David Barquero Declara, Alejandro Blasco Pelicano, Alfredo Mata Bilbao
{"title":"Transpancreatic sphincterotomy with double guidewire and pancreatic prothesis after involuntary passage of the guidewire to the pancreas in attempts at biliary cannulation.","authors":"David Barquero Declara, Alejandro Blasco Pelicano, Alfredo Mata Bilbao","doi":"10.17235/reed.2024.10826/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10826/2024","url":null,"abstract":"<p><p>In this work we review the approach to difficult cannulation situations during ERCP. Among the known options to solve this problem, we suggest a technical variant that we believe can be useful to successfully complete ERCP with complication rates similar to a conventional ERCP, at least in our experience. To do this, we reviewed 1488 ERCPs and the 23 cases in which we applied this technical variant with its results and complications.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between ulcerative colitis and acute appendicitis - A Mendelian randomization study.","authors":"Sangsang Chen, Zhebin Dong, Hanting Xiang, Chao Liang","doi":"10.17235/reed.2024.10818/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10818/2024","url":null,"abstract":"<p><p>Although the etiology of UC is not clear, some studies show that the appendix may be the starting point of UC, and the incidence of appendicitis is high in patients with UC. We performed a MR analysis to examine whether there is a potential causal relationship between UC and acute appendicitis. Our MR study revealed that the genetic liability of UC (OR, 0.9362; 95% CI 0.9014 - 0.9723; p = 0.00064) was associated with a decreased risk of acute appendicitis. More research is needed in the future to support our findings and better explain why UC reduces the risk of acute appendicitis.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Agustín Albillos Martínez, Julia López Cardona, Javier Crespo García, Fernando Carballo Álvarez
{"title":"Population screening for colorectal cancer in Spain - A public health success with remaining challenges.","authors":"Agustín Albillos Martínez, Julia López Cardona, Javier Crespo García, Fernando Carballo Álvarez","doi":"10.17235/reed.2024.10774/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10774/2024","url":null,"abstract":"<p><p>The development of organized colorectal cancer screening programs in developed countries has led to a reduction in the incidence and mortality of this cancer. The implementation of the national screening program in Spain represents a major achievement in public health, aligning us with other European countries, but it still faces ongoing challenges. One of the main issues is the low participation rate of the eligible population, averaging 45%, with significant variation between autonomous communities. This requires allocating specific resources to overcome barriers that hinder participation. Another key aspect to improving the screening program is extending the screening age up to 74 years, in line with the recommendations of the European Union, as many member states are already doing.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Needle knife assisted removal of the displaced metal stent.","authors":"Sen Liu, Lun Zhang, Shunchao Wang, Zhen Li, Jingzeng Pan, Peng Zhang","doi":"10.17235/reed.2024.10781/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10781/2024","url":null,"abstract":"<p><p>The removal of a metal stent with proximal displacement was challenging. We present a case where a needle knife was used to incise the duodenal papilla to remove the displaced metal stent.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sónia Barros, Luís Miguel Relvas, Isabel Malta Carvalho, Ana Margarida Vaz, Rita Ornelas, Bruno Peixe
{"title":"Cat scratch colon and cecal barotrauma perforation during colonoscopy with CO2 insufflation.","authors":"Sónia Barros, Luís Miguel Relvas, Isabel Malta Carvalho, Ana Margarida Vaz, Rita Ornelas, Bruno Peixe","doi":"10.17235/reed.2024.10777/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10777/2024","url":null,"abstract":"<p><strong>Background: </strong>Cecal perforation from barotrauma is a rare complication of colonoscopy, even with the use of CO₂ insufflation, which is generally preferred over room air due to its rapid absorption and reduced patient discomfort.</p><p><strong>Case report: </strong>A 64-year-old woman with hypertension and dyslipidemia underwent a routine colonoscopy with CO₂ insufflation. Multiple diverticula were noted, and upon reaching the cecum, several parallel linear lesions with spontaneous bleeding, consistent with \"cat scratch\" colon, were observed. Hemostasis was achieved with 10 endoscopic clips. A subsequent CT scan revealed pneumoperitoneum and the clips in the cecum. The patient was managed conservatively with bowel rest and intravenous antibiotics, showing a favorable clinical course and was discharged on the fifth day.</p><p><strong>Discussion: </strong>This case highlights the potential for cecal perforation due to barotrauma even with CO₂ insufflation during colonoscopy, emphasizing the need for awareness and prompt management of such complications.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shubei Chen, Qiang Geng, Ying Lin, Yong Ye, Qing Yang
{"title":"Gastroscopic treatment of acute gastric variceal rupture through the right lateral position.","authors":"Shubei Chen, Qiang Geng, Ying Lin, Yong Ye, Qing Yang","doi":"10.17235/reed.2024.10797/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10797/2024","url":null,"abstract":"<p><p>Acute variceal bleeding is a life-threatening condition and a common cause of cirrhosis-related death, severe acute bleeding is difficult to treat and has a high mortality rate, drug treatment is often ineffective. We encountered a patient with cirrhosis with ruptured and bleeding gastroscopic varices requiring emergency endoscopic surgical treatment. However, in the routine left lateral position the treatment was interfered with by a fresh blood clot obscuring the gastric fundus. We were able to expose the gastric fundus by turning the patient to the right lateral position and eventually successfully treated the patient. This provides a new idea for the endoscopic treatment of acute gastric varices and may improve the success rate of treatment.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spontaneous esophageal submucosal hematoma.","authors":"Zhen Liu, Jia Feng, Haifeng Jin, Quanhui Chen","doi":"10.17235/reed.2024.10775/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10775/2024","url":null,"abstract":"<p><p>A 57-year-old woman presented to our hospital with chest distension, sore throat and back discomfort beginning the previous day after taking 5 panax notoginseng capsules. She had a history of hypertension for more than 2 years. Physical examination was unremarkable. Blood tests revealed results: A red blood cell count of4.27T/L, a platelet count of 296G/L, a hemoglobin count of 130 g/L (130-175 g/L), and a D-dimer count of0.252 mg/L. Endoscopy showed a longitudinal dark red submucosal hematoma (SH) extending from 20 cm down to 36 cm, with no active bleeding. The next day an enhanced CT of the chest showed uneven thickening of esophageal wall suggestive of intramural esophageal hematoma. A second endoscopy was performed 6 days later, and it showed an esophageal ulcer where the hematoma had been seen at the previous part. The patient was treated with a proton pump inhibitor (PPI) and nutritional support while oral intake was completely prohibited. Her symptoms gradually improved and disappeared. She was discharged one week after the second Upper GI endoscopy when she was able to eat liquid diet. After discharge, she continued the PPI and Kang Fuxin for 2 months. During the 4-month follow up, the symptoms did not recur.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Vieira, Inês Allen Martinho, Ana Catarina Vieira, Alberto Vieira
{"title":"Active biloma and the use of hepatobiliary specific MR contrast agent.","authors":"João Vieira, Inês Allen Martinho, Ana Catarina Vieira, Alberto Vieira","doi":"10.17235/reed.2024.10792/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10792/2024","url":null,"abstract":"<p><p>We present a case of a woman in her 70s, with right upper quadrant pain and jaundice, who underwent laparoscopic cholecystectomy 14 days, previously. The ultrasound and computer tomography scan revealed a fluid lesion in the gallbladder fossa with intrahepatic extension. At this point a wide differential diagnosis was possible. In order to reach a definitive diagnosis, a magnetic resonance imaging exam with a biliary excretion contrast agent - gadoxetate disodium (hepatobiliary specific paramagnetic gadolinium-based contrast) was obtained, which showed a lesion with delayed, but important contrast enhancement, 4 hours after contrast injection, demonstrating leaking of bile reaching the final diagnosis of biloma. Our patient was successfully treated with ultrasound-guided percutaneous drainage.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ulcerative colitis complicating pneumomediastinum, subcutaneous emphysema and pneumothorax.","authors":"Maki Setake, Ryosaku Tomiyama, Tomoya Kuda, Kanetaka Maeshiro, Akira Hokama","doi":"10.17235/reed.2024.10795/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10795/2024","url":null,"abstract":"<p><p>A 17-year-old man with ulcerative colitis (UC) presented to our hospital with neck pain and fever after vomiting. On examination, a snowflake sensation was noted in the neck. A chest radiograph showed extensive subcutaneous emphysema in the chest. CT scans showed extensive subcutaneous emphysema in the neck, shoulders and axilla, as well as pneumomediastinum and pneumothorax. A diagnosis of pneumomediastinum with exacerbation of UC was made, and he was fasted and treated with antibiotics. Intensive granulocyte and monocyte adsorption apheresis (GMA) was started for exacerbation of UC. His symptoms and the radiological findings of pneumomediastinum improved. He remained in remission on azathioprine. UC is a chronic inflammatory bowel disease (IBD) associated with extraintestinal manifestations (EIM). Very few cases have been complicated by pneumomediastinum. The increase in alveolar pressure due to vomiting and systemic inflammation-related pleural or esophageal damage may cause pneumomediastinum in this case. Prevention of progression to mediastinitis and treatment of exacerbated UC are contradictory. GMA was successful because it was not an immunosuppressive therapy. Our case highlights that rare EIM may complicate exacerbation of UC.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Carlos Gonçalves, Joana Magalhães, Maria João Moreira, José Cotter
{"title":"Jejunal Dieulafoy's lesion - An exceptionally rare and challenging culprit of gastrointestinal bleeding.","authors":"João Carlos Gonçalves, Joana Magalhães, Maria João Moreira, José Cotter","doi":"10.17235/reed.2024.10785/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10785/2024","url":null,"abstract":"<p><p>A 78-year-old male presented to the emergency department with melena. He was hemodynamically stable but displayed a hemoglobin level of 5.8g/dL necessitating blood transfusion. Initial esophagogastroduodenoscopy and colonoscopy failed to identify a bleeding source, prompting a capsule endoscopy that revealed an active bleeding site in the jejunum. A single-balloon enteroscopy identified an aberrant vessel in the mid-jejunum protruding through a 3mm mucosal defect, devoid of surrounding inflammation, consistent with a Dieulafoy's lesion, in which two through-the-scope clips were applied. Despite this, ongoing melena and decreasing hemoglobin levels in the subsequent days led to a second single-balloon enteroscopy, which confirmed continued bleeding. Definitive hemostasis was achieved through diluted adrenaline injection, four additional through-the-scope clips, and polidocanol sclerotherapy. Jejunal Dieulafoy's lesion is extremely rare and presents notable diagnostic and therapeutic challenges. Ávila et al. recently reported a case where, despite capsule endoscopy identifying the bleeding site, single-balloon enteroscopy failed to confirm the diagnosis, leading to the use of motorized enteroscopy with argon and metallic clip treatment. Similarly, our experience highlights the diagnostic value of capsule endoscopy and the crucial role of device-assisted enteroscopy in a multimodal therapeutic approach, which was essential for achieving successful hemostasis.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}