The epidemic of fatty liver disease is closely linked to the rapidly growing prevalence of obesity and associated metabolic disorders. In contrast to earlier concepts, alcoholic and non-alcoholic fatty liver disease significantly overlap, share many features, and may be viewed as a spectrum of disease. Recent studies of the gut microbiome not only improve our understanding of the pathogenesis but also lead to early recognition of progressive forms of fatty liver disease. Alterations of the gut microbiome associated with inflammatory changes and damage of the intestinal barrier, represent novel targets for both treatment and prevention strategies. Medical interventions should focus on eliminating causative factors rather than treating symptoms of disease. This objective can be achieved by using nutrition therapy, lifestyle modifications and targeted probiotics. Future clinical trials evaluating these approaches may facilitate the development of specific treatment guidelines.

Perianal fistula formation is common and therapy-resistant complication of Crohn's Disease with a lifetime prevalence of 21-23%. Biological treatment represents a great breakthrough in their treatment; however, the rate of complete fistula closure can be achieved in only 22-36% of cases during the one-year treatment. Mesenchymal stem cell transplantation is a new, complementary therapeutic alternative in the management of conventional combined surgical and drug resistant fistulas. Its most important advantage is that it not only inhibits the inflammation, but also directly promotes the regeneration process of damaged tissue. The allogeneic adipose tissue derived mesenchymal stem cells (darvadastrocel) therapy has become available in Hungary therefore, our review article aims to summarize the effectiveness and therapeutic mechanism of stem cell transplantation in the management of perianal fistulizing Crohn's Disease.

Acute pancreatitis is one of the most common gastrointestinal disorders requiring hospital treatment. In Hungary 20-50 cases (per year per 100,000 inhabitant) are registered. Drug Induced Acute Pancreatitis is a rarely occurring and difficult to diagnose entity because it has no specific clinical features that make it easy to distinguish between more common etiologies. The median time between the administration of the drug and the onset of symptoms of pancreatitis can range from a few days to a few months, but may also occur with persistent medication. Our case study is about a young female patient who has been diagnosed with drug-induced pancreatitis by re-challenge.

The role of imaging modalities are essential in the differential diagnosis of acute abdominal pain but the limitations of the radiological methods can complicate the diagnosis of the disease. Our aim is to draw attention to the possibility that mesenterial panniculitis, a common radiological finding, can mimic more serious, life-threatening illnesses. We report the cases of two middle-aged male patients who had been first admitted to our Department with the diagnosis of mesenterial panniculitis while one having superior mesenterial venous thrombosis, and the other having multiple abdominal arterial occlusions causing the acute abdominal pain. In the case of imaging studies that are not relevant to the clinical picture, revision of the radiological findings is absolutely warranted.

Among acute, life-threatening gastroenterological disorders, severe acute pancreatitis and acute liver failure are high-mortality diseases, and their treatment remains a challenge today. In both cases, significant cell damage occurs and, in addition, frequently associated infections may result in an excessive immune response, a “cytokine storm”. Since attempts to control this condition using medication therapy have not been successful enough, extracorporal techniques are more often preferred. Of cytokine absorbers, CytoSorb is the most widely used agent globally, which can also be combined with other extracorporeal organ replacement treatments. This paper presents our current therapeutic options and experiences based on two cases.