Coledocoduodenostomía guiada por ultrasonografía endoscópica ante fallo o imposibilidad de CPRE / Endoscopic ultrasound-guided choledochoduodenostomy after a failed or impossible ERCP

Introducción: el drenaje biliar endoscópico guiado por ultrasonografía (DBUSE) es una alternativa al drenaje biliar percutáneo transhepático (CTPH) ante fallo de la colangiografía retrógrada endoscópica (CPRE). Métodos: descripción retrospectiva de seis casos de drenaje biliar guiado por ultrasonografía endoscópica, mediante coledocoduodenostomía (USE-CDS), así como de sus características clínicas, procedimiento endoscópico, complicaciones y posterior seguimiento. Resultados: todos nuestros casos presentaban obstrucción biliar distal de etiología maligna. En cuatro de los seis pacientes se concluyó el procedimiento con buen drenaje posterior. Registramos dos complicaciones tardías por migración de prótesis, sin muertes relacionadas con el procedimiento. El tiempo medio de seguimiento fue de seis meses. Conclusión: la USE-CDS se plantea como una opción terapéutica válida, no exenta de complicaciones, en casos seleccionados y en manos de un equipo de endoscopistas expertos ante fallos del drenaje por CPRE, y como alternativa al CTPH

Introduction: endoscopic ultrasound-guided biliary drainage (EUS-BD) is an alternative to percutaneous trans-hepatic biliary drainage (PTBD) in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). Methods: this is a retrospective description of six cases of endoscopic ultrasound-guided biliary drainage via choledochoduodenostomy (EUCD), as well as the clinical characteristics, endoscopic procedure, complications and monitoring. Results: all cases had malignant distal biliary obstruction. The procedure was concluded with good drainage in four out of six patients. Two late complications were recorded that were caused by stent migration and there were no deaths related with the procedure. The average monitoring period was six months. Conclusions: EUCD can be considered as a valid therapeutic choice in some selected cases and when performed by a team of expert endoscopists in cases of failed ERCP drainage or as an alternative to PTBD. However, the procedure has some associated complications

Endoscopic ultrasound-guided choledochoduodenostomy after a failed or impossible ERCP.

INTRODUCTION: endoscopic ultrasound-guided biliary drainage (EUS-BD) is an alternative to percutaneous trans-hepatic biliary drainage (PTBD) in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). METHODS: this is a retrospective description of six cases of endoscopic ultrasound-guided biliary drainage via choledochoduodenostomy (EUCD), as well as the clinical characteristics, endoscopic procedure, complications and monitoring. RESULTS: all cases had malignant distal biliary obstruction. The procedure was concluded with good drainage in four out of six patients. Two late complications were recorded that were caused by stent migration and there were no deaths related with the procedure. The average monitoring period was six months. CONCLUSIONS: EUCD can be considered as a valid therapeutic choice in some selected cases and when performed by a team of expert endoscopists in cases of failed ERCP drainage or as an alternative to PTBD. However, the procedure has some associated complications.

Hepatitis crónica por virus de la hepatitis E tratada con ribavirina / Chronic hepatitis caused by hepatitis E virus and treated with ribavirin

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Tumor de células epitelioides perivasculares de íleon. Descripción de un caso / Perivascular epithelioid cell tumor of the ileum. A case report

Los tumores de células epiteliodes perivasculares son tumores de células epiteliales vasculares con características inmunohistoquímicas de músculo liso y células melanocíticas. Los gastrointestinales son infrecuentes. El tratamiento es quirúrgico aunque existen datos que indican buena respuesta a la rapamicina (AU)

Perivascular epithelioid cell tumors (PEComa) are tumors of perivascular epithelioid cells with immunohistochemical features of smooth muscle and melanocytic tumors. The PEComa of the gastrointestinal tract is rare. The treatment is surgical, although there are data that suggest a good response to rapamycin (AU)

Pancreatitis aguda secundaria a déficit parcial de multidrug resistance 3 p-glycoprotein / Acute pancreatitis secondary to partial multidrug resistance 3 p-glycoprotein deficit

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Aumento de la incidencia de cáncer colorrectal en la provincia de Salamanca. Comparación de dos periodos: 2004-2006 y 2010-2012 / Increasing incidence of colorectal cancer in the province of Salamanca. Comparison of two periods: 2004-2006 and 2010-2012

Objetivos: comparar incidencia, mortalidad y características epidemiológicas de los pacientes diagnosticados de cáncer colorrectal (CCR) en la provincia de Salamanca entre dos periodos: 2010-2012 y 2004-2006. Métodos: estudio observacional retrospectivo. Incluimos todos los CCR diagnosticados según criterios histopatológicos del 01/01/2004 al 31/12/2006 y del 01/01/2010 al 31/12/2012. Las variables estudiadas fueron género, edad, fecha de diagnóstico y localización del tumor. Se han calculado incidencia acumulada e incidencia específica por grupos de edad comparando los resultados entre periodos. Hemos ajustado las tasas por edad a la población mundial estándar para poder compararla con otras poblaciones. Resultados: detectamos un 38% más de CCR en el periodo de 2010 a 2012 que en el de 2004 a 2006. Las variables (sexo, edad de diagnóstico y localización) han sido similares en ambos grupos. En el periodo de 2010-2012 se realizaron más del doble de colonoscopias que en el de 2004-2006. La mortalidad poblacional por CCR también aumentó, aunque de manera mucho menos importante que la incidencia. Conclusiones: existe un claro aumento de la incidencia del CCR en la provincia de Salamanca entre los años 2004-2006 y 2010-2012 no relacionado con el envejecimiento. El aumento considerable de colonoscopias puede haber sido un factor importante para el aumento en la detección (AU)

Objectives: To compare incidence, mortality and epidemiological characteristics of patients diagnosed with colorectal cancer (CRC) in the province of Salamanca over two different periods: 2010-2012 and 2004-2006. Methods: Retrospective observational study. We include all diagnosed cases of CRC according to histopathological criteria from 01/01/2004 to 31/12/2006 and from 01/01/2010 to 31/12/2012. The studied variables were sex, age, date of diagnosis and tumor location. Cumulative incidence and specific incidence in different age groups were measured and compared between the two periods. The age rates were adjusted to the standard world population so that the results could be compared with those of other populations. Results: We detected 38% more cases of CRC in the 2010-2012 period than in 2004-2006. Variables distribution (sex, age at diagnosis and location) was similar in both groups. More than twice as many colonoscopies were performed in 2010-2012 than in 2004-2006. Population mortality due to CRC also increased, although much less importantly than the incidence of this condition. Conclusions: There has been a clear increase in CRC incidence in the province of Salamanca from 2004-2006 to 2010-2012 which is not related to the ageing of the population. The remarkable increase in colonoscopies may have been an important factor for the increased detection (AU)

Increasing incidence of colorectal cancer in the province of Salamanca. Comparison of two periods: 2004-2006 and 2010-2012.

OBJECTIVES: To compare incidence, mortality and epidemiological characteristics of patients diagnosed with colorectal cancer (CRC) in the province of Salamanca over two different periods: 2010-2012 and 2004-2006. METHODS: Retrospective observational study. We include all diagnosed cases of CRC according to histopathological criteria from 01/01/2004 to 31/12/2006 and from 01/01/2010 to 31/12/2012. The studied variables were sex, age, date of diagnosis and tumor location. Cumulative incidence and specific incidence in different age groups were measured and compared between the two periods. The age rates were adjusted to the standard world population so that the results could be compared with those of other populations. RESULTS: We detected 38% more cases of CRC in the 2010-2012 period than in 2004-2006. Variables distribution (sex, age at diagnosis and location) was similar in both groups. More than twice as many colonoscopies were performed in 2010-2012 than in 2004-2006. Population mortality due to CRC also increased, although much less importantly than the incidence of this condition. CONCLUSIONS: There has been a clear increase in CRC incidence in the province of Salamanca from 2004-2006 to 2010-2012 which is not related to the ageing of the population. The remarkable increase in colonoscopies may have been an important factor for the increased detection.

Perivascular epithelioid cell tumor of the ileum. A case report.

Perivascular epithelioid cell tumors (PEComa) are tumors of perivascular epithelioid cells with immunohistochemical features of smooth muscle and melanocytic tumors. The PEComa of the gastrointestinal tract is rare. The treatment is surgical, although there are data that suggest a good response to rapamycin.

Hemorragia digestiva secundaria a enteritis por herpes virus en paciente inmunodeprimido / Gastrointestinal bleeding secondary to enteritis due to herpes virus in an immunosuppressed man

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