Evaluation of a catch-up strategy for the vaccination in patients with hepatitis C virus.

Vaccination in patients with advanced chronic liver disease (ACLD) is an essential part of their comprehensive healthcare. These individuals may have impaired phagocytic function and diminished production of opsonizing antibodies, resulting in increased susceptibility to bacterial infections, particularly pneumococcal pneumonia. Similarly, there is an increased risk of fulminant hepatitis due to hepatitis A and B viruses. The Ministry of Health updated specific vaccination recommendations for this group in 2018.

Upper gastrointestinal bleeding and Rigler triad.

Gallstone ileus is a rare complication of cholelithiasis, characterized by mechanical bowel obstruction due to a biliary calculus originating from a bilioenteric fistula. The Rigler triad, consisting of aerobilia, ectopic gallstone, and intestinal obstruction, is rarely observed in its complete form. We present the case of a 92-year-old male with a history of acute lithiasic cholecystitis who presented to the Emergency department with acute epigastric pain. Initial evaluation revealed gallbladder dilatation, gallstones, and gallbladder wall thickening suggestive of acute cholecystitis. During hospitalization, the patient experienced an episode of hematemesis, leading to the diagnosis of a cholecystoduodenal fistula and a large blood clot in the duodenal bulb. Further imaging showed an ectopic gallstone causing small bowel obstruction. The patient underwent urgent surgery for stone extraction, followed by endoscopic intervention for the bleeding vessel identified at a subsequent gastroscopy. Unfortunately, the patient had a poor postoperative course and passed away seven days later. This case report highlights the exceptional occurrence of both the Rigler triad and upper gastrointestinal bleeding in a patient with gallstone ileus. Surgical intervention is crucial for the initial resolution of intestinal obstruction, followed by cholecystectomy and repair of the bilioenteric fistula. Awareness of these rare presentations is important for timely diagnosis and appropriate management of this uncommon complication of cholelithiasis.

Large bowel obstruction secondary to a simple renal cyst: an exceptional complication.

We report the case of an 81-year-old female with large bowel obstruction secondary to a giant simple renal cyst (16 cm), which was producing a compression of the descending colon against the abdominal wall. Percutaneous drainage of the renal cyst was performed by a urologist. The follow-up CT scan revealed a collapsed cyst with resolution of the bowel obstruction. The patient showed resolution of the symptoms with an improvement in blood test results.

McKittrick-Wheelock syndrome: rectal villous adenoma as a cause of acute renal failure.

We report the case of a 67-year-old male with a history of arterial hypertension and atrial fibrillation, who was admitted for acute renal failure (creatinine: 4.41 mg/dl) and hypotension. He also presented hyponatremia (129 mmol/L) and hypokalemia (2.7 mmol/L). The patient referred profuse diarrhea during the previous two months as a possible triggering cause. Physical examination showed signs of dehydration and palpation of a polypoid mass in the rectal ampulla.

Shock séptico secundario a síndrome de Mirizzi resuelto en 2 tiempos / Septic shock secondary to Mirizzi syndrome resolved in two stages

No disponible

Implementación de la sedación con propofol: utilidad del análisis modal de fallos y efectos. Calidad y seguridad centrada en el paciente / Propofol sedation Quality and safety. Failure mode and effects analysis

No disponible

Propofol sedation Quality and safety. Failure mode and effects analysis.

Sedation is a key component of digestive endoscopy. While ensuring procedural safety and quality represents a primary goal, a detailed assessment of patient-focused risks and improvements is lacking on most occasions. Failure mode and effect analysis (FMEA) is a useful tool in this context as a means of raising barriers and defense mechanisms to prevent adverse events from developing.

Estenosis anastomótica de gastroyeyunostomía derivativa resuelta con endoprótesis tipo yo-yo / Derivative anastomotic gastrojejunostomic stenosis resolved with a yo-yo type stent

No disponible