Revista Espanola De Enfermedades Digestivas最新文献

A 86-year-old man presented with a 2-month history of epigastric pain. The patient denied nausea, vomiting, hematochezia, or hematemesis. Physical examination on admission showed tenderness beneath the xiphoid process, with a palpable hard mass. Abdominal CT revealed a huge irregular inhomogeneous low density mass between liver and stomach, with moderate enhancement.

Congenital portosystemic shunts are rare abnormalities in which blood flow from the liver is diverted to the systemic circulation. We would like to present the case of a 48-year-old male, during his neurological follow-up he was diagnosed with a congenital intrahepatic portosystemic shunt. Embolization of the portosystemic communicating veins was attempted on two occasions, but without success. Due to the poor clinical course, the patient was presented to our transplant committee and a liver transplant was decided upon.

Patient aged 71 with a history of type 2 diabetes mellitus. He came to the emergency department for abdominal pain and vomiting. Laboratory tests showed an increase in acute phase reactants. Abdominal CT scan showed dilated jejunal loops, compatible with intestinal occlusion. Urgent intervention was performed, resecting the affected segment. The pathology report showed a prominent transmural inflammatory infiltrate and interstitial oedema, with moderate villous atrophy, identifying parasitic structures compatible with anisakis larvae (family Anisakidae). Given the mechanism of tissue invasion, the larvae are surrounded by a predominantly eosinophilic inflammatory infiltrate, organised as granulomas or abscesses.

Here we report a 60-year-old male with a polypoid lesion due to sigmoid diverticulitis treated by endoscopic double-band ligation without resection. The method offers a safe, simple and effective way for polypoid lesions caused by diverticulitis and avoids the risk of perforation.

Despite advances in the treatment of inflammatory bowel disease, particularly with biological therapies and new small molecules, a significant gap still exists in achieving persistent remission from a symptomatic, biomarker, and endoscopic perspective. In this context, hyperbaric oxygen therapy (HBOT) is considered as a therapeutic strategy. This approach has also been suggested for managing ischemic ulcers located at anastomotic sites. In this clinical case, we describe the clinical and endoscopic evolution of a challenging-to-manage Crohn's disease (CD) patient with an ischemic ulcer at the ileo-rectal anastomosis who underwent HBOT.

Biliary obstruction is a common gastrointestinal disorder with many etiological factors, such as benign and malignant diseases of the biliary tract, pancreas, and liver. Endoscopic ultrasound guided biliary drainage provides a new method for the treatment of biliary obstruction when ERCP cannula fails.

We reported a 47-year-old female with a history of laparoscopic cholecystectomy presented with a complex duodenal fistula. The bleeding artery embolization and endoscopic suture of the duodenal fistula were performed successfully. We highlight the endoscopic tissue clip suture as a safe and feasible option when surgery is too risky.

The incidence of metastasis from clear cell renal carcinoma (CCR) to the small intestine is relatively rare. While most patients exhibit symptoms such as upper gastrointestinal bleeding or obstructive symptoms, the identification of small intestine metastases often faces diagnostic delays.

An unusual case of chronic dypshagia associated with impaired quality of life in a 73-years old patient with past medical history of tongue squamous cell carcinoma. Prior esophagogastroduodenoscopy (EGD) with formalin-fixed biopsies has demonstrated inespecific findings. A few months later, new EGD was performed and esophageal stricture with sloughed mucosa was shown. With formaline and fresh biopsies was made the diagnosis of esophageal lichen planus. With medical treatment and dilations the patient had a good outcome. This is an underdiagnostic disease that has been associated with squamous cell carcinoma and impair quality of life due to the dysphagia. Immunohistochemistry can be useful for diagnosis and fresh biopsies should be considered to increase diagnostic sensitivity.

A 59-year-old man was referred to us for evaluation of asymptomatic mass in the liver that had been detected on ultrasonography performed during a physical screening. He had no history of hepatitis, and was otherwise well. Tumor markers were normal, including alpha fetoprotein, carcinoembryonic antigen, neuron-specific enolase and cancer antigen 199. Abdominal CT showed a 5.0 cm diameter low density mass in the S6 segment of his liver, with mild peripheral enhancement. Abdominal MR demonstrated the mass with hypointensity on T1WI, inhomogeneous hyperintensity on fat-suppressed T2WI, and mild peripheral enhancement. Partial hepatectomy was performed and pathological examination indicated undiferentiated pleomorphic sarcoma, with immunohistochemical results as follows: Vimentin (+), CK (-), CD68 (+), INI-1 (+), Hepa (-), Gly-3 (-), Arg-1 (-), HMB45 (-), CAM5,2 (-), CD31 (-), CD34 (-), CK7 (-), CK19 (-),Desmin (-), SMA (+), EMA (-), S-100 (-), Ki67 (50%+). The patient underwent postoperative chemotherapy with karelizumab and gemcitabine. However, repeat MR 3 months later showed multiple nodules with rim-like enhancement around the surgical margin. Subsequent repeat CT 6 months later reveled marked progression of the lesions.