Heyde syndrome, marked by aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome, is often underreported. Shear stress from a narrowed aortic valve degrades von Willebrand factor multimers, leading to angiodysplasia formation and von Willebrand factor deficiency. This case report aims to raise clinician awareness of Heyde syndrome, its complexity, and the need for a multidisciplinary approach. We present a 75-year-old man with aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome type 2A. The patient was successfully treated with argon plasma coagulation and blood transfusions. He declined further treatment for aortic stenosis but was in good overall health with improved laboratory results during follow-up. Additionally, we provide a comprehensive review of the molecular mechanisms involved in the development of this syndrome, discuss current diagnostic and treatment approaches, and offer future perspectives for further research on this topic.
Esophageal motility disorders are common conditions that impede the normal movement of food and liquids from the esophagus to the stomach, frequently manifesting as dysphagia, chest pain, and regurgitation. These disorders arise from a variety of etiological factors and can greatly diminish patients’ quality of life. If left untreated, esophageal motility disorders may lead to severe complications, including malnutrition, weight loss, and aspiration pneumonia. This chapter offers an in-depth examination of the etiology and pathogenesis of both primary and secondary EMDs. It thoroughly investigates the clinical manifestations and diagnostic methods, highlighting the critical role of differential diagnosis in the accurate identification of these conditions. Additionally, the chapter reviews current treatment options, including pharmacological interventions, endoscopic procedures, and surgical techniques, and discusses the potential of novel therapies and future research directions. Through a detailed analysis of these aspects, the chapter aims to provide a comprehensive understanding of esophageal motility disorders and to guide effective clinical management and innovative therapeutic approaches.
Chemerin, encoded by the RARRES2 gene, is an adipokine with potent immunometabolic functions mediated through CMKLR1, GPR1, and CCRL2. Its regulation is tissue- and context-dependent, conferring dual protective and pathogenic roles. In the upper GI tract, chemerin facilitates immune tolerance in Barrett’s adenocarcinoma and promotes invasion in esophageal and gastric cancers. In pancreatic disease, it acts as a biomarker of acute and chronic injury, while modulating β-cell function and carcinogenesis. In the liver, chemerin contributes to NAFLD/NASH pathogenesis with both anti-inflammatory and pro-steatotic actions, predicts prognosis in cirrhosis, and demonstrates tumor-suppressive potential in hepatocellular carcinoma. In IBD, chemerin exacerbates colitis via impaired macrophage polarization, yet protects epithelial antimicrobial defense, underscoring its context-specific biology. Collectively, these findings position chemerin as a versatile regulator bridging metabolic dysfunction, inflammation, and gastrointestinal malignancy, and as a potential candidate for biomarker development and therapeutic intervention.
Short bowel syndrome (SBS) develops when the remaining intestine is unable to sustain adequate nutrient and electrolyte absorption following extensive bowel resection. The condition is characterized by malabsorption and significant fluid losses which lead to dehydration and progressive weight loss, thus promoting patient dependence on parenteral fluids or nutrition. After an initial acute phase marked by accelerated intestinal transit and gastric hypersecretion, long-term clinical outcomes are largely determined by the capacity of the remaining bowel for intestinal adaptation—a sustained process of structural, functional, and molecular remodeling that enhances absorptive efficiency and restores fluid and nutrient homeostasis. This review summarizes the key histological and cellular features of the adaptive response, including crypt and villus remodeling, mucosal hyperplasia, and smooth muscle hypertrophy, and integrates emerging concepts in crypt biology that define the dynamic cross-talk between intestinal stem cells and the mesenchymal niche, together with their upstream regulatory pathways.
Inflammatory bowel disease is a recognized risk factor for venous thromboembolism, whereas arterial thrombotic events remain underappreciated despite their substantial clinical consequences. We report a 45-year-old man without significant comorbidities who developed severe ulcerative colitis complicated by diffuse arterial thrombosis, including cerebral infarctions, an ascending aortic mural thrombus, iliac artery thrombosis, and multi-organ infarctions. After stabilization with supportive care and anticoagulation, remission-directed ulcerative colitis therapy and a vascular safety–oriented maintenance strategy were initiated, including vedolizumab and individualized secondary thrombosis prevention. To contextualize this presentation, we integrate current evidence on the epidemiology, clinical phenotypes, underlying mechanisms, and risk factors for arterial thrombosis in inflammatory bowel disease, highlight disease activity as a dominant trigger, and summarize therapy-specific vascular safety considerations across IBD treatment classes.
Colonoscopy is a key screening method for colorectal cancer (CRC), but its effectiveness is limited. Computer-aided detection (CADe) and computer-aided diagnostics (CADx), as part of an artificial intelligence (AI) system, improve the detection and optical characterization of lesions. This review maps and analyzes the evidence on the application of AI in colonoscopy, with a focus on the detection, segmentation, and characterization of colon neoplasms, available platforms, architectural models and implementation. The review was conducted in accordance with JBI and PRISMA-ScR guidelines, using the PCC framework. Meta-analyses, randomized controlled trials, systematic and narrative reviews, observational studies, guidelines, and consensus documents on the use of AI systems in different phases of colonoscopy were searched. CADe significantly improves adenoma detection and reduces the number of missed lesions. CADx, segmentation, depth of invasion assessment, and detection of learned lesions remain limited and heterogeneous. CADe has strong evidence for improving ADR, whereas current evidence for CADx remains insufficient to support a “resect-and-discard” strategy. Further cost-effectiveness studies are needed. Commercial platforms vary in their features and level of clinical validation. Colonoscopy using AI is a current topic with rapid development. This scoping review comprises heterogeneous literature covering clinical applications, technical aspects, the potential benefits and limitations of AI in improving colonoscopy performance and reducing the burden of colorectal cancer. Further trials involving diverse patient populations across different countries are needed to validate and extend the current evidence.