ABSTRACT
La trombosis venosa mesentérica corresponde a un factor obstructivo del sistema venoso intestinal intraluminal, trayendo consecuencias clínicas dadas por isquemia intestinal y aumento de la circulación colateral debido a una dificultad del drenaje sanguíneo. Raramente, esto podría generar várices ectópicas, pero esta descrito en la literatura la existencia de várices duodenales producto de este mecanismo. En este articulo se presenta un reporte de un caso, que presenta un sangrado variceal de origen duodenal secundaria a una trombosis venosa portal y mesentérica, sin causa aparente.
Mesenteric vein thrombosis is an intraluminal obstruction of the intestinal venous system with clinical consequences due to intestinal ischemia and an increase in collateral circulation caused by compromised venous return. It very rarely generates ectopic varicose veins but duodenal varicose veins caused by this mechanism have been described in the literature. In this article we report the case of duodenal variceal bleeding secondary to a portal and mesenteric venous thrombosis with no apparent cause.
ABSTRACT
Involvement of gastrointestinal tract by cytomegalovirus (CMV) is common. CMV infections mainly run their course without any clinical signs in immunocompetent hosts. In contrast, CMV can cause severe infections with serious consequences in a immunocompromised state typically associated with organ transplants, highly immunosuppressive cancer chemotherapy, advanced HIV infection or treatment with corticosteroids. The incidence and severity of these manifestations of CMV is directly proportional with the degree of cellular immune dysfunction, i.e., CD8+ Cytotoxic T-cell response. Clinical manifestations of CMV can become apparent in different situations including reactivation of CMV from latency, primary infection in a seronegative host, or exposure of a seropositive host to a new strain of CMV. As the clinical signs of CMV in immunodeficient patients are usually sparse, physicians should be highly vigilant about CMV infection, a treatable condition that otherwise is associated with significant mortality. Here we report a rare case of severe gastrointestinal CMV infection with sustained immunodeficiency secondary to treatment with steroids manifesting as fatal duodenal diverticular bleeding.
