pain, distention, nausea, and vomiting. Clinically, her abdomen was distended but without signs of peritonitis. A CT scan showed a cholecystoduodenal fistula, along with a 3.3-cm gallstone causing a large bowel obstruction at the sigmoid colon. An attempt at flexible sigmoidoscopy to remove the stone failed due to its size and distal hypertrophy. The patient underwent exploratory laparotomy and Hartmann's procedure to relieve the obstruction and remove the gallstone. CONCLUSION: Gallstone ileus remains an uncommon but clinically important cause of mechanical bowel obstruction, typically occurring in elderly patients with significant comorbidities. This case underscores an especially rare manifestation - large bowel obstruction secondary to gallstone ileus - which can pose diagnostic and therapeutic challenges and is easily overlooked. By illustrating this atypical presentation, our report highlights the need for heightened clinical suspicion in older patients presenting with bowel obstruction and pneumobilia. Furthermore, it emphasizes the spectrum of available management strategies and the importance of individualized decision-making based on patient frailty, anatomical considerations, and surgical risk.
Rectal Gastrointestinal Stromal Tumor Complicated by Tumor Lysis Syndrome after Imatinib Initiation: A Rare and Fatal Case.
Louati C, Tlili K, Dahmane A … +3 more , Gargouri F, Mansouri N, Msakni I
Case Rep Gastroenterol · 2026 · PMID 41994196 · Full text
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal connective tumors. They generally develop from the gastric or intestinal wallor. Rectal location is rare. In fact, rectal GISTs account for 5% of...
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal connective tumors. They generally develop from the gastric or intestinal wallor. Rectal location is rare. In fact, rectal GISTs account for 5% of cases and 0.1% of all rectal tumors. CASE PRESENTATION: We report the case of a stromal tumor of rectal localization in order to study the clinical, anatomopathological and radiological particularities of this entity. We report the case of a 73-year-old patient who was initially admitted for a stent placement. A rectoscopy showed a half circumferential rectal process. It was situated at 2 cm from the anal verge. The magnetic resonance imaging of the pelvis showed a large tumor of the lower rectum, with a focal rupture of the right rectal wall and invading the sphincter apparatus. Pathological examination revealed a proliferation of spindle-shaped cells with abundant cytoplasm and ovoid atypical nuclei with a high mitotic index. The immunohistochemical study showed that the tumor cells were positive for CKit and DOG1 and negative for AML and PS100. The retained diagnosis was high-risk spindle cell GIST. CONCLUSION: Rectal GISTs are rare tumors. Diagnosis is based on anatomopathological examination with immunohistochemical study. Surgical resection is the standard treatment for localized GIST. Imatinib is the first-line prescribed treatment, with particular attention to potentially life-threatening adverse effects.
Adebrelimab Combined with Chemotherapy for Esophageal Neuroendocrine Carcinoma: A Case Report.
Zhao YG, Zhao T, Ma K … +1 more , Wang SX
Case Rep Gastroenterol · 2026 · PMID 41982809 · Full text
INTRODUCTION: Esophageal neuroendocrine carcinoma is an extremely rare type of esophageal cancer. Due to the limited number of cases, there are no established diagnostic and treatment guidelines. CASE PRESENTATION: A 60-...
INTRODUCTION: Esophageal neuroendocrine carcinoma is an extremely rare type of esophageal cancer. Due to the limited number of cases, there are no established diagnostic and treatment guidelines. CASE PRESENTATION: A 60-year-old male presented with dysphagia and was subsequently diagnosed with large cell neuroendocrine carcinoma of the esophagus. He received four cycles of treatment with adebrelimab combined with etoposide and carboplatin, which resulted in significant tumor shrinkage. CONCLUSION: Esophageal neuroendocrine carcinoma is a highly malignant tumor with a high mortality rate. A better understanding of its diagnosis and treatment strategies may contribute to favorable trends in patient outcomes, while its actual effect on long-term prognosis remains to be validated with extended follow-up.
Erratum.
Case Rep Gastroenterol · 2026 · PMID 41959624 · Full text
[This corrects the article DOI: 10.1159/000549436.].
[This corrects the article DOI: 10.1159/000549436.].
Complete Rectal Anastomotic Occlusion That Spontaneously Recanalized, Allowing for Unusual Endoscopic Treatment with a Lumen-Apposing Metal Stent: A Case Report.
Weiss T, Kirshon M, Zilbermints V … +3 more , Tchernin N, Kessel B, Gal O
Case Rep Gastroenterol · 2026 · PMID 41939788 · Full text
INTRODUCTION: Complete anastomotic occlusion following rectal surgery is a rare and challenging complication. While surgical revision remains the standard treatment, it is associated with significant morbidity. Recently,...
INTRODUCTION: Complete anastomotic occlusion following rectal surgery is a rare and challenging complication. While surgical revision remains the standard treatment, it is associated with significant morbidity. Recently, novel endoscopic techniques have emerged as minimally invasive alternatives. CASE PRESENTATION: We report the case of a 64-year-old patient who developed complete rectal anastomotic occlusion after low anterior resection and declined further surgery. Five months later, spontaneous recanalization was observed, allowing for successful endoscopic treatment using a lumen-apposing metal stent (LAMS). The stent was later removed, and ileostomy reversal was completed successfully. CONCLUSION: Watchful surveillance for spontaneous recanalization may offer a safe opportunity for endoscopic intervention in selected high-risk, diverted patients with complete rectal anastomotic occlusion. LAMS may serve as an effective alternative to fully covered self-expandable metal stents in cases of severe strictures.
Gastrointestinal Bleeding due to Intussuscepted Duodenal Lipoma: A Case Report.
Machann S, Angst E, Derungs U … +1 more , Bingisser A
Case Rep Gastroenterol · 2026 · PMID 41908873 · Full text
INTRODUCTION: Duodenal lipomas are rare benign tumors which are typically asymptomatic but may cause significant gastrointestinal symptoms. CASE PRESENTATION: This case shows an uncommon presentation of duodenal intussus...
INTRODUCTION: Duodenal lipomas are rare benign tumors which are typically asymptomatic but may cause significant gastrointestinal symptoms. CASE PRESENTATION: This case shows an uncommon presentation of duodenal intussusception due to a lipoma in a 65-year-old male patient, presenting with melena, hypotension, and vertigo. Upon investigation, a CT scan revealed a 5.7 × 7.1 cm lipomatous mass in the duodenum. Endoscopy confirmed the presence of associated bleeding. Despite initial management with proton pump inhibitors and blood transfusions, the patient required emergency endoscopic interventions for persistent bleeding. A subsequent laparotomy revealed an intussusception of the lipoma into the second part of the duodenum, thus also affecting the gastric antrum. The patient underwent distal gastrectomy and resection of the first part of the duodenum, followed by Roux-Y reconstruction. Histology showed that the submucosal lipoma originated from the first part of the duodenum. CONCLUSION: This case highlights the rarity of duodenal lipoma as a cause of duodenal intussusception and emphasizes the diagnostic challenges associated with the identification of this condition in adults. Furthermore, it highlights the importance of an interdisciplinary team approach to manage this rare condition effectively.
Accidental Caustic Exposure from Ingestion of Contaminated Beer: A Case Series.
Canaff L, Hagans TA, Carter E … +1 more , Nemec F
Case Rep Gastroenterol · 2026 · PMID 41908872 · Full text
INTRODUCTION: This report presents three cases of unintentional ingestion of beer line cleaner (BLC), a strongly caustic alkaline solution (pH 13-14). In each incident, unflushed BLC entered the draft system and was serv...
INTRODUCTION: This report presents three cases of unintentional ingestion of beer line cleaner (BLC), a strongly caustic alkaline solution (pH 13-14). In each incident, unflushed BLC entered the draft system and was served as drinkable beer (pH 4.0-4.5) in different taverns due to deficiencies in regulatory oversight and enforcement. CASE PRESENTATIONS: A 37-year-old female, a 37-year-old male, and a 40-year-old male presented with esophageal injuries after consuming contaminated beer in unrelated events. Endoscopy revealed findings ranging from erythema and esophageal nodules to benign strictures and very severe Grade D esophagitis. Patients required extended proton pump inhibitor therapy and dietary changes, and they experienced ongoing symptoms, including dysphagia, reflux, taste alterations, and weight loss. CONCLUSION: This case series highlights the serious and lasting consequences of BLC ingestion and underscores the need for standardized beer line flushing protocols, tracer dyes, and point-of-use testing to prevent future exposures in commercial establishments where uniform regulations are insufficient. It also demonstrates the underreported health risks associated with accidental BLC ingestion. Greater physician awareness can facilitate earlier diagnosis and treatment and improve outcomes. Enhanced reporting of BLC ingestion can increase identification of caustic hazards and strengthen public health awareness of this largely unrecognized risk.
Emergence of Takayasu Arteritis and Chronic Recurrent Multifocal Osteomyelitis during Maintenance Therapy in Remission 13 Years after the Diagnosis of Very Early-Onset Ulcerative Colitis: A Case Report.
Yamane Y, Hashimoto K, Yuda A … +1 more , Sasaki M
Case Rep Gastroenterol · 2026 · PMID 41908871 · Full text
INTRODUCTION: Inflammatory bowel disease (IBD) is associated with Takayasu arteritis (TAK). Chronic recurrent multifocal osteomyelitis (CRMO) is a nonbacterial osteomyelitis that occurs at multiple sites, some of which a...
INTRODUCTION: Inflammatory bowel disease (IBD) is associated with Takayasu arteritis (TAK). Chronic recurrent multifocal osteomyelitis (CRMO) is a nonbacterial osteomyelitis that occurs at multiple sites, some of which are associated with IBD. We herein report a pediatric patient diagnosed with CRMO and TAK 13 years after the onset of very early-onset ulcerative colitis (VEO-UC). Concurrent presentations of UC, TAK, and CRMO are extremely rare. CASE PRESENTATION: A 15-year-old female diagnosed with VEO-UC at 22 months developed CRMO and TAK 13 years later despite maintained remission on infliximab. The patient was presented with knee pain and fever. 18-fluorodeoxyglucose positron emission tomography revealed not only multiple bone uptake but also arterial wall thickening. Contrast-enhanced magnetic resonance imaging showed circumferential wall thickening from distal aortic arch to descending aorta. Bone biopsy confirmed chronic osteomyelitis without infection. TAK (type IIb) and CRMO were diagnosed. Methylprednisolone pulse therapy was administered for induction. Treatment was switched to adalimumab (ADA), which has reported efficacies for all three conditions. However, only TAK did not achieve remission. ADA was switched to tocilizumab (TCZ) without changing other medications to treat TAK, successfully achieving remission of all three diseases and allowing steroid reduction. CONCLUSION: Clinicians should consider concurrent vasculitis and CRMO when IBD patients present with unexplained inflammatory responses. TCZ may effectively treat TAK developing in anti-tumor necrosis factor-treated UC patients.
PTCD-Assisted ERCP for Severe Stricture at the Biliary-Enteric Anastomosis following Pancreaticoduodenectomy: A Case Report.
Lv Z, Chen K
Case Rep Gastroenterol · 2026 · PMID 41868190 · Full text
INTRODUCTION: Post-pancreaticoduodenectomy (PD) biliary-enteric anastomosis stenosis (BEAS) poses substantial therapeutic challenges secondary to surgically altered anatomy. Conventional endoscopic interventions are freq...
INTRODUCTION: Post-pancreaticoduodenectomy (PD) biliary-enteric anastomosis stenosis (BEAS) poses substantial therapeutic challenges secondary to surgically altered anatomy. Conventional endoscopic interventions are frequently unsuccessful in patients with both altered gastrointestinal anatomy and severe fibrotic strictures. This study reports the utilization of a combined percutaneous transhepatic cholangiodrainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) rendezvous technique, incorporating an innovative mechanical dilation method using a stent retriever, for the management of refractory BEAS. CASE PRESENTATION: A 50-year-old male who had undergone PD developed recurrent cholangitis due to BEAS, which was confirmed by magnetic resonance cholangiopancreatography (MRCP). Previous attempts to access the anastomosis via conventional ERCP and to dilate the stricture using a standard PTCD-based approach were unsuccessful. Consequently, a novel hybrid approach that utilized both PTCD for access and endoscopic therapy for treatment was employed. The procedure involved advancing a guidewire through the PTCD tract into the jejunal lumen under fluoroscopic guidance, which was then endoscopically retrieved using foreign body forceps. Bidirectional traction stabilized the access route, enabling gastroscopic navigation to the anastomosis. For the refractory stenosis, controlled mechanical dilation was performed using a stent retriever for rotational drilling, followed by balloon dilation and placement of a nasobiliary catheter. CONCLUSIONS: This hybrid approach integrates percutaneous and endoscopic modalities to overcome anatomical barriers in complex BEAS. The innovative use of a stent retrieval device for controlled mechanical dilation provides a salvage option when standard devices fail. This strategy demonstrates technical feasibility and efficacy for refractory BEAS, expanding therapeutic possibilities in challenging post-surgical anatomy.
Macroamylasemia in a Two-Year-Old Boy as the First Manifestation of Celiac Disease: A Case Report.
Dimitrovska-Ivanova M, Simeonovska Joveva E, Karakolevska Ilova M … +3 more , Demerdzieva A, Coneska Jovanova B, Palcevska Kocevska S
Case Rep Gastroenterol · 2026 · PMID 41852500 · Full text
INTRODUCTION: Macroamylasemia is a rare biochemical disorder in which the amylase molecule binds to other macromolecules, most commonly immunoglobulin A or G. The increased molecular weight of this complex reduces renal...
INTRODUCTION: Macroamylasemia is a rare biochemical disorder in which the amylase molecule binds to other macromolecules, most commonly immunoglobulin A or G. The increased molecular weight of this complex reduces renal excretion of the enzyme, resulting in chronically elevated serum amylase levels. It can be associated with various non-pancreatic conditions, including celiac disease. In some reported cases, macroamylasemia resolved with a gluten-free diet. We present a pediatric case in which macroamylasemia was the initial manifestation of celiac disease. CASE PRESENTATION: A two-year-old boy presented with a 3-month history of abdominal pain, anemia, and constipation. Physical examination revealed paraumbilical tenderness. Laboratory tests showed hypochromic anemia; elevated serum amylase (171 U/L); low serum iron (2.5 µmol/L); vitamin D3 deficiency (15.9 ng/mL), and low urine amylase with an amylase/creatinine clearance ratio below 1%, confirming macroamylasemia. Imaging studies were normal. HLA typing revealed the HLA-DQ2 haplotype. Celiac serology was positive for tissue transglutaminase-IgA (87.55 IE/mL) and endomysial antibody-IgA (1:>100). Duodenal biopsy confirmed Marsh type IIIb histology. A gluten-free diet was initiated alongside iron and vitamin D3 supplementation. Symptoms resolved within 2 months, accompanied by normalization of serum amylase levels and a weight gain of over 1 kg. Vitamin D3 therapy was continued until serum levels normalized. CONCLUSION: Celiac disease should be considered in patients with unexplained macroamylasemia, even in the absence of classical gastrointestinal symptoms. The primary treatment in such cases is a strict gluten-free diet, which can lead to the normalization of serum amylase levels when macroamylasemia is associated with celiac disease.
A Diagnostic Dilemma: High-Grade Appendiceal Mucinous Neoplasm Presenting as Acute Appendicitis in a 16-Year-Old Female - Case Report and Literature Review.
Singh M, Gore C, Gurwale S … +2 more , Mandala J, Makan A
Case Rep Gastroenterol · 2026 · PMID 41660160 · Full text
INTRODUCTION: High-grade appendiceal mucinous neoplasms (HAMNs) are rare mucin-producing epithelial tumors of the appendix, typically seen in middle-aged to elderly individuals. They are defined by high-grade cytologic a...
INTRODUCTION: High-grade appendiceal mucinous neoplasms (HAMNs) are rare mucin-producing epithelial tumors of the appendix, typically seen in middle-aged to elderly individuals. They are defined by high-grade cytologic atypia and complex architecture but without infiltrative invasion. Occurrence in pediatric or adolescent patients is virtually unknown. CASE PRESENTATION: We report a 16-year-old female who presented with signs and symptoms suggestive of acute appendicitis. Ultrasonography supported the diagnosis. A laparoscopic appendectomy was performed. Gross examination revealed a dilated appendix with mucoid contents. Histopathological evaluation confirmed HAMN confined to the appendix. CONCLUSION: To our knowledge, this is the second reported case of HAMN in an adolescent. This case underscores the importance of histopathologic evaluation of all appendectomy specimens, even in young patients, due to the possibility of underlying neoplasia.
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