Case Reports In Gastroenterology[JOURNAL]
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200 papers
A Case Report: Cryptogenic Multifocal Ulcerative Stenosing Enteritis - A Diagnostic Challenge Mimicking Crohn's Disease.
Luke N, De Leon IC, Azizi S … +1 more , Katz S
Case Rep Gastroenterol · 2025 · PMID 40170795 · Full text
INTRODUCTION: Cryptogenic multifocal ulcerative stenosing enteritis (CMUSE) is a rare and underrecognized small bowel disorder that often mimics Crohn's disease, leading to delays in diagnosis and misdirected treatment....
INTRODUCTION: Cryptogenic multifocal ulcerative stenosing enteritis (CMUSE) is a rare and underrecognized small bowel disorder that often mimics Crohn's disease, leading to delays in diagnosis and misdirected treatment. Given its relapsing nature and resistance to conventional inflammatory bowel disease (IBD) therapies, CMUSE presents significant diagnostic and therapeutic challenges. CASE PRESENTATION: We present the case of a 41-year-old male with chronic anemia, fatigue, weight loss, and intermittent abdominal pain with melena, who remained undiagnosed for 9 years despite extensive evaluations. Imaging and endoscopy failed to identify a definitive cause, and management with TNF inhibitors and IL-12/IL-23 blockade provided only temporary relief. The patient required multiple surgical resections due to recurrent strictures. Pathological examination consistently revealed multifocal jejunal ulceration with stenosis but lacked granulomas, vasculitis, or systemic inflammatory markers, ultimately confirming CMUSE. Given its distinct pathology and treatment resistance, differentiating CMUSE from Crohn's disease is essential. The patient's ongoing management includes upadacitinib, a JAK1 inhibitor, which may help modulate immune pathways contributing to ulcer formation and stricture development. CONCLUSION: This case underscores the need for heightened clinical recognition of CMUSE, particularly in patients with unexplained small bowel strictures and ulceration unresponsive to standard IBD therapies. Genetic testing may aid in distinguishing CMUSE from Crohn's disease, preventing unnecessary immunosuppressive treatments. Further research is necessary to establish effective, targeted therapies and improve outcomes for patients with this rare condition.
Primary Peritoneal Clear Cell Carcinoma Presenting with Nonspecific Gastrointestinal Symptoms in a 39-Year-Old Woman: A Case Report.
Vasireddy R, Delungahawatta T, Gaddipati G … +3 more , Iding J, Szeto B, Haas CJ
Case Rep Gastroenterol · 2025 · PMID 40135043 · Full text
INTRODUCTION: Primary peritoneal clear cell carcinoma (PPCCC) is a rare abdominal tumor, affecting 7 out of every million people. Its vague presenting signs and symptoms often lead to delayed diagnosis and poor prognosis...
INTRODUCTION: Primary peritoneal clear cell carcinoma (PPCCC) is a rare abdominal tumor, affecting 7 out of every million people. Its vague presenting signs and symptoms often lead to delayed diagnosis and poor prognosis. We present a case involving a young woman with anemia and abdominal discomfort who on further investigation had a 26-cm abdominal tumor identified to be PPCCC. Multimodal therapy with tumor debulking and chemotherapy was pursued. Given the aggressive nature of PPCCC, any clinical suspicion of peritoneal carcinoma should prompt thorough diagnostic evaluation. CASE PRESENTATION: A 39-year-old woman with menorrhagia and peptic ulcer disease presented with abdominal discomfort of 2 days duration. She initially had headaches managed with ibuprofen. Following this, she had generalized abdominal pain with bloating that worsened with food and had no relief with use of stool softeners. She had associated dizziness with palpitations, chest pressure, and exertional dyspnea. In the emergency department, the patient was mildly tachycardic but otherwise stable. On exam, she had a distended abdomen with generalized tenderness and normoactive bowel sounds. Labs showed normocytic anemia with a hemoglobin of 5.2 mg/dL. Electrocardiogram and abdominal and chest X-rays were normal. A non-contrast computed tomography of the abdomen and pelvis showed a fibroid uterus and posterior displacement of multiple bowel loops by a large septate cystic mass (13.5 × 26.0 × 26.7 cm) occupying the entire abdominal cavity. Elevated CA 125 and CA 19-9 were also noted. She underwent exploratory laparotomy with mass resection, partial omentectomy, left colectomy (given extension into transverse colon), appendectomy, and total abdominal hysterectomy with bilateral salpingectomy. Biopsy and immunohistochemical staining (positive for PAX-8, ER, P53, P16, Napsin A and negative for PR and WT-1) confirmed mass as stage IIIB PPCCC. There was no evidence of malignancy in other tissue samples. The patient was discharged with a plan for outpatient chemotherapy and genetic counseling. CONCLUSION: Given the rarity of PPCCC, our case highlights how increased clinical vigilance and prompt multidisciplinary efforts are essential for an accurate diagnosis, especially in younger patients to not delay management. Currently, there are no established management guidelines; however, initial treatment with surgical debulking followed by chemotherapy is often practiced.
Aseptic Abscess Syndrome: A Case Report of a Rare Extraintestinal Manifestation of Inflammatory Bowel Disease.
Miranda CJ, Hossein-Javaheri N, Sparacino GM … +3 more , Soofi Y, Azad F, Duong N
Case Rep Gastroenterol · 2025 · PMID 40017495 · Full text
INTRODUCTION: Aseptic hepatic abscesses are a highly uncommon phenomenon and even more rare in the spectrum of extraintestinal manifestations of inflammatory bowel disease. Part of the spectrum of "neutrophilic disease,"...
INTRODUCTION: Aseptic hepatic abscesses are a highly uncommon phenomenon and even more rare in the spectrum of extraintestinal manifestations of inflammatory bowel disease. Part of the spectrum of "neutrophilic disease," both the pathogenesis and the optimal management of these aseptic abscesses remain unclear. In the context of inflammatory bowel disease, sometimes these abscesses appear despite normal endoscopic findings. CASE PRESENTATION: We describe a highly uncommon case of aseptic hepatic abscess formation in a patient with inflammatory bowel disease. CONCLUSION: In doing so, we investigated the concept of "aseptic abscess syndrome" as it relates to similar autoimmune conditions.
An Intra-Abdominal Desmoid Tumor with Edematous Loose Collagen Fibers.
Iino M, Oura S
Case Rep Gastroenterol · 2025 · PMID 40008075 · Full text
INTRODUCTION: Diagnostic physicians tend to judge a low-dense area on computed tomography (CT) as central necrosis when it has no contrast enhancement and locates in the center of large tumors. CASE PRESENTATION: An 80-y...
INTRODUCTION: Diagnostic physicians tend to judge a low-dense area on computed tomography (CT) as central necrosis when it has no contrast enhancement and locates in the center of large tumors. CASE PRESENTATION: An 80-year-old woman was referred to our hospital due to the detection of an abdominal mass on ultrasound (US). CT showed a well-demarcated oval mass, 11 cm in size, with a central low-density area. US showed high internal echoes and enhanced posterior echoes. Magnetic resonance imaging (MRI) showed the low-density area on CT to be hypo-intense on T1-weighted images and hyper-intense on T2-weighted images. MRI further showed the central part of the tumor to be hyper-intense both on diffusion-weighted images and apparent diffusion coefficient images. Under the tentative diagnosis of a gastrointestinal stromal tumor with central necrosis, the patient underwent tumor resection, revealing the tumor to be a jejunal submucosal tumor. Pathological study showed collagen fibers with heterogeneous density and sparse proliferation of spindle cells. The center of the tumor had marked edema in addition to sparse collagen fibers. Immunostaining showed that the atypical cells were diffusely positive for β catenin and negative for S100 protein, desmin, and DOG1, leading to the diagnosis of desmoid tumor (DT). CONCLUSIONS: Physicians should note that intra-abdominal DT can have edematous loose collagen fibers and may show central necrosis-like findings on CT.
Drug-Induced Liver Injury Associated with Turmeric and Piperine: A Case and Review.
Shrestha A, Elliott S, Abasszade JH … +4 more , Wu K, Worland T, Simpson I, Dev A
Case Rep Gastroenterol · 2025 · PMID 39995754 · Full text
INTRODUCTION: Turmeric is a common spice used in traditional Chinese and Ayurvedic medicine for a variety of purported health benefits. Recent concerns have arisen regarding turmeric-induced liver injury linked to formul...
INTRODUCTION: Turmeric is a common spice used in traditional Chinese and Ayurvedic medicine for a variety of purported health benefits. Recent concerns have arisen regarding turmeric-induced liver injury linked to formulations with enhanced bioavailability, often including piperine found in black pepper. CASE PRESENTATION: We explore a case of a 40-year-old female with increasing fatigue, pruritus, and dark urine following consumption of turmeric and black pepper "wellness shots" leading to a significant drug-induced liver injury. CONCLUSION: This case underscores the critical need to recognise herbal remedies, such as turmeric, as potential sources of hepatotoxicity. Despite a reputation of safety, limited regulation and testing of turmeric may mean potential adverse effects are under-recognised. Understanding the mechanisms behind turmeric and black pepper's hepatotoxicity, including the role of potential genetic predispositions, requires further investigation for its safe use.
Inflammatory Bowel Disease in a Patient Returning from Colombia: Association with Dipeptidyl Peptidase 4 Inhibitor?
Bayoumy AB, Masclee GMC, de Boer NKH … +2 more , Neefjes-Borst A, Stenvers DJ
Case Rep Gastroenterol · 2025 · PMID 39990805 · Full text
INTRODUCTION: Recent-onset colitis poses a diagnostic challenge, necessitating a thorough evaluation to identify potential infectious and non-infectious etiologies. We considered inflammatory bowel disease (IBD) secondar...
INTRODUCTION: Recent-onset colitis poses a diagnostic challenge, necessitating a thorough evaluation to identify potential infectious and non-infectious etiologies. We considered inflammatory bowel disease (IBD) secondary to dipeptidyl peptidase 4 (DPP-4) inhibitor-induced colitis. CASE PRESENTATION: This case report details the presentation and management of a patient with persistent dysentery, refractory to conventional treatments, ultimately attributed to IBD possibly secondary to long-term DPP-4 inhibitor use. Following an episode of suspected amebiasis, the patient experienced prolonged bloody diarrhea with an endoscopic image compatible with ulcerative colitis. Extensive infectious diagnostics were negative. Ultimately, the cessation of sitagliptin therapy resulted in rapid symptom resolution and normalization of eosinophilia, as well as endoscopic improvement. However, after a few weeks, the patient was readmitted with diarrhea after continued cessation of sitagliptin. CONCLUSION: This case underscores the importance of considering IBD secondary to DPP-4 inhibitor use in the evaluation of patients with recent-onset IBD. Further research is needed to elucidate the pathophysiological mechanisms underlying the relationship between DPP-4 inhibitors and IBD.
Colitis-Induced Pancreatic Fistula with Pancreatic Ascites.
Winrich E, Steele E, Shine A … +1 more , Parajuli D
Case Rep Gastroenterol · 2025 · PMID 39981172 · Full text
INTRODUCTION: Although cases of severe pancreatitis causing fistula formation into the colon have been documented, the reverse process of colitis causing a pancreatic fistula remains undocumented. CASE PRESENTATION: We p...
INTRODUCTION: Although cases of severe pancreatitis causing fistula formation into the colon have been documented, the reverse process of colitis causing a pancreatic fistula remains undocumented. CASE PRESENTATION: We present the case of a 79-year-old male with severe colitis resulting in perforation and pericolonic abscess formation adjacent to the pancreas, which resulted in an internal pancreatic fistula and pancreatic ascites. After 2 paracenteses, our patient ultimately underwent endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and pancreatic duct stent placement. The patient clinically improved and was ultimately discharged. CONCLUSION: Follow-up ERCP was performed 2 months after discharge and showed no contrast extravasation, illustrating closure of the previous pancreatic fistula. Ultimately, our case demonstrates that cases of severe colitis may contribute to adjacent pancreatic fistula and ascites formation.
Rare Encounter: A Case Report of Hepatic Perivascular Epithelioid Cell Tumor - An Uncommon Mesenchymal Tumor in the Liver.
Paula D, Amaral MJ, Madeira J … +4 more , Simões J, Lázaro A, Silva N, Tralhão JG
Case Rep Gastroenterol · 2025 · PMID 39981171 · Full text
INTRODUCTION: Perivascular epithelioid cell tumor (PEComa) is a rare neoplastic mesenchymal tumor, more frequently found in the uterus, although it can occur in different organs. Hepatic PEComa is extremely rare, with on...
INTRODUCTION: Perivascular epithelioid cell tumor (PEComa) is a rare neoplastic mesenchymal tumor, more frequently found in the uterus, although it can occur in different organs. Hepatic PEComa is extremely rare, with only a few cases described in the literature. CASE PRESENTATION: We present a case report of a 33-year-old female patient with a history of macroprolactinoma. She was initially referred to our Department due to a 9-mm hepatic nodule incidentally diagnosed in an abdominal ultrasound in 2018. She was asymptomatic. Follow-up ultrasound showed a growth from 9 mm to 16 mm in 2019 and 30 mm in a liver magnetic resonance imaging (MRI) scan in 2022. The case was discussed in a multidisciplinary team meeting, and since malignant transformation or hepatocellular carcinoma could not be ruled out, the decision was to undergo hepatic resection. An open hepatic subsegmentectomy of segment 5 was performed, with uneventful postoperative period. The definitive diagnosis was hepatic PEComa. CONCLUSION: Hepatic PEComas are rare liver tumors, and their preoperative diagnosis is challenging due to the lack of specific radiological features. In most cases, the diagnosis is only confirmed through histopathological and immunohistochemical studies. Resection of the lesion appears to be the curative treatment; however, due to the rarity of the condition, there are no studies comparing surgical treatment with other options. In our case, the hypervascular lesion was initially misdiagnosed as an adenoma. PEComas should be considered as a differential diagnosis in liver nodules with well-defined margins and increased uptake in the arterial phase in computed tomography or MRI scan. Surgical resection was curative, and no recurrence was detected during the patient's follow-up.
Risankizumab and Certolizumab Pegol Dual-Targeted Therapy for Crohn's Disease and Axial Spondyloarthritis: A Case Report.
Lehmann A, Vosbeck J, Kyburz D … +2 more , Hruz P, Niess JH
Case Rep Gastroenterol · 2025 · PMID 39981170 · Full text
INTRODUCTION: Treatment of Crohn's disease (CD) and axial spondyloarthritis (axSpA) is challenging, with CD refractory to anti-TNF antibodies. Here, we present for the first time a case treated with dual-targeted therapy...
INTRODUCTION: Treatment of Crohn's disease (CD) and axial spondyloarthritis (axSpA) is challenging, with CD refractory to anti-TNF antibodies. Here, we present for the first time a case treated with dual-targeted therapy (DTT) using the anti-IL-23 monoclonal risankizumab and the anti-TNF antibody certolizumab pegol. CASE PRESENTATION: Our patient initially presented with axSpA at the age of 27. Nine years later, CD was diagnosed by the age of 36. One year after the diagnosis of CD, a spontaneous ileal perforation occurred as part of a disease course refractory to multiple anti-TNF antibodies and intolerance to immunomodulators. However, the axSpA showed a response to the anti-TNF certolizumab pegol. After stopping certolizumab pegol, we enrolled the patient into the M15-991 induction trial (MOTIVATE) and the maintenance trial (FORTIFY) testing the anti-IL-23 antibody risankizumab versus placebo in CD with failure to prior biological therapy. As a result, risankizumab induced a CD response but failed to control the axSpA. Considering the CD refractory and the axSpA responding to anti-TNFs, we initiated a DTT with risankizumab and certolizumab pegol. Risankizumab and certolizumab pegol together improved both CD and axSpA. As adverse events, there were only two episodes of spontaneously resolving common colds during the 19-month reviewed period. CONCLUSION: DTT using risankizumab and certolizumab pegol is effective in CD and axSpA without serious adverse events in our patient. Combining biologicals that target specific pathways in immune-mediated diseases promises excellent potential in CD associated with extraintestinal manifestations.
Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report.
Huynh D, Khaing MM, Fernandes RG … +6 more , Malloy R, Lin L, Gilmore R, Walker N, Khoo E, Begun J
Case Rep Gastroenterol · 2025 · PMID 39981169 · Full text
INTRODUCTION: Acute severe ulcerative colitis (ASUC) represents a medical emergency associated with high mortality and morbidity. While corticosteroids are the primary treatment, cases that are unresponsive often require...
INTRODUCTION: Acute severe ulcerative colitis (ASUC) represents a medical emergency associated with high mortality and morbidity. While corticosteroids are the primary treatment, cases that are unresponsive often require rescue therapy with either infliximab or cyclosporine to reduce the rate of colectomy. Janus kinase inhibitors, such as tofacitinib and upadacitinib, are a highly efficacious therapy with rapid induction of clinical response in moderate to severe ulcerative colitis (UC). Limited data are available on its use on ASUC. We present the first case utilizing upadacitinib as sequential medical rescue therapy in ASUC as well as intestinal ultrasound as a useful tool for disease and response monitoring. CASE PRESENTATION: A 69-year-old female who presented with corticosteroid-refractory ASUC partially responded to dose-intensified infliximab and finally achieved clinical remission with upadacitinib. This resulted in swift clinical remission and significant improvement in her mucosal inflammation on intestinal ultrasound. CONCLUSION: This successful intervention not only avoided colectomy but demonstrated sustained clinical and sonographic remission 16 weeks of post-treatment. Upadacitinib, with its rapid action and efficacy, shows promise in ASUC and should be supported by registration trials and real-world studies. Despite successful outcomes in this case, further validation and long-term data are necessary.
Anaphylaxis to a Vedolizumab Infusion following Drug Holiday in a Patient with Ulcerative Colitis: A Case Report.
Karp J, Shen H, Goodwin T … +1 more , Sparrow MP
Case Rep Gastroenterol · 2025 · PMID 39981168 · Full text
INTRODUCTION: Vedolizumab is a commonly prescribed biologic agent due to its safety profile and clinical efficacy. Severe infusion-related reactions are exceedingly rare, with no previously documented cases of anaphylaxi...
INTRODUCTION: Vedolizumab is a commonly prescribed biologic agent due to its safety profile and clinical efficacy. Severe infusion-related reactions are exceedingly rare, with no previously documented cases of anaphylaxis to vedolizumab infusion following a drug holiday. CASE PRESENTATION: We report the case of a 65-year-old male with ulcerative colitis who had a severe anaphylactic reaction to the first re-induction infusion of vedolizumab following a 30-month drug holiday. No pre-infusion prophylactic medication was administered. Upon commencement of the infusion, the patient developed anaphylactic symptoms including airway compromise that required intensive care unit admission and treatment with an adrenaline infusion. CONCLUSION: Anaphylactic reactions to vedolizumab after a drug holiday can occur. As is done for infliximab, we recommend administration of an antipyretic, antihistamine, and corticosteroid prior to vedolizumab re-induction infusions when it is given after a drug holiday.
Endovascular Management of a Portal Vein Pseudoaneurysm following Pancreatoduodenectomy: A Case Report and Review of Literature.
Oor JE, Groeneweg E, Bloemsma GC … +2 more , Bokkers RPH, Klaase JM
Case Rep Gastroenterol · 2025 · PMID 39981167 · Full text
INTRODUCTION: Portal vein pseudoaneurysm is a rare but potential life-threatening complication following pancreatoduodenectomy. We herein report on the successful, minimally invasive treatment of this serious complicatio...
INTRODUCTION: Portal vein pseudoaneurysm is a rare but potential life-threatening complication following pancreatoduodenectomy. We herein report on the successful, minimally invasive treatment of this serious complication. CASE PRESENTATION: A 68-year-old male patient who had undergone pancreatoduodenectomy with portal vein wedge resection at another facility presented to our department due to persistent bile leakage and intermittent bleeding. Abdominal computed tomography scanning demonstrated a large fluid collection surrounding the pancreatojejunostomy, with an occlusion of the common hepatic artery as well as a portal vein pseudoaneurysm. Treatment was performed by means of a minimally invasive approach, including endovascular portal vein stent placement and percutaneous transhepatic biliary drainage (PTBD) through the dehiscent hepaticojejunostomy. This was followed by the placement of a percutaneous pigtail in the peripancreatic fluid collection for adequate drainage. Antibiotics were administered for a total duration of 6 weeks following stent placement. In the subsequent weeks, the PTBD could be internalized and the pigtail removed, after which patient was discharged. During outpatient visits, a contrast injection through the PTBD confirmed the absence of bile leakage, after which the drain could be removed. CONCLUSION: This article presents one of the few published cases of portal vein pseudoaneurysm following pancreatoduodenectomy and underscores the vital role of minimally invasive endovascular stent and PTBD placement in managing this rare and potentially lethal complication.
Steroid-Refractory Immune-Related Hepatitis Caused by Pembrolizumab with Stage IVB Non-Small Cell Lung Cancer: A Case Report.
Hamaguchi T, Ueno M, Kobayashi S … +7 more , Tezuka S, Morimoto M, Kato T, Saito H, Sato S, Furuse J, Maeda S
Case Rep Gastroenterol · 2025 · PMID 39981166 · Full text
INTRODUCTION: We report the case of a man in his 50s with stage IVB non-small cell lung cancer who developed severe immune-related hepatitis caused by pembrolizumab. CASE PRESENTATION: He received carboplatin, pemetrexed...
INTRODUCTION: We report the case of a man in his 50s with stage IVB non-small cell lung cancer who developed severe immune-related hepatitis caused by pembrolizumab. CASE PRESENTATION: He received carboplatin, pemetrexed, and pembrolizumab as first-line therapy. After four courses, each of the triplet regimen and maintenance therapy with pemetrexed and pembrolizumab, the patient developed immune-related pneumonitis and colitis. Therefore, pemetrexed and pembrolizumab were discontinued, and 0.5 mg/kg/day prednisolone was started. Despite gradual reduction of the prednisolone to 15 mg/day along with resolution of the pneumonitis and colitis, hepatic dysfunction occurred (elevated serum bilirubin and transaminase levels). We made a diagnosis of immune-related hepatitis based on liver biopsy results and negative results for other causes, such as viral infection. We increased the prednisolone dose to 2 mg/kg/day; however, the hepatic dysfunction was not resolved. Upon sequential methylprednisolone pulse therapy (1,000 mg/day), mycophenolate mofetil, and azathioprine treatment, the hepatic dysfunction plateaued but was not resolved. The patient did not respond to steroids for immune-related hepatitis, developed infectious enteritis owing to a compromised state, and died of sepsis on day 107 after diagnosis of immune-related hepatitis. CONCLUSION: This case highlights the importance of early diagnosis of steroid-refractory disease, prompt initiation of immunosuppressive agents, and steroid dose reduction in such cases. The changes in liver function during steroid non-response and immunosuppressive drug induction in this case are valuable as a reference for future cases of immune-related adverse event hepatitis.
Jackhammer Esophagus as a Complication of Tonsillectomy and Adenoidectomy: A Case Report.
McDonnell WM, Tewnion A
Case Rep Gastroenterol · 2025 · PMID 39981165 · Full text
INTRODUCTION: Tonsillectomy is a safe and common procedure. It has not been associated with the development of hypercontractile conditions of the esophagus. Jackhammer esophagus is a type of hypercontractile esophagus wi...
INTRODUCTION: Tonsillectomy is a safe and common procedure. It has not been associated with the development of hypercontractile conditions of the esophagus. Jackhammer esophagus is a type of hypercontractile esophagus with vigorous contraction of the esophagus associated with dysphagia and chest pain. CASE PRESENTATION: A 42-year-old woman with no previous history of gastroesophageal dysfunction or symptoms developed Jackhammer esophagus with severe dysphagia and chest pain after undergoing tonsillectomy and adenoidectomy. CONCLUSION: Although Jackhammer esophagus has been reported as a complication of several invasive procedures, this is the first report of Jackhammer esophagus as a complication of tonsillectomy and adenoidectomy.
Gastrointestinal Neuroectodermal Tumor/Extraskeletal Ewing Sarcoma of the Ileum with Ulcerative Colitis.
She T, Ren S, Katz S
Case Rep Gastroenterol · 2024 · PMID 39980582 · Full text
INTRODUCTION: Malignant gastrointestinal neuroectodermal tumor (GNET), previously known as clear cell sarcoma-like tumor of the gastrointestinal tract, is an extremely rare and aggressive mesenchymal neoplasm characteriz...
INTRODUCTION: Malignant gastrointestinal neuroectodermal tumor (GNET), previously known as clear cell sarcoma-like tumor of the gastrointestinal tract, is an extremely rare and aggressive mesenchymal neoplasm characterized by high rates of recurrence, metastases, and mortality. Currently, there are no standardized guidelines for therapy. CASE PRESENTATION: We present a case of GNET in a 32-year-old male with a history of lymphoma and ulcerative colitis (UC), who also had synchronous multiple liver metastasis. To our knowledge, this is the first documented case of GNET in a patient with inflammatory bowel disease. CONCLUSION: The narrow time frame in which UC and GNET were diagnosed warrants further investigation into their potential relationship.
Severe Acute Pancreatitis Complicated by Multiple Intra-Abdominal Hemorrhages.
Wang CY, Gu Y, Yan RP … +5 more , Li X, He F, Feng XL, Zhang G, Cui YF
Case Rep Gastroenterol · 2025 · PMID 39974518 · Full text
INTRODUCTION: Intra-abdominal hemorrhage is a rare yet life-threatening complication of acute pancreatitis (AP), with a higher prevalence in cases of severe acute pancreatitis (SAP). This condition is primarily caused by...
INTRODUCTION: Intra-abdominal hemorrhage is a rare yet life-threatening complication of acute pancreatitis (AP), with a higher prevalence in cases of severe acute pancreatitis (SAP). This condition is primarily caused by vessel wall erosion and rupture of pseudoaneurysms (PSAs). However, SAP cases involving multiple sequential arterial hemorrhages are extremely rare. This condition is primarily brought on by the process of vessel wall degeneration and the development of PSAs. Nonetheless, SAP necessitating multiple episodes of arterial bleeding is very uncommon. CASE PRESENTATION: Here is the case history of a 31-year-old man already being treated for SAP. His condition was then complicated by massive, frequent intra-abdominal bleeding. The patient initially presented to the hospital with SAP. He was transferred to the intensive care unit for proper management. Massive intra-abdominal bleeds occurred on the 31st, 45th, and 60th days during hospitalization. The maximum blood loss was 1,500 mL. In each of the instances, digital subtraction angiography (DSA) embolization was carried out after the bleeding source had been verified. In order to manage SAP, continuous percutaneous drainage and staged pancreatic necrosectomy were undertaken for 6 months. No recurrence of intra-abdominal hemorrhage was detected. Infection of the abdominal cavity was properly controlled. The patient left the hospital in good condition. CONCLUSION: Spontaneous bleeding in the abdominal cavity is a severe and life-threatening complication of SAP. This is often caused by vessel wall erosion. In such cases, DSA plays a crucial role in diagnosis and management. Besides precisely locating the bleeding source, one can perform a much-needed embolization immediately. Consequently, the disease is under total control, and the patient is much more likely to survive.
Hybrid Endoscopic/Fluoroscopic Gastrostomy Tube Placement: Case Report of a Novel Technique.
Girardi N, Wharton B, Cicuto K … +2 more , Wiley A, LaGrone L
Case Rep Gastroenterol · 2025 · PMID 39967998 · Full text
INTRODUCTION: We report the case of a 60-year-old female with a history of perforated gastric ulcer, abdominal abscesses, enterocutaneous fistula, and small bowel obstruction requiring durable gastric decompression prior...
INTRODUCTION: We report the case of a 60-year-old female with a history of perforated gastric ulcer, abdominal abscesses, enterocutaneous fistula, and small bowel obstruction requiring durable gastric decompression prior to delayed fistula takedown. The patient had contraindications to or failed attempts at traditional gastrostomy approaches (surgical, endoscopic, interventional radiology). CASE REPORT: Gastrostomy was successfully performed via a novel technique combining interventional radiology and endoscopic placement. DISCUSSION: In certain patients with complex presentations, a hybrid approach to gastrostomy tube placement using fluoroscopy and endoscopy may prove a viable alternative when traditional methods are contraindicated or unsuccessful.
Management of Refractory Esophageal Variceal Bleeding when TIPSS Is Not Possible: Review of a Challenging Case.
Qatomah A, Bessissow A, Chen YI … +2 more , Bessissow T, Benmassaoud A
Case Rep Gastroenterol · 2025 · PMID 39949594 · Full text
INTRODUCTION: Esophageal variceal bleeding (EVB) is a common complication of portal hypertension. Guidelines recommend initiation of vasoactive agents in combination with antimicrobial therapy prior to endoscopic varicea...
INTRODUCTION: Esophageal variceal bleeding (EVB) is a common complication of portal hypertension. Guidelines recommend initiation of vasoactive agents in combination with antimicrobial therapy prior to endoscopic variceal ligation. In cases of refractory EVB, trans-jugular intrahepatic portosystemic shunt (TIPSS) is recommended; however, it is contraindicated in up to 35% of cases. CASE PRESENTATION: We report a case of a 61-year-old male newly diagnosed with hepatocellular carcinoma and extensive portal vein thrombosis. The patient developed a refractory EVB failing medical and endoscopic therapies which was successfully treated with transcutaneous left gastric vein embolization (LGVE). CONCLUSION: LGVE could be contemplated in instances where anatomical complexities or contraindications to TIPSS arise.
Successful Pregnancy in a Patient with Crohn's Disease and Short Bowel Syndrome: Off Total Parenteral Nutrition and On Teduglutide, a Glucagon-Like Peptide-2 Analog - A Case Report.
Dahar MM, Both M, Lord LM … +2 more , Densmore C, Saubermann LJ
Case Rep Gastroenterol · 2025 · PMID 39906192 · Full text
INTRODUCTION: Patients with short bowel syndrome (SBS) on conventional oral diets often face nutritional deficiencies and dehydration, a challenge further compounded during pregnancy. This case report describes the use o...
INTRODUCTION: Patients with short bowel syndrome (SBS) on conventional oral diets often face nutritional deficiencies and dehydration, a challenge further compounded during pregnancy. This case report describes the use of a glucagon-like peptide-2 (GLP-2) analog in the nutritional management of an SBS patient dependent on total parenteral nutrition (TPN). CASE PRESENTATION: A 29-year-old woman with a significant medical history of Crohn's disease leading to SBS was traditionally dependent on TPN for sustenance. During her pregnancy, she was successfully managed with a GLP-2 analog, which enabled her to wean off TPN. This successful management underscores the therapeutic potential of GLP-2 analogs in effectively altering the nutritional landscape for SBS patients, including during the physiologically demanding period of pregnancy. CONCLUSION: GLP-2 analogs helped with the nutritional management of patients with SBS during pregnancy and helped them wean off TPN. There is a need for further research and exploration into GLP-2 analogs as viable alternatives to conventional treatments such as TPN in the care and management of SBS patients during pregnancy.
Colonic Dieulafoy Lesion as a Rare Cause of Lower Gastrointestinal Bleeding.
Farag M, Diaz Y, Patel H
Case Rep Gastroenterol · 2025 · PMID 39897406 · Full text
INTRODUCTION: Dieulafoy lesion is one of the most under-recognized sources of gastrointestinal (GI) bleeding (GI), typically manifesting as acute upper gastrointestinal bleeding; endoscopy is usually the first diagnostic...
INTRODUCTION: Dieulafoy lesion is one of the most under-recognized sources of gastrointestinal (GI) bleeding (GI), typically manifesting as acute upper gastrointestinal bleeding; endoscopy is usually the first diagnostic and therapeutic modality utilized to handle these lesions by employing a variety of procedures. CASE REPORT: This is a case of an 81-year-old female who was being assessed after experiencing repeated bouts of melena with hemoglobin drop. The patient had multiple comorbidities but no history of gastrointestinal bleeding. Esophagogastroduodenoscopy (EGD) revealed only Erythematous duodenopathy without active bleeding; the initial colonoscopy revealed a large amount of blood without identifying the source of bleeding; a second colonoscopy revealed classic Dieulafoy lesions in the splenic flexure, which were injected and clipped, and the bleeding ceased. CONCLUSION: Dieulafoy lesions are most frequently found in the stomach and gastroesophageal junction, but they have also been documented in other parts of the gastrointestinal tract. In this particular instance, the lesions were identified in the colon, which is an unusual location for them, and they were treated endoscopically by clipping and injecting. In conclusion, colonic Dieulafoy lesions, although rare, have the potential to cause life-threatening bleeding and should be included in the differential diagnosis of lower gastrointestinal bleeding.
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