No abstract

A 46-year-old woman presented with a gastric subepithelial tumor. The tumor was incidentally detected during a screening endoscopy. The tumor was located on the posterior wall of the gastric fundus, without any observable erosion or ulceration on its surface (Fig. 1A). When compressed using biopsy forceps, the tumor felt hard and partially fixed. On endoscopic ultrasonography, the tumor measured 0.8 cm in diameter and presented as a heterogeneously hypoechoic lesion in the submucosal layer (Fig. 1B). Examination of the specimen obtained from the endoscopic biopsy revealed only chronic gastritis. The patient underwent a follow-up endoscopy 2 years later, which revealed that the tumor size had increased (Fig. 1C). Therefore, traction-assisted endoscopic submucosal dissection was performed (Fig. 1D-F).What is the most likely diagnosis?

Extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD) is approximately 36%. Of genitourinary complications as an EIM of Crohn’s disease (CD), nephrolithiasis is the most common urinary complication in patients with CD. CD patients have been shown to have decreased urinary volume, pH, magnesium, and excretion of citrate, all of which are significant risk factors for nephrolithiasis. Genitourinary complications often occur in case of a severe longstanding disease and are associated with, the activity of bowel disease, especially in those who have undergone bowel surgery. As uncontrolled nephrolithiasis could impair renal function as well as adversely affect quality of life, proper monitoring, early detection, and prevention of the occurrence of urologic complications in CD is crucial. Few data are available about urolithiasis in patients with CD. Herein we report a case of a successful removal of a 2.7 cm calcium oxalate stone using percutaneous nephrolithotomy from a patient with long-standing CD with a previous surgery for small intestinal and colonic stricture.