RESUMEN
Hypertriglyceridemia is the third cause of acute pancreatitis after lithiasis and alcohol. When triglycerides are >2000 mg/dL the risk increases to 20%. Acute pancreatitis is an important cause of morbidity in patients infected with human immunodeficiency virus (HIV), especially in those treated with lamivudine, due to hypertriglyceridemia.
RESUMEN
Febuxostat is a drug from the group of xanthine dehydrogenase inhibitors and is used in the treatment of hyperuricemia and gouty arthritis. However, it is not free of adverse effects, including alteration of liver profile tests. This is why we must pay attention to this type of adverse events in case it is necessary to suspend treatment. We present a clinical case of acute hepatitis secondary to Febuxostat.
RESUMEN
Duodenal-type follicular lymphoma is a clinical variant of follicular lymphoma located in the intestine, presenting as multiple small polyps. The estimated frequency is 1/7000 people and extraduodenal involvement is rare. It predominantly affects middle-aged women, although some cases of young patients have been published in the literature. They are usually located in the second periampullary portion of the duodenum. It is diagnosed incidentally or after performing an imaging test due to non-specific digestive symptoms (abdominalgia, diarrhea or hyporexia). The prognosis is usually favorable without specific treatment5.
Asunto(s)
Colestasis , Neoplasias Colorrectales , Neoplasias Duodenales , Linfoma Folicular , Persona de Mediana Edad , Humanos , Femenino , Linfoma Folicular/complicaciones , Linfoma Folicular/diagnóstico por imagen , Linfoma Folicular/patología , Neoplasias Duodenales/complicaciones , Neoplasias Duodenales/diagnóstico por imagen , Duodeno/patología , Pronóstico , Neoplasias Colorrectales/patologíaRESUMEN
We present the case of 67 years-old man with unremarkable medical history. He was admitted to our department for abdominal pain compatible with choledocholithiasis associated with acute cholecystitis. ERCP was performed but direct papillary canulation attempts failed by means of conventional sphincterotome. So, pre- cut papillotomy was successfully attempted getting free access to distal choledochus and retrieving a small lithiasis. Unfortunately, the patient developed severe post-ERCP acute pancreatitis.
Asunto(s)
Colangiopancreatografia Retrógrada Endoscópica , Pancreatitis , Masculino , Humanos , Anciano , Pancreatitis/complicaciones , Pancreatitis/diagnóstico por imagen , Pancreatitis/cirugía , Enfermedad Aguda , Cateterismo , Ultrasonografía Intervencional , Esfinterotomía EndoscópicaRESUMEN
The inflammatory myoglandular or Nakamura polyp is a very rare polyp, with about 100 cases having been described in the literature. It has specific endoscopic and histological characteristics, making its knowledge of it very important for its proper diagnosis. Its differential diagnosis with other types of polyps is of vital importance, both histologically and with respect to its endoscopic follow-up. We present the clinical case of a Nakamura polyp as an incidental finding in a screening colonoscopy.
Asunto(s)
Pólipos del Colon , Humanos , Pólipos del Colon/diagnóstico , Pólipos del Colon/patología , Colonoscopía/métodos , Diagnóstico DiferencialRESUMEN
GIST tumors are mesenchymal tumors that are usually positive for the CD-117 marker. They present mostly at middle ages of life and although the most frequent locations are the stomach, small intestine and rectum/colon, they can appear in unusual places such as the retroperitoneum. The case that we present reflects the diagnostic process with imaging tests such as echo-endoscopy with puncture, of a retroperitoneal GIST tumor.
Asunto(s)
Tumores del Estroma Gastrointestinal , Neoplasias Retroperitoneales , Endosonografía , Tumores del Estroma Gastrointestinal/patología , Neoplasias Retroperitoneales/patología , Dolor Abdominal/etiología , Pérdida de Peso , Tomografía Computarizada por Rayos X , Biopsia con Aguja Fina , Humanos , Femenino , Anciano de 80 o más AñosRESUMEN
MALS, also called celiac artery compression syndrome, celiac axis syndrome, or Dunbar syndrome, is a rare entity caused by progressive stenosis of the celiac trunk secondary to extrinsic compression of the fibers of the median arcuate ligament. The prevalence is unknown, but it is estimated that it is a casual finding in up to a third of autopsies2,3, being more prevalent in women between 30 and 50 years of age4. Symptoms and signs include postprandial abdominal pain, exercise-induced pain, nausea, vomiting, and weight loss3. However, most cases are asymptomatic. The case that we present was a 56-year-old man, with a history of dyslipidemia, type 2 diabetes mellitus, and chronic ischemic heart disease. He was a former smoker. He reported a history of recurrent abdominal pain, especially postprandial.
Asunto(s)
Diabetes Mellitus Tipo 2 , Síndrome del Ligamento Arcuato Medio , Masculino , Humanos , Femenino , Persona de Mediana Edad , Síndrome del Ligamento Arcuato Medio/complicaciones , Síndrome del Ligamento Arcuato Medio/diagnóstico por imagen , Diabetes Mellitus Tipo 2/complicaciones , Arteria Celíaca/diagnóstico por imagen , Vómitos/etiología , Dolor Abdominal/etiologíaAsunto(s)
Cuidados Críticos , Neoplasias , Humanos , Anciano , Neoplasias/terapia , Unidades de Cuidados IntensivosRESUMEN
DRESS syndrome is a multisystem disorder that appears in the context of an adverse drug reaction, characterized by fever, rash and peripheral eosinophilia with involvement of other organs such as the liver. The typical liver involvement is acute toxic hepatitis (DILI), showing improvement and a tendency to resolution when corticotherapy is started. We must not forget this manifestation in the clinical context of a DRESS syndrome.
Asunto(s)
Síndrome de Hipersensibilidad a Medicamentos , Eosinofilia , Exantema , Humanos , Síndrome de Hipersensibilidad a Medicamentos/etiología , Síndrome de Hipersensibilidad a Medicamentos/tratamiento farmacológico , Anticonvulsivantes/efectos adversos , Carbamazepina/efectos adversos , Exantema/inducido químicamente , Exantema/tratamiento farmacológico , Eosinofilia/inducido químicamente , Eosinofilia/tratamiento farmacológico , BenzodiazepinasRESUMEN
Liver cirrhosis is an entity that predisposes to adrenal insufficiency. Adequate screening for this condition in patients with liver cirrhosis, since several studies have shown increased survival with the use of corticosteroids in cirrhotic patients with septic shock, it seems reasonable to identify patients with adrenal insufficiency in the context of liver cirrhosis and individualize your treatment.
Asunto(s)
Insuficiencia Suprarrenal , Choque Séptico , Humanos , Hidrocortisona , Insuficiencia Suprarrenal/complicaciones , Insuficiencia Suprarrenal/diagnóstico , Cirrosis Hepática/complicaciones , CorticoesteroidesRESUMEN
There are many daily antibiotic prescriptions, especially beta-lactams in trivial infections such as cystitis in young women. Many of these drugs carry an implicit probability of producing hepatotoxicity, manifested by a nonspecific general picture and elevated analytical transaminases. We must take it into account when making the differential diagnosis in the hepatotoxicity study and suspend it as soon as we recognize it.
Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Hepatitis , Antibacterianos/uso terapéutico , Cefalosporinas/farmacología , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Femenino , Hepatitis/tratamiento farmacológico , Hepatitis/etiología , Humanos , Pruebas de Sensibilidad MicrobianaRESUMEN
Renal squamous cell carcinoma is a rare neoplasm in adults, but with an aggressive behavior. It is diagnosed in most cases in advanced stages. The invasion of the digestive tract by this type of tumor is rare, due to the anatomical arrangement of the colon, however, when it occurs, it carries a poor prognosis for the patient. Digestive endoscopy allows us to reach a definitive diagnosis since these patients usually present digestive manifestations, such as diarrhoea, digestive bleeding or abdominal pain.
Asunto(s)
Carcinoma de Células Renales , Carcinoma de Células Escamosas , Neoplasias Renales , Adulto , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico por imagen , Diarrea/complicaciones , Endoscopía Gastrointestinal , Humanos , Neoplasias Renales/complicaciones , Neoplasias Renales/diagnóstico por imagenRESUMEN
We present the case of a 66-year-old woman with intermittent dysphagia and esophageal food impaction. The endoscopic examination showed an upper and middle esophagus with a diffuse circumferential, white, crackleware epithelium. Esophageal biopsies revealed acanthosis and papillomatosis with diffuse hyperkeratosis. High dose of Proton pump inhibitors was initiated with improvement of all symptoms 6 weeks later.