RESUMO
We present an otherwise healthy 27 year-old-man who was admitted to our hospital referring acute abdominal pain, diarrhea, rectorrhagia, heavy vomiting, heartburn, dysphagia, high fever and involuntary weight loss of 12 kg in one week. An acute kidney injury, anemia and lymphopenia of 85 CD4 were observed in his blood work. The patient underwent a colonoscopy that was unremarkable. However, the oesophagogastroduodenoscopy (OGD) showed an oesophageal candidiasis in the upper oesophagus along with multiple confluent circumferential ulcerations in its lower 10 cm. Multiple biopsies were taken from the center and the edge of the ulcerations, revealing the presence of inclusion cell bodies.
Assuntos
Síndrome de Imunodeficiência Adquirida , Candidíase , Infecções por Citomegalovirus , Esofagite , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/complicações , Adulto , Candidíase/complicações , Citomegalovirus , Infecções por Citomegalovirus/complicações , Esofagite/complicações , Infecções por HIV/complicações , Humanos , Masculino , ÚlceraRESUMO
An 80-year-old female with a mechanic mitral valve treated with acenocumarol was admitted to the hospital due to tarry stools over the last two days and hemoglobin levels of 5.6 g/dl. She had not biliary pathology. An emergency esophagogastroduodenoscopy showed lots of fresh clots over the second part of the duodenum that seemed to come from the major papilla. A duodenoscopy was performed in order to obtain a direct view, showing a huge clot near the papilla. Its removal with a polypectomy snare revealed a large duodenum diverticulum with little saculations inside, one of which showed a visible, actively bleeding vessel. Sclerosis with epinephrine was performed and subsequently, two through-the-scope Cook® 11 mm clips were placed, achieving the cessation of the hemorrhage. Several attempts with different clips were needed since they were separated by the elevator nail of the duodenoscope. No complications developed during the procedure or once anticoagulation was restarted.
Assuntos
Divertículo , Trombose , Idoso de 80 Anos ou mais , Divertículo/complicações , Divertículo/diagnóstico por imagem , Duodenoscopia/efeitos adversos , Duodeno , Feminino , Hemorragia Gastrointestinal/terapia , Humanos , Trombose/complicaçõesRESUMO
We present the case of an 81-year-old male with a history of surgically resected colorectal and bladder cancer, who was admitted to our hospital with a urinary infection. A routine renal ultrasound showed a pelvic cyst and a CT scan confirmed a non-complicated cyst, but a lesion was observed in the left lung. He underwent a PET-CT in which an unexpected enhancement of the small bowel attracted our attention.
