Case Reports In Gastroenterology[JOURNAL]
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200 papers
Hepatic Angiosarcoma Associated with Chronic Schistosomiasis in a Patient with Decompensated Cirrhosis: A Rare Case Report.
Swaid T, Kassab C, Ben Ghashir NS … +1 more , Al Marzooqi SH
Case Rep Gastroenterol · 2026 · PMID 41586403 · Full text
INTRODUCTION: Hepatic angiosarcoma (HA) is a rare endothelial malignancy with poor prognosis. Chronic Schistosoma infection causes periportal fibrosis and portal hypertension, but has not been established as a risk facto...
INTRODUCTION: Hepatic angiosarcoma (HA) is a rare endothelial malignancy with poor prognosis. Chronic Schistosoma infection causes periportal fibrosis and portal hypertension, but has not been established as a risk factor for hepatic vascular tumors. We report a case of high-grade HA coexisting with chronic schistosomiasis in a patient presenting with acute decompensated cirrhosis. CASE PRESENTATION: A 64-year-old Filipino woman with no known chemical exposures presented with progressive abdominal pain, jaundice, ascites, and hepatic encephalopathy. Doppler ultrasound initially suggested Budd-Chiari syndrome, later excluded on advanced imaging. MRI showed multifocal hepatic lesions, and CT demonstrated multiple intra-abdominal hematomas without active bleeding. Liver biopsy confirmed poorly differentiated HA (CD31+/CD34+) and revealed calcified Schistosoma eggs. Her course was complicated by hemorrhagic shock after biopsy and paracentesis, spontaneous bacterial peritonitis, acute kidney injury, and worsening hepatic encephalopathy. She died despite aggressive supportive care. CONCLUSION: This case illustrates the diagnostic challenges and rapid progression of HA, especially in coagulopathic patients where biopsy carries significant risk. The coexistence of chronic schistosomiasis raises the possibility of parasitic inflammation contributing to hepatic vascular tumorigenesis. HA should be considered among unexplained hepatic masses with atypical imaging and clinical features.
Endoscopic Ultrasound-Guided Pelvic Abscess Drainage Especially for Pediatric Patients: A Report of Two Cases.
Yokotani Y, Kitae H, Takakura S … +2 more , Akamatsu N, Soga K
Case Rep Gastroenterol · 2026 · PMID 41574327 · Full text
INTRODUCTION: Endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) was reported for the first time in 2003. However, there were few reports focused on EUS-PAD in pediatric patients beforehand. This procedure is...
INTRODUCTION: Endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) was reported for the first time in 2003. However, there were few reports focused on EUS-PAD in pediatric patients beforehand. This procedure is one of the minimally invasive methods of treating pelvic abscess, which is close to the rectum. Here, we report the cases of two pediatric patients who underwent EUS-PAD. CASE PRESENTATION: Two pediatric patients were referred to our hospital for the treatment of pelvic abscesses associated with appendicitis. Using endoscopic ultrasound (EUS) guidance, a pelvic abscess was identified adjacent to the rectal wall. After successive dilatation through a guidewire during fluoroscopic imaging, the deployment of one or two double pigtail stents was performed. Following successful stent deployment, both patients experienced good courses without any complications. After addressing the consequences of complicated appendicitis, both patients underwent laparoscopic appendectomy, which resulted in favorable postoperative courses. CONCLUSIONS: EUS-guided drainage can be considered a safe and effective method for primarily dealing with pelvic abscesses and as an efficacious bridge-to-surgery strategy for pediatric patients.
Life-Threatening Upper Gastrointestinal Bleeding following Percutaneous Endoscopic Gastrostomy Tube Removal under Traction: A Case Report.
Shephard CJ, Ma X, Karamatic R
Case Rep Gastroenterol · 2026 · PMID 41551415 · Full text
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) tubes are commonly used to facilitate long-term enteral nutrition. Selected PEG tubes may be appropriately removed without endoscopic guidance via gentle traction,...
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) tubes are commonly used to facilitate long-term enteral nutrition. Selected PEG tubes may be appropriately removed without endoscopic guidance via gentle traction, which is seldom associated with major bleeding sequelae. Rare reports of major upper gastrointestinal (GI) hemorrhage following PEG tube removal have been managed using Foley catheter balloon tamponade or endoscopic over-the-scope clipping. Prompt reinsertion of a PEG tube may also be considered. CASE PRESENTATION: We present the case of a multi-morbid 73-year-old female who experienced life-threatening hemodynamically unstable upper GI bleeding following traction PEG tube removal, which proved refractory to standard endoscopic measures of adrenaline injection and hemostatic clipping, as well as rotational thromboelastometry-guided correction of consumptive coagulopathy. There was no suitable target for angioembolization. Ultimately, in the context of continued hemodynamically unstable GI bleeding, definitive surgical hemostasis - a mode of intervention not frequently reported for bleeding of this nature - was achieved during emergency laparotomy via complete excision of the PEG tract and wedge excision of the involved stomach wall. CONCLUSION: Life-threatening hemodynamically unstable GI bleeding rarely complicates traction PEG tube removal. In elderly patients with multiple comorbidities, PEG tract bleeding refractory to standard endotherapy and not targetable by angioembolization can be safely and effectively managed with timely surgical intervention.
Long-Term Remission of Peritoneal Lymphangiomatosis with Sirolimus Therapy: A Case Report with 8-Year Follow-Up.
Jovanovic P, Zerem E, Basic Denjagic M … +5 more , Rifatbegovic Z, Iljazovic E, Mustedanagic-Mujanovic J, Tupkovic Rakovac L, Cerkez I
Case Rep Gastroenterol · 2026 · PMID 41446572 · Full text
INTRODUCTION: Peritoneal lymphangiomatosis is a rare benign lymphatic disorder with diagnostic and therapeutic challenges. It may mimic peritoneal carcinomatosis or mesothelioma, often requiring histological confirmation...
INTRODUCTION: Peritoneal lymphangiomatosis is a rare benign lymphatic disorder with diagnostic and therapeutic challenges. It may mimic peritoneal carcinomatosis or mesothelioma, often requiring histological confirmation. Management options are limited, and long-term data on targeted therapies, including sirolimus, remain scarce. CASE PRESENTATION: We present the case of a 45-year-old woman with a history of surgically corrected atrial septal defect, who developed progressive abdominal distension and dysuria in May 2014. Abdominal ultrasound and contrast-enhanced abdominal computed tomography revealed diffuse ascites, peritoneal thickening, and cystic changes. Diagnostic uncertainty led to an exploratory laparotomy in May 2015, where histopathology confirmed peritoneal lymphangiomatosis. After failed conservative management including dietary modification, diuretic therapy, and repeated paracenteses, she was started on sirolimus 2 mg/day in August 2016. Her serum trough levels were maintained between 5 and 15 ng/mL. She achieved a Karnofsky Performance Score of 100% (indicating full functional capacity) within 2 months and has remained in complete clinical and radiologic remission for over 8 years. Diabetes mellitus type 2 was diagnosed during follow-up and is well controlled with insulin therapy. CONCLUSION: This case underscores the difficulty of diagnosing peritoneal lymphangiomatosis and highlights the transformative potential of sirolimus therapy. To our knowledge, this is one of the longest documented remissions of peritoneal lymphangiomatosis under mechanistic target of rapamycin (mTOR) inhibition.
High-Dose Upadacitinib Maintenance Therapy for Refractory Crohn's Disease: A Case Series and Review of the Literature.
Alfadhli Y, Kermani R, Shehab M
Case Rep Gastroenterol · 2026 · PMID 41438188 · Full text
INTRODUCTION: Crohn's disease (CD) is a chronic, relapsing-remitting disorder affecting the gastrointestinal tract that falls under the umbrella term of inflammatory bowel disease (IBD). Its etiology is unknown, but it i...
INTRODUCTION: Crohn's disease (CD) is a chronic, relapsing-remitting disorder affecting the gastrointestinal tract that falls under the umbrella term of inflammatory bowel disease (IBD). Its etiology is unknown, but it is suggested that there is a strong genetic and environmental interaction, leading to its development. The mainstay of treatment for patients with moderate to severe CD is advanced therapy, such as biologics or small molecules. Despite the use of these medications, the disease may be unresponsive to these agents, leading to refractory disease. The use of novel therapies expanded the treatment options for patients with refractory CD or those who failed multiple biologics. Upadacitinib (UPA), a small molecule drug, belongs to a class of medications known as Janus kinase (JAK) inhibitors. UPA is known to be effective against CD with a dosage of either 15 or 30 mg. However, this dose deemed to be ineffective in the cases we reported. A higher maintenance dose of 45 mg was introduced and the patient's reported resolution of symptoms. It is important to note that larger studies are required to prove the efficacy of this treatment for CD. CASE PRESENTATIONS: This is a case-series of 3 patients with a history of refractory CD and prior exposure to at least 1 biologic agent, who achieved clinical remission and endoscopic healing on UPA maintenance therapy 45 mg orally once daily. CONCLUSION: This case series illustrates potential benefit and supports the rationale for larger controlled studies evaluating high-dose UPA maintenance therapy.
Successful Treatment with Tezepelumab for an Adult with Refractory and Severe Fibrostenotic Eosinophilia Esophagitis: A Case Report.
Maniaci JL, Burbank AJ, Dellon ES
Case Rep Gastroenterol · 2025 · PMID 41409506 · Full text
INTRODUCTION: Non-response to treatment in eosinophilic esophagitis (EoE) is common, and the approach to treatment-refractory patients with EoE is challenging. With increasing knowledge of EoE pathogenesis, mechanisms ca...
INTRODUCTION: Non-response to treatment in eosinophilic esophagitis (EoE) is common, and the approach to treatment-refractory patients with EoE is challenging. With increasing knowledge of EoE pathogenesis, mechanisms can be targeted by medications that are approved for other atopic diseases with a similar pathophysiology. CASE PRESENTATION: We present an adult with EoE who had longstanding symptoms prior to diagnosis, developed severe fibrostenosis with the narrow caliber phenotype requiring multiple esophageal dilations, and was previously nonresponsive to proton pump inhibitors (PPIs), topical corticosteroids (tCS), and food elimination diets (FED). Because of his concomitant severe asthma, he was treated with the eosinophil-depleting biologics mepolizumab and benralizumab. These reduced eosinophil counts on esophageal biopsy but did not improve symptoms, endoscopic features, or other histologic findings. He continued to require esophageal dilation for symptom control. His asthma control also remained suboptimal, prompting a trial of tezepelumab, an antibody against thymic stromal lymphopoietin (TSLP). In addition to controlling asthma, he improved across EoE symptom, endoscopic, and histologic metrics over a year of follow-up, including improvements in the EoE Endoscopic Reference Score, esophageal caliber, basal zone hyperplasia, dilated intercellular spaces, and lamina propria fibrosis as measured by the EoE Histologic Scoring System. CONCLUSION: This patient, who did not respond to PPI, FED, tCS, mepolizumab, or benralizumab, ultimately had response to tezepelumab across multiple outcome domains of EoE. This demonstrates proof-of-concept that targeting TSLP may be a promising modality in EoE and supports further study of this mechanism for treatment of EoE.
Colonic Mucosal Pseudolipomatosis with Hemorrhage: A Case Report of Peracetic Acid-Induced Pathogenesis.
Wang C, Zhong Y, Zheng R
Case Rep Gastroenterol · 2025 · PMID 41403782 · Full text
INTRODUCTION: Colonic mucosal pseudolipomatosis (CMP) is a rare mucosal lesion of the colon. Most patients are asymptomatic, while some present with abdominal pain, diarrhea, or bloating. However, cases complicated by he...
INTRODUCTION: Colonic mucosal pseudolipomatosis (CMP) is a rare mucosal lesion of the colon. Most patients are asymptomatic, while some present with abdominal pain, diarrhea, or bloating. However, cases complicated by hemorrhage are extremely rare and have not been previously reported. Endoscopically, CMP manifests as solitary or multiple scattered white plaques in intestinal segments, manifesting as a "snow-white sign." CASE PRESENTATION: This article reports a case of CMP with hemorrhage following colonoscopy. CONCLUSION: With the increasing incidence of CMP in recent years, endoscopists have gained deeper insights into this lesion. The vigilance is warranted for its potential association with hemorrhage. In addition, in order to avoid such iatrogenic injury, endoscope disinfection monitoring should be paid more attention.
Immunohistochemical Staining for Disseminated Carcinomatosis of the Bone Marrow in a Patient with Post-Colonoscopy Colorectal Cancer: A Case Report.
Mochimaru T, Kawashima K, Onizawa M … +11 more , Watahiki Y, Takahata Y, Murakami M, Otomo K, Asano T, Yoshida S, Kawana S, Gunji N, Hashimoto Y, Hikichi T, Ohira H
Case Rep Gastroenterol · 2025 · PMID 41403781 · Full text
INTRODUCTION: The incidence of disseminated carcinomatosis of the bone marrow (DCBM) associated with colorectal cancer is low, but it can rapidly progress and cause even death. A previous study has suggested a relationsh...
INTRODUCTION: The incidence of disseminated carcinomatosis of the bone marrow (DCBM) associated with colorectal cancer is low, but it can rapidly progress and cause even death. A previous study has suggested a relationship between mucin profiles and the prognosis of colorectal cancer. However, there are no reports of mucin staining in cases of DCBM with post-colonoscopy colorectal cancer (PCCRC). CASE PRESENTATION: A 58-year-old man who had undergone colonoscopy (CS) 1 year ago complained of fatigue and fever. The man was diagnosed with virus-associated hemophagocytic syndrome and received steroid pulse therapy. Despite treatment, his condition deteriorated. F-fluorodeoxyglucose positron emission tomography-computed tomography revealed diffuse uptake in the bone marrow. A bone marrow biopsy revealed atypical CK20-positive and CK7-negative cellular nests, suggesting a primary gastrointestinal tumor. Subsequent CS at our hospital revealed a 30-mm type 4 transverse colorectal cancer lesion. Thus, the patient was diagnosed with DCBM associated with PCCRC. The patient died 18 days after his last CS. Mucin staining revealed that the cancer cells were MUC2-positive and MUC5AC-negative. MUC5AC negativity has been associated with poor prognosis in colorectal cancer and may have suggested rapid disease progression. CONCLUSION: The mucin staining result of MUC5AC negativity suggested rapid disease progression and poor prognosis in this case.
Multiorgan Dysfunction in Severe Acute Pancreatitis: A Case of Septic Shock, Renal Cortical Necrosis, and Takotsubo Cardiomyopathy.
Patel B, Patel R, Hajariwala N … +3 more , Sharma D, Bhargava Y, Rana P
Case Rep Gastroenterol · 2025 · PMID 41393104 · Full text
INTRODUCTION: Severe acute pancreatitis (AP) may evolve rapidly into systemic inflammatory response syndrome and multiorgan dysfunction syndrome, posing significant management challenges. CASE PRESENTATION: We present a...
INTRODUCTION: Severe acute pancreatitis (AP) may evolve rapidly into systemic inflammatory response syndrome and multiorgan dysfunction syndrome, posing significant management challenges. CASE PRESENTATION: We present a rare and complex case of severe AP complicated by septic shock, bilateral renal cortical necrosis (RCN), and Takotsubo cardiomyopathy (TTC). Septic shock contributed to profound hemodynamic instability, while RCN - a rare and often fatal form of acute kidney injury - added to the severity of renal dysfunction. Concurrent TTC, likely precipitated by catecholamine surges during critical illness, led to transient myocardial dysfunction. CONCLUSION: This case highlights the importance of early recognition, a multidisciplinary approach, and advanced critical care strategies, including SLED with hemoadsorptive filters, to improve outcomes in patients with severe AP complicated by rare systemic manifestations.
Denture Ingestion, Gastrointestinal Transit and Subsequent Complications in a 75-Year-Old Male: A Case Report.
Wagner TR, Hardon SF, den Boer FC … +1 more , Meekel JP
Case Rep Gastroenterol · 2025 · PMID 41393103 · Full text
INTRODUCTION: Foreign body ingestion is a common clinical occurrence, often resolving spontaneously as the object passes through the gastrointestinal tract. We present a unique case of sigmoid perforation with an associa...
INTRODUCTION: Foreign body ingestion is a common clinical occurrence, often resolving spontaneously as the object passes through the gastrointestinal tract. We present a unique case of sigmoid perforation with an associated local abscess, successfully managed with sigmoidectomy and direct anastomosis. CASE PRESENTATION: A 75-year-old male presented to the emergency department after accidentally ingesting his dentures. Conservative management was attempted initially. Four days later, the patient developed abdominal pain. Computed tomography scan revealed signs of perforation, and diagnostic laparoscopy confirmed a sigmoid perforation with a localized abscess. A sigmoidectomy with end-to-end circular stapled anastomosis was performed, during which the dentures were mobilized retrogradely to enable controlled extraction, leading to a full and rapid recovery. CONCLUSION: This case highlights the potential complications and occasional need for surgery due to ingested foreign bodies and the importance of accurate diagnosis and vigilant monitoring in managing these patients.
Inflammatory Bowel-Like Disease with Ileocolic and Perianal Involvement Induced by Ocrelizumab: A Case Report.
Soares C, Canastra A, Domingues  … +6 more , Carvalho AC, Martins D, Sousa P, Cancela E, Silva A, Ministro P
Case Rep Gastroenterol · 2025 · PMID 41384101 · Full text
INTRODUCTION: Immune-mediated colitis (IMC) is a common immune-related adverse event associated with immune checkpoint inhibitors. Other classes of biological therapy, such as monoclonal antibody with anti-CD20 activity,...
INTRODUCTION: Immune-mediated colitis (IMC) is a common immune-related adverse event associated with immune checkpoint inhibitors. Other classes of biological therapy, such as monoclonal antibody with anti-CD20 activity, have also been associated with drug-induced gastrointestinal injuries, although through different immunomechanisms. In the literature, there are some previously described cases reporting on enterocolitis induced by rituximab and ocrelizumab highlighting its potential severity. Consequently, recently, the FDA amended the Prescribing Information of ocrelizumab to include IMC in the Warnings and Precautions section. CASE PRESENTATION: We present the case of a patient with chronic diarrhea due to immune-mediated enterocolitis, markedly resembling Crohn's disease with ileocolic and perianal involvement induced by ocrelizumab. Endoscopically, this condition is indistinguishable from inflammatory bowel disease with significant overlap in histology. With discontinuation of ocrelizumab, the lesions and the symptoms disappeared. To our knowledge, this is the first case reporting perianal involvement. CONCLUSION: There are no clear recommendations on how to manage these patients. Clinicians must be aware of this entity and report on these unquestionably increasing conditions.
A Simple Method for Removing Recyclable Metal Stents via Endoscopy: A Case Report.
Xie Y, Wang P, Jin J … +1 more , Wang W
Case Rep Gastroenterol · 2025 · PMID 41367629 · Full text
INTRODUCTION: Gastrointestinal tract stenosis is a common pathological condition encountered in clinical practice, caused by various factors such as malignant tumors, postoperative anastomotic strictures, radiation injur...
INTRODUCTION: Gastrointestinal tract stenosis is a common pathological condition encountered in clinical practice, caused by various factors such as malignant tumors, postoperative anastomotic strictures, radiation injury, or inflammatory diseases like Crohn's disease. It often leads to serious complications, including dysphagia, obstruction, and malnutrition. Endoscopic metal stent placement has become a key treatment for alleviating both benign and malignant stenosis due to its minimally invasive nature, effectiveness, and repeatability. However, stent displacement is one of the most frequent complications, and its management requires a comprehensive approach based on the type of displacement (partial or complete), clinical symptoms, and anatomical location. Endoscopy is the preferred intervention method, and multidisciplinary collaboration can optimize patient outcomes. CASE PRESENTATION: A 22-year-old male patient developed persistent nausea and vomiting 2 months ago after accidentally ingesting toilet cleaner. Gastroscopy revealed pyloric obstruction. After admission, a covered intestinal metal stent was placed. Two days later, the stent had migrated distally beyond the narrowed intestinal lumen. We attempted to directly remove the displaced stent under endoscopic visualization. However, the procedure was unsuccessful. Subsequently, we safely removed recyclable metal stents directly using a simple method: a transparent cap-fitted endoscope inserted through the forceps channel to control the stent's retrieval line. CONCLUSION: Our method of controlling the retrieval thread of the metal stent through endoscopic forceps to remove the displaced stent is feasible, safe, and effective.
New-Onset Ulcerative Colitis after Secukinumab Initiation: A Case Report.
Hagh-Doust H, Nadeem H, Bessissow T … +1 more , Lakatos PL
Case Rep Gastroenterol · 2025 · PMID 41323447 · Full text
INTRODUCTION: Secukinumab is an anti-interleukin (IL)-17 used in the treatment of rheumatological conditions such as ankylosing spondylitis and psoriasis. Despite elevated IL-17A levels in inflammatory bowel disease (IBD...
INTRODUCTION: Secukinumab is an anti-interleukin (IL)-17 used in the treatment of rheumatological conditions such as ankylosing spondylitis and psoriasis. Despite elevated IL-17A levels in inflammatory bowel disease (IBD) patients, clinical trials suggest IL-17 inhibition may exacerbate disease activity in IBD. Multiple sclerosis (MS) also has a suspected association with IBDs. CASE PRESENTATION: A 22-year-old man who has a paternal grandfather with a history of MS was started on secukinumab for suspected ankylosing spondylitis. Three months after secukinumab initiation, he developed new gastrointestinal (GI) symptoms and was diagnosed with ulcerative colitis. He responded to a course of corticosteroids, and his secukinumab was stopped. He remains in clinical and endoscopic remission 5 months after completing his course of steroids. CONCLUSIONS: This case highlights the potential association between IL-17 inhibition and new-onset IBD in a patient with a family history of MS and illustrates a compelling clinical dilemma regarding the initial selection of biologic therapy in a patient with multiple autoimmune risk factors. Before starting an anti-IL-17 agent, physicians should review the patient's personal and family history of IBD, as well as other risk factors, including immune-mediated conditions such as MS that may increase IBD risk. Patients should then be closely monitored for the development of any new GI symptoms.
Transformation of Primary Small Intestinal Follicular Lymphoma to CD20-Negative Diffuse Large B-Cell Lymphoma following Rituximab Treatment: A Case Report.
Kitamura M, Sakamoto H, Shinozaki S … +4 more , Sakaguchi M, Yano T, Fukushima N, Yamamoto H
Case Rep Gastroenterol · 2025 · PMID 41323446 · Full text
INTRODUCTION: Follicular lymphoma is an indolent B-cell lymphoma that can involve the gastrointestinal tract, most commonly the small intestine. Although rituximab-based therapy is effective, transformation to diffuse la...
INTRODUCTION: Follicular lymphoma is an indolent B-cell lymphoma that can involve the gastrointestinal tract, most commonly the small intestine. Although rituximab-based therapy is effective, transformation to diffuse large B-cell lymphoma (DLBCL) can occur and becomes difficult to diagnose after CD20 loss. CASE PRESENTATION: We report the case of a 64-year-old woman initially diagnosed with primary small intestinal follicular lymphoma who subsequently developed transformation to DLBCL 2 years after rituximab therapy. Double-balloon enteroscopy revealed progression of mucosal lesions, raising suspicion of histologic transformation. However, endoscopic biopsy was inconclusive because of the loss of CD20 expression, likely resulting from prior rituximab therapy. Surgical resection was performed to relieve intestinal obstruction and to establish a definitive diagnosis. Histopathological examination confirmed transformation to CD20-negative DLBCL. CONCLUSION: This case highlights the diagnostic limitation of endoscopic biopsy following rituximab therapy. Therefore, clinicians should be cautious in relying solely on endoscopic findings and remain open to surgical intervention to achieve a timely and accurate diagnosis.
A Single Colonic Polyp Having Both Tubular Adenoma and Mantle Cell Lymphoma: A Case Report.
Abuquteish D, Al-Azzeh A, Bannoura S
Case Rep Gastroenterol · 2025 · PMID 41323445 · Full text
INTRODUCTION: Mantle cell lymphoma (MCL) is a distinct subtype of B-cell non-Hodgkin lymphoma. MCL lymphoma can occur in the gastrointestinal tract (GIT) as a primary lymphoma; more commonly, the GIT can be secondarily i...
INTRODUCTION: Mantle cell lymphoma (MCL) is a distinct subtype of B-cell non-Hodgkin lymphoma. MCL lymphoma can occur in the gastrointestinal tract (GIT) as a primary lymphoma; more commonly, the GIT can be secondarily involved. A colonic polyp simultaneously having MCL with overlying adenomatous changes is highly unusual, and few cases were reported. Herein, we describe a unique instance of a single adenomatous polyp in the left colon overlying a small lymphoid population proven to be MCL in a patient recently diagnosed with MCL. We believe this report will increase the awareness of pathologists and clinicians of such a unique and unusual clinical presentation. CASE PRESENTATION: A 53-year-old male patient presented with a history of generalized lymphadenopathy, bilateral pleural deposits, and splenomegaly. Axillary lymph node excisional biopsies were sent for pathology and reported MCL, diffuse pattern, classic variant. Three weeks later, the patient underwent upper and lower endoscopy for mild upper abdominal discomfort. Upper endoscopy showed mild gastropathy, and colonoscopy revealed a small polyp at the descending colon. Pathology of the colonic polyp showed a tubular adenoma with low-grade dysplasia overlying a well-circumscribed mucosal/submucosal nodular lymphoid aggregate. The lymphoid aggregate exhibited histological and immunohistochemical features of MCL. Thus, a diagnosis of tubular adenoma coexisting with MCL in the same polyp was made. CONCLUSION: Tubular adenoma with MCL is an exceedingly rare phenomenon with unclear pathogenesis. We report this case to highlight the importance of examining lymphoid tissue in adenomas and to increase the awareness among clinicians and pathologists of such a unique presentation.
An Adolescent Case of Ulcerative Colitis Complicated by Toxic Megacolon.
Kato M, Yamashita M, Tsukui M … +14 more , Iijima Y, Araki K, Shikano N, Saji S, Tsukamoto K, Ishida J, Komatsu T, Nakamoto Y, Kawashima A, Endo A, Matsunaga A, Sato Y, Maehata T, Tateishi K
Case Rep Gastroenterol · 2025 · PMID 41323444 · Full text
INTRODUCTION: Toxic megacolon is a serious complication of ulcerative colitis (UC), characterized by marked colonic dilatation, abnormal bowel function, and systemic toxicity. Although toxic megacolon is rare in children...
INTRODUCTION: Toxic megacolon is a serious complication of ulcerative colitis (UC), characterized by marked colonic dilatation, abnormal bowel function, and systemic toxicity. Although toxic megacolon is rare in children and adolescents, it should remain in the differential diagnosis for acute severe UC in this group because delayed diagnosis and treatment can be fatal. The treatment for UC complicated by toxic megacolon is either immediate emergency surgery or short-term intensive drug therapy. If the latter does not result in significant improvement, emergency surgical intervention is necessary. Current treatment guidelines do not establish a standard medical approach for this condition. CASE PRESENTATION: In this report, we describe an adolescent case of UC complicated by toxic megacolon. In this patient, the condition was initially controlled with steroid pulse therapy followed by oral tacrolimus. However, due to an inadequate response, treatment was escalated to infliximab (IFX), leading to remission and successful avoidance of surgical intervention. CONCLUSION: When opting for conservative treatment of UC complicated by toxic megacolon, intensive steroid pulse, tacrolimus, and IFX therapy should be considered as a potentially effective treatment option.
Duodenal Perforation following Argon Plasma Coagulation for Angiodysplasia: A Case Report.
Chan WY, Chong KH, Wang CC … +4 more , Chen JH, Hsiao TH, Chen HD, Su WC
Case Rep Gastroenterol · 2025 · PMID 41323443 · Full text
INTRODUCTION: Argon plasma coagulation (APC) is a widely used technique for hemostasis and ablation in gastrointestinal tract lesions due to its ease of use and safety. However, gastrointestinal tract muscle injury can o...
INTRODUCTION: Argon plasma coagulation (APC) is a widely used technique for hemostasis and ablation in gastrointestinal tract lesions due to its ease of use and safety. However, gastrointestinal tract muscle injury can occur with high-power settings and prolonged application. CASE PRESENTATION: We present a case of an elderly female with angiodysplasia bleeding in the second portion of the duodenum treated with APC, resulting in a complication of bowel wall perforation and peritonitis. CONCLUSION: Acute perforation has been rarely reported with APC, either due to direct wall injury or explosion from overinflation. To avoid perforation, careful control of ablation power and duration, especially in regions with a thin gastrointestinal wall such as the gastric fundus and ascending colon, should be maintained.
Iatrogenic Intramural Esophageal Dissection in Eosinophilic Esophagitis: A Rare Complication of Diagnostic Endoscopy in a Young Atopic Patient - Case Report and Review.
Swaid T, Hamzeh L, Al Ahmad M … +2 more , Magdub S, Ahmed I
Case Rep Gastroenterol · 2025 · PMID 41323442 · Full text
INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated esophageal disease characterized by eosinophilic infiltration of the esophageal mucosa, leading to symptoms of esophageal dysfunction. Common pre...
INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated esophageal disease characterized by eosinophilic infiltration of the esophageal mucosa, leading to symptoms of esophageal dysfunction. Common presentations include dysphagia, food impaction, and chest discomfort, often in patients with a history of atopy. CASE PRESENTATION: This case report highlights an atypical outcome of EoE, intramural esophageal dissection, in a young adult patient post-endoscopy. CONCLUSION: This case report emphasizes the importance of early recognition and treatment to prevent long-term complications, both pathological and iatrogenic.
Local Recurrence due to Needle Tract Seeding after Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Pancreatic Tail Cancer: A Case Report.
Matsumoto K, Nakamatsu D, Yamamoto M … +5 more , Hayashi S, Fukui K, Yamashita M, Shimizu J, Nishida T
Case Rep Gastroenterol · 2025 · PMID 41323441 · Full text
INTRODUCTION: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an essential diagnostic tool for pancreatic tumors, but rare complications such as needle tract seeding (NTS) may cause local recurrence. CAS...
INTRODUCTION: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an essential diagnostic tool for pancreatic tumors, but rare complications such as needle tract seeding (NTS) may cause local recurrence. CASE PRESENTATION: A 79-year-old man with a history of right hemicolectomy for colon cancer presented during follow-up in 2020 with a 16-mm pancreatic tail mass. He was asymptomatic, and laboratory findings including carcinoembryonic antigen and carbohydrate antigen 19-9 were normal. EUS-FNA confirmed adenocarcinoma (cT3N0M0, stage IIA), and after neoadjuvant chemotherapy, laparoscopic distal pancreatectomy was performed. No recurrence was observed until 2022, when elevated tumor markers and fluorodeoxyglucose positron emission tomography/computed tomography revealed a lesion near the stomach. Chemotherapy with gemcitabine and nab-paclitaxel was initiated, but the lesion persisted. Repeat EUS-FNA confirmed adenocarcinoma, suggesting NTS from the initial FNA. Subsequently, partial gastrectomy was performed, and pathology confirmed pancreatic adenocarcinoma. CONCLUSION: This case illustrates the risk of NTS following EUS-FNA for pancreatic tail cancer, particularly when the puncture route is not resected during pancreatectomy. Despite neoadjuvant chemotherapy, NTS occurred, indicating that this risk cannot be fully prevented. Surgical resection achieved disease control, underscoring the importance of vigilant follow-up and timely intervention in managing this rare but clinically significant complication.
Esophageal Cancer Secondary to Achalasia: A Case Series Study.
Xu W, Long Y, Li B … +2 more , Zhang F, Chen H
Case Rep Gastroenterol · 2025 · PMID 41323440 · Full text
INTRODUCTION: Achalasia is a primary motility disorder affecting the esophageal body and lower esophageal sphincter. Although the linkage between achalasia and elevated esophageal cancer risk is already known, the precis...
INTRODUCTION: Achalasia is a primary motility disorder affecting the esophageal body and lower esophageal sphincter. Although the linkage between achalasia and elevated esophageal cancer risk is already known, the precise mechanisms remain poorly elucidated due to the disease's relative scarcity. We aim to summarize the clinical characteristics of esophageal cancer (EC) secondary to achalasia and improve the understanding of achalasia combined with EC and further reduce the risk of ECs. CASE PRESENTATIONS: Retrospective statistics were conducted on patients with ECs secondary to achalasia in our hospital from 2009 to 2023. We categorized all achalasia cases with their initial treatment and recorded subsequent interventions when the symptoms recurred. Additionally, we performed detailed analyses of both EC characteristics and therapeutic regimens. We present a case series comprised of 5 patients with achalasia who presented with EC. Three of the patients diagnosed with achalasia were treated by endoscopy or operation to improve symptoms. One patient was treated by pneumatic dilation. All were histologically diagnosed as squamous cell carcinoma. The validity period of endoscopic treatment has been lost in all patients. The erosions were all distributed over the thoracic esophagus. CONCLUSION: The high relative risk of ECs was demonstrated in achalasia patients, even in the treated achalasia patients. Therefore, surveillance endoscopy may be recommended regularly in the treated patients.
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