Editor-in-Chief, Deputy Editor 2017-2019

 

Editor-in-Chief:

Tom MOREELS

 

Deputy Editor:

Nicolas LANTHIER

 

Letters



A rare complication of Henoch-Schönlein Syndrome : gastrointestinal infarction and perforation


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We want to report an intestinal perforation with intestinal ischemia as a result of fatal complication of Henoch-Schönlein purpura (HSP). A 39 year old male patient was admitted with 5 days history of abdominal pain, melena and vomiting. Abdominal pain was severe and colicky with vomiting. The patient had respiratory tract infection 2 weeks before admission. He had also edema and pain in both ankles a week before admission. On the next day of admission petechial rashes emerged on posterior of both legs and in front of each tibias. Biopsy samples from rashes were taken. Meanwhile, abdominal, knee and ankle pain worsened. The first laboratory tests revealed the following results : white blood cells 20.4 × 1000/dl, haemoglobin 10.2 gr/dl, thrombocytes count 83 × 1000/L. Abdominal examination disclosed diffuse tenderness and rebound tenderness. There was severe distension in the abdomen with reduced bowel sounds. [Product Details...]



A rare complication of Percutaneous Endoscopic Gastrojejunostomy (PEG-J) : duodenal bulb perforation due to retrograde migration


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Jejenum delivery of enteral nutrition with percutaneous endoscopic gastrojejunostomy (PEG-J) is necessary for the patients who are complicated by gastro paresis, gastro - esophageal reflux, gastric resection, pancreatitis, severe aspiration risk, or gastric feeding intolerance (1). We present here a patient with esophagomediastinal fistula, whose nutritional support was maintained through a PEG-J tube which caused a rare complication. Sixty-three years old male patient who presented with shortness of breath, cough, dysphagia and aspiration was diagnosed lung cancer and esophagomediastinal fistula. He was hospitalized in our clinic in order to establish percutaneous enteral access for nutritional support. The patient was cachectic and had bilateral inspiratory rales on bases of lungs. [Product Details...]



Combined endoscopic sphincterotomy and trans-catheter arterial embolization for the treatment and prevention of acute pancreatitis induced by hemobilia from hepatocellular carcinoma


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Here, we report a case of hepatocellular carcinoma (HCC) with bile duct invasion and acute pancreatitis. The patient was successfully treated by endoscopic sphincterotomy (ES) and bile duct lavage for hemobilia. Trans-catheter arterial embolization (TAE) was performed to stop tumor bleeding and recurrent pancreatitis did not occur anymore during the following 7 years. [Product Details...]



Dilation of a severe biliary stricture by using a guidewire left in place overnight


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Endoscopic placement of a biliary stent is frequently used in the treatment and palliation of benign and malignant biliary strictures. Dilation of fibrous and tight stenosis with either a balloon or bougie facilitates stent insertion. There is a group of patients in which tight stricture permit passage of only a small caliber guidewire and attempts to dilate with conventional dilators in order to place a stent or nasobiliary drain fail. Using a Soehendra stent retriver or small-caliber angioplasty balloon for dilation and percutaneous or surgical management of the stricture are rescue treatment methods in these patients (1-4). Herein we report the use of a guidewire traversing the stricture and left in place for 24 hours as a dilator in two patients with a severe biliary stricture not traversable by conventional dilators which could be of interest to interventional endoscopists. [Product Details...]



Synchronous hepatocellular carcinoma and sigmoid colon metastasis presenting as liver and intra-abdominal abscesses


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Hepatocellular carcinoma (HCC) is a common malignant tumor. The reported incidence of clinical HCC with GI tract invasion is 0.5-2% (1), and direct invasion to the colon is extremely rare (2). Extrahepatic metastasis to the distal sigmoid colon has never been reported before and HCC presenting as a liver abscess is also rare (3). Here, we report an extremely rare case of HCC with metastasis to the distal sigmoid colon, which initially presented as liver and intra-abdominal abscesses. [Product Details...]


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