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A 13-year-old boy presented with an 8-year history of repeated episodes of anemia. Laboratory investigations confirmed iron deficiency anemia due to occult blood loss from the gastrointestinal tract. Despite undergoing esophagogastroduodenoscopy, colonoscopy, and push enteroscopy, no abnormalities were detected. Subsequent computed tomography enterography also yielded normal results. However, a capsule endoscopy revealed multiple superficial ulcers in the jejunum and proximal ileum. Initially, the patient was treated for Crohn’s disease using various therapeutic approaches, all of which were unsuccessful. Further investigation led to a positive diagnosis for a rare condition known as chronic enteropathy associated with SLCO2A1 mutation (CEAS), marking the first reported case in India.

Background: Charcot-Marie-Tooth disease (CMTD) is a group of hereditary motor and sensory neuropathies with a prevalence of approximately 1 per 2,500 individuals. The most common feature of this disease is muscle weakness and impaired sensation in the extremities. However, this disease group, which includes various heterogeneous diseases, can present in different ways, such as foot infections and ulcers. Case presentation: In this case report study, we discuss an 18-year-old female patient who was referred to us with a non-healing ulcer on the plantar surface of her right foot. She was diagnosed with CMTD based on her history of sensory and motor symptoms, as well as the results of electromyography. After five sessions of extracorporeal shock wave therapy (ESWT), her ulcer healed successfully. Conclusion: In addition to the importance of considering patient symptoms for the diagnosis of CMTD, this case demonstrates the effectiveness of ESWT in promoting wound healing for a non-healing ulcer within a CMTD context. Further research is necessary to validate this treatment as a standard of care for such patients.

Background/Aims: Solitary rectal ulcer syndrome (SRUS) can be overlooked, diagnosed late, or misdiagnosed, particularly in childhood. This study reviewed the 13-year experience of the authors’ institution to increase clinicians' awareness of SRUS in the presence of symptoms. This paper reports the endoscopic and histopathological findings in children presenting with hematochezia. Methods: The clinical and laboratory findings of 22 patients diagnosed with biopsy-proven SRUS in the authors’ clinic between 2007 and 2020 were evaluated retrospectively. Results: The mean age at diagnosis was 12.5±2.6 years, and 59.1% of the patients were male. The median time of diagnosis was 24 months. A single ulcer lesion was found by colonoscopy in 18 patients (81.8%), two ulcers in two patients (9%), and more than two ulcers in two patients (9%). The pathology reports of all biopsies taken from the lesions were consistent with a solitary rectal ulcer. In the first stage, the treatment was started with toilet training, a high-fiber diet, and laxatives. In 11 patients (50%) who did not respond to the initial treatment, a 5-ASA enema was added. A glucocorticoid enema was added to treatment in five patients (22%) whose complaints did not regress despite this treatment. Clinical remission was achieved in five of the patients (18.1%). The time to diagnosis was significantly shorter in those in remission than those not in remission (p=0.04). Conclusions: This study is the first large series on Turkish children. An increased awareness of SRUS in children will increase the rate of early diagnosis and treatment, allowing remission in more patients.

Abstract Background/Aims Upper gastrointestinal bleeding (UGIB) is a frequent medical issue. The primary risk factors for bleeding peptic ulcers are Helicobacter pylori infection and non-steroidal anti-inflammatory drugs. The association between acute gastric/duodenal ulcer and opium use has been previously proposed; however, there is no available data on endoscopic findings of patients with acute UGIB who use opium. Materials and methods In the present descriptive cross-sectional study, endoscopic data of 50 consecutive patients with oral opium use and 50 consecutive patients without any opium use who were admitted for UGIB were recorded. The size (5–10 mm, 11–20 mm, or more than 20 mm), number (single, double, or multiple), and location of the ulcers (esophagus, gastric corpus including the fundus and body, antrum, angulus, or duodenum) were examined by endoscopy in both groups. Results Three or more ulcers were observed in 46% and 16% of patients with oral opium use and without opium use, respectively (P-value = 0.001). The rate of giant ulcers (> 20 mm) was significantly higher in patients who used oral opium (40% vs. 12%; P-value = 0.007). Esophageal ulcers were also more common in oral opium users (30%) than non-users (8%) with UGIB (P-value = 0.01). Nevertheless, the location of the ulcers between the two groups generally was not statistically different. Conclusions This study has demonstrated that multiple, large peptic ulcers in GIB are potential complications of oral opium use. This could aid the needed modifications in the treatment protocol for these patients.

This article discusses a case of a patient with metastatic renal cell carcinoma who developed nivolumab-induced lichenoid dermatitis (LD), which initially presented as a penile ulcer. The patient later developed extensive mucocutaneous re-emergent LD, which was successfully treated with hydroxychloroquine. The article highlights the diverse clinical presentations and variable time of onset of cutaneous immune-related adverse events (cirAEs) associated with immune checkpoint inhibitor (ICI) treatment. It also suggests that hydroxychloroquine may be a safe and effective option for managing severe lichenoid cirAEs. [Extracted from the article]

This article discusses the management of peptic ulcer bleeding, which is the most common cause of gastrointestinal bleeding and a significant source of healthcare expenditures in the United States. The article highlights the various therapeutic options available, including endoscopic therapy, angiography, and surgery, and their success rates. It also acknowledges the disparities in access to endoscopic therapies among rural or minority populations. The study analyzed hospitalization data from 2018 and found that endoscopic therapy had the highest rates of hemostasis, followed by radiologic and surgical interventions. However, there are limitations to the study, such as the inability to account for certain factors that may affect the success of hemostasis. The article concludes by emphasizing the need for further exploration of new tools and advances in medicine to improve ulcer hemostasis. [Extracted from the article]

Pemphigus is a rare autoimmune mucocutaneous bullous disease that can be life-threatening. We report a case of pemphigus vulgaris with pharyngeal ulcer as the initial presentation that was treated with glucocorticoid therapy. [ABSTRACT FROM AUTHOR]

Abstract Introduction Recurrent Aphthous Stomatitis (RAS) is the most common type of ulceration in the oral cavity which can occur due to several factors. Aims To determine the factors related to the incidence of RAS and examine the social class inequality in RAS among the Indonesian population using data from the fifth wave of the Indonesian Family Life Survey (IFLS5) in 2014. Methods This study is a descriptive study with a cross-sectional design using secondary data from IFLS5 data in 2014 (n = 28,410). Socio-economic position (SEP) was calculated by Adult Equivalent Scale and categorized into 4 classes. Outcome is RAS. Mediating factors were psychosocial (stress), eating behavioral (food consumption), and systemic diseases. Descriptive analysis, chi-square and a series of logistic regressions were performed to analyze the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results. Results Only 18.39% of IFLS5 respondents experienced the incidence of recurrent aphthous stomatitis in 2014. The bivariate (chi-square) results showed that there was a relationship between the incidence of RAS and the related independent variables. Logistic regression showed the highest possibility of RAS in respondents aged 18–34 years, female, unmarried, high school education level, living in the city, having frequent stress levels, having food habits that frequently drinking soda, sweet foods, chili sauce, fried food and has systemic diseases such as, asthma, cancer, rheumatism, and digestion. The lowest SEP group had the highest probability of occurrence of RAS over the other groups among the different models. Conclusions There are several factors that determine the incidence of RAS. There was a monotonic gradient of inequality in RAS according to SEP group. This study might be useful to provide information regarding the relationship of determinants factors with the incidence of RAS to prevent it and promote oral health in the future.