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Pancreatic panniculitis is a rare dermatological manifestation of pancreatic disorders, characterized by painful, erythematous nodules. We present the case of an 84-year-old woman with acute pancreatitis who developed erythematous-violaceous nodular lesions on her lower limbs. Histopathological examination revealed lobular panniculitis with fat necrosis and ghost adipocytes, confirming the diagnosis. Supportive treatment resulted in complete resolution of the lesions within one week. This case underscores the importance of clinical awareness in identifying pancreatic panniculitis as a potential early indicator of underlying pancreatic disease.

Background: Cecal perforation from barotrauma is a rare complication of colonoscopy, even with the use of CO₂ insufflation, which is generally preferred over room air due to its rapid absorption and reduced patient discomfort., Case Report: A 64-year-old woman with hypertension and dyslipidemia underwent a routine colonoscopy with CO₂ insufflation. Multiple diverticula were noted, and upon reaching the cecum, several parallel linear lesions with spontaneous bleeding, consistent with "cat scratch" colon, were observed. Hemostasis was achieved with 10 endoscopic clips. A subsequent CT scan revealed pneumoperitoneum and the clips in the cecum. The patient was managed conservatively with bowel rest and intravenous antibiotics, showing a favorable clinical course and was discharged on the fifth day., Discussion: This case highlights the potential for cecal perforation due to barotrauma even with CO₂ insufflation during colonoscopy, emphasizing the need for awareness and prompt management of such complications.

A 60-year-old female with chronic pancreatitis and a history of splenectomy presented with epigastric pain, vomiting, and asthenia. Elevated pancreatic enzymes and CT imaging revealed a pseudocyst in the pancreatic head with suspected communication to the portal vein, confirmed by MR Cholangiopancreatography and endoscopic ultrasound (EUS). EUS-guided puncture revealed high amylase levels. Given her manageable symptoms, a conservative approach was adopted, leading to symptomatic relief and pseudocyst size reduction. Pancreatic pseudocyst-portal vein fistula is a rare pancreatitis complication, challenging to diagnose, with no gold-standard treatment. Endoscopic stenting offers a promising alternative to surgery for severe cases.

Diagnosing IgG4-related sclerosing cholangitis (IgG4-SC) presents significant challenges, especially when serum IgG4 levels are normal and other organs are not involved. We report a case of a 51-year-old patient with typical symptoms of biliary obstruction, including jaundice and abdominal pain. Despite normal serum IgG4 levels, imaging suggested cholangiocarcinoma, leading to extensive surgical intervention. Histological analysis of the surgical specimen revealed extensive lymphoplasmacytic infiltration and numerous IgG4-positive plasma cells, confirming IgG4-SC. This case underscores the difficulty in differentiating IgG4-SC from other biliary diseases such as primary sclerosing cholangitis and cholangiocarcinoma, highlighting the need for thorough histological examination in atypical presentations.

We present a case of gastro-jejunal anastomotic stenosis due to the progression of malignant disease, successfully treated endoscopically by placing a lumen-apposing metal stent. This case illustrating the successful use of a lumen-apposing metal stent in a complex clinical scenario. This approach can significantly improve patient outcomes, especially in those who are poor surgical candidates or have advanced disease.

Splenic artery pseudoaneurysm (SAP) is a rare and potentially life-threatening complication of pancreatitis, with a high risk of rupture and mortality rate. Early diagnosis and treatment are crucial, typically through endovascular approaches such as embolization. A 46-year-old woman with chronic pancreatitis experienced gastrointestinal bleeding from a ruptured SAP, which was successfully treated with embolization using hydrocoils, resulting in complete recovery.

Carcinoid tumors are rare neoplasms, most frequently found in the gastrointestinal tract, responsible for the production of neuroendocrine mediators. Carcinoid syndrome is even rarer and consists of a set of symptoms characteristic of the release of these mediators into the systemic circulation. We present an interesting case of a patient with carcinoid syndrome as a late manifestation of a gastric neuroendocrine tumor with, highlighting the importance of knowing how to identify the carcinoid syndrome.

Capsule endoscopy (CE) is considered the first-line for the investigation of OGIB after conventional non-diagnostic endoscopic examinations. A detection rate of lesions outside the small bowel segment has been reported to range from 3.5% to >30%. Our primary objective was to analyze the role of CE in identifying lesions outside the small bowel segment that were not identified on conventional endoscopy in patients suspected of OGIB. In our study, CE appears to be effective and safe in diagnosing OGIB, also proving to be a tool in identifying lesions outside the small intestine segment.