Revista Española de Enfermedades Digestivas

Vaccination in patients with advanced chronic liver disease (ACLD) is an essential part of their comprehensive healthcare. These individuals may have impaired phagocytic function and diminished production of opsonizing antibodies, resulting in increased susceptibility to bacterial infections, particularly pneumococcal pneumonia. Similarly, there is an increased risk of fulminant hepatitis due to hepatitis A and B viruses. The Ministry of Health updated specific vaccination recommendations for this group in 2018...

Patients with ulcerative colitis are at increased risk for colorectal neoplasia compared to the general population. The risk factors include family history of colorectal cancer, wide extent of colitis, disease duration, cumulative inflammatory burden, and primary sclerosing cholangitis. Here, we report a case of colorectal neoplasia developed in a patient with ulcerative colitis.

A 58-year-old woman was found to have a submucosal bulging lesion in the anterior wall of the gastric fundus during a screening esophagogastroscopy. Endosonographic evaluation revealed it to be a 3.1×2.5cm, hypoechoic mass originating from muscularis propria (MP). Endoscopic full-thickness resection (EFR) was attempted. After submucosal injection, a four-fifth circumferential mucosal incision was made around the lesion. Submucosal dissection was performed to unroof the overlying mucosa, which was preserved via the remaining one-fifth circumferential mucosal edge...

A previously healthy 39-year-old woman was hospitalized with upper abdominal pain for 1-month duration. A semipedunculated protrusion with smooth surface was found at the gastric angle measuring 2.0 × 2.5-cm by gastroscopy. Endoscopic ultrasound (EUS) showed a hypoechoic mass originated from the mucosal layer. Abdominal computed tomography (CT) revealed a circular pedunculated and slightly low-density mass with mild enhancement in the stomach cavity. Endoscopic submucosal dissection (ESD) was performed...

I read with great interest the letter by Calderón et al., who clearly described effectiveness of hyperbaric oxygen therapy (HBOT) for refractory ischemic ulcer at the ileorectal anastomosis in Crohn's disease (CD). I congratulate them on their efforts in achieving a favorable long-term outcome. I would like to share my experience of HBOT for perianal CD (PCD). In addition, I discuss recent trials of HBOT for PCD.

We present the case of a patient with smoking, alcoholism, cirrhosis and HIV who was endoscopically diagnosed with esophageal candidiasis due to an episode of dysphagia. After treatment with antifungals and PPIs, the patient remained asymptomatic for almost 3 years. He presented an event of food impaction that was resolved by an upper endoscopy in which an esophageal stenosis and multiple esophageal pseudodiverticulosis were visualized. The biopsies only showed chronic nonspecific esophagitis. The stenosis was dilated with a balloon and PPIs were continued, with good response...

A 69-year-old male, three years post-endovascular exclusion for an abdominal aortic aneurysm, presented with asthenia and fever. An abdominal CT scan showed no gastrointestinal tract communications, abscess, or contrast extravasation. Tc-99m-HMPAO-labeled leukocytes scintigraphy with SPECT/CT revealed increased uptake on the posterior surface of the aortic graft, along with air bubbles in its right iliac limb. Upper gastrointestinal endoscopy was performed, revealing a duodenal ulcer in the transition between the second and third portions...

Brunner's gland hyperplasia or Brunneroma is a rare benign proliferative lesion of the small intestine. It is often incidentally discovered during endoscopy or imaging studies. The endoscopic presentation can be nodular, polypoid, or a diffuse glandular proliferation with thickening of the duodenal wall, which can be mistaken for malignant neoplasia. It rarely causes gastrointestinal bleeding. Is presented a case of a 25-year-old man who presented with melena and anemia secondary to Brunner's gland hyperplasia...

The increasing number of endoscopic explorations help recognize rare lesions of the gastrointestinal tract, such as lymphangiomas, rare benign vascular tumours in adults. Patients with lymphangioma are generally asymptomatic but if complications arise, the approach is endoscopic or surgical. Endoscopic ultrasound aids in distinguishing this tumour from other subepithelial lesions. We present the case of a patient who underwent upper endoscopy and endoscopic ultrasound with findings of two duodenal lymphangiomas...

A 77-year-old male patient with heart disease, kidney disease under study, and quiescent multiple myeloma. He presented a 2 years history of weight loss and digestive symptoms. In the endoscopic study, multiple gastric ulcers were observed, whose histological study ruled out the initial suspicion. The patient died a month later from refractory shock.

Syphilitic proctitis is a rare sexually transmitted disease caused by spirochete pallidum infecting the rectal mucosa. It usually has no specific clinical manifestations and is easily misdiagnosed with other rectal and anal diseases such as rectal cancer, malignant lymphoma, inflammatory bowel disease, etc.. Therefore, diagnosis of the disease is difficult and treatment options are often unreasonable. A case of syphilitic proctitis in our hospital with "rectal mass" as the main manifestation is reported as follows and relevant literature is reviewed...

Removal of common bile duct stones in patients with a previous cholecystectomy was one of the first indications for ERCP with biliary sphincterotomy. Thanks to a minimally invasive procedure, patients were prevented from having a new operation. Subsequently, as the technique proved to be successful, ERCP was extended to all patients with choledocholithiasis, regardless of whether or not they had gallbladder. Also contributing was the fact that, at least in the beginnings, surgical interventions on the bile duct with laparoscopic cholecystectomy were more difficult...

Neurogastroenterology and Motility is a subspecialty of Gastroenterology dedicated to the management of gastrointestinal (GI) motor diseases and disorders of gut- brain interaction (DGBI). Both types of conditions may impair the nutritional status of the patients. In the case of motility disorders, because a deficient gastrointestinal motility may impair the correct digestion and absorption of foods. In DGBI because development of gastrointestinal symptoms may impair the correct nutrition of the patient. In both cases, different studies have shown that patients start restrictive diets by their own, without supervision of a dietician, leading to nutritional deficits in many cases...

Esophageal stents have become an emergent, effective treatment for esophageal perforation, whether spontaneous or iatrogenic. We report a case of iatrogenic perforation secondary to malposition of a Sengstaken-Blakemore balloon (SBB), which was inserted to control acute variceal bleeding. SBB currently has very limited indications in the management of variceal bleeding given the ongoing advances in endoscopic techniques, and its use is not exempt from complications such as the one reported herein.

NF1 is an autosomal dominant hereditary disease, with a prevalence of at least 1 in 4000-5000 population. The diagnosis criteria of NF1 included typical manifestations such as café-au-lait spots, frecking in the axilla or inguinal region, multiple neurofibromas, Lisch nodeules, and distinctive osseous lesions. Genetic testing shows NF1 mutation. It is essential for tumor surveillance in NF1 patients because their life expectancy is about 54 years due to malignancy. A case of NF-1 patient receive laparoscopic small bowel resection and finally diagnosed as adenocarcinoma and ganglioneuroma...

We have read the letter from García-Cano et al. regarding our Editorial and are very grateful for the response as it contributes to deepening the debate we aim to generate on the topic. We are aware that changing a paradigm is always difficult, takes years, and requires publication of good quality studies. However, the way to progress in medicine and provide the best for patients involves questioning existing paradigms and considering the possibility of changing them. Currently, the outcomes of endoscopic ultrasonography guided transmural biliary drainage (EUS-TBD) have been progressively improving and the rate of adverse events (AE) has considerably decreased...

Inflammatory bowel disease (IBD) diagnosis requires clinical, laboratory, endoscopic and histologic findings, and sometimes it can become a challenge. An exhaustive differential diagnosis with infectious disease, immunodeficiencies, hematologic, neoplastic, or vascular diseases must be made1, since prognosis and treatment vary depending on etiology. We present the case of a 62-year-old man, with no personal history of interest, who undergoes a colonoscopy after a positive colorectal cancer screening test (fecal occult blood test)...

no abstract.

Ectopic pancreas (EP) is defined as pancreatic tissue that lacks anatomical or vascular connections to the normal pancreas. EP is generally asymptomatic and is detected incidentally during endoscopy. However, due to pseudocyst formation, inflammation, or malignant transformation, it may cause non-specific gastrointestinal symptoms, such as abdominal pain, abdominal discomfort, nausea, vomiting, and bleeding. Pseudocyst formation in EP may result from the retention of exocrine secretions in the absence of connections between the glandular epithelium and gastric lumen...

A 7-year-old girl, coming from a rural area in Cameroon, presented to the emergency department with a 3-months history of abdominal pain. Her family also reported vomiting and minimal food intake for two weeks. Physical examination showed a palpable and mobile abdominal mass. An ultrasound showed a large intrabdominal multicystic lesion of about 10cm, close to the intestine and with no solid lesions in other organs. A laparotomy was scheduled and a mobile mass dependent on the jejunum was found. The mass caused an intestinal obstruction and was composed of several large cysts with whitish fluid...