Radiofrequency ablation for hepatocellular carcinoma and liver metastases: experience in Hospital La Paz

INTRODUCTION: Radiofrequency ablation for patients presenting with non-resectable primary or metastatic liver tumours seems to be a valid therapeutic alternative. In the present study, we show a descriptive list of indications, results and complications of Radiofrequency Ablation Technique for treating non-resectable solid hepatic tumours. MATERIALS AND METHODS: Twenty two patients were included in this study; eleven of them (50%) sustained liver metastases from colorectal adenocarcinoma, ten patients (45.5%) had hepatocellular carcinoma and 1 patient had insulinoma. RESULTS: Local recurrence rate of hepatocellular carcinoma was 22.7% and 27.3% for colorectal carcinoma, after a respective median follow-up of 21 and 14 months. Complications rate was 6.9% and technique-associated mortality rate was 0%. CONCLUSIONS: Radiofrequency ablation is an easy to make, safe and useful technique for the treatment of primary and metastatic liver tumours (AU)

Pancreatitis aguda leve y déficit de proteína C como causas de trombosis venosa mesentérica / Acute pancreatitis and protein C deficiency as a cause of mesenteric venous thrombosis

No disponible

Bruising of the esophagus as a cause of gastrointestinal bleeding in a case of heatstroke.

Alterations in blood clotting are a frequent complication of serious heatstroke and may result in gastrointestinal bleeding. We report the case of a 26-year-old man who was admitted to our hospital with symptoms of hyperthermia associated with encephalopathy and disseminated intravascular coagulation (DIC) after prolonged exposure to sunlight. He presented hematemesis, after which he was diagnosed with having a bruising of the esophagus that took up the upper and lower thirds, there being no other lesions in the stomach or duodenum. After supportive treatment and following the resolution of the underlying pathology, the endoscopy-revealed injuries healed with a complete normalization of the esophageal mucosa. Esophageal submucosal bruising is an exceptional cause of hematemesis in serious heatstroke not previously described in the literature.

Eosinofilia y enteritis actínica secundarias a radioterapia por adenocarcinoma de próstata / Eosinophilia and actinic enteritis due to radiotherapy for prostatic adenocarcinoma

No disponible

Hematomas esofágicos como causa de hemorragia digestiva en un caso de golpe de calor / Bruising of the esophagus as a cause of gastrointestinal a case of heatstroke

Las alteraciones de la coagulación son una complicación frecuenteen el golpe de calor grave, y pueden ser causa de hemorragiadigestiva. Presentamos el caso de un varón de 26 años quefue admitido en nuestro hospital por un cuadro de hipertermia,asociado con encefalopatía y coagulación intravascular diseminadatras exposición solar prolongada. Presentó hematemesis por laque fue diagnosticado de múltiples hematomas esofágicos queocupaban los tercios superior e inferior del órgano, en ausenciade otras lesiones en estómago y duodeno. Tras el tratamiento desoporte y la resolución de la patología subyacente, desaparecieronlas lesiones endoscópicas, normalizándose la mucosa esofágica

Alterations in blood clotting are a frequent complication ofserious heatstroke and may result in gastrointestinal bleeding.We report the case of a 26-year-old man who was admitted toour hospital with symptoms of hyperthermia associated with encephalopathyand disseminated intravascular coagulation (DIC)after prolonged exposure to sunlight. He presented hematemesis,after which he was diagnosed with having a bruising of theesophagus that took up the upper and lower thirds, there beingno other lesions in the stomach or duodenum. After supportivetreatment and following the resolution of the underlying pathology,the endoscopy-revealed injuries healed with a completenormalization of the esophageal mucosa. Esophageal submucosalbruising is an exceptional cause of hematemesis in seriousheatstroke not previously described in the literature

Eosinophilic esophagitis in adults, an emerging cause of dysphagia. Description of 9 cases.

BACKGROUND: Eosinophilic esophagitis is a rare condition mainly affecting children, although the number of cases reported in adults is on the increase. It is characterized by intense infiltration of eosinophilic leukocytes in the esophageal mucosa, without involvement of other sections of the alimentary canal. MATERIAL AND METHODS: Over the past year, following the performance of endoscopies and biopsies, our service identified nine patients who were diagnosed with suffering from this disorder. Each patient sought medical help for episodes of long-term, self-limited dysphagia or food impaction in the alimentary canal. RESULTS: Endoscopy revealed esophageal stenosis in the form of simultaneous contraction rings or regular stenosis. In six cases, the manometric study showed a nonspecific motor disorder of severe intensity affecting the esophageal body, and another patient had a disorder characterized by the presence of simultaneous waves and secondary peristaltic waves in the three thirds of the organ. These disorders are presumably due to eosinophilic infiltration of the muscular layer or ganglionar cells of the esophagus, and account for symptoms in these patients. Although the etiopathogenesis of this illness is uncertain, it is clearly an immunoallergic manifestation. CONCLUSIONS: As the number of diagnosed cases is on the increase, eosinophilic esophagitis is in adults a specific entity within the differential diagnosis of dysphagia in young males with a history of allergies. Eosiniphilic esophagitis responds in a different number of ways to therapies used. We successfully used fluticasone propionate, a synthetic corticoid applied topically, which proved to be efficient in the treatment of this illness by acting on the pathophysiological basis of the process. It does not have any adverse effects, thus offering advantages over other therapies such as systematic corticoids or endoscopic dilations.

Esofagitis eosinofílica del adulto, causa emergente de disfagia. Presentación de 9 casos / Eosinophilic esophagitis in adults, an emerging cause of dysphagia. Description of 9 cases

Introducción: la esofagitis eosinofílica es una enfermedad poco frecuente, propia de la edad pediátrica, aunque cada vez son más los casos descritos en pacientes adultos. Se caracteriza por la intensa infiltración de la mucosa esofágica por leucocitos eosinófilos, en ausencia de afectación de otros tramos del tubo digestivo. Material y métodos: en nuestro servicio hemos identificado durante el último año a 9 pacientes que fueron diagnosticados de esta entidad tras la endoscopia y toma de biopsias. Todos consultaron por episodios de disfagia autolimitada de larga evolución o por impactación de alimento en esófago. En la endoscopia se observaron estenosis esofágicas, en forma de anillos de contracción simultánea o estenosis regulares. Resultados: el estudio con manometría esofágica demostró la existencia de un trastorno motor de cuerpo esofágico de tipo inespecífico e intensidad severa en 6 casos, y en otro paciente un trastorno caracterizado por la presencia de ondas simultáneas en los tres tercios del órgano y ondas secundarias peristálticas. Dichos trastornos son debidos presumiblemente a la infiltración eosinofílica de la capa muscular o de las células ganglionares del esófago, y justifican los síntomas de estos pacientes. Conclusiones: aunque la etiopatogenia de la enfermedad no es bien conocida, parece claro que se trata de una manifestación inmunoalérgica. Su prevalencia diagnóstica está en aumento, por lo que la esofagitis eosinofílica del adulto es una entidad específica en el diagnóstico diferencial de la disfagia en varones jóvenes con antecedentes de alergia. La esofagitis eosinofílica presenta una respuesta variable a las terapias utilizadas. Nosotros hemos utilizado con éxito el propionato de fluticasona, un corticoide sintético de aplicación tópica, eficaz en el tratamiento de esta entidad al actuar sobre la base fisiopatológica del proceso. Carece de efectos adversos, por lo que presenta ventajas frente a otras terapias como los corticiodes sistémicos o las dilataciones endoscópicas

Background: eosinophilic esophagitis is a rare condition mainly affecting children, although the number of cases reported in adults is on the increase. It is characterized by intense infiltration of eosinophilic leukocytes in the esophageal mucosa, without involvement of other sections of the alimentary canal. Material and methods: over the past year, following the performance of endoscopies and biopsies, our service identified nine patients who were diagnosed with suffering from this disorder. Each patient sought medical help for episodes of long-term, self-limited dysphagia or food impaction in the alimentary canal. Results: endoscopy revealed esophageal stenosis in the form of simultaneous contraction rings or regular stenosis. In six cases, the manometric study showed a nonspecific motor disorder of severe intensity affecting the esophageal body, and another patient had a disorder characterized by the presence of simultaneous waves and secondary peristaltic waves in the three thirds of the organ. These disorders are presumably due to eosinophilic infiltration of the muscular layer or ganglionar cells of the esophagus, and account for symptoms in these patients. Although the etiopathogenesis of this illness is uncertain, it is clearly an immunoallergic manifestation. Conclusions: as the number of diagnosed cases is on the increase, eosinophilic esophagitis is in adults a specific entity within the differential diagnosis of dysphagia in young males with a history of allergies. Eosiniphilic esophagitis responds in a different number of ways to therapies used. We successfully used fluticasone propionate, a synthetic corticoid applied topically, which proved to be efficient in the treatment of this illness by acting on the pathophysiological basis of the process. It does not have any adverse effects, thus offering advantages over other therapies such as systematic corticoids or endoscopic dilations