Fístula aorto-entérica secundaria a prótesis vascular como causa de hemorragia digestiva / Aortoenteric fistula due to a vascular prosthesis as the cause of gastrointestinal bleeding

La fístula aorto-entérica es una entidad muy infrecuente, pero dada la situación urgente y en algunas ocasiones vital que supone su diagnóstico, es importante recordar su existencia, sobre todo en aquellos pacientes que han sido sometidos a una cirugía vascular previa. Por tanto, la hemos de tener en cuenta a la hora de hacer un diagnóstico diferencial con otras causas de hemorragia digestiva. Presentamos el caso de un paciente que acude a urgencias por hematemesis y rectorragia, y analizamos su diagnóstico y tratamiento (AU)

Aortoenteric fistulas are very rare, but because of the urgent and sometimes life-threatening nature of this complication, its possibility should be taken into consideration, especially if patients have undergone vascular surgery. In such situations, aortoenteric fistula should be included in the differential diagnosis for gastrointestinal bleeding. We report the case of a man who came to the emergency department with hematemes is and rectal bleeding. Diagnosis and treatment are analyzed (AU)

Paludismo: el resurgir de una enfermedad importada / Malaria: resurgence of an imported disease

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Disección de aorta torácica / Thoracic aorta dissection

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[Sensory demyelinating polyneuropathology as a manifestation of paraneoplastic encephalomyelitis associated to adenocarcinoma of the prostate]. / Polineuropatia sensitiva desmielinizante como manifestación de encefalomielitis paraneoplásica asociada al adenocarcinoma de próstata.

INTRODUCTION: Different neurological disorders affecting different levels of the nervous system, both central and peripheral, are included among the paraneoplastic symptomologies of cancers, although their incidence is not well defined and varies according to the type of tumour. CASE REPORT: We report the case of a 73 year old male patient who was admitted with a suspected polyneuropathy that had been developing for one month. The diagnosis was confirmed by electromyography. The only probable aetiology found in the course of a specific exploration was an adenocarcinoma of the prostate, with a widespread distribution throughout the central ganglionic chains and bone metastases, which were observed by computerised tomography of the abdomino pelvic region and bone gammography, and had not previously been diagnosed. CONCLUSIONS: We reviewed the literature on the relation between neurological paraneoplastic syndromes and neoplasias that are not of a pulmonary origin and we found a low rate of association between the two processes. The relation between adenocarcinoma of the prostate and neurological paraneoplastic processes receives very little attention. These syndromes vary greatly in their neurological expression, and there is a link with different antibodies that could explain an etiopathogenic mechanism of an immunitary nature. No effective treatment exists in spite of its usually being aggressive and varied. The disease often progresses quickly and leads to death after a few months.

Polineuropatía sensitiva desmielinizante como manifestación de encefalomielitis paraneoplásica asociada al adenocarcinoma de próstata / Sensory demyelinating polyneuropathology as a manifestation of paraneoplastic encephalomyelitis associated to adenocarcinoma of the prostate

Introducción. Dentro de la sintomatología paraneoplásica de los cánceres se incluye la afectación neurológica a distintos niveles del sistema nervioso, tanto central como periférico, sin que esté bien definida su incidencia, variando la misma según el tipo de tumor. Caso clínico. Presentamos el caso de un varón de 73 años que ingresa por sospecha de polineuropatía de un mes de evolución. El diagnóstico se confirmó por electromiografía. Al efectuarse el estudio específico se encontró como única probable etiología un adenocarcinoma de próstata, con una amplia extensión en las cadenas ganglionares centrales y metástasis óseas, objetivadas por una tomografía computarizada abdominopélvica y gammagrafía ósea, no diagnosticado previamente. Conclusiones. Realizamos una revisión bibliográfica sobre la relación existente entre los síndromes paraneoplásicos neurológicos y las neoplasias de origen no pulmonar, en la que se ha encontrado una baja frecuencia de asociación entre ambos procesos, con escasas reseñas en la literatura sobre la asociación entre el adenocarcinoma de próstata y los procesos paraneoplásicos neurológicos. Existe una gran diversidad de expresión neurológica de estos síndromes, así como una asociación a distintos anticuerpos que podrían explicar un mecanismo etiopatogénico de carácter inmunitario. No existe un tratamiento efectivo a pesar de que éste suele ser agresivo y variado. El curso es con frecuencia rápidamente progresivo y conduce a la muerte en pocos meses (AU)

Introduction. Different neurological disorders affecting different levels of the nervous system, both central and peripheral, are included among the paraneoplastic symptomologies of cancers, although their incidence is not well defined and varies according to the type of tumour. Case report. We report the case of a 73-year-old male patient who was admitted with a suspected polyneuropathy that had been developing for one month. The diagnosis was confirmed by electromyography. The only probable aetiology found in the course of a specific exploration was an adenocarcinoma of the prostate, with a widespread distribution throughout the central ganglionic chains and bone metastases, which were observed by computerised tomography of the abdomino-pelvic region and bone gammography, and had not previously been diagnosed. Conclusions. We reviewed the literature on the relation between neurological paraneoplastic syndromes and neoplasias that are not of a pulmonary origin and we found a low rate of association between the two processes. The relation between adenocarcinoma of the prostate and neurological paraneoplastic processes receives very little attention. These syndromes vary greatly in their neurological expression, and there is a link with different antibodies that could explain an etiopathogenic mechanism of an immunitary nature. No effective treatment exists in spite of its usually being aggressive and varied. The disease often progresses quickly and leads to death after a few months (AU)

Infiltrado pulmonar y lesiones cutáneas / Pulmonary infiltrate and cutaneous lesions

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