Clinical Image

1. Clinical Image A 54-year-old woman with history of cholangiocarcinoma with treatment consisting in endoscopic biliary stents implantation and six month of chemotherapy, was referred to the emergency department for fever and shivers started 7 days earlier. On physical examination, she presented a significant pain in the abdominal right upper quadrant, tachycardia, and hypotension. Blood …

An Unexpected Complication of Cholecystitis Read More »

1. Abstract 1.1. Introduction: Anastomotic leakage in colorectal resection and primary anastomosis is a common and feared complication. Fully Covered Self Expandable Metal Stents (FCSEMS) have been used for treatment of anastomotic leakage. It is still unknown if FCSEMS affect anastomosis healing negatively by causing ischemia. In an animal study we investigated the metabolic effects …

Fully Covered Self-Expandable Metal Stent Placed Over a Colon Anastomosis in an Animal Model – A Pilot Study of Colon-Metabolism Over the Stent Read More »

Clinical Image A 52-year-old man with schizophrenia was admitted owing to symptoms of bleeding at the lumen of the upper part of the gastrointestinal tract. Emergency gastroscopy revealed a large penetrating ulcer on the anterior gastric wall, with symptoms of previous bleeding. Intensive conservative treatment was performed. During control gastroscopy three days later, a gastroscope …

An Uncommon Complication of Peptic Ulcer Disease Read More »

1. Abstract Meckel’s diverticulum is a common malformation of the gastrointestinal tract. Technetium-99m (99mTc) pertechnetate planar scintigraphy is the procedure of choice to localize ectopic gastric mucosa. On the other hand, single photon emission computed tomography/computed tomography (SPECT/CT) imaging comes up with more precise landmarks and scintigraphic findings. We present a case where SPECT/CT provided …

The Clinical Utility of SPECT/CT Hybrid Imaging on Bleeding Meckel’s Diverticulum in Adults: A Case Report Read More »

1. Abstract Intraductal papillary neoplasia of the bile ducts (IPN-B) is a rare intracanal tumor characterized by papillary proliferation of the biliary epithelium responsible for more or less abundant production of mucus, causing dilation of the duct [1]. IPN-B is the “biliary” equivalent of TIPMP. MRI cholangiography and transcutaneous abdominal ultrasound are the best examinations …

Resection of Fourth Segment of Liver as a Cause of Hepatoblastoma in A 8 Month- Old-Boy Read More »

1. Clinical Case Postoperative complications can occur. Most of them are frequent and we are used to dealing with them, but there are others that seem to appear only in a few posts, and when they happen to your patient you cannot explain why.

1. Clinical Image A 71-year-old man presented to the emergency department with a seven-day history of intermittent fever, middle and right upper abdominal pain, and general malaise. The physical examination of the abdomen was normal. Ten years ago he underwent open cholecystectomy and stone removal from common bile duct by endoscopic retrograde cholangiopancreatography (ERCP). At …

Pneumobilia Read More »

1. Clinical Image A 61-year-old man presented with iron-deficiency anemia (hemoglobin, 8.1 g/dl). He had been taking warfarin and low-dose aspirin for atrial fibrillation and post mitral valve replacement. He had also taken 15 mg lansoprazole daily for 6 years for treatment of gastroesophageal reflux disease. Serum anti-Helicobacter pylori IgG antibody and H. pylori testing …

Concurrent Gastric Hyperplastic and Fundic Gland Polyps in a Patient Taking Proton-Pump Inhibitor Read More »

1. Clinical Image Synchronous cancers are characterized by the simultaneous occurrence of multiple primary tumors in the same patient. Synchronous malignancies most commonly occur in the colon, with a high prevalence in elderly patients [1,2]. The occurrence of synchronous colorectal cancers is extremely rare and may be identified at any location within the large intestine …

Synchronous Triple Colorectal Cancer with Intestinal Obstruction in an Elderly Patient: Rare Case of Malignancy of the Large Intestine Read More »

1. Clinical Image We present a 22-month-old girl affected by surgical palliative corrected Tetralogy of Fallot and peculiar facial features characterized by prominent forehead, deep-set eyes, pointed chin and bulbous tip of nose (Figure 1) typical of Alagille Syndrome (AS). Hypoplasia of the distal phalanges of both feet and two butterfly vertebrae at D10-D11 on …

Alagille Syndrome: Not Always Hepatic Involvement Read More »