Spontaneous intramural small bowel hematoma (SISBH) is a rare disease. This article reports analyzed the clinical data of 4 patients with SISBH induced by oral warfarin admitted to Jining First People's Hospital, aiming to provide references for its diagnosis and treatment.

Colonoscopy and tissue sampling are the gold standard for the diagnosis of ulcerative colitis (UC). However, in recent years, intestinal ultrasound has been assuming an increasingly crucial role not only in the diagnosis but also in the disease assessment of UC. Specifically, ultrasound has the potential to exert a more significant influence in evaluating disease activity, monitoring early - stage treatment, and managing acute severe cases. This article aims to expound on the application value and the latest advancements of intestinal ultrasound in the diagnosis and treatment of UC.

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To evaluate the diagnostic performance of fecal calprotectin (FC) in predicting endoscopic activity of ulcerative colitis (UC), and to compare it with high-sensitivity C reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) .Methods:A cross-sectional stydy was conducted. UC patients diagnosed at Peking Union Medical College Hospital between May 2023 and July 2025 were retrospective enrolled. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity. FC levels were measured using latex-enhanced turbidimetric immunoassay (LETIA). Receiver operating characteristic (ROC) curves and logistic regression models were used to assess diagnostic efficacy. Subgroup analyses were conducted according to disease extent.Results:A total of 166 UC patients were enrolled, including 92 males and 74 females with the age of 40.00 (32.00, 52.00) years old and disease course 5.00 (2.00, 10.75) years. Forty-six patients were assigned to the active group, while the remaining 120 were assigned to the remission group. FC levels were significantly higher in the active group than in the remission group (620.72 μg/g vs. 29.00 μg/g, P < 0.001), with an AUC of 0.894 at a cutoff value of 122.54 μg/g. hsCRP and ESR had lower AUC (0.712 and 0.736, respectively). The combination of FC, hsCRP, and ESR slightly improved specificity (AUC 0.898). FC was strongly correlated with the endoscopic activity ( r =0.669, P < 0.001) but not with disease extent. Conclusions:FC measured by latex-enhanced turbidimetric immunoassay had comparable diagnostic accuracy to ELISA-based methods commonly used abroad, and provided a reference cutoff value of 122.54 μg/g. FC outperforms hsCRP and ESR in assessing intestinal inflammation in UC and it is less affected by disease extent, making it a reliable non-invasive biomarker for UC monitoring.

Objective:To investigate the impact of delayed ileostomy closure (>6 months) on postoperative complications in patients with ulcerative colitis (UC) undergoing ileal pouch-anal anastomosis (IPAA) .Methods:Using propensity score matching. Clinical data of UC patients who underwent IPAA and subsequent ileostomy closure at Jinling Hospital from January 2014 to December 2021 were retrospectively analyzed. Patients were categorized into a routine group (2 to ≤6 months) and a delayed group (>6 months) based on the timing of ileostomy closure. A 1∶1 propensity score matching analysis was performed to compare early (≤30 days) and late (>30 days) postoperative complications between the two groups.Results:A total of 225 UC patients who underwent IPAA and ileostomy closure were included, comprising 129 males (57.3%) and 96 females (42.7%). After propensity score matching, 88 patients were included in the analysis, with 44 patients in each group. There was no significant difference in the overall incidence of early postoperative complications (11.4% vs. 15.9%, P = 0.534) or late postoperative complications (43.2% vs. 43.2%, P = 1.000) between the delayed and routine groups. Additionally, no significant differences were observed in other postoperative complications (all P > 0.05) . Conclusion:Delayed ileostomy closure following IPAA does not significantly increase the risk of postoperative complications in UC patients.

Objective:To evaluate the predictive efficacy of fecal calprotectin (FC) for endoscopic activity in patients with Crohn's disease (CD) .Methods:A cross-sectional study was conducted and patients diagnosed as CD at Peking Union Medical College Hospital from June 2023 to September 2025 were enrolled consecutively. Data was collected including general information, laboratory tests [hemoglobin (HGB), platelet (PLT), FC, high-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR) and so on], and endoscopic results. FC levels were measured by latex-enhanced turbidimetric immunoassay (LETIA). Endoscopic activity was defined as the simplified endoscopic score for Crohn's disease (SES-CD) > 2. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity, and the differences in clinical data between the two groups were compared. Spearman correlation analysis was used to assess the correlation between FC and endoscopic activity, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of FC, hsCRP and ESR for endoscopic activity, and the differences were compared.Results:A total of 90 CD patients were enrolled, including 65 males and 25 females with the age of 30 (22, 41) years old and disease course 4.0 (0.5, 8.0) years. Seventy-one patients (78.9%) had ileocolonic disease involvement (L3), and 55 patients (61.1%) were using biologics. Sixty-nine patients in endoscopic active phase were assigned to the endoscopically active group, while the remaining 21 were assigned to the endoscopic remission group. There were no statistically significant differences in general characteristics such as age and gender between the two groups (all P > 0.05). Compared with endoscopic remission group, HGB was significantly lower in the endoscopically active group, while PLT, hsCRP, ESR, and FC were moderataly higher (all P < 0.05). Among the 90 CD patients, FC levels were moderatly correlated with endoscopic activity (ρ = 0.494). ROC curve analysis indicated that the area under the curve for FC in predicting endoscopic activity was 0.836 (95% CI: 0.737-0.935), with a sensitivity of 0.725, specificity of 0.952, and accuracy of 0.778 at the optimal FC cutoff value of 153.8 μg/g. FC outperformed hsCRP and ESR. Conclusion:FC measured by LETIA demonstrates certain efficacy in predicting endoscopic activity in CD and will assist in efficient clinical monitoring of CD patients.

Objective:To investigate the incidence, risk factors, and bile acid profile characteristics of Crohn's disease (CD) patients complicated by gallstones.Methods:A retrospective observational study was conducted. Clinical data of CD patients admitted to Zhongda Hospital of Southeast University from January 2020 to December 2023 were collected. Patients were divided into the gallstone group and the non-gallstone group according to the presence of gallstones. Univariate analysis and Logistic multivariate analysis were perfomed to identify the risk factors of CD patients complicated by gallstones. Sixty-eight CD patients in remission were selected, and serum levels of 15 bile acids were compared between patients with and without gallstones.Results:A total of 296 CD patients were enrolled, including 211 males and 85 females, with a mean age of 37.8 ± 14.8 years, disease duration of 2.0 (1.0, 6.0) years, Crohn's disease activity index of 265.3 ± 121.2, and body mass index of 22.4±2.2 kg/m 2. Among them, 44 patients (14.9%) had gallstones and were assigned to the gallstone group, while the remaining 252 patients (85.1%) were assigned to the non-gallstone group. Univariate analysis and multivariate Logistic regression analysis showed that location was an independent risk factor for CD patients complicated by gallstones. Patients with ileocolonic CD have a 3.92-fold higher risk of developing gallstones than those with colonic CD ( OR=3.92, 95% CI: 1.13-13.61, P = 0.031). Analysis of bile acid profiles in 68 CD patients in remission revealed that, compared to those without gallstones ( n = 50), patients with gallstones ( n = 18) had lower levels of ursodeoxycholic acid and an higher ratio of secondary conjugated bile acid/secondary free bile acid, the differences were significant (both P < 0.05) . Conclusions:CD patients have a high incidence of gallstones, which may be associated with abnormal bile acid metabolism. The ileocolonic CD patients are more prone to developing gallstones.

Inflammatory bowel disease (IBD) is a chronic, nonspecific inflammatory disease of the intestine. In recent years, the treatment goals for IBD have evolved from symptom control and endoscopic remission to histological remission, which is associated with significantly better prognoses. Current parameters for histological evaluation include the Nancy histological index (NHI), Geboes score (GS), Robarts histological index (RHI), and global histological activity score (GHAS). However, the evaluation of clinical histological remission remains limited by the lack of standardized criteria and poor reproducibility, hindering its widespread application. With the development of artificial intelligence (AI) technology, AI tools have been increasingly applied in histological evaluation of IBD and can be integrated with endoscopic and multi-omics approaches. This article reviews the current applications, research progress, and associated challenges of AI in the histological evaluation of IBD.

Inflammatory bowel disease (IBD) is a chronic and recurrent intestinal inflammatory disease, which not only affects the digestive tract, but also involves extraintestinal organs and tissues such as joints and eyes, and ultimately endangers human health and affects the quality of life of patients. With the development of information technology, there is an increasing application of digital therapeutics in the management of IBD. This article aims to comprehensively analyze the characteristics, use, and challenges of digital therapeutics in the management of IBD, and explore its potential to improve treatment adherence, disease surveillance, and improve patients' quality of life.

Crohn's disease (CD), a chronic and recurrent inflammatory bowel disease, requires repeated intestinal evaluations. As a non-radioactive, non-invasive, well-tolerated, inexpensive and easily reproducible detection tool, intestinal ultrasound (IUS) has been more and more widely used in the diagnosis and treatment of CD in recent years. Various parameters of IUS, such as bowel wall thickness, bowel wall stratification, color doppler signals, and inflammatory mesenteric fat, provide a lot of critical information in the diagnosis and treatment of CD. IUS can not only accurately diagnose CD and its complications, but also well evaluate CD disease activity and treatment response, and effectively predict CD transmural remission, disease duration, surgical risk, and postoperative recurrence. IUS has demonstrated good accuracy in the diagnosis, evaluation and prediction of CD.