Editor-in-Chief & Deputy Editor 2019-2021





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Clinical images

A rare cause of rectal bleeding

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A 65 year-old-woman with a prior history of diabetes mellitus, heart failure and atrial fibrillation, was referred to our endoscopy unit because of rectal bleeding. Digital examination of the rectum revealed a firm, nonobstructing mass near the anal verge. Rectosigmoidoscopy showed a 3cm, blackish mass which is located next to internal hemorrhoids, and just above the dentate line (Figure 1). Biopsy of the mass lesion was performed. Bleeding after biopsy procedure was controlled by argon plasma coagulation therapy. What is your diagnosis? [Product Details...]

An uncommon cause of overt small bowel bleeding

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Question An 84-year-old man with atrial fibrillation under Dabigatran and surgically-resected colorectal neoplasia was admitted with 1-day hematochezia with hemodynamic stability. His past medical history was relevant for intermittent hematochezia episodes over several months with inconclusive conventional endoscopic study. Laboratory analysis revealed severe iron-deficiency anemia (Hg-5.4 (N:13-17g/dL)), aPTT 54.8 (N:25-34seconds) and INR 1.56. Upper and lower gastrointestinal endoscopy were non-diagnostic. A small bowel capsule endoscopy was performed showing a subepithelial lesion at the proximal jejunum (Fig. 1A). Subsequent antegrade double-balloon enteroscopy confirmed the presence of a caterpillar-shaped subepithelial lesion at the proximal jejunum with 20mm in diameter (Fig. 1B), which was tattooed with SPOT® (GI Supply, Camphill, PA, USA). What is the diagnosis and how it should be managed? [Product Details...]

Beyond colonic neoplasia

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Question An 81-year-old woman with hypertension and type 2 diabetes was admitted to the emergency department complaining of 2-months abdominal pain without fever, weight loss or abdominal trauma. Physical examination revealed a large palpable mass at the right iliac fossa. Laboratory parameters showed microcytic normochromic anaemia (haemoglobin:10.1g/dL) with normal white blood cell count (8.9x109/L) and C-reactive protein (0.49; Normed with an intense cecum deformation with mucosal congestion (Figure 1-C). What is the diagnosis and how it should be managed? [Product Details...]

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