Case Rep Gastroenterol
· 2025 · PMID 40365554
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INTRODUCTION: Wilson's disease (WD) is a rare genetic condition characterized by impaired copper metabolism and can rarely present as acute liver failure with an associated high mortality rate. Treatment often requires l...INTRODUCTION: Wilson's disease (WD) is a rare genetic condition characterized by impaired copper metabolism and can rarely present as acute liver failure with an associated high mortality rate. Treatment often requires liver transplantation, and few rescue treatments have been shown to be effective by randomized trials. This is a case report and scoping literature review on plasmapheresis in acute liver failure due to WD. CASE PRESENTATION: We report a case of a previously undiagnosed 32-year-old female who presented with acute liver failure due to WD. Initial severity indices (MELD = 31 and RWPI - Revised Wilson Prognostic Index = 14) warranted liver transplant referral; however, no facilities were available. The patient was managed by two sessions of plasmapheresis with plasma exchange with persistent improvement in MELD score over 1 week. Subsequent ongoing chelation therapy resulted in a total reversal of clinical liver disease over 2 years. Literature review resulted in 74 patients reported to have been treated with plasmapheresis for WD and acute liver failure. Of these, 40% survived without transplant. Out of the total patients reported, 54 patients had an available NWI score, with 46 patients having a high-risk score of ≥11 (85%) and 8 patients had a score <11 (15%). Of the 46 patients with a score ≥11, 21 (46%) recovered without liver transplantation, 16 (35%) underwent liver transplantation, 8 (17%) died of liver failure, and 1 (∼2%) died of sepsis. Of the 8 patients with a score of <11, 4 (50%) recovered without a liver transplantation, and 4 (50%) underwent transplantation. CONCLUSION: The outcomes observed in the literature and the favorable outcome of our patient suggest an emphasis on the use of urgent plasmapheresis with plasma exchange as an initial intervention for acute liver failure in WD, although further randomized controlled trials are needed for determining the optimal dose and duration of treatment.
Suzuki Y, Ito S, Ishii T
… +2 more, Oda M, Hoteya S
Case Rep Gastroenterol
· 2025 · PMID 40357413
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INTRODUCTION: Endoscopic submucosal dissection (ESD) is an effective treatment for superficial pharyngeal cancer. However, pharyngeal deformity caused by postoperative ulcer contraction is a major concern and can result...INTRODUCTION: Endoscopic submucosal dissection (ESD) is an effective treatment for superficial pharyngeal cancer. However, pharyngeal deformity caused by postoperative ulcer contraction is a major concern and can result in a poor quality of life. While local steroid injections have been shown to prevent strictures after ESD for esophageal cancer, their effectiveness in preventing deformities following ESD for pharyngeal cancer remains unclear. CASE PRESENTATION: A 60-year-old woman with superficial pharyngeal cancer in the left pyriform sinus underwent ESD. After ESD, 80 mg of triamcinolone acetonide was injected into the ulcer bed to prevent scar contracture. The patient experienced mild pharyngeal pain, which resolved within a few days. Histopathological examination confirmed the lesion was well-differentiated SCC, with negative resection margins and no lymphovascular invasion. Follow-up endoscopy at 6 weeks showed granulation tissue in the surgical wound, which completely healed without pharyngeal deformity by 14 weeks post-ESD. CONCLUSION: This case demonstrated that the injection of triamcinolone in an ulcer that developed after ESD may be an effective method of preventing pharyngeal deformity caused by scar contracture.
Case Rep Gastroenterol
· 2025 · PMID 40351853
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INTRODUCTION: COVID-19 infection can cause bowel ischemia, with an incidence ranging from 0.22% to 10.5. The COVID-19 vaccine reduces respiratory symptoms and the need for cardiopulmonary support. However, its effects on...INTRODUCTION: COVID-19 infection can cause bowel ischemia, with an incidence ranging from 0.22% to 10.5. The COVID-19 vaccine reduces respiratory symptoms and the need for cardiopulmonary support. However, its effects on other manifestations, such as bowel ischemia, have not been extensively studied. Despite having mild respiratory symptoms and receiving three doses of the COVID-19 vaccine, our patient developed ischemic colitis after her first infection and small bowel ischemia following her second infection. CASE PRESENTATION: An 86-year-old woman presented to the emergency department (ED) with abdominal pain after a mild COVID-19 infection. She was admitted with ischemic colitis, but conservative treatment failed. In the operating room, her entire colon was found to be ischemic, necessitating a total colectomy with end ileostomy. Nine months later, she returned to the ED with mild respiratory symptoms and severe right upper quadrant pain. Imaging revealed pneumoperitoneum and a mid-abdominal abscess. An emergency laparotomy revealed small bowel perforation, with final histology confirming ischemia. The patient had received three doses of the COVID-19 vaccine and was on therapeutic anticoagulation for a history of pulmonary embolism. CONCLUSION: COVID-19 may increase the risk of bowel and colon ischemia even after vaccination. Patients presenting to the ED with severe abdominal pain and a recent COVID-19 infection should be carefully evaluated for ischemic events.
Case Rep Gastroenterol
· 2025 · PMID 40337124
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INTRODUCTION: Pseudomelanosis duodeni (PD) is a rare condition characterized by multiple pigmented speckles in the duodenum. It is typically seen in adults and has been associated with chronic kidney disease, hypertensio...INTRODUCTION: Pseudomelanosis duodeni (PD) is a rare condition characterized by multiple pigmented speckles in the duodenum. It is typically seen in adults and has been associated with chronic kidney disease, hypertension, iron deficiency anemia, diabetes mellitus, and the use of medications like oral iron, hydralazine, furosemide, and hydrochlorothiazide. While oral iron is common, only one documented PD has been associated with intravenous (IV) iron supplementation. CASE PRESENTATION: A 69-year-old female with multiple comorbidities, including stage 4 chronic kidney disease and hypertension, presented with persistent nausea and vomiting. An esophagogastroduodenoscopy (EGD) revealed diffuse, dark speckling throughout the duodenal mucosa. Biopsies confirmed PD through Perl Prussian blue and Fontana-Masson staining, which detected iron in black/brown pigmentations within macrophages. The patient received a 5-week course of weekly intravenous iron supplementation 6 months before presentation. Previous EGD 7 and 5 years earlier showed no evidence of PD despite the patient being on sulfur-containing antihypertensive medications. This case suggests a likely interplay between IV iron and sulfur-containing medications in PD development. CONCLUSION: While PD has been associated with multiple comorbidities and certain medications, the causal mechanism remains unclear. PD likely entails defective iron transport and iron sulfide accumulation within duodenal macrophages. This case highlights the potential role of IV iron supplementation in PD development, even in the absence of oral iron intake. PD is regarded as a benign condition with no specific guidelines for treatment or follow-up, but a biopsy is crucial to rule out other differential diagnoses and avoid unwanted interventions.
Lang N, Davidov Y, Hoffman T
… +4 more, Harnik S, Eliakim AR, Ben-Horin S, Ungar B
Case Rep Gastroenterol
· 2025 · PMID 40330085
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INTRODUCTION: Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon. About 5% of ulcerative colitis patients also present with primary sclerosing cholangitis, a chronic inflammatory disease ma...INTRODUCTION: Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon. About 5% of ulcerative colitis patients also present with primary sclerosing cholangitis, a chronic inflammatory disease marked by cholestasis and progressive fibrosis of the bile ducts, and results in the necessity of liver transplantation. Ulcerative colitis treatment in primary sclerosing cholangitis patients is challenging due to potential resistance to conventional therapies. CASE PRESENTATIONS: We describe a patient with ulcerative colitis and primary sclerosing cholangitis, whose ulcerative colitis relapsed following a liver transplant. After failure of conventional treatment and further deterioration in her colitis, with negative clostridium difficile, she was treated with vancomycin with beneficial long-term clinical and endoscopic responses. CONCLUSION: This case report, along with others we reviewed, suggests that vancomycin treatment should be considered as a treatment for ulcerative colitis and primary sclerosing cholangitis patients after conventional therapies for the colitis prove ineffective.
Case Rep Gastroenterol
· 2025 · PMID 40330084
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INTRODUCTION: Cap polyposis syndrome is a rare subtype of mucosal prolapse disease characterized by erythematous, inflammatory colonic polyps covered by a cap of fibrinopurulent mucous. Although a benign condition, patie...INTRODUCTION: Cap polyposis syndrome is a rare subtype of mucosal prolapse disease characterized by erythematous, inflammatory colonic polyps covered by a cap of fibrinopurulent mucous. Although a benign condition, patients may present with significant symptoms that can be suggestive of inflammatory bowel disease or colorectal cancer. CASE PRESENTATION: We describe the case of a 34-year-old male who presented with a 5-month history of diarrhea and 40-lb weight loss following hospitalization for enterotoxigenic colitis. The patient had a past medical history significant for prior colonoscopy revealing hundreds of polyps and a father who died of colorectal cancer at age 45. Multiple repeat infectious stool workups were negative, and antibiotics failed to resolve the patient's symptoms. The patient underwent endoscopy which revealed numerous polyps from the rectum to the terminal ileum that appeared similarly to pseudopolyps giving concern for inflammatory bowel disease. Subsequent histology demonstrated surface erosion and inflammation without dysplasia. Review of endoscopy showed inflammatory polyps with a cap of fibrinopurulent mucous. In the absence of chronic inflammation (C-reactive protein was within normal limits following hospitalization), endoscopic and histologic findings were suggestive of cap polyposis syndrome. CONCLUSION: Cap polyposis is diagnosed endoscopically and histologically. While most cases of cap polyposis are confined to the distal colon and rectum, we believe that this is the first case of cap polyposis syndrome extending to the terminal ileum. Treatment of cap polyposis syndrome is dependent on the severity of symptoms.
Case Rep Gastroenterol
· 2025 · PMID 40304017
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INTRODUCTION: Autoimmune pancreatitis (AIP) is a rare and distinct condition in children compared to adults. Despite being based on adult diagnostic criteria, several differences have been reported, making pediatric AIP...INTRODUCTION: Autoimmune pancreatitis (AIP) is a rare and distinct condition in children compared to adults. Despite being based on adult diagnostic criteria, several differences have been reported, making pediatric AIP a challenging diagnosis. CASE PRESENTATION: A 14-year-old adolescent presented to the emergency department with abdominal pain, vomiting, and jaundice. A combination of biological and radiological assessments led to the diagnosis of AIP. The patient experienced a swift and complete recovery without intensive treatment. CONCLUSION: AIP in children is an intriguing diagnosis and should be considered when a child presents with abdominal pain, vomiting, and jaundice. The natural history and pathophysiology of the disease are still uncertain. Specific markers for the disease need to be established. Studies on larger sample sizes are necessary to address these questions and improve AIP diagnosis and management.
Beck NS, Jeong YO, Lee KH
… +3 more, Jun EM, Im JI, Hong SY
Case Rep Gastroenterol
· 2025 · PMID 40304016
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INTRODUCTION: Most patients with compensated cirrhosis remain asymptomatic. However, with the onset of decompensation, electrolyte and acid-base disturbances are frequent in patients with chronic liver disease, including...INTRODUCTION: Most patients with compensated cirrhosis remain asymptomatic. However, with the onset of decompensation, electrolyte and acid-base disturbances are frequent in patients with chronic liver disease, including hypokalemia. We encountered a case of chronic liver disease with portal hypertension, primarily presenting with motor weakness caused by intractable hypokalemia, hypoxia-associated respiratory alkalosis, and chronic diarrhea. CASE PRESENTATION: A 54-year-old male presented to the emergency department with motor weakness. He reported experiencing exertional dyspnea and watery diarrhea for the past 3 months, approximately ten times daily. Arterial blood gas analysis indicated hypoxia and hypocapnia compatible with chronic respiratory alkalosis. The transtubular potassium gradient was 1.69, and the aldosterone/renin ratio was 17.6 (ng/dL)/(ng/mL/h). The patient had a 30-year history of consuming 360-720 mL of 20% alcohol almost daily. Abdominal computed tomography revealed multiple regenerative and dysplastic nodules in the liver, splenomegaly, ascites, esophageal varices, and diffuse edematous wall thickening in the bowel, suggesting portal hypertensive enteropathy. Computed tomography of the lungs showed no specific abnormalities in the lungs, pleura, or thoracic wall. CONCLUSION: We present a case of liver cirrhosis complicated by intractable hypokalemia, respiratory alkalosis, portal hypertension, and chronic diarrhea. A 24-h urine analysis showed renal excretion levels of Na, K, and Cl at 6.0, 2.5, and 11.0 mmol, respectively, suggesting renal retention of these electrolytes. Meanwhile, the serum levels of Na, K, and Cl were 136, 1.8, and 98 mEq/L, respectively, indicating a preserved balance of sodium and chloride but not potassium. This case underscores the importance of clinicians considering both liver cirrhosis-associated hypoxia and chronic liver disease-induced chronic diarrhea as potential underlying causes, especially when more common causes of hypokalemia have been excluded.
Noverati N, Torre B, Mostyka M
… +4 more, Choudhary C, Henry C, Kastenberg D, Moleski S
Case Rep Gastroenterol
· 2025 · PMID 40297387
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INTRODUCTION: Acute esophageal necrosis, or black esophagus, is a rare clinical phenomenon typically seen in older men after an acute triggering event. It may present with dysphagia due to stricturing or dysmotility, a c...INTRODUCTION: Acute esophageal necrosis, or black esophagus, is a rare clinical phenomenon typically seen in older men after an acute triggering event. It may present with dysphagia due to stricturing or dysmotility, a complication of severe esophageal inflammation. CASE PRESENTATION: Here we describe a case of a woman with several cardiovascular risk factors who developed black esophagus following diverticular-related hemorrhagic shock and presented with chest pain followed by dysphagia and food impaction likely as a result of mucosal sloughing and altered esophageal motility. The diagnosis was confirmed endoscopically and pathology revealed coagulative necrosis due to ischemia. DISCUSSION: Acute esophageal necrosis should be suspected in patients with cardiovascular risk factors and hemodynamic compromise and may be confirmed with endoscopy. As dysphagia may complicate this condition, slow advancement of diet while healing is advised.
Sun G, Abasszade JH, Low E
… +3 more, Low LS, Wu AIY, Holt DQ
Case Rep Gastroenterol
· 2025 · PMID 40297386
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INTRODUCTION: Intramural oesophageal dissection is a rare oesophageal injury that occurs primarily in the elderly and is associated with aggravating factors such as coagulopathy or anticoagulation therapy. It can be emet...INTRODUCTION: Intramural oesophageal dissection is a rare oesophageal injury that occurs primarily in the elderly and is associated with aggravating factors such as coagulopathy or anticoagulation therapy. It can be emetogenic, trauma-related, iatrogenic, or spontaneous. CASE PRESENTATION: We present an unusual case of an 87-year-old woman on low dose aspirin who presented with severe chest pain and sudden onset of haematemesis without prior history of forceful vomiting or Valsalva manoeuvres. An emergency upper gastrointestinal endoscopy confirmed the initial diagnosis of a spontaneous intramural oesophageal haematoma and a follow up computed tomography scan of the chest confirmed the presence of an intramural oesophageal dissection. CONCLUSION: Spontaneous intramural oesophageal dissections should be considered as a differential diagnosis in a patient presenting with acute chest pain without known risk factors such as coagulopathy.
Vespere G, Sedda S, Madonna P
… +8 more, Abete R, D'Avino A, Maione M, Lugarà M, Tazza A, Scaldaferri F, Vitiello G, De Luca L
Case Rep Gastroenterol
· 2025 · PMID 40290099
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INTRODUCTION: Acute severe ulcerative colitis (ASUC) is a serious complication affecting 9%-15% of patients with UC within 3 months of diagnosis and up to 28% of patients during the course of the disease. Despite the use...INTRODUCTION: Acute severe ulcerative colitis (ASUC) is a serious complication affecting 9%-15% of patients with UC within 3 months of diagnosis and up to 28% of patients during the course of the disease. Despite the use of infliximab and calcineurin inhibitors, the rate of colectomy remains high both during the hospitalization and in the 5 years after an acute episode. We present a case of ASUC that was unresponsive to conventional therapies but was successfully treated with filgotinib. CASE PRESENTATION: A 21-year-old male with a recent diagnosis of UC presented to our hospital with a severe flare. He received rescue therapy of high-dose intravenous steroids and 10 mg/kg infliximab. We observed little clinical and biochemical benefits. The patient declined the surgical option. Therefore, we decided to start a second rescue therapy with a new and rapid-acting Janus kinase inhibitor, filgotinib, due to its characteristics and pharmacokinetic profile of rapid absorption and metabolism. The patient showed an immediate clinical and biochemical response at 48 h, an endoscopic response at week 3, and an endoscopic remission at week 10. No recurrence was observed after 12 months of follow-up. The patient is in clinical remission with a good quality of life. CONCLUSION: Filgotinib may be an effective second-line therapy in an emergency setting such as ASUC in patients unresponsive to conventional therapy.
Case Rep Gastroenterol
· 2025 · PMID 40271495
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INTRODUCTION: Chronic gastrointestinal bleeding in patients with Crohn's disease presents diagnostic challenges. Adult intussusception is rare and typically caused by a pathological lead point, such as a tumor or inflamm...INTRODUCTION: Chronic gastrointestinal bleeding in patients with Crohn's disease presents diagnostic challenges. Adult intussusception is rare and typically caused by a pathological lead point, such as a tumor or inflammatory lesion. Lipomas, though benign, can lead to obstruction and bleeding, requiring differentiation from inflammatory causes for appropriate management. CASE PRESENTATION: A 70-year-old male with Crohn's disease and chronic anemia presented with recurrent obscure gastrointestinal bleeding. Initial endoscopy was unremarkable, but capsule endoscopy identified a bleeding jejunal lesion. Double-balloon enteroscopy and imaging confirmed a jejunal lipoma causing intermittent intussusception. Due to persistent anemia, the patient underwent laparoscopic resection, with pathology confirming an ulcerated lipoma. His anemia resolved postoperatively. CONCLUSION: This case underscores the importance of considering structural lesions like lipomas in patients with chronic bleeding and Crohn's disease. A multimodal approach, including advanced imaging and enteroscopy, is crucial for accurate diagnosis and management. Surgical resection remains the preferred treatment for symptomatic small bowel lipomas.
Raj A, Londhe M, Bade Y
… +3 more, Singh M, Gore C, Sharma A
Case Rep Gastroenterol
· 2025 · PMID 40242139
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INTRODUCTION: Erosive damage to the upper gastrointestinal (GI) tract caused by therapeutic oral iron supplements is relatively uncommon. While such injuries are frequently linked to overdoses of oral iron, they can also...INTRODUCTION: Erosive damage to the upper gastrointestinal (GI) tract caused by therapeutic oral iron supplements is relatively uncommon. While such injuries are frequently linked to overdoses of oral iron, they can also occur with doses within the standard therapeutic range. Cases have highlighted GI complications caused by iron, predominantly involving the stomach and sometimes the esophagus. During absorption, iron is initially processed as ferrous iron, which, when bound to proteins, can lead to cellular injury. Additionally, ferric iron exerts a corrosive effect on the GI mucosa and disrupts cellular processes by generating free radicals and triggering lipid peroxidation. CASE PRESENTATION: A 55-year-old female with dysphagia, pain, and anorexia showed linear to circumferential ulcers covered with white slough extensively around central esophagus with thickened and erythematous mucosa with focal erosions on esophagogastroduodenoscopy. CONCLUSION: This case highlights a rare case report of iron-induced esophageal ulcer found incidentally and the significance of acknowledging that iron preparations can harm the esophageal mucosa, especially in an Indian population where anemia is fairly predominant.
Shintaku M, Okunobo T, Nakamura H
… +3 more, Doi T, Tanaka A, Tsuta K
Case Rep Gastroenterol
· 2025 · PMID 40196422
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INTRODUCTION: Primary (or idiopathic) panniculitis involving the intra-abdominal adipose tissue is rare, and its pathogenesis remains unknown. A case of primary eosinophilic panniculitis that involved the greater omentum...INTRODUCTION: Primary (or idiopathic) panniculitis involving the intra-abdominal adipose tissue is rare, and its pathogenesis remains unknown. A case of primary eosinophilic panniculitis that involved the greater omentum of a girl is reported. CASE PRESENTATION: The patient, an 11-year-old girl, complained of dull periumbilical pain and nausea, and radiological examination showed a mass lesion in the abdomino-pelvic cavity. On laparoscopy, a plaque-like, flat mass was seen in the greater omentum, and laparoscopic omental resection was performed. On histopathological examination, the interlobular fibrous septa of omental adipose tissue were widened by inflammatory edema, prominent infiltration of eosinophils, and loose proliferation of myofibroblasts. Dense lymphocytic infiltration was also noted around small veins. Inflammatory changes were mild in the fat lobules, and fat necrosis and infiltration of lipid-laden macrophages were absent. Findings of obliterative phlebitis or arteritis were not seen. CONCLUSION: Isolated involvement of the omentum by a panniculitic process is rare, and the pathogenesis of eosinophilic septal panniculitis found in the present case remains unknown, but involvement of a hypersensitivity reaction against some unknown stimuli is presumed, based on the histopathological resemblance of the omental lesions to erythema nodosum or eosinophilic panniculitis of the skin. We should keep in mind the possibility that the omental lesion in this patient is a harbinger of more serious immunological disorders. Careful, long-term follow-up and monitoring of the patient are needed.
Case Rep Gastroenterol
· 2025 · PMID 40196421
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INTRODUCTION: Endoscopic clot removal in complex huge esophageal hematoma is a rare clinical entity. CASE PRESENTATION: A 48-year-old male patient presented to our hospital with vomiting blood with black stool for 1 day...INTRODUCTION: Endoscopic clot removal in complex huge esophageal hematoma is a rare clinical entity. CASE PRESENTATION: A 48-year-old male patient presented to our hospital with vomiting blood with black stool for 1 day after drinking alcohol. Esophageal hematoma was diagnosed after chest CT and EGD. After conservative treatment with intravenous fluids, the patient's symptoms of vomiting blood persisted and the hemoglobin decreased significantly. We decided to perform another EGD: the huge hematoma had ruptured. We performed endoscopic hemostasis and blood clot removal. Long-term postoperative follow-up shows the mucosa heals well. CONCLUSION: Endoscopic clot removal is an effective method of treating esophageal huge hematoma accompanied by rupture.
Case Rep Gastroenterol
· 2025 · PMID 40177218
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INTRODUCTION: Organ-preserving treatment for rectal cancer using local excision (LE) and/or chemoradiotherapy (CRT) is increasingly used. Locoregional metastasis precludes LE and locoregional regrowth, recurrence, or per...INTRODUCTION: Organ-preserving treatment for rectal cancer using local excision (LE) and/or chemoradiotherapy (CRT) is increasingly used. Locoregional metastasis precludes LE and locoregional regrowth, recurrence, or persistence after LE or chemoradiation (CRT) may prompt total mesorectal excision (TME). We believe that the time has passed to make such life-changing treatment decisions without pathological confirmation and investigated the use of linear endoscopic ultrasound with fine-needle aspiration (EUS-FNA). CASE PRESENTATIONS: We report 8 cases of suspected locoregional tumor growth (LRTG) on MRI: adjacent or in the rectal wall, within the mesorectal fascia, high presacral region, and obturator foramen. MRI images were studied thoroughly before and during EUS to identify the target lesion using rectal EUS-FNA. Patients were prepared using an enema. The procedure was performed on an outpatient basis without conscious sedation. FNA was performed using a 25G needle. The patient received a 3-day course of ciprofloxacin after the procedure to prevent infection of the perirectal space. Identification of the target was the most difficult part of EUS but was successful in all cases. FNA revealed adenocarcinoma in 7 cases. Five cases were confirmed by TME results: 1 patient died before the operation, and 1 patient was treated with CRT. One patient with a suspected node in the obturator foramen was free of tumors on FNA. The TME resection specimen contained 31 lymph nodes without metastasis. All procedures were well tolerated, and no complications were observed. CONCLUSION: Suspected LRTG on MRI can be confirmed using EUS-FNA. In the era of organ-preserving treatment for rectal cancer, EUS-FNA may play a supportive role when considering TME or CRT.
Selig TM, Siddique A, Reagan JL
… +2 more, Feller ER, Shah SA
Case Rep Gastroenterol
· 2025 · PMID 40177217
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INTRODUCTION: Collagenous sprue (CS) is an extremely rare enteropathy of unknown etiology and if untreated, can lead to substantial morbidity and mortality. CS often copresents with celiac disease. The presence of a sube...INTRODUCTION: Collagenous sprue (CS) is an extremely rare enteropathy of unknown etiology and if untreated, can lead to substantial morbidity and mortality. CS often copresents with celiac disease. The presence of a subepithelial collagen band on histology differentiates CS from celiac disease, as both have villous blunting. The management of the two diseases is different, and thus it is critical that the proper diagnosis of CS is made promptly to prevent complications. CASE PRESENTATION: We present a case report of CS in an elderly male who was initially diagnosed with celiac disease alone before returning to care years later with unresolved gastrointestinal symptoms. CONCLUSION: Clinicians must verify that CS has been ruled out following a celiac disease diagnosis. In regard to CS's mechanism, CS's high frequency of comorbid autoimmune conditions and its robust response to corticosteroids support an immune-mediated process. Future research should continue to aim to elucidate the mechanism as it would allow for a more targeted approach to treatment, such as anti-fibrotic or specific immunomodulator therapy.
Jamileh E, Khan Y, Hijazi U
… +1 more, Abusheikha M
Case Rep Gastroenterol
· 2025 · PMID 40170796
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INTRODUCTION: Bronchoesophageal fistulas (BOF) have predominantly been found to result in a decreased quality of life and an increased rate of mortality, particularly due to their severe complications and difficult treat...INTRODUCTION: Bronchoesophageal fistulas (BOF) have predominantly been found to result in a decreased quality of life and an increased rate of mortality, particularly due to their severe complications and difficult treatment. CASE PRESENTATION: This report discusses the case of a 71-year-old female who presented with shortness of breath and a continuous cough secondary to a fistula between the oesophagus and right bronchus on the background of squamous cell carcinoma (SCC). This patient was seen by oncologists for the treatment of her lung cancer after right middle and lower lobe lobotomies, which was then treated with radiotherapy. On admission, a computed tomography scan revealed that the patient had a BOF due to therapeutic radiotherapy for SCC. She underwent intervention from the gastrointestinal and respiratory physicians to treat the BOF. Oesophageal stent placement was performed for treatment; however, the BOF remained patent, so a bronchial stent was considered for insertion. While the patient was awaiting the bronchial stent, she died. CONCLUSION: This case highlights the complexities and challenges of BOFs, emphasising the need for further research and documentation to improve treatment strategies. More studies are needed to determine when oesophageal stenting is preferred over bronchial stenting and to evaluate the suitability and safety of dual stenting in both the oesophagus and bronchus.