Revista Espanola De Enfermedades Digestivas最新文献

{"title":"Peptic perforation due to Candida spp.","authors":"Silvia Fernández Noël, Julia Gutiérrez de Prado, Óscar Caso Maestro, Carmelo Loinaz Segurola, Iago Justo Alonso","doi":"10.17235/reed.2025.11095/2025","DOIUrl":"https://doi.org/10.17235/reed.2025.11095/2025","url":null,"abstract":"<p><p>The incidence of peptic perforation has not decreased despite the successful management of Helicobacter pylori (HP), suggesting other mechanisms are involved in the pathological process. Our findings support the relevance of Candida spp. in these types of perforations. These findings provide insight into the management of peptic perforations complicated by fungal infections and highlight the importance of routinely performing peritoneal culture and biopsies in these patients. We propose that Candida coinfection be considered an independent risk factor in the mortality of patients with peritonitis, as shown by other studies.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450096","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":"Atypical hemolytic uremic syndrome triggered by acute pancreatitis.","authors":"Qing Yang, Qiang Geng, Shubei Chen, Ying Lin, Yong Ye","doi":"10.17235/reed.2025.11114/2025","DOIUrl":"https://doi.org/10.17235/reed.2025.11114/2025","url":null,"abstract":"<p><p>The clinical manifestations of atypical hemolytic uremic syndrome （aHUS） are hemolytic anemia, thrombocytopenia, and acute kidney injury. It is one of the Thrombotic microangiopathy (TMA), with triggers for activation of the complement bypass pathway, such as infection and pregnancy, present in 70-80% of patients. Treatment for this disease requires plasma exchange or eculizumab, we encountered a patient with aHUS induced by gallstone-pancreatitis, after the initial plasma exchange, the patient's condition was improved, but the subsequent incomplete treatment eventually led to severe sequelae. In a word, early, correct and adequate treatment is critical to the prognosis of these patients.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449974","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":"Visceral adiposity index as a key predictor of severity in acute pancreatitis - A large-scale retrospective cohort study.","authors":"Tingting Wang, Fei Cao, Jiajun He, Lei Zhu, Xiaoxi Yang, Shuli Ma, Quping Zhu, Yuanhao Li, Chuting Yang, Jun Liu, Chaowu Chen, Chen Weiwei","doi":"10.17235/reed.2025.10864/2024","DOIUrl":"https://doi.org/10.17235/reed.2025.10864/2024","url":null,"abstract":"<p><strong>Background and aims: </strong>Visceral adipose tissue has been indicated closely connected with the severity of acute pancreatitis (AP). Visceral adiposity index (VAI) is a mathematical model that consists of waist circumference, body mass index, triglyceride and high-density lipoprotein cholesterol, which has been demonstrated to be a better indicator of visceral fat than other traditional indices. This study aimed to evaluate the relationship between VAI and the severity of AP.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a cohort of 1174 patients diagnosed with AP. These patients were categorized into two groups based on their VAI values: the normal VAI (NVAI) group and the elevated VAI (EVAI) group.</p><p><strong>Results: </strong>The EVAI group were much younger, mainly male and had higher incidence of severe acute pancreatitis (SAP) compared with the NVAI group (p < 0.001). The EVAI group developed higher incidences of persistent respiratory failure, acute peripancreatic fluid collection (APFC) and acute necrotic collection (ANC). The VAI level and the percentage of EVAI showed an increasing trend with the severity of AP (p < 0.001). EVAI was the most independent risk factor for persistent respiratory failure (OR = 6.405, 95% CI 2.317-17.705), APFC (OR = 2.093, 95% CI 1.255-3.578) and ANC (OR = 4.910, 95% CI 1.736-13.887).</p><p><strong>Conclusions: </strong>EVAI was strongly related to the severity of AP. It was the most independent risk factor of persistent respiratory failure, APFC and ANC.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450101","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":"Arterio-biliary fistula after TIPS placement: a rare but serious complication.","authors":"Elisa Antolinos Macho, Abel González Huete, Alberto Velasco Hernández, José Montilla","doi":"10.17235/reed.2025.11125/2025","DOIUrl":"https://doi.org/10.17235/reed.2025.11125/2025","url":null,"abstract":"<p><p>A 54-year-old male with cirrhosis and portal hypertension developed recurrent upper GI bleeding after transjugular intrahepatic portosystemic shunt (TIPS) placement. Severe anemia and hypotension ensued, with imaging revealing a hepatic artery pseudoaneurysm and arterio-biliary fistula. Arterio-biliary fistulas, though rare, are serious complications often linked to trauma or iatrogenic injury. This case highlights the importance of early recognition, imaging, and multidisciplinary management in high-risk post-TIPS patients to prevent catastrophic outcomes.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449968","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":"Ileal bile acid transport inhibitors - A new future in treatment of cholestatic diseases.","authors":"Amaia Salinas Uhalte, Ignacio Ros Arnal, Paula Casajús Pelegay, Enrique Medina Benítez, Ruth García Romero","doi":"10.17235/reed.2025.10600/2024","DOIUrl":"https://doi.org/10.17235/reed.2025.10600/2024","url":null,"abstract":"<p><p>We present a 14-year-old male with PFIC1 who required double liver transplant at five years old. Subsequently, liver function normalized, nevertheless, bowel habits and intestinal malabsorption worsened (10-12 daily and nocturnal stools, Bristol 6-7), with severe dehydration that required multiple hospitalizations, associating malnutrition and failure to thrive that required daily home parenteral nutrition(PN). At 14 years old, Odevixibat (40 mcg/kg/day) was initiated, leading to a marked improvement in bowel habits by the second day (1-2 daily stools, Bristol 2) and progressive weight gain, which allowed after 40 days of treatment discontinue PN following seven years.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450006","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":"Treatment of functioning insulinoma using endoscopic ultrasound-guided radiofrequency ablation.","authors":"Sandra Pérez Prado, Alberto Fernández Atutxa, María López López, Aitor Orive Calzada","doi":"10.17235/reed.2025.10962/2024","DOIUrl":"https://doi.org/10.17235/reed.2025.10962/2024","url":null,"abstract":"<p><p>85-year-old patient who underwent endoscopic ultrasound (EUS)-guided radiofrequency ablation for a functioning pancreatic insulinoma and was previously treated with acenocoumarol due to a high thrombotic risk. Acenocoumarol was discontinued three days prior to the procedure and replaced with enoxaparin at 40 mg daily, with the basal anticoagulant therapy being restarted 24 hours after the procedure. Ten days later, the patient was diagnosed with an acute hematoma in the tail of the pancreas and gastric body, which led to clinical signs of hypotension and acute anemia, requiring the discontinuation of anticoagulation once again. Therefore, we believe that caution should be taken when managing anticoagulant therapy in patients undergoing endoscopic ultrasound (EUS)-guided radiofrequency ablation.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391671","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":"Genetic map of Wilson disease in Spain - A great tool to improve diagnosis and screening.","authors":"Pablo Alonso-Castellano, Zoe Mariño, Antonio Tugores, Antonio Olveira, Javier Ampuero, Marina Berenguer, José Ramón Fernández-Ramos, Jose María Moreno-Planas, María Lázaro-Ríos, Helena Masnou, María Luisa González-Diéguez, José María Pinazo-Bandera, Esther Molina-Pérez, Manuel Hernández-Guerra, Marta Romero-Gutiérrez, Paula Fernández-Álvarez, Carolina Muñoz, Sara Lorente, Alba Cachero, Manuel Delgado-Blanco, Víctor Vargas, Judith Gómez-Camarero, Francisca Cuenca, Luis Ibáñez-Samaniego, Miguel Fernández-Bermejo, Beatriz Álvarez-Suárez, Paula Iruzubieta, Ana Arencibia-Almeida, Luis García-Villarreal","doi":"10.17235/reed.2025.11005/2024","DOIUrl":"https://doi.org/10.17235/reed.2025.11005/2024","url":null,"abstract":"<p><strong>Background: </strong>A National Registry for Wilson disease (WD) was recently started by the Spanish Association for Study of the Liver (AEEH). We evaluated the genetic data of the patients and the differences between regions and hospitals.</p><p><strong>Method: </strong>Multicentric observational study from the WD Registry after the first year.</p><p><strong>Results: </strong>Patients from 30 hospitals, in 13/17 Spanish regions (covering 80% of population) were included. Genetic data were available for 260/320 patients. More than 130 mutations in the ATP7B gene were registered, the majority in less than 4 alleles, being most prevalent p.Met645Arg (20% alleles, mainland and the Canary Islands), p.Leu708Pro (16.5%, Canary Islands) and p.His1069Gln (8.3%, mainland). Only 15 mutations occurred in homozygosis, 3 in more than 5 patients: p.Leu708Pro (24 patients), p.Met645Arg and p.His1069Gln (6 patients each). Genetic data availability ranged from 0-100% among regions; similarly, the difference among hospitals within a region was larger than 50%. Without a genetic test up to 45% of patients would not have reached Leipzig score >3. In screening cases, genetics was used in 45/58 (78%); without genetics, two thirds of them would not have reached a Leipzig score >3 (33/49).</p><p><strong>Conclusion: </strong>Here we present the first genetic map of WD in Spain. The use of genetic test was highly heterogeneous, being higher in screening cases. Although a large variability of mutations was found, regional characteristics indicated that screening for a limited number of exons (6, 8, 10, 14 or 17) would detect more than 50% of alleles in a given region, thus enabling the design of better diagnosis/screening tailored strategies.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391668","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":"Successful management of eosinophilic esophagitis with mometasone: an unusual therapeutic approach.","authors":"Ana Lancho Muñoz, José María López Tobaruela, Paula Iglesias Conejero, Eduardo Redondo Cerezo","doi":"10.17235/reed.2025.11106/2025","DOIUrl":"https://doi.org/10.17235/reed.2025.11106/2025","url":null,"abstract":"<p><p>Eosinophilic esophagitis is a chronic, immune-mediated esophageal condition characterized by eosinophilic infiltration of the esophageal mucosa. This report discusses the case of a patient with EoE who showed significant clinical and histological improvement following treatment with mometasone, a corticosteroid rare used for this disease. Mometasone has shown promise due to its enhanced mucosal absorption and potent anti-inflammatory properties. In this case, the patient exhibited resolution of symptoms and marked reduction in endoscopic and histological involvement, suggesting that mometasone could serve as a viable alternative therapy in specific clinical scenarios.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391670","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":"Gastric volvulus, a surgical or endoscopic emergency?","authors":"Marta Nabal Mirat, Ignacio Cavaller Murillo, Pablo Vázquez Beltrán, Alfredo Vivas López, Javier Martínez Caballero, Elena Gómez-Domínguez","doi":"10.17235/reed.2025.10993/2024","DOIUrl":"https://doi.org/10.17235/reed.2025.10993/2024","url":null,"abstract":"<p><p>We present the case of a 62 year old male who presented to the emergency room with abdominal pain and vomiting in coffee grounds. In the diagnostic study, a gastric volvulus was detected and initial endoscopic management was decided. He presented a torpid clinical evolution, which eventually required surgical intervention as the final treatment. We highlight gastric volvulus as a rare urgent pathology, whose optimal management is still to be defined.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391667","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":"Histologic findings of liver injury during pembrolizumab-axitinib treatment.","authors":"Rita Carrilho Pichel, Hugo Miguel Miranda, Diogo Carvalho Sá, João Queirós Coelho, Pedro Lemos Lopes, Maria João Ramos, José Ramón Viscaíno, António Araújo","doi":"10.17235/reed.2025.11064/2025","DOIUrl":"https://doi.org/10.17235/reed.2025.11064/2025","url":null,"abstract":"<p><p>Hepatotoxicity is a significant concern in systemic cancer treatments. The pembrolizumab-axitinib combination, used in advanced renal cell carcinoma (RCC), is associated with a 22% incidence of ≥G3 liver enzyme elevations. In this case report we provide the first description of liver biopsy findings of axitinib or pembrolizumab-axitinib drug-induced liver injury (DILI). These findings may enhance understanding of the hepatotoxic effects of this combination and inform strategies for patient management.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391669","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}