Pancreatic encephalopathy, a little known complication of acute pancreatitis.

A 62-year-old male presented with severe post-endoscopic retrograde cholangiopancreatography (post-ERCP) acute pancreatitis. He required admission to the Intensive Care Unit (ICU) twice due to respiratory and renal failure and neurological deterioration. On the hospitalization ward, he presented a fluctuating alteration of the level of consciousness, with bradypsychia, disorientation and somnolence, which persisted after hemodynamic, metabolic and renal stabilization. A brain magnetic resonance imaging (MRI) was performed showing focal lesions due to small vessel disease, some with cavitations due to necrosis, and mild to moderate subcortical atrophy. A diagnosis of pancreatic encephalopathy was made given the clinical and radiological findings. The patient recovered full cognitive capacity after one week with adequate nutrition supported by protein supplementation.

Hipertensión portal e ictericia colestásica como forma de presentación de una amiloidosis sistémica / Portal hypertension and cholestatic jaundice as a form of presentation of systemic amyloidosis

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Hemofilia A adquirida secundaria al tratamiento con peginterferón α - 2a en un paciente con hepatitis crónica por el virus C / Acquired hemophilia A in a patient with chronic hepatitis C virus infection receiving treatment with peginterferon α - 2a

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Hepatoportal sclerosis clinical different evolutionary stages: presentation of 3 cases and literature review.

Hepatoportal sclerosis (HPS) is characterized by presinusoidal intrahepatic portal hypertension associated with splenomegaly and anemia in patients with non-cirrhotic liver. Liver biopsy is essential, especially to rule out other processes. Being a disease of unknown etiology, the majority of cases have been described in eastern countries. However, it may be an underdiagnosed disease in the West. Symptoms are related to portal hypertension and the clinical spectrum is wide, ranging from anemia with normal liver function tests to bleeding due to esophageal varices. Treatment is directed to the complications and the prognosis is better than in patients with cirrhosis.We report three cases of HPS presenting at different clinical stages and the findings of liver biopsies, the clinical outcomes and a review of scientific literature.

Esclerosis hepatoportal en estadios clínicos evolutivos diferentes: presentación de 3 casos y revisión de la literatura / Hepatoportal sclerosis clinical different evolutionary stages: presentation of 3 cases and literature review

La esclerosis hepatoportal se caracteriza por hipertensión portal intrahepática presinusoidal asociada a esplenomegalia y anemia en pacientes con un hígado no cirrótico. La biopsia hepática es fundamental, sobre todo para descartar otros procesos. Se trata de un cuadro de etiología desconocida cuya gran mayoría de los casos se ha descrito en países orientales, si bien podría estar infradiagnosticada en Occidente. Se manifiesta con síntomas asociados a la hipertensión portal y el espectro clínico es muy amplio: desde anemia con pruebas de función hepática normales hasta hemorragia por varices esofagogástricas. Su tratamiento es el de las complicaciones y el pronóstico es mejor que en los pacientes con cirrosis. Presentamos tres casos de EHP que presentan estadios clínicos diferentes, así como los hallazgos de las biopsias hepáticas, su evolución clínica posterior y una revisión de la literatura científica(AU)

Hepatoportal sclerosis (HPS) is characterized by presinusoidal intrahepatic portal hypertension associated with splenomegaly and anemia in patients with non-cirrhotic liver. Liver biopsy is essential, especially to rule out other processes. Being a disease of unknown etiology, the majority of cases have been described in eastern countries. However, it may be an underdiagnosed disease in the West. Symptoms are related to portal hypertension and the clinical spectrum is wide, ranging from anemia with normal liver function tests to bleeding due to esophageal varices. Treatment is directed to the complications and the prognosis is better than in patients with cirrhosis. We report three cases of HPS presenting at different clinical stages and the findings of liver biopsies, the clinical outcomes and a review of scientific literature(AU)