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A rare case of abdominal tuberculosis with vomiting : letter to the editorPrice: €10,00 |
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A 40-year-old female patient presented with vomiting,
consisting of bile and food consumed the previous night,
approximately 1 hour after each meal. She had experienced
this symptom for 4 months, and the vomiting had
increased in severity during the previous 2 months. The
patient had not experienced abdominal pain, abdominal
distension, jaundice or fever. An oesophago-gastro-duodenoscopy
revealed two distal duodenal ulcers. Biopsies
(Figs. 1 and 2) revealed non-specific inflammation. The
patient was treated with proton pump inhibitors and aluminium
phosphate gel for 2 months, but the vomiting did
not improve. A barium meal (Fig. 3) was then administered,
and a colonoscopy (Fig. 4) was performed despite
the absence of lower gastrointestinal (GI) symptoms. The
barium meal revealed one long stricture in the descending
part of the duodenum, and a colonoscopy revealed
persistent narrowing of the ascending colon and a circumferential
ulcer. In addition, nodular ileitis was noted
in the terminal ileum. A biopsy revealed non-specific
inflammation,
and acid-fast bacilli (AFB) staining was
negative. [Product Details...] |
Abdominal pain and fullness in young patientPrice: €10,00 |
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A 25-year-old man presented with abdominal pain and
fullness within four months. On physical examination he
was afebrile, with a blood pressure of 130/75 mm/Hg, a
pulse of 74 beats per minute. The abdominal physical examination
revealed soft, distended abdomen with left upper
abdominal palpable mass. Blood tests showed the
white-cell count was 11.400 per cubic millimeter (with
normal eosinophils range), the hemoglobin level
16.2 g/dl (reference range : 13.6-17.2 g/dl), the platelet
count 437000 per cubic millimeter, erythrocyte sedimentation
38 mm/h and C-reactive protein 45 mg/L (reference
range : 1.0-3.0 mg/L). Hepatic and renal function
tests were all normal. Testing was negative for hepatitis
B, hepatitis C and human immunodeficiency virus (on
polymerase-chain-reaction assay). An ultrasonographic
examination
of the abdomen showed the vertical size of
liver was 12 cm, mild increase in liver echo density with
no gall stones. Ultrasonography also revealed a giant
well defined, non-multilocular cystic lesion of the spleen
with a size of 165 × 110 mm. [Product Details...] |
Case of a successful liver transplantation from a living donor with focal nodular hyperplasiaPrice: €10,00 |
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The number of patients awaiting liver transplantation
is increasing, whereas the donors are few. Thus, the
donor
pool must be optimized. Due to the increasing
demand
for liver donations, the eligibility criteria have
been reviewed and “extended donor criteria” have been
suggested with the aim of expanding the donor pool.
Generally, applicants with hepatic lesions identified by
using different imaging methods are excluded from the
list. However, mass lesions in the liver should not constitute
a definitive contraindication to donation. Evaluation
as to whether a donor applicant meets the extended donation
criteria is possible via imaging techniques and/or
histopathological assessment. In this article, we present a
case of a successful liver transplantation from a living
donor with a focal nodular hyperplasia (FNH) identified
by imaging techniques. [Product Details...] |
Esophageal and gastric ulceration due to synchronous herpes simplex virus, cytomegalovirus and Epstein-Barr virus infectionPrice: €10,00 |
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The authors report the case of a man of 71 years-old,
with a previous history of type 2 diabetes mellitus, hypertension,
and renal transplantation in 2013 due to chronic
kidney disease. He was under immunosuppression with
prednisolone, mycophenolate mofetil and tacrolimus.
The patient was admitted by worsening of his health status
lasting for one month, with progressive asthenia, anorexia
weight loss, and marked backache with movement
limitation. Analytically he presented with microcytic
anemia de novo (hemoglobin 9.6 g/dL), hypoalbuminemia
and a slight increase of liver tests. Initially a thoraco-
abdominal computerized tomography was performed
and revealed the presence of multiple nodules in the liver
parenchyma, suggestive of metastases. In this context it
was decided to carry out endoscopic work-up for malignancy
screening. The upper endoscopy showed two
superficial
and longitudinal ulcers in the distal esophagus
and in the gastric antrum there were two other larger
ulcers
with regular edges (Figs. 1 and 2). Histological
evaluation revealed the presence of morphological findings
compatible with ulcerated lesions (Fig. 3), with
immunohistochemical
analysis inconclusive for cytomegalovirus
(CMV), while the evaluation by molecular
biology (polymerase chain reaction – PCR) strongly
positive for herpes simplex virus (HSV) type 1, CMV
and Epstein-Barr virus (CMV) synchronous infection.
Later it was performed a colonoscopy that revealed the
presence of a malignant neoplasm in sigmoid colon, confirmed
after histological evaluation. The patient was then
referred for symptomatic treatment. [Product Details...] |
Fecal transplant for Clostridium difficile infection relapses using “pooled” frozen feces from non-related donorsPrice: €10,00 |
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Clostridium difficile infection (CDI) is associated with
high morbidity and mortality (1). About 20-50% of patients
develop relapses after antibiotic treatment (2,4).
Fecal microbiota transplantation (FMT) is an effective,
inexpensive and secure treatment option for these patients
(1,3), even in immunosuppressed patients (5).
Conventional FMT (from fresh or frozen feces) from a
healthy related donor (2), has shown effectiveness in
approximately
90% of CDI relapses (1,3,4). [Product Details...] |
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Acta Gastro-Enterologica Belgica is indexed in NCBI/PubMed.
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica