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Diagnostics
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Complex Digestive Diseases: Diagnosis and Management
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Complex Digestive Diseases: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 1836

Editor

Prof. Dr. Dong Wu

E-Mail Website
Guest Editor
Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Interests: pancreatic disease; endoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Complex digestive diseases represent a significant challenge in modern gastroenterology, encompassing conditions such as challenging and rare pancreatobiliary and intestinal diseases, as well as gastrointestinal involvement in systemic diseases. These conditions are characterized by multifaceted pathogenesis, diagnostic difficulties, and often suboptimal treatment outcomes. This Special Issue, "Complex Digestive Diseases: Diagnosis and Management," aims to address these challenges by highlighting the latest advances in both diagnostic methodologies and therapeutic interventions. We are particularly interested in exploring novel diagnostic approaches, including advanced endoscopic techniques, biomarker discovery, artificial intelligence applications, and multi-omics integration. Furthermore, this issue will feature cutting-edge management strategies, ranging from targeted biological therapies and minimally invasive procedures to personalized treatment algorithms. We welcome contributions that bridge the gap between basic research and clinical practice, with a focus on improving patient care and outcomes. Original research articles and comprehensive reviews are invited to provide new insights into the mechanisms, diagnosis, and treatment of these complex digestive disorders, ultimately contributing to enhanced clinical decision-making and patient quality of life.

Prof. Dr. Dong Wu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • complex digestive diseases
  • precision diagnosis
  • advanced endoscopy
  • personalized management
  • artificial intelligence

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Published Papers (4 papers)

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15 pages, 1700 KB  
Article
Duodenal Lymphomas: Comprehensive Evaluation of Endoscopic Features and Clinical Outcomes in a Tertiary Center
by Zhiyu Yan, Yuheng Zhang, Congwei Jia, Yan Zhang, Shengyu Zhang and Aiming Yang
Diagnostics 2026, 16(8), 1173; https://doi.org/10.3390/diagnostics16081173 - 15 Apr 2026
Viewed by 541
Abstract
Background/Objectives: Duodenal lymphomas (DLs) are a rare subset of gastrointestinal lymphomas with incompletely characterized clinicopathological features due to low incidence and diagnostic challenges. This study assessed DL survival outcomes, characterized clinical/endoscopic features, and identified prognostic factors. Methods: This was a retrospective [...] Read more.
Background/Objectives: Duodenal lymphomas (DLs) are a rare subset of gastrointestinal lymphomas with incompletely characterized clinicopathological features due to low incidence and diagnostic challenges. This study assessed DL survival outcomes, characterized clinical/endoscopic features, and identified prognostic factors. Methods: This was a retrospective observational study of patients undergoing endoscopic examinations between 1 November 2002 and 1 November 2022 at Peking Union Medical College Hospital, with a subsequent histopathological diagnosis of DL. The primary outcome was overall survival (OS), and Cox proportional hazards modeling was used for survival analyses. Results: Sixteen patients (32%) had indolent B-cell lymphoma, 20 (40%) had aggressive B-cell lymphoma, and 14 (28%) had T-cell lymphoma. Diarrhea and weight loss were more common in patients with T-cell lymphoma. The most common endoscopic appearance was mucosal granularity, and 40% of patients had mass lesions. The median OS was 24.1 (95% CI: 13.3–117) months, with 1- and 5-year survival rates of 68.0% (95% CI: 56.2–82.2%) and 33.8% (95% CI: 22.3–51.44%), respectively. In multivariable analysis, a granular appearance (HR: 0.33, 95% CI: 0.11–0.99, and p = 0.049) and taking chemotherapy (HR: 0.22, 95% CI: 0.07–0.69, and p = 0.01) were associated with better OS, while T-cell lymphoma (HR: 9.19, 95% CI: 2.12–32.83, and p = 0.003) and stage IV lymphoma (HR: 12.76, 95% CI: 1.70–95.66, and p = 0.013) were associated with worse OS. Conclusions: This first integrated study provides new information on the clinical, endoscopic, and prognostic features of DL. While no specific clinical or endoscopic feature is diagnostic of DL, DL must remain in the differential diagnosis of any patient presenting with nonspecific gastrointestinal symptoms. Full article
(This article belongs to the Special Issue Complex Digestive Diseases: Diagnosis and Management)
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5 pages, 3402 KB  
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Hepatobiliary Nontuberculous Mycobacterial Infection Mimicking Malignancy in a Patient with Anti-Interferon-γ Autoantibodies
by Mengmeng Zhang, Qiang Wang, Xi Wu, Dong Wu and Aiming Yang
Diagnostics 2026, 16(12), 1774; https://doi.org/10.3390/diagnostics16121774 - 9 Jun 2026
Viewed by 183
Abstract
Obstructive jaundice is a common digestive disorder with multiple etiologies. Non-tuberculous mycobacterial (NTM) infection is an opportunistic disease that may present with localized pulmonary involvement or disseminated multi-organ manifestations. However, biliary involvement in disseminated NTM infection is rare, and its characteristics and progression [...] Read more.
Obstructive jaundice is a common digestive disorder with multiple etiologies. Non-tuberculous mycobacterial (NTM) infection is an opportunistic disease that may present with localized pulmonary involvement or disseminated multi-organ manifestations. However, biliary involvement in disseminated NTM infection is rare, and its characteristics and progression remain poorly understood. We report a patient with progressive jaundice who was eventually considered to have probable biliary NTM infection after comprehensive evaluation, exclusion of alternative etiologies, and a favorable therapeutic response despite negative microbiological testing. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to relieve biliary obstruction, but the patient developed recurrent and refractory ampullary bleeding requiring repeated endoscopic interventions. Clinical improvement was achieved following combined antimycobacterial therapy and immunomodulatory treatment. Biliary NTM infection is a rare cause of obstructive jaundice, and ERCP remains necessary for biliary decompression, while post-ERCP bleeding risk should be carefully monitored. Full article
(This article belongs to the Special Issue Complex Digestive Diseases: Diagnosis and Management)
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4 pages, 2862 KB  
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Optical Biopsy and Diagnosis of Gastric Mucosa-Associated Lymphoid Tissue-Type Lymphoma by Probe-Based Confocal Laser Endomicroscopy
by Mengmeng Zhang, Xinxin Mao, Xi Wu, Wen Shi, Yunlu Feng and Aiming Yang
Diagnostics 2026, 16(10), 1451; https://doi.org/10.3390/diagnostics16101451 - 10 May 2026
Viewed by 295
Abstract
The endoscopic findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma are highly nonspecific and the sampling error or false-negative probabilities during conventional biopsy make its diagnosis more challenging. Confocal laser endomicroscopy is a novel technology which allows in vivo microscopic analysis of gastrointestinal [...] Read more.
The endoscopic findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma are highly nonspecific and the sampling error or false-negative probabilities during conventional biopsy make its diagnosis more challenging. Confocal laser endomicroscopy is a novel technology which allows in vivo microscopic analysis of gastrointestinal mucosa. Here we present a case of gastric MALT lymphoma by targeted biopsy guided by magnifying endoscopy and probe-based confocal laser endomicroscopy. Full article
(This article belongs to the Special Issue Complex Digestive Diseases: Diagnosis and Management)
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18 pages, 3002 KB  
Case Report
Blind-Ending Esophageal Fistula Complicating Eosinophilic Esophagitis: Case Report and Up-to-Date Strategy from Diagnosis to Therapy
by Anthony Rasuceanu, Adrian Constantin, Florin Achim, Alex-Claudiu Moraru, Alexandru Rotariu, Andreea-Gabriela Manole, Petre Hoara, Roxana-Elena Stefan, Madalina-Georgiana Mitrea-Tocitu, Cristian Rosianu, Anca Evsei-Seceleanu, Dragos-Viorel Scripcariu and Dragos Predescu
Diagnostics 2026, 16(9), 1374; https://doi.org/10.3390/diagnostics16091374 - 30 Apr 2026
Viewed by 443
Abstract
Background and Clinical Significance: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disorder characterized by esophageal dysfunction and dense eosinophilic infiltration. EoE frequently evolves into a fibrostenotic phenotype, in which uncontrolled inflammation drives progressive tissue remodeling. This evolution increases the risk of complex [...] Read more.
Background and Clinical Significance: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disorder characterized by esophageal dysfunction and dense eosinophilic infiltration. EoE frequently evolves into a fibrostenotic phenotype, in which uncontrolled inflammation drives progressive tissue remodeling. This evolution increases the risk of complex structural complications—most commonly fixed rings and strictures, and, in rare advanced cases, deep mural injury or fistulization—substantially increasing both diagnostic and therapeutic complexity. Case Presentation: This report describes an uncommon presentation of EoE complicated by a blind-ending esophageal fistula, managed successfully through a multidisciplinary strategy integrating pharmacologic therapy, dietary modification, and endoscopic intervention. Conclusions: Nutritional support through gastrostomy, combined with multidisciplinary medical and endoscopic management, can lead to favorable outcomes in EoE complicated by esophageal fistula. Early recognition and individualized management are essential to optimize outcomes. Full article
(This article belongs to the Special Issue Complex Digestive Diseases: Diagnosis and Management)
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