Adenocarcinoma in the ileostomy of a patient with long-standing ulcerative colitis: a case report and review of the literature.

Primary adenocarcinoma in a permanent ileostomy carries a poor prognosis from other gastrointestinal malignancies. Surveillance and identification of patient at risk for ileostomy malignancies is a challenging problem. There are not reliable biological markers. The clinical evaluation, suspicion of the disease, common presenting symptoms including difficulty fitting the stomal appliance, bowel obstruction, and a friable mass should be considered as part of the evaluation and screening in a long standing terminal ileostomy. Biopsy of newly developed lesions in the periostomal area is recommended for diagnosis and treatment. This is a case of a primary adenocarcinoma in an ileostomy forty years after total colectomy for ulcerative colitis.

Acute fatty liver of pregnancy. Case report and review of the literature

A case of acute fatty liver of pregnancy is presented. This case is characterized by many of the reported diagnostic features of AFLP, including the abrupt onset of symptoms with progressive liver failure, coagulopathy and encephalopathy, during the third trimester of pregnancy. Autopsy findings confirmed the diagnosis. The literature is reviewed, emphasizing the clinical and laboratory features helpful in the diagnosis of this entity