RESUMEN
Esophagogastric varices are a frequent complication of portal hypertension. Bleeding from ectopic varices of the ileum is not only life-threatening, but its accurate diagnosis is also difficult. We have presented the case of a 31-year-old man with massive hematochezia. He was a known case of non-cirrhotic portal hypertension since 15 years prior. Conventional examination that included angiography did not define the site of bleeding. Hence, the patient underwent an intraoperative enteroscopy. The varices were located at the distal part of the ileum. Segmental resection of the ileum was performed and the patient was discharged in good condition seven days later. Intraoperative enteroscopy could be considered in the diagnostic and therapeutic management of ectopic varices.
RESUMEN
Chronic hepatitis C [CHC] is a major contributor to cirrhosis and hepatocellular carcinoma and major global public health problem that causes mortality in both developed and developing countries. For the past decade, treatment with pegylated interferon [peg interferon alpha] ribavirin [RBV] has been associated with rates of sustained virologic response of = 66% among patients with hepatitis C virus [HCV] infection. In this study, we report the response rate of Iranian treatment-nave CHC patients to Pegaferon, a locally developed pegylated interferon-alpha2a [PEG-IFN alpha2a]. Patients diagnosed with CHC who referred to two university based outpatient clinics in Tehran from December 2007 to May 2011 were enrolled in a single-group, open-labeled experimental design. Eligible patients were above 15 years of age and had HCV infection with evidence of chronic hepatitis. Exclusion criteria included the presence of a debilitating disease, decompensated cirrhosis or refusal to participate in the study. Patients were treated with 180 micro g Pegaferon weekly in addition to 800-1200 mg daily, weight-based RBV for 24 or 48 weeks depending on genotype. Viral response and adverse effects were recorded. A total of 216 patients were enrolled in the study of which 83.3% were male and 16.7% were female. In 93 [43.1%] patients, the HCV RNA viral load was >/= 800,000 IU/ml before starting treatment. "As-treated analysis" indicated that a total of 168 [77.8%] patients achieved sustained viral response [SVR, undetectable plasma HCV RNA 24 weeks after the last planned dose of study treatment]. This study, with a larger number of participants, confirms the results of a previous study by the authors that Pegaferon, a PEG-IFN alpha 2a locally produced in Iran, is effective in treatment-nave CHC patients