RESUMO
An 80-year-old female with a mechanic mitral valve treated with acenocumarol was admitted to the hospital due to tarry stools over the last two days and hemoglobin levels of 5.6 g/dl. She had not biliary pathology. An emergency esophagogastroduodenoscopy showed lots of fresh clots over the second part of the duodenum that seemed to come from the major papilla. A duodenoscopy was performed in order to obtain a direct view, showing a huge clot near the papilla. Its removal with a polypectomy snare revealed a large duodenum diverticulum with little saculations inside, one of which showed a visible, actively bleeding vessel. Sclerosis with epinephrine was performed and subsequently, two through-the-scope Cook® 11 mm clips were placed, achieving the cessation of the hemorrhage. Several attempts with different clips were needed since they were separated by the elevator nail of the duodenoscope. No complications developed during the procedure or once anticoagulation was restarted.
Assuntos
Divertículo , Trombose , Idoso de 80 Anos ou mais , Divertículo/complicações , Divertículo/diagnóstico por imagem , Duodenoscopia/efeitos adversos , Duodeno , Feminino , Hemorragia Gastrointestinal/terapia , Humanos , Trombose/complicaçõesRESUMO
We present the case of a 47-year-old male with a personal history of radically removed malignant melanoma (pT3bN2M0) who was receiving adjuvant nivolumab for the prevention of recurrence. He was admitted to our service complaining of epigastric pain and hyporexia after receiving the ninth dose of nivolumab. He underwent a preferential esophagogastroduodenoscopy, which showed intense inflammation limited to the stomach.
Assuntos
Gastrite , Melanoma , Neoplasias Cutâneas , Gastrite/induzido quimicamente , Gastrite/tratamento farmacológico , Humanos , Masculino , Melanoma/tratamento farmacológico , Melanoma/patologia , Pessoa de Meia-Idade , Nivolumabe/efeitos adversos , Neoplasias Cutâneas/tratamento farmacológicoRESUMO
We present the case of an 81-year-old male with a history of surgically resected colorectal and bladder cancer, who was admitted to our hospital with a urinary infection. A routine renal ultrasound showed a pelvic cyst and a CT scan confirmed a non-complicated cyst, but a lesion was observed in the left lung. He underwent a PET-CT in which an unexpected enhancement of the small bowel attracted our attention.
