Prevalencia y patrón de consumo de alcohol en pacientes con carcinoma hepatocelular / Prevalence and pattern of alcohol consumption in patients with hepatocellular carcinoma

Objetivo Estudio transversal prospectivo realizado para conocer la prevalencia y el patrón de consumo de alcohol (CA) de los pacientes con carcinoma hepatocelular (CHC) y evaluar la utilidad del AUDIT en estos. Métodos Se incluyeron 102 pacientes consecutivos atendidos en consulta entre febrero y marzo de 2022; se excluyeron aquellos con encefalopatía hepática en el momento de la entrevista, pacientes en lista de espera para trasplante por esta indicación y aquellos en seguimiento postrasplante. Resultados La prevalencia del CA en pacientes con diagnóstico de CHC es del 35%, si bien menos del 10% consume más de 100g de etanol a la semana. El CA fue más frecuente en varones, ambiente urbano, con diagnóstico de CHC hace más de un año y en pacientes en estadio inicial/muy inicial del BCLC. La puntuación AUDIT mayor o igual a 3 (AUROC 0,849) predice cualquier CA con una sensibilidad del 75% (IC 95%: 59,47-90,53%) y con una especificidad del 84% (IC 95%: 74,70-94,05%). Conclusiones A pesar del diagnóstico de CHC, más de un tercio de los pacientes consume alcohol. La puntuación AUDIT igual o mayor de 3 discrimina cualquier CA con una sensibilidad del 75% y una especificidad del 84% en esta población (AU)

Aim Prospective cross-sectional study conducted to determine the prevalence and pattern of alcohol consumption (AC) in patients with hepatocellular carcinoma (HCC) and to assess the utility of the AUDIT in HCC patients. Methods One hundred and two consecutive patients form our HCC monographic outpatient clinic visited between February and March 2022 were included. Patients with hepatic encephalopathy at the time of the interview, on the waiting list for liver transplantation and those undergoing post-transplant follow-up were excluded. Results The prevalence of AC in patients diagnosed with HCC is 35%, although less than 10% consume more than 100g per week. AC was more frequent in males, in an urban environment, with a diagnosis of HCC more than a year ago, and in patients in early/very early stages of BCLC. AUDIT score greater than or equal to 3 (AUROC 0.849) predicts any AC with a sensitivity of 75% (95% CI: 59.47-90.53%) and a specificity of 84% (95% CI: 74.70-94.05%). Conclusions Despite the diagnosis of HCC, more than a third of the patients consume alcohol. An AUDIT score equal to or greater than 3 discriminates any AC with a sensitivity of 75% and a specificity of 84% in this population (AU)

[Prevalence and pattern of alcohol consumption in patients with hepatocellular carcinoma]. / Prevalencia y patrón de consumo de alcohol en pacientes con carcinoma hepatocelular.

AIM: Prospective cross-sectional study conducted to determine the prevalence and pattern of alcohol consumption (AC) in patients with hepatocellular carcinoma (HCC) and to assess the utility of the AUDIT in HCC patients. METHODS: One hundred and two consecutive patients form our HCC monographic outpatient clinic visited between February and March 2022 were included. Patients with hepatic encephalopathy at the time of the interview, on the waiting list for liver transplantation and those undergoing post-transplant follow-up were excluded. RESULTS: The prevalence of AC in patients diagnosed with HCC is 35%, although less than 10% consume more than 100g per week. AC was more frequent in males, in an urban environment, with a diagnosis of HCC more than a year ago, and in patients in early/very early stages of BCLC. AUDIT score greater than or equal to 3 (AUROC 0.849) predicts any AC with a sensitivity of 75% (95% CI: 59.47-90.53%) and a specificity of 84% (95% CI: 74.70-94.05%). CONCLUSIONS: Despite the diagnosis of HCC, more than a third of the patients consume alcohol. An AUDIT score equal to or greater than 3 discriminates any AC with a sensitivity of 75% and a specificity of 84% in this population.

Upper gastrointestinal bleeding secondary to late gastric metastasis of renal cell carcinoma.

Clear cell renal cell carcinoma is the most common renal neoplasm in adults. It has a relatively slow growth pattern that delays diagnosis until the onset of local, paraneoplastic or metastasis-related manifestations, and an unpredictable behavior ranging from aggressive tumors with poor short-term prognosis to late recurrence cases where metastases are identified years after nephrectomy, the latter scenario being the subject of the case we herein report.

Ethmoidal metastasis as an uncommon presentation and diagnostic form of hepatocellular carcinoma.

Nasopharynx metastases are an extremely rare cause of hepatocarcinoma debut. We report the case of a 71 year old man who presented symptoms of nosebleed and diplopia event, diagnosed by imaging and biopsy of ethmoidal metastasis of hepatocarcinoma.

Diagnosis of biliary papillomatosis with a Spyglass® cholangioscope.

We report the case of a 78-year-old woman with dyspepsia for several years and a history of cholecystectomy, informed by pathology as calculous cholecystopathy, where CT revealed a left-sided intrahepatic bile duct dilation. Cholangio-MRI confirmed a size increase in the distal intrahepatic bile duct on the left side, with T2-hyperintense contents with scarce contrast enhancement, which resulted in the observed dilation. . A Spybite® forceps was used to obtain a biopsy sample, which showed a benign papillary growth compatible with biliary papillomatosis. Biliary papillomatosis or intraductal papillary neoplasm of the biliary tract is a rare, uncommon condition characterized by intraductal papillary growth of the biliary epithelium. It has a tendency towards malignization, hence must be considered a premalignant condition . Major symptoms include jaundice, abdominal pain, and repeat cholangitis, with imaging studies being key for diagnostic suspicion . The development of cholangioscopy with biopsies allows an early diagnosis of malignant precursor lesions of the bile duct, thus allowing early treatment.

Endoscopic submucosal dissection of gastric plexiform fibromyxoma, an alternative to the traditional approach.

We report the case of a 62-year-old woman with no history of interest who presented with dyspepsia of 2 years' standing. Gastroscopy revealed a subepithelial lesion at the greater antral curvature with irregular surface and preserved mucosal and vascular pattern, 15 mm in diameter. Because of clinical persistence a radial endoscopic ultrasonogram (EUS) was performed, which showed a well-delimited hypoechoic lesion with heterogeneous areas that was dependent on the muscularis mucosae layer. A biopsy was obtained using the "bite-on-bite" technique, which provided no pathological findings. With these findings an endoscopic submucosal dissection (ESD) procedure was performed with wide margins and no complications. Pathology found low-grade mesenchymal fusicellular proliferation dependent on the muscularis mucosae with immunohistochemistry positive for smooth-muscle vimentin and actin, consistent with plexiform fibromyxoma.

Capecitabine-induced hyperammonemic encephalopathy.

We report the case of a 79-year-old male who had undergone surgery for a mucus-secreting, stage-III pancreatic adenocarcinoma 2 years previously, who was recently started on capecitabine monotherapy for radiographic local progression. He developed disorientation, asterixis, nausea and elevated serum ammonia (221 µmol/L) 48-72 hours after treatment onset with preserved liver function. After ruling out potential causes of encephalopathy and tumor progression by abdominal and brain CT scans, his symptoms were related by exclusion to the recently initiated treatment with capecitabine. Capecitabine discontinuation, onset of standard anti-encephalopathy measures, and intravenous hydration led to a rapid, complete resolution of symptoms with serum ammonia normalization.

Pancreatitis aguda por bortezomib, una reacción adversa poco frecuente / No disponible

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Eosinophilic enterocolitis: an uncommon cause of chronic diarrhea.

Eosinophilic enterocolitis is a rare entity included in the group of primary eosinophilic gastrointestinal disorders. It is characterized by eosinophilic infiltrate in the absence of other causes of enterocolonic eosinophilia (infection, allergic or drug reaction, inflammatory disease, etc). The most common gastrointestinal manifestations are abdominal pain, diarrhea or malabsorption. The lack of well-defined diagnostic criteria and patchy microscopic involvement make diagnosis difficult. We report the case of a 44-year-old male with chronic diarrhea. After performing multiple studies, he was diagnosed of eosinophilic enterocolitis, with a suitable response to corticosteroids.

Bortezomib-induced acute pancreatitis, an uncommon adverse event.

Acute pancreatitis is one of the main reasons for hospitalization, with an increasing incidence and associated non-negligible morbidity and mortality. Its most common causes are alcohol and gallstones, and medications are a rare cause. The pathogenesis of acute drug pancreatitis is not yet known exactly and the diagnosis is based on the evident temporal relationship, having excluded the rest of the possible known causes of acute pancreatitis. We present the case of a 71-year-old patient diagnosed with IgG multiple myeloma treated with the Daratumumab, Bortezomib and Dexamethasone regimen. After Bortezomib administration, he developed epigastric pain and elevated pancreatic enzymes in the range of acute pancreatitis. After ruling out common causes, the diagnosis of acute pancreatitis caused by Bortezomib was reached, which presents a favorable rapid evolution after its elimination.

Quiste biliar clasificación Todani tipo VI: malformación del cístico como causa infrecuente de dolor abdominal / No disponible

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Encefalopatía de Wernicke en paciente con fístula enterocolónica tardía tras cirugía bariátrica / No disponible

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Todani type VI bile duct cyst: cystic duct malformation as an uncommon cause of abdominal pain.

We report the case of a 62-year-old woman who was admitted for epigastralgia and oral intolerance for 15 days, associating cholestasis in blood tests. A magnetic resonance cholangiography (MRC) revealed the presence of a lobulation continuous with the cystic duct that was consistent with a Todani VI bile duct cyst. The biliary cyst Todani VI is a rare entity within bile duct malformations. The first well-documented case was reported back in 1983, and its inclusion as sixth type in the classification was suggested in 1991. It is an uncommon cause of abdominal pain that we must keep in mind, and the importance of early diagnosis and treatment lies in the condition's oncogenic potential.

Wernicke's encephalopathy in a patient with late-onset enterocolic fistula after bariatric surgery.

Wernicke´s encephalopathy (WE) is an acute neurologic disorder secondary to thiamine deficiency. We report the case of a patient with history of bariatric surgery who develops a late-onset enterocolic fistula, with alcohol consumption associated.