Rescate endoscópico de endoprótesis biliar plástica fistulizante / Endoscopic rescue of a fistulizing biliary plastic stent

55-year-old male with a history of cholecystectomy complicated by perforation of the common bile duct, contained with placement of a plastic biliary stent. He presented several subsequent episodes of recurrent cholangitis secondary to biliary lithiasis and residual benign stenosis of the common bile duct, resolved with the implantation of plastic biliary prostheses. Finally, given the recurrent episodes of cholangitis, it was agreed to perform a hepaticojejunostomy. During the operation, the last implanted stent was not detected, which was identified by CT scan of the abdomen, causing a fistulous tract between the duodenum and the ascending colon. The stent was removed endoscopically, without complications, and the fistulous tract was resolved.(AU)

Endoscopic rescue of a fistulizing biliary plastic stent.

55-year-old male with a history of cholecystectomy complicated by perforation of the common bile duct, contained with placement of a plastic biliary stent. He presented several subsequent episodes of recurrent cholangitis secondary to biliary lithiasis and residual benign stenosis of the common bile duct, resolved with the implantation of plastic biliary prostheses. Finally, given the recurrent episodes of cholangitis, it was agreed to perform a hepaticojejunostomy. During the operation, the last implanted stent was not detected, which was identified by CT scan of the abdomen, causing a fistulous tract between the duodenum and the ascending colon. The stent was removed endoscopically, without complications, and the fistulous tract was resolved.

Eagle's syndrome as a cause of oropharyngeal dysphagia.

Eagle's syndrome is a little known entity defined as the elongation of the stylohyoid process and/or calcification of the stylohyoid ligament. It is a rare pathology that due to its presentation and possible complications should be taken into consideration in the differential diagnosis of oropharyngeal dysphagia. We present the case of a patient with Eagle's syndrome as well as essential aspects in the diagnosis and treatment of this entity.

Síndrome del conducto pancreático desconectado. Abordaje endoscópico. / Disconnected pancreatic duct syndrome. Endoscopic approach

El síndrome del conducto pancreático desconectado (SCPD) es debido a la interrupción del conducto pancreático (CP) principal o sus ramas secundarias, complicación presente entre un 30-80% de las pancreatitis agudas necrotizantes. La secreción de enzimas pancreáticas por el tejido pancreático aislado funcionante puede facilitar la recurrencia de colecciones necróticas encapsuladas, por lo que su manejo endoscópico sigue siendo un tema controvertido en la práctica diaria. Exponemos un caso de síndrome de ducto pancreático desconectado resuelto tras colocación de prótesis pancreática. (AU)

Disconnected pancreatic duct syndrome. Endoscopic approach.

Disconnected pancreatic duct syndrome (DPCS) is due to disruption of the main pancreatic duct (PC) or its secondary branches, a complication present in 30-80% of acute necrotizing pancreatitis. The secretion of pancreatic enzymes by isolated functioning pancreatic tissue can facilitate the recurrence of encapsulated necrotic collections, so its endoscopic management remains a controversial issue in daily practice. We present a case of disconnected pancreatic duct syndrome resolved after placement of a pancreatic stent.

Therapeutic approach of esophageal bezoar due to enteral feed.

Enteral feed bezoars are a rare and difficult to treat complication of enteral feeding. In our case, we report the case of a young man with prolonged admission at the intensive care unit; who requires enteral nutrition. This doesn't run properly after a week; which is why we performed an endoscopy with the finding of an esophageal bezoar that didn't respond to endoscopic treatment at first; being finallay resolved with a second endoscopic therapy after treatment with solvent substances.

Is gastroparesis that is often detected in patients with alcoholic chronic liver disease a manifestation of an autonomic dysfunction syndrome? A preliminary study.

BACKGROUND: the autonomic dysfunction defines the neuropathy of the autonomic nervous system. The prevalence of the gastric dysmotility and its relationship with the autonomic dysfunction in patients with alcohol chronic liver disease is not well known. METHODS: thirty-six patients with alcohol chronic liver disease and 25 healthy controls were evaluated, in order to detect an autonomic dysfunction through different cardiovascular reflexes and gastric emptying tests. RESULTS: ninety-four per cent of the patients showed an impaired R index (variations in heart rate during six deep inspirations-expirations per minute) and/or S/S-HR (variations in heart rate when standing from a supine position). Seventy-five per cent of the patients showed gastroparesis (T1/2: gastric half-emptying time was delayed). There was a correlation between the R index and T1/2 (r = -0.49; p < 0.01). CONCLUSIONS: we suggest that gastroparesis detected in alcoholic chronic liver disease is another clinical manifestation of the autonomic parasympathetic dysfunction.