Gastro hep advances最新文献

{"title":"Helicobacter pylori Exploit Short-Chain Fatty Acids-Induced CAPZA1 Overexpression to Emerge CD44v9-Positive Stemness","authors":"Hitoshi Tsugawa ,&nbsp;Jin Imai ,&nbsp;Eiji Sugiyama ,&nbsp;Chanudporn Sugiyama ,&nbsp;Takashi Ueda ,&nbsp;Miwa Hirai ,&nbsp;Kenichiro Todoroki ,&nbsp;Hidekazu Suzuki","doi":"10.1016/j.gastha.2025.100860","DOIUrl":"10.1016/j.gastha.2025.100860","url":null,"abstract":"<div><h3>Background AND Aims</h3><div>Although <em>Helicobacter pylori</em> infects a large proportion of the global population, only a small subset of the infected individuals develop gastric cancer. The molecular mechanisms underlying the selective progression of gastric carcinogenesis are not fully understood. This study aimed to elucidate these mechanisms by focusing on CD44v9-positive cell generation in <em>H pylori</em>–infected gastric mucosa.</div></div><div><h3>Methods</h3><div>Using <em>H pylori</em> infection models in human gastric adenocarcinoma cells, mice, and mouse-derived gastric organoids, we examined the effects of short-chain fatty acids (SCFAs) on the induction of CD44v9-positive cells using western blotting and immunofluorescence. SCFA concentrations and microbiota compositions were analyzed in gastric juice samples from <em>H pylori</em>–infected patients to evaluate their association with gastric cancer risk.</div></div><div><h3>Results</h3><div>Propionate and butyrate induced capping actin protein of muscle Z-line α subunit 1 (CAPZA1) overexpression via histone deacetylase inhibition. In SCFA-induced CAPZA1-overexpressing cells, the <em>H pylori</em>–derived oncoprotein CagA accumulated due to impaired autophagic degradation, leading to enhanced CD44v9 expression. In the gastric antrum, CD44v9-positive cells undergo CagA-mediated stem cell transformation, whereas a distinct signaling mechanism operates in the gastric corpus. In patients with early gastric cancer, intragastric concentrations of propionate and butyrate are elevated, and the microbiota is enriched with SCFA-producing bacteria.</div></div><div><h3>Conclusion</h3><div>SCFA-induced CAPZA1-overexpressing cells serve as a scaffold niche that supports CagA activity and promotes CD44v9-positive cancer stem-like cells. This study sheds new light on the early molecular events driving <em>H pylori</em>–associated gastric carcinogenesis and may inform future strategies for early detection and intervention.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100860"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound–Directed Transgastric Fine-Needle Aspiration in Diagnosis of Pancreatic Head Mass","authors":"Luke Durbin,&nbsp;Reem Al Shabeeb,&nbsp;William Abel,&nbsp;Abbinaya Elangovan,&nbsp;Patrick Okolo,&nbsp;Paul Yeaton,&nbsp;Varun Kesar,&nbsp;Vivek Kesar","doi":"10.1016/j.gastha.2025.100864","DOIUrl":"10.1016/j.gastha.2025.100864","url":null,"abstract":"<div><div>Renal cell carcinoma is an aggressive malignancy, with distant metastases often diagnosed many years following radical nephrectomy. We describe a case of pancreatic metastasis in a patient with prior renal cell carcinoma and history of Roux-en-Y gastric bypass, diagnosed using endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) procedure. Our case demonstrates the utility of endoscopic ultrasound–directed transgastric ERCP to both diagnose and manage treatment of malignancy in patients with altered anatomy, as a minimally invasive alternative to ERCP.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100864"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates and Factors Associated With Hepatocellular Carcinoma Diagnosis, Stage, Treatment, and Survival","authors":"George N. Ioannou ,&nbsp;Vera Yakovchenko ,&nbsp;Tamar Taddei ,&nbsp;Alexander Monto ,&nbsp;Heather Patton ,&nbsp;Monica Merante ,&nbsp;Patrick Spoutz ,&nbsp;Linda Chia ,&nbsp;Jennifer Yudkevich ,&nbsp;Ayse Aytaman ,&nbsp;Atoosa Rabiee ,&nbsp;Binu John ,&nbsp;Boris Blechacz ,&nbsp;Cindy X. Cai ,&nbsp;Hochong Gilles ,&nbsp;Anand S. Shah ,&nbsp;Heather McCurdy ,&nbsp;Puneet Puri ,&nbsp;Janice Jou ,&nbsp;Khurram Mazhar ,&nbsp;Shari S. Rogal","doi":"10.1016/j.gastha.2025.100859","DOIUrl":"10.1016/j.gastha.2025.100859","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Up-to-date information is needed on hepatocellular carcinoma (HCC) diagnosis, stage, treatment, and survival.</div></div><div><h3>Methods</h3><div>Of &gt; 2000 patients with a new diagnosis of HCC in 2023 in the US Veterans Health Administration, a random subsample of 194 confirmed HCC cases were selected for a structured medical record review by expert hepatologists.</div></div><div><h3>Results</h3><div>Among 194 confirmed HCC cases in 2023, mean age was 73 years, and only 56.7% had cirrhosis diagnosed before HCC, while 12.9% had cirrhosis diagnosed after HCC and 22.2% did not have cirrhosis. Stage at diagnosis was T1 in 17.5%, T2 in 42.3%, and beyond T2 in 40.2%. Early-stage diagnosis (T1 or T2) was more common in the following groups: cirrhosis diagnosed before HCC (70.9%), HCC diagnosed by screening (86.3%), high performance status (73.0%), receipt of Veterans Affairs (VA) primary care (63.3%), or VA liver care (72.6%). Among 147 of 194 patients (75.8%) who received HCC-directed treatments, the most common, first-line treatment was Y-90 radioembolization (28.6%), followed by ablation (21.1%), transarterial chemoembolization (20.4%), systemic therapy (17.0%), surgical resection (7.5%), and external beam radiation (5.4%). Mortality (29.9% at 1 year, 44.8% at 2 years) was lower in those with early-stage diagnosis, diagnosis via screening, Child-Turcotte-Pugh class A, Model for End-Stage Liver Disease ≤ 10, absence of cirrhosis, cured hepatitis C virus, receipt of curative treatments, VA primary or liver care, and good performance status.</div></div><div><h3>Conclusion</h3><div>These results highlight the importance of HCC screening and engagement in liver care for early HCC diagnosis, curative treatment, and improved survival while demonstrating the feasibility of a national quality improvement program for addressing persistent gaps in the HCC screening, diagnosis, and treatment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100859"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Esophageal Stricture Following Caustic Injury From a Concentrated Herbal Preparation in a Resource-Limited Setting","authors":"Audy Meutia Ariana ,&nbsp;Budi Widodo","doi":"10.1016/j.gastha.2025.100865","DOIUrl":"10.1016/j.gastha.2025.100865","url":null,"abstract":"<div><div>Caustic esophageal injury is a frequently overlooked health problem, despite its serious impact on patients’ quality of life. We report the case of a 24-year-old male from an island region of Indonesia who developed esophageal stricture after consuming a traditional herbal preparation with low potential of Hydrogen. Delayed endoscopy, due to limited facilities and financial constraints, further worsened the condition. The patient experienced recurrent dysphagia 6 months after dilation, necessitating conservative management with staged dilation and intralesional triamcinolone injection. This case highlights an unusual etiology, a multidimensional burden, and the need for effective therapeutic strategies and preventive health policies.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100865"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unrecognized Fibrosis Risk in MASLD: A Real-World Analysis and the Case for AI-Augmented Stratification","authors":"Ruona Ebiai ,&nbsp;Jasmine McNair ,&nbsp;Sameera Shuaibi ,&nbsp;Adil Memon ,&nbsp;Anshuman Desai ,&nbsp;Lisa Birdsall Fort ,&nbsp;Leo Seoane ,&nbsp;Nigel Girgrah ,&nbsp;George Therapondos","doi":"10.1016/j.gastha.2025.100857","DOIUrl":"10.1016/j.gastha.2025.100857","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Current fibrosis risk stratification in metabolic dysfunction–associated steatotic liver disease (MASLD) relies on provider-initiated noninvasive testing and referral, making it vulnerable to variability in awareness, documentation, and follow-through. We aimed to quantify care gaps associated with this provider-dependent approach and explore opportunities for artificial intelligence to improve MASLD detection and management.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of all adults undergoing abdominal ultrasound in 2024 at Ochsner Health’s South Shore campuses. Natural language processing identified reports with hepatic steatosis, and patients with at least 1 cardiometabolic risk factor were included. Fibrosis-4 index (FIB-4) scores were calculated from recent laboratory data (within 6 months of ultrasound) using age-adjusted thresholds to classify patients as low, indeterminate, or high fibrosis risk. Management was defined as hepatology referral for high- or indeterminate-risk patients and documentation of a primary care provider for low-risk patients requiring reassessment.</div></div><div><h3>Results</h3><div>Among 14,814 adults with ultrasound in 2024, 3052 (20.6%) met the MASLD criteria. Based on age-adjusted FIB-4, 15.2% were high risk, 18.0% indeterminate, and 66.0% low risk for advanced fibrosis. Of 465 high-risk patients, only 33.5% had hepatology referrals, leaving 309 (10.1% of the MASLD cohort) without appropriate specialty evaluation. Among 549 indeterminate-risk patients, 58.7% lacked referral for secondary assessment. In the low-risk group, 224 (7.3%) had no documented primary care provider for follow-up, and 24 (0.8%) lacked sufficient laboratory data for FIB-4 calculation. Overall, 28.0% of the MASLD cohort had a critical, moderate, or monitoring care gap.</div></div><div><h3>Conclusion</h3><div>Significant gaps persist in MASLD fibrosis risk stratification and management, largely reflecting system-level coordination failures rather than access barriers. Artificial intelligence–driven workflows integrated into the electronic health record could automate steatosis detection, calculate FIB-4 scores, flag care gaps, and prompt risk-stratified referrals or reassessments, offering a scalable solution to standardize MASLD management and improve outcomes.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100857"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like Peptide-1 Receptor Agonists and Risk of Pneumonia and Postprocedure Hospitalization Among Patients Undergoing Gastrointestinal Endoscopy","authors":"Chunyuan Qiu ,&nbsp;Qiaoling Chen ,&nbsp;Stephanie Tovar ,&nbsp;Karl Kwok ,&nbsp;Antonio T. Hernandez Conte ,&nbsp;Jammie T. Ferrara ,&nbsp;Vimal Desai ,&nbsp;Jiaxiao M. Shi ,&nbsp;Andrew Q. Giap ,&nbsp;Bechien U. Wu","doi":"10.1016/j.gastha.2025.100869","DOIUrl":"10.1016/j.gastha.2025.100869","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Safety concerns have been raised regarding the glucagon-like peptide-1 receptor agonist (GLP-1RA) use in patients undergoing procedural sedation and anesthesia. The objective of this study is to assess the association between GLP-1RA use and postprocedural risk of pneumonia and all causes of urgent care (UC), emergency department, and hospitalization.</div></div><div><h3>Methods</h3><div>Using a propensity-matched retrospective cohort design, we matched patients with active GLP-1RA at the time of gastrointestinal endoscopic procedure between January 2008 and June 2023 to non–GLP-1RA–exposed controls (1:4) using propensity scores generated by logistic regression. The primary outcome was risk of postprocedural pneumonia and all-cause hospitalization further adjusted for type sedation (conscious sedation vs monitored anesthesia care) as well as study year. We further assessed association between pre-endoscopic GLP-1RA exposure and subsequent UC, emergency department visits, and 30-day mortality.</div></div><div><h3>Results</h3><div>The propensity-matched cohort comprised 63% colonoscopy, 25% esophagogastroduodenoscopy and 12% bidirectional endoscopy among 3825 patients with active GLP-1RA matched to 14,920 controls. There was no significant association between active GLP-1RA use and postprocedure pneumonia (0.13% vs 0.25%, odds ratio 0.56 (95% confidence interval: 0.22, 1.45)) or 30-day postprocedural hospitalization (1.9% vs 2.6%, 0.76 (95% confidence interval: 0.59, 0.98)) compared to nonusers. No significant association was observed for UC, emergency department visits or mortality at 7- or 30-days postprocedure.</div></div><div><h3>Conclusion</h3><div>Uninterrupted use of GLP-1RA was not associated with major adverse events among patients undergoing gastrointestinal endoscopy with sedation.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100869"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Social Vulnerability Impacts Presentation and Decreases Treatment Response in Eosinophilic Esophagitis","authors":"Angelica R. Lackey ,&nbsp;Stefani Aleman ,&nbsp;Alexandra A. Weir ,&nbsp;Sean S. LaFata ,&nbsp;Timothy S. Gee ,&nbsp;Arjun K. Juneja ,&nbsp;Hannah L. Thel ,&nbsp;Brenderia A. Cameron ,&nbsp;Justin McCallen ,&nbsp;Christopher J. Lee ,&nbsp;Gustaf N. Hendrick ,&nbsp;Jose C. Bermudez ,&nbsp;Daniel Song ,&nbsp;Walker D. Redd ,&nbsp;Trevor S. Barlowe ,&nbsp;Cary C. Cotton ,&nbsp;Craig C. Reed ,&nbsp;Evan S. Dellon","doi":"10.1016/j.gastha.2025.100856","DOIUrl":"10.1016/j.gastha.2025.100856","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Social vulnerability describes relative disadvantage according to demographics, socioeconomic status, and resources. The impact of social vulnerability on eosinophilic esophagitis (EoE) remains unknown. We aimed to determine whether social vulnerability influences EoE presentation or treatment outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients of any age with newly diagnosed EoE. The social vulnerability index (SVI) was used to estimate patients’ relative vulnerability (with higher scores indicating more vulnerability). For patients with topical corticosteroid (tCS) treatment or dietary elimination and a follow-up endoscopy, we assessed histologic, symptomatic, and endoscopic responses. We compared baseline characteristics and post-treatment responses by SVI.</div></div><div><h3>Results</h3><div>Among 1457 patients, the mean SVI was 0.42 ± 0.26. Patients with higher SVIs frequently presented with atypical symptoms like vomiting (<em>P</em> &lt; .001), abdominal pain (<em>P</em> = .01), or nausea (<em>P</em> = .01). The SVI was similar for patients treated with tCS or dietary elimination (mean 0.41 vs 0.40). However, patients with higher SVIs had decreased histologic response to tCS treatment that persisted after adjusting for confounders (adjusted odds ratio 0.32 for response &lt;15 eosinophils per high-power field; 95% confidence interval: 0.18–0.65). When analyzing SVI by quartiles, patients in the highest quartile (highest social vulnerability) had 58% lower odds of histologic response to tCS compared to patients with the lowest social vulnerability (adjusted odds ratio 0.42, 95% confidence interval: 0.21–0.84). SVI was not associated with histologic response after dietary elimination.</div></div><div><h3>Conclusion</h3><div>In patients with EoE, higher social vulnerability was independently associated with lower histologic response to tCS. This association warrants further exploration of explanatory factors, including treatment adherence and increased allostatic load.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100856"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover: Changes on Nailfold Video Capillaroscopy Associate With High-Resolution Esophageal Manometry Findings in Patients With Scleroderma","authors":"","doi":"10.1016/S2772-5723(25)00248-1","DOIUrl":"10.1016/S2772-5723(25)00248-1","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 1","pages":"Article 100861"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Advances in Pancreatic Cancer Treatment in Population Mortality: A Surveillance, Epidemiology, and End Results–Based Study","authors":"Calvin Ghimire ,&nbsp;Jerry Kenmoe ,&nbsp;Pujan Kandel ,&nbsp;Sajana Poudel ,&nbsp;Sajan Acharya ,&nbsp;Alex Rabadi ,&nbsp;Matthew Jankowski ,&nbsp;Bibek Karki ,&nbsp;Manoj Ghimire ,&nbsp;Karun Shrestha ,&nbsp;Arvind Kunadi ,&nbsp;Mustafa Alnounou","doi":"10.1016/j.gastha.2025.100739","DOIUrl":"10.1016/j.gastha.2025.100739","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Pancreatic cancer is a significant health burden with increasing incidence and mortality rates. This study analyzes trends in incidence rates, incidence-based mortality, 2-year survival rates, and disease progression, focusing on gender and racial disparities.</div></div><div><h3>Methods</h3><div>We utilized data from the Surveillance, Epidemiology, and End Results database, covering the period from 2001 to 2019. Incidence rates, incidence-based mortality, and 2-year survival rates were evaluated, with a particular focus on variations across gender and racial groups.</div></div><div><h3>Results</h3><div>The study revealed a higher incidence rate of pancreatic cancer in males compared to females, consistent with previous research. Both genders experienced an upward trajectory in incidence rates. Incidence-based mortality rates also increased for both genders, with higher rates observed in males. Notably, 2-year survival rates improved among most racial groups, except for American Indian/Alaska Natives, where no significant changes were observed. The Black population exhibited the highest incidence rate, followed by White and Asian/Pacific Islanders. The study also highlighted an increase in regional metastatic disease, emphasizing the need for early detection and intervention.</div></div><div><h3>Conclusion</h3><div>The findings underscore the growing burden of pancreatic cancer and the critical need for enhanced early detection and preventive strategies. Disparities in incidence and mortality rates across gender and racial groups were evident, pointing to the necessity of tailored interventions. Improved survival rates in specific populations may be attributed to advances in treatment and the approval of new immunotherapy agents. Future research should focus on optimizing combination therapies and addressing racial disparities to improve outcomes for all pancreatic cancer patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 2","pages":"Article 100739"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-Enhanced Ultrasound and Somatostatin Receptor Scintigraphy Unveil an Occult Neuroendocrine Tumor With Carcinoid Syndrome and Presumed Small Intestinal Origin – A Case Report","authors":"Tairyu Sato ,&nbsp;Akira Nishio ,&nbsp;Tadashi Kegasawa ,&nbsp;Kazuna Hazu ,&nbsp;Chihiro Tarumi ,&nbsp;Koki Yamada ,&nbsp;Yuki Nishiura ,&nbsp;Kumi Higashihara ,&nbsp;Shogo Nagahama ,&nbsp;Takayuki Matsumae ,&nbsp;Yuki Tokuda ,&nbsp;Aya Ishimi ,&nbsp;Satoshi Hiyama ,&nbsp;Masafumi Ogata ,&nbsp;Chiaki Nakai ,&nbsp;Keitaro Masuko ,&nbsp;Katsumi Yamamoto ,&nbsp;Nobuyuki Tatsumi ,&nbsp;Yasuyuki Yoshida ,&nbsp;Kayako Isohashi ,&nbsp;Akira Kaneko","doi":"10.1016/j.gastha.2025.100866","DOIUrl":"10.1016/j.gastha.2025.100866","url":null,"abstract":"<div><div>A 68-year-old man with postprandial flushing and palpitations was referred for multiple hepatic lesions. Computed tomography showed hypoattenuating metastases without a detectable primary, whereas contrast-enhanced ultrasound revealed arterial hyperenhancement and Kupffer-phase defects, indicating hypervascularity typical of neuroendocrine tumors (NETs). Urinary 5-hydroxyindoleacetic acid elevation, together with liver biopsy findings, confirmed a well-differentiated NET (grade 2), presenting with carcinoid syndrome. Somatostatin receptor scintigraphy demonstrated diffuse hepatic uptake and a mesenteric focus, suggesting a small intestine origin. Lanreotide was initiated, achieving partial symptom improvement and radiologic stability. This case highlights contrast-enhanced ultrasound for demonstrating hypervascularity and somatostatin receptor scintigraphy for localizing an occult origin in NET.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 3","pages":"Article 100866"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}