[Endoscopic sclerosis of bleeding caused by Dieulafoy's lesion]. / Esclerosis endoscópica de lesión de Dieulafoy Gástrica Sangrante.

The upper gastrointestinal bleeding by Dieulafoy's lesion is a rare cause of bleeding, it is a massive haemorrhage and it is difficult to diagnose. Endoscopy is the diagnostic method of choice, in many cases are necessary repeated examinations. Endoscopic therapy is the therapeutic approach of choice, it can achieve the hemostasis in more than 90% of cases; combined therapy methods being more effective than single monotherapy. Surgical treatment remains for cases of uncontrolled hemorrhaging. Dieulafoy's lesion is a rare condition. We have only two nation wide reports. We present two cases of patients with gastric Dieulafoy's lesion with active bleeding which were successfully treated with injection endoscopic of epinephrine and absolute alcohol therapy, showing no relapse of bleeding after 12 months. They did not present other episode of haemorrhage during the twelve months after initial bleeding.

[Peutz-Jeghers syndrome and colon adenocarcinoma]. / Síndrome de Peutz-Jeghers y adenocarcinoma de colon.

The Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by the presence of hamartomatous polyps and characteristic mucocutaneous pigmentations. It is a rare syndrome and its associated to high risk for both gastrointestinal and non-gastrointestinal malignancies. The case of a patient, 32 years old, with symptoms of abdominal pain and rectal bleeding is reported. The upper gastric endoscopy and colonoscopy showed hamartomatous polyps and a tumor in the colon. Reported as a tubular polyp with severe dysplasia, the patient underwent surgical treatment. The final anatomopathologic diagnosis was colon adenocarcinoma.

Esclerosis endoscópica de lesión de Dieulafoy gástrica sangrante / Endoscopic sclerosis of Bleeding Dieulafoy lesion

La hemorragia digestiva alta por Lesión de Dieulafoy es una causa rara de sangrado, siendo en la gran mayoría de casos masiva y de diagnóstico difícil. El método diagnóstico de elección es el endoscópico, requiriéndose a veces endoscopias repetidas. La terapia endoscópica es el método terapéutico de elección, alcanzando la hemostasia en más del 90 por ciento de los casos, siendo los métodos combinados más eficaces que la monoterapia endoscópica; quedando la cirugía para aquellos casos de sangrado incontrolado. Por ser la lesión de Dieulafoy una entidad rara y al encontrar sólo dos publicaciones nacionales, es que se presentan éstos dos casos de pacientes con Lesiones de Dieulafoy gástricas con sangrado activo, que fueron exitosamente tratadas con terapia endoscópica de inyección con adrenalina y alcohol absoluto, no existiendo recidiva del sangrado 12 meses después.

The upper gastrointestinal bleeding by Dieulafoy’s lesion is a rare cause of bleeding, it is a massive haemorrhage and it is difficult to diagnose. Endoscopy is the diagnostic method of choice, in many cases are necessary repeated examinations. Endoscopic therapy is the therapeutic approach of choice, it can achieve the hemostasis in more than 90 per cent of cases; combined therapy methods being more effective than single monotherapy. Surgical treatment remains for cases of uncontrolledhemorraghe. Dieulafoy’s lesion is a rare condition. We have only two nation widereports. We present two cases of patients with gastric Dieulafoy’s lesion with active bleeding which were successfully treated with injection endoscopic of epinephrine and absolute alcohol therapy, showing no relapse of bleeding after 12 months. They did not present other episode of haemorrhage during the twelve months after initialbleeding.

Síndrome de Peutz-Jeghers y adenocarcinoma de colon / Syndrome of Peutz-Jeghers and adenocarcinoma of colon

El síndrome de Peutz-Jeghers es un desorden autosómico dominante, caracterizado por la presencia de pólipos hamartomatosos intestinales y pigmentaciones mucocutáneas características. Es un síndrome raro y se halla asociado a un alto riesgo de malignidad gastrointestinal y no gastrointestinal. Presentamos el caso de una paciente de 32 años con historia de dolor abdominal y sangrado rectal. La endoscopia digestiva alta y colonoscopia revelaron pólipos hamartomatosos y una tumoración en el colon, informada como pólipo tubular con displasia severa, por lo que fue indicado el tratamiento quirúrgico. El diagnóstico anátomo-patológico final fue un adenocarcinoma de colon.

The Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by the presence of hamartomatous polyps and characteristic mucocutaneous pigmentations. It is a rare syndromeand its associated to high risk for both gastrointestinal and non-gastrointestinal malignancies. The case of a patient, 32 years old, with symptoms of abdominal pain and rectal bleeding is reported.The upper gastric endoscopy and colonoscopy showed hamartomatous polyps and a tumor in the colon. Reported as a tubular polyp with severe dysplasia, the patient underwent surgical treatment. The final anatomopathologic diagnosis was colon adenocarcinoma.