GE Portuguese Journal of Gastroenterology最新文献

{"title":"Portuguese Pancreatic Club Perspective on the Surveillance Strategy for Intraductal Papillary Mucinous Neoplasms: When and How to Do It?","authors":"Francisco Vara-Luiz, Alexandra Fernandes, Miguel Bispo, Filipe Vilas-Boas, Tiago Cúrdia-Gonçalves, Eduardo Rodrigues-Pinto, Pedro Pinto-Marques","doi":"10.1159/000547298","DOIUrl":"10.1159/000547298","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cysts are increasingly recognized nowadays, with estimated prevalence that may reach 50% in aging populations. Most cysts are of benign origin, and only a small proportion has malignant potential, including intraductal papillary mucinous neoplasms (IPMNs). Since pancreatic cysts are common, the most important goal was to identify the small percentage at high risk of developing malignancy. The increased detection and awareness of IPMNs led to the development of several consensus and guidelines, with only the most recent being evidence-based.</p><p><strong>Summary: </strong>Current consensus guidelines recommend risk assessment to prioritize high-risk patients for malignancy. In the Fukuoka/Kyoto guidelines, the predictive factors of malignancy are called \"high-risk stigmata\" and \"worrisome features.\" Conversely, other guidelines consider the terms \"absolute indication\" and \"relative indication\" for surgery, as well as criteria for referral to multidisciplinary groups. In case of non-resected IPMNs, criteria for surveillance depend on cyst size, with magnetic resonance imaging pointed as the most consensual modality for follow-up, although the recommended imaging modality varies among consensus. In some situations, namely, older age, frailty/comorbidities, or stability of cyst size, follow-up discontinuation may be considered.</p><p><strong>Key message: </strong>Performance of surveillance guidelines is measured by the ability to identify patients with high-grade dysplasia/early stage-invasive cancer. Guidelines with more intense protocols will likely lead to fewer missed cancers, balanced by a greater number of benign resections. Multidisciplinary management preferably in reference centers is of utmost importance given the indolent and complex nature of the disease, and a global evidence-based guideline that combines the several guidelines' groups is mandatory to uniformize care. In this review, the Portuguese Pancreatic Club summarizes the risk assessment and surveillance strategy of a patient with an IPMN according to different guidelines in order to create an updated perspective and to guide clinical care.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance and Treatment of Barrett's Esophagus: Results from a Portuguese Tertiary Center.","authors":"Ana Clara Vasconcelos, Marco Pereira, Diogo Libânio, Mário Dinis-Ribeiro, Inês Marques de Sá","doi":"10.1159/000546857","DOIUrl":"10.1159/000546857","url":null,"abstract":"<p><strong>Introduction: </strong>Barrett's esophagus (BE) is a premalignant condition that requires surveillance, in order to diagnose and treat dysplasia, improving survival. Results from surveillance and endoscopic treatment are well-described in different populations. This is the first evaluation of the outcomes of endoscopic resection and ablation of BE patients in a Portuguese center.</p><p><strong>Methods: </strong>This is a single-center retrospective cohort study analyzing the results of endoscopic surveillance and treatment of patients with BE between January 2004 and September 2024. The following outcomes were evaluated: detection of dysplasia and/or visible lesions; rate of curative endoscopic resection; rate of BE refractory to ablation; adverse event (AE) rates of endoscopic resection and ablation; BE-related mortality and survival.</p><p><strong>Results: </strong>Eighty-nine patients were followed for a median of 3 years (interquartile range 1-6). A total of 37 lesions were identified, and treated with endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD) and other modalities in 76%, 16%, and 8% of patients, respectively, with curative resection and AE rates of 86% (95% CI: 67%-96%) and 11% (95% CI: 2%-28%) for EMR, and 67% (95% CI: 22%-96%) and 17% (95% CI: 0%-64%) for ESD, respectively. A response rate of 97% was observed in 33 patients submitted to mucosal ablation, with 1 patient presenting refractory disease and 1 patient showing recurrence of intestinal metaplasia. One patient died of BE-related neoplasia.</p><p><strong>Conclusion: </strong>Our study shows results of BE treatment generally comparable to published literature, in a low-prevalence country. A high curative resection and a high success rate of mucosal ablation were achieved, with low refractory and recurrent disease.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buschke-Löwenstein Tumor: An Unusual Therapeutic Approach.","authors":"Raquel Gonçalves, Isabel Garrido, Rosa Coelho, Rita Coelho, José Lopes, Guilherme Macedo","doi":"10.1159/000546859","DOIUrl":"10.1159/000546859","url":null,"abstract":"<p><strong>Introduction: </strong>Giant condyloma acuminatum, known as Buschke-Löwenstein tumor, is a rare benign tumor. Several risk factors are described, including immunosuppression, diabetes, tobacco use, and multiple sexual partners. About 90% of cases are associated with human papillomavirus infection. Given the rarity of this lesion, there are still no established guidelines for the assessment and treatment of this tumor. The most reported and consensus approach described in the literature is surgical intervention.</p><p><strong>Case presentation: </strong>We report a case of a 32-year-old man who was immunosuppressed following a lung transplant due to cystic fibrosis. He also had stage IV chronic kidney disease and chronic pancreatitis. The patient was evaluated in a proctology consultation due to complaints of itching, perianal pain, and constipation with a 4-month history. Clinical examination showed a cauliflower-like, papillomatous tumor measuring 9 cm along the perianal area with other surrounding smaller lesions. The evaluation of immunodeficiency virus, hepatitis C virus, hepatitis B virus and syphilis was negative. The patient denied engaging in receptive anal sex and other risky sexual behaviors. A macro biopsy of the lesion was performed, and the histopathological examination revealed an anal condyloma acuminatum, with no signs of malignancy. Therapy with imiquimod was initiated for several weeks, with no significant reduction in lesion size. In a multidisciplinary discussion, it was decided to start neoadjuvant chemoradiotherapy with capecitabine and mitomycin. After 5 months of treatment, a significant reduction in lesion size was observed with significant clinical improvement. Currently, the patient has no proctological symptoms and no need for analgesia.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Pitfalls in Wilson Disease with Autoimmune Features: A Case Report.","authors":"Sara Ramos Lopes, Madalena Teixeira, Cristiana Sequeira, Ana Carvalho, Élia Gamito, Ana Luísa Alves","doi":"10.1159/000546205","DOIUrl":"10.1159/000546205","url":null,"abstract":"<p><strong>Introduction: </strong>Wilson's disease is a rare inherited disorder caused by mutations in the copper transporter ATP7B.</p><p><strong>Case presentation: </strong>We present the case of a 33-year-old woman who was admitted with decompensated liver cirrhosis, initially suspected to have autoimmune hepatitis and treated with corticosteroids without improvement. Further investigation confirmed the diagnosis of Wilson disease. Despite initiating penicillamine therapy, the patient's condition worsened, requiring urgent liver transplantation.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of Wilson's disease, given its rarity and mimicry of other conditions, particularly when accompanied by autoimmune features, underscoring the importance of early referral for transplantation.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactose Intolerance and Malabsorption Revisited: Exploring the Impact and Solutions.","authors":"Ana Isabel Borralho, Pedro Marcos","doi":"10.1159/000545923","DOIUrl":"10.1159/000545923","url":null,"abstract":"<p><strong>Background: </strong>Lactose intolerance (LI) is a condition in which the consumption of lactose-containing products leads to gastrointestinal symptoms. Despite being a common digestive disorder worldwide, LI is often overlooked, and there are few established recommendations for its diagnosis and management. This review aims to provide a comprehensive overview of LI, focusing on its clinical features, diagnostic evaluation, and management strategies.</p><p><strong>Summary: </strong>A review of literature published from 2013 to 2023 on PubMed was conducted. Systematic reviews, meta-analyses, randomized controlled trials, case-control studies, cohort studies, and expert reviews were prioritized for analysis. LI is a common condition that shares symptoms with several other diseases. Various diagnostic tests are available to identify LI, including hydrogen breath test (HBT), lactose tolerance test, urinary galactose test, gaxilose test, rapid lactase test, and genetic testing. Managing LI may involve adopting a lactose-free or low-lactose diet, taking oral enzyme supplements, using probiotics and prebiotics, or consuming plant-based alternative beverages.</p><p><strong>Key messages: </strong>LI affects many people worldwide and can significantly impact their quality of life. The HBT is the most widely used and effective method for diagnosing LI, along with a thorough assessment of symptoms. Instead of following a completely dairy-free diet, adopting a low-lactose diet - allowing up to 12-15 g of lactose per day - has been shown to be well tolerated and beneficial for most individuals with LI. While probiotics, prebiotics, and plant-based beverages may be helpful, their effectiveness in managing LI has not yet been proven.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypereosinophilic Syndrome Presenting with Digestive Symptoms in Pediatric Patients: A Portuguese Tertiary Hospital Case Series.","authors":"Maria Sousa, Sara Catarino, Céu Espinheira, Mariana Rodrigues, Fátima Ferreira, Eunice Trindade","doi":"10.1159/000545921","DOIUrl":"10.1159/000545921","url":null,"abstract":"<p><strong>Introduction: </strong>Hypereosinophilic syndrome (HES) is an uncommon disorder characterized by persistent peripheral eosinophilia and involvement of different organs. It is rare in pediatric ages.</p><p><strong>Cases presentation: </strong>We present 3 pediatric patients diagnosed with HES exhibiting digestive symptoms. Clinical records, laboratory results, imaging studies, and treatment plans were systematically collected and analyzed. All patients underwent an extensive etiological investigation to exclude infectious, autoimmune, and tumoral causes. Treatment with corticosteroids resulted in symptomatic and analytical improvement in all patients.</p><p><strong>Conclusion: </strong>This case series highlights the complexity of pediatric HES presenting with digestive manifestations. The diverse clinical presentation underscores the importance of considering HES in the differential diagnosis of unexplained gastrointestinal symptoms in children. Diagnostic and treatment challenges demand a multidisciplinary approach. These insights enhance our knowledge of this rare condition, enlarging the limited literature on this subject in the pediatric population.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12113416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifaximin as a Therapeutic Ally in the Modulation of Dysbiosis: A Narrative Review of Its Applicability in Gastrointestinal Disorders.","authors":"Joana Frias, Miguel Martins, Armando Peixoto, Guilherme Macedo","doi":"10.1159/000545926","DOIUrl":"10.1159/000545926","url":null,"abstract":"<p><strong>Background: </strong>The gastrointestinal microbiota is vital for a well-functioning digestive tract, nutrient metabolism, immune support, and protection against pathogenic microorganisms. Disruption of this balance is known as dysbiosis. Rifaximin, an oral antibiotic with selective action, reduces harmful gut bacteria while preserving beneficial species, aiding in microbiota restoration.</p><p><strong>Summary: </strong>Alterations in the intestinal microbiota are implicated in many gastrointestinal disorders. Rifaximin, by targeting and modulating the microbiota, may serve as a powerful tool in the approach of these conditions.</p><p><strong>Key messages: </strong>This narrative review summarizes the main uses of rifaximin in gastrointestinal disorders like irritable bowel syndrome, diverticular disease, small intestinal bacterial overgrowth, traveler's diarrhea, hepatic encephalopathy, <i>Clostridioides difficile</i> infection, and inflammatory bowel disease.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for the Clinical Practice concerning the Use of Cholangiopancreatoscopy: Proceedings from a Consensus Meeting.","authors":"Jorge Canena, Pedro Pereira, Tiago Bana E Costa, David Horta, Luís Carvalho Lourenço, Eduardo Rodrigues-Pinto, Isabel Tarrio, Ana Rita Franco, Tarcísio Araújo, Luís Lopes","doi":"10.1159/000545718","DOIUrl":"10.1159/000545718","url":null,"abstract":"<p><p>After a consensus meeting including experts from all over the country (more than 6 years of experience, at least 50 procedures and their center perform more than 30 procedures/year), several recommendations were issued. Main recommendations: (1) Single-operator digital cholangioscopy is indicated in cases of undetermined biliary strictures (UBSs) in which visual inspection, with or without histology, may change the patient's approach. (Strong recommendation, moderate quality of evidence). (2) In a cholangioscopy for a stricture of unclear etiology, the optical assessment aspects should be recorded in a standardized report and, according to the endoscopist's visual impression, suggest a malignant or benign etiology. (Strong recommendation, high quality of evidence). (3) When using cholangioscopy regardless of the visual impression, biopsies of the stenosis should be taken (ideally in a number equal to or greater than 6 fragments). (Strong recommendation, moderate quality of evidence). (4) Cholangioscopy with biopsies has a high diagnostic accuracy in the evaluation of UBSs, with a technical success >98% and visual diagnosis with sensitivity/specificity >95%. However, it must be considered that the sensitivity of histological diagnosis is lower (around 70%). (Strong recommendation, high quality of evidence). (5) The single-operator cholangioscopy (SOC)-assisted lithotripsy is a safe procedure associated with high rates of success. (Strong recommendation, high quality of evidence). (6) SOC-assisted lithotripsy should be reserved for selected cases in which conventional techniques for the treatment of difficult biliary stones have failed. However, SOC-assisted lithotripsy should be used early in the treatment algorithm to avoid repeated procedures. (Strong recommendation, moderate quality of evidence). (7) Pancreatoscopy can allow the diagnosis of lesions suggestive of malignancy in the pancreatic duct of patients with intraductal papillary mucinous neoplasm of the main duct with high sensitivity and specificity. The groups of patients who benefit most from its use are those with a diffusely dilated duct with a diameter greater than 10 mm, and in whom sectional imaging methods and endoscopic ultrasound do not reveal focal lesions. (Weak recommendation, low quality of evidence). (8) The use of intraductal lithotripsy guided by pancreatoscopy in patients with lithiasis in the main pancreatic duct should be reserved for patients with pain and lithiasis greater than 5 mm that cannot be removed using conventional techniques. Patients with an excessively distal location in the tail or head may cause increased technical difficulty. (Low recommendation, low quality of evidence).</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":"1-21"},"PeriodicalIF":1.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referral to Liver Transplant: A National Survey from Portugal.","authors":"Filipe S Cardoso, Mónica Sousa, Luís Bagulho, Milena Mendes, Élia Mateus, Helena Glória, Jorge Lamelas, Luís Bicho, Raquel Mega, João S Coelho, Rui Perdigoto, Hugo P Marques","doi":"10.1159/000545593","DOIUrl":"10.1159/000545593","url":null,"abstract":"<p><strong>Introduction: </strong>The referral of patients with cirrhosis to liver transplant (LT) is a multi-stage, complex process. There is a lack of data on potential challenges to this process. We aimed to characterize challenges faced by Portuguese referring clinicians.</p><p><strong>Methods: </strong>This was a cross-sectional survey from Curry Cabral Hospital, Lisbon, Portugal. The survey was open for 90 days, from August to November 2024. The survey included 13 questions: characterization of participants with 5 questions and characterization of the process of referral to LT with 8 questions.</p><p><strong>Results: </strong>Overall, 56 clinicians responded to the survey (response rate of 46.7%). Their median (IQR) age was 38.1 (33.2-42.1) years. Their level of training was specialist grade for 47 (83.9%) and fellow or intern grade for 9 (16.1%) individuals. The responders were from 21 different hospitals in Portugal; 8 (38.1%) provided tertiary care and 2 (9.5%) were LT centers. Among responders, there was heterogeneity regarding the following topics: referring criteria to LT, liver-related prognostic scores, contact channels with the LT center, tests and visits part of the LT workup. Many of them suggested the following improvements to develop national or regional referral criteria, to expedite communication with the LT team, to accelerate access to the tests or visits part of the LT workup, and to shorten the time to the first appointment with the LT team.</p><p><strong>Conclusion: </strong>Portuguese clinicians identified several challenges and improvements to the referral of patients with cirrhosis to LT. These findings may inform future strategies to streamline the referral to LT.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual Portal Hypertension in Hepatic Tuberculosis: A Case Report.","authors":"Amal Joseph, Prajob Geevarghese Prasad, Jeby Jacob, Harikumar Nair","doi":"10.1159/000545522","DOIUrl":"10.1159/000545522","url":null,"abstract":"<p><strong>Background: </strong>Hepatic tuberculosis in itself is a rare condition, and that causing portal hypertension is even rarer. We present a unique clinical scenario of portal hypertension in a 64-year-old woman, with tuberculosis causing both sinusoidal and prehepatic portal hypertension.</p><p><strong>Case presentation: </strong>A 64-year-old woman presented with esophageal variceal bleeding. Evaluation revealed a rare combination of sinusoidal portal hypertension from hepatic tuberculosis and a prehepatic component of portal hypertension due to tubercular periportal lymphadenopathy compressing the portal vein at the hilum. Hepatic venous pressure gradient was 7 mm Hg, indicative of sinusoidal portal hypertension. Liver biopsy demonstrated bridging fibrosis and hepatic granulomas accounting for the sinusoidal component of portal hypertension. Since clinically significant portal hypertension is more than 10 mm Hg, variceal bleeding resulted from the additional element of prehepatic portal hypertension contributed by compression of extrahepatic portal vein by periportal lymph nodes. Positive tuberculosis polymerase chain reaction from lymph nodes confirmed the diagnosis and initiation of antitubercular therapy (ATT) led to significant clinical and biochemical improvement. This case represents a novel occurrence; hepatic tuberculosis causing both intrahepatic and prehepatic components of portal hypertension has not been reported in the literature.</p><p><strong>Conclusion: </strong>This case sheds light on the rarity of hepatic tuberculosis causing portal hypertension and also the importance of considering this diagnosis in patients with atypical presentations of tuberculosis. Recognizing and treating this unique complication promptly with ATT can lead to favorable clinical outcomes.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":" ","pages":"1-4"},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}