[Heterotopic gastric mucosa in the rectum: Report of a case]. / Mucosa gástrica heterotópica en el recto: reporte de un caso.

BACKGROUND: Ectopic gastric mucosa has been described in different locations of the digestive tract, but that of the rectum is the least frequent. CLINICAL CASE: The case is described of a 48 year-old woman being investigated by the gastrointestinal department due to rectal bleeding and rectal tenesmus. Colonoscopy showed a diverticular cavity 3 cm, which was reported by histology as fundic-type heterotopic gastric mucosa. Barium enema and abdominopelvic CT showed a diverticular image at level of the right posterolateral wall of the rectal ampulla. Trans-rectal diverticulectomy was performed with primary closure of the resulting mucosal defect. The surgical specimen showed areas of gastric epithelium with no signs of atypia. CONCLUSIONS: It is not known whether the origin of heterotopic gastric mucosa occurs during foetal development or is the result of abnormal regeneration under inflammatory conditions. It is usually clinically asymptomatic or presents as haematochezia, especially in cases where gastric acid is being produced. In these cases there must be an initial treatment with proton pump inhibitors, although the definitive treatment is always surgical or endoscopic excision of the mucosa.

[Splenic artery aneurysm. Report of a case]. / Aneurisma de arteria esplénica. A propósito de un caso.

BACKGROUND: The incidence of splenic artery aneurysm is not well known because they are often asymptomatic. CLINICAL CASE: The case is presented of a 40 year-old woman diagnosed with a splenic artery aneurysm. She was clinically asymptomatic. A three-dimensional angiographic study was performed. The artery embolisation was rejected, according to the results of the study; thus it was decided to perform a laparoscopic splenic-aneurysmectomy. CONCLUSIONS: Splenic artery aneurysms may present with non-specific symptoms, such as abdominal pain or anorexia. However 2-10% of aneurysms debut as spontaneous rupture. For this reason treatment is indicated in symptomatic aneurysms or those with rupture risk factors. In these cases there are different possibilities, such as therapeutic embolisation, endovascular stenting or surgery. Surgical approach varies depending on the location of the aneurysm in the splenic artery, enabling aneurysmectomy, splenic-aneurysmectomy, or aneurysm exclusion to be performed.