Acute kidney injury (AKI) is a serious clinical condition that is linked to markedly higher rates of morbidity and mortality in cirrhosis patients. Its diagnosis is challenging due to overlapping clinical and laboratory features among causes such as hepatorenal syndrome (HRS), acute tubular injury (ATI), and prerenal hypovolemia. In order to address the distinct pathophysiology and clinical context of cirrhosis, the definitions and classification of AKI have changed over time, moving from RIFLE and AKIN to KDIGO and ICA-AKI. Because cirrhosis patients have altered muscle mass and fluid retention, traditional markers like serum creatinine (sCr) and urine output have significant limitations. Neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and cystatin C (CysC) are some of the new biomarkers that have shown promise in early AKI detection and in differentiating structural from functional kidney injury. NGAL and KIM-1 are sensitive indicators of tubular damage with potential prognostic implications. IL-18 reflects inflammatory injury, and CysC offers a more reliable measure of glomerular filtration. Incorporating these markers may improve early diagnosis, risk stratification, and treatment decisions, representing a key direction for future research in managing AKI in cirrhosis.

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease; non-invasive biomarkers that accurately reflect the endoscopic and histological activity of UC require validation. Therefore, our study focused on exploring the potential of serum oncostatin M (OSM) as a biomarker for evaluating UC severity. A total of UC 89 eligible participants (≥18 years) underwent extensive clinical and paraclinical evaluation. Clinical, endoscopic, and histological activity were assessed using the partial Mayo score (pMS), the Mayo endoscopic score (MES), and the Nancy Histological Index (NHI), respectively. Serum OSM levels were determined by ELISA test and measured in pg/mL; fecal calprotectin (FC) was measured in µ/g. In our study, serum OSM was significantly associated with all four outcome measures: higher OSM levels predicted higher pMS (β = 0.471, p < 0.001, R² = 0.222), MES (β = 0.422, p < 0.001, R² = 0.178), NHI (β = 0.422, p < 0.001, R² = 0.256), and FC (β = 0.431, p < 0.001, R² = 0.186). Furthermore, ROC curve analyses demonstrated that OSM had excellent diagnostic accuracy for active disease, particularly in relation to histological inflammation (AUC = 0.967). In comparison, FC showed good but slightly lower accuracy (AUC = 0.875). Notably, OSM also outperformed FC in discriminating histological remission. Pairwise ROC curve analyses using DeLong’s test further confirmed the diagnostic accuracy of OSM, FC, and combined biomarker scores (OSM+FC) across clinical, endoscopic, and histological endpoints. The combined score PRE1 (OSM + FC based on NHI) achieved perfect discrimination (AUC = 1.000, p < 0.001). Composite models PRE2 and PRE3 (OSM+FC based on MES and pMS) improved diagnostic accuracy relative to OSM, confirming the value of combining OSM with FC. Although both outperformed OSM (p < 0.05), neither achieved a superior advantage over FC. Serum OSM is strongly associated with histological activity in UC and demonstrates superior performance compared with FC in assessing histological remission.

Backwash ileitis (BWI) refers to inflammation in the distal ileum in patients with extensive ulcerative colitis (UC) that is thought to be caused by a “reflux” or “backwash” of colonic contents. In the absence of well-defined diagnostic criteria for BWI, more recently, the term UC-associated ileitis was proposed in favor of the backwash theory, which questions the existence of backwash ileitis as a distinct disease-specific subset of patients. Moreover, distinguishing UC-associated BWI from terminal ileitis of Crohn’s disease or other conditions could be a diagnostic challenge and significantly affect treatment management. Therefore, clinical, endoscopic, histologic, and imagistic diagnostic features may aid in making this distinction. This literature review related to BWI outlines the hypothesis that the ileum may also become involved in UC as a primary manifestation of UC based on recent findings. This study also highlights the possibility that associated ileitis in UC patients may represent a potential risk factor for neoplasia, a positive association with primary sclerosing cholangitis, and a higher risk for the subsequent development of pouchitis after restorative proctocolectomy. It synthesizes recent key findings and highlights areas for further research.

Introduction: Chronic inflammation in Crohn’s disease (CD) is associated with systemic alterations, including the loss of skeletal muscle mass. While nutritional deficits are known to impact clinical trajectories, the specific prognostic value of muscle wasting remains underutilised. The primary objective of this study is to construct a composite score integrating sarcopenia with paraclinical parameters to predict an unfavourable disease outcome (UO) more accurately. Materials and Methods: We conducted a retrospective study of patients with CD who were hospitalized at our institution between January 2020 and June 2024 and were treated with biologics or small molecules. Using previous CT scans, we measured skeletal muscle area (SMA) and skeletal muscle index (SMI) to assess their association with disease outcomes. Univariate and multivariate analyses were performed to identify significant predictors of UO, and Area Under the Curve (AUC) values were calculated to assess the predictive performance and to construct a composite prognostic score. Results: Multivariate analysis in the study group (52 patients) identified sarcopenia (low SMI), faecal calprotectin levels >129 μg/g, and complicated disease behaviour (Montreal B2/B3) as independent predictors of UO. Integrating these parameters into a composite risk score resulted in a promising predictive model with an Area Under the Curve (AUROC) of 0.864, significantly outperforming individual biomarkers. Conclusions: We performed a hypothesis-generating study suggesting that nutritional assessment in CD could provide an important benefit in stratifying patients for whom additional nutritional interventions may enhance the long-term outcomes.

Metastatic melanoma is one of the most common malignancies associated with the spread of the primary tumor. The primary site is usually the skin or the eyes. The most frequent site of metastases is the gastrointestinal tract, accounting for 60% of cases at autopsy. In 2% of patients, metastases occur without a detectable primary tumor. We present a rare case of upper digestive bleeding caused by multiple gastrointestinal tract metastases from an amelanotic melanoma. This case report describes a 65-year-old male who arrived at the emergency department after experiencing an episode of upper gastrointestinal bleeding (melena). One week prior to admission, he had been treated with nonsteroidal anti-inflammatory drugs for lower back pain due to L4–L5 disc herniation. Upper digestive endoscopy revealed multiple polypoid masses in the stomach and duodenum, and capsule endoscopy showed additional lesions in the small bowel. Histopathological examination confirmed the diagnosis: metastases from an amelanotic malignant melanoma. Abdominal and cranial computed tomography scans revealed multiple secondary lesions in the brain, gallbladder, retroperitoneal area, gastrointestinal tract, and peritoneum. Localized radiotherapy was applied to the cerebral metastasis, and systemic chemotherapy with dacarbazine was initiated, resulting in a partial clinical response. Unfortunately, the disease progressed, and the patient died one month after diagnosis. Metastatic melanoma of the gastrointestinal tract is an exceedingly rare cause of upper digestive bleeding.

Background: Mesenteric panniculitis (MP) is a chronic fibroinflammatory disorder of the mesenteric adipose tissue and is frequently considered an idiopathic condition. Its association with inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), remains poorly characterized, with only limited evidence available in the literature. In addition to presenting a clinical case, we performed a narrative review of the literature regarding the relationship between MP and IBD, including epidemiology, pathophysiological mechanisms, diagnostic challenges, and therapeutic approaches. Case Presentation: We report the case of a 32-year-old woman with UC in deep clinical, endoscopic, and histological remission while receiving vedolizumab therapy, who developed symptomatic MP diagnosed by contrast-enhanced computed tomography. Infectious, neoplastic, and selected fibroinflammatory causes were excluded during the diagnostic work-up. Histological confirmation was not obtained. The patient was treated with prednisone and tamoxifen, resulting in complete clinical and radiological remission while vedolizumab therapy was continued. Conclusions: This case describes the rare co-occurrence of MP and UC in deep remission during ongoing vedolizumab treatment. Given the absence of histological confirmation and the frequently idiopathic nature of MP, a causal relationship with either UC activity or vedolizumab therapy cannot be established. The observation should therefore be regarded as hypothesis-generating. Further studies are required to clarify the potential relationship between MP, IBD, and biologic therapies.