Misplacement of the PEG tube through the transverse colon, an uncommon but possible complication.

Misplacement of the Percutaneous Endoscopic Gastrostomy (PEG) tube through the transverse colon mainly by traction is an uncommon complication probably due to inadvertent puncture of colon during PEG placement, resulting in gastrocolocutaneous fistula. Stool drainage through the stoma is usually the only symptom. We report a 52-year-old male with Wernicke-Korsakoff syndrome and PEG tube placement 7 months earlier and replacement one month ago. Due to stool drainage through the stoma was observed, he was performed a computed tomography (CT) in which PEG tube was visualized lodged in transverse colon without pneumoperitoneum associated. Due to important morbility, endoscopic management was decided. Balloon was removed through cutaneous orifice and Ovesco clip was placed simultaneously, achieving a complete closure of wall defect. Although spontaneous closure of the fistula usually happens, surgery is sometimes required, with endoscopic treatment being a less invasive and effective alternative to solve this complication.

Gran úlcera rectal secundaria a fotocoagulación con argón plasma en paciente con proctitis actínica / No disponible

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A huge rectal ulcer due to argon plasma coagulation in a patient with radiation proctitis.

Radiation proctitis (RP) is a complication of radiotherapy in patients with pelvic cancer. A 64-year-old male underwent brachytherapy 2 years previously due to prostate cancer. Subsequently, he developed RP which was treated with argon plasma coagulation (APC). He was subsequently hospitalized due to rectal bleeding and underwent a colonoscopy. A large deep ulcer was seen in the anterior rectum wall, in the same place where APC was performed 3 months earlier. A perforated rectal ulcer was seen via pelvic MRI. However, it was contained by the mesorrectum. Rectal ulcers after APC are uncommon, but they can develop as a result of thermal damage to an ischemic mucosa due to radiotherapy. The treatment of choice of large ulcers is surgery, with a temporary colostomy in order to aid re-epithelialization.

Quiste broncogénico atípico con sobreinfección fúngica / No disponible

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An atypical bronchogenic cyst with yeast over-infection.

Bronchogenic cysts (BC) are rare congenital anomalies that result from abnormal budding of the tracheobronchial tree during fetal development. BC are usually located in the lung and the mediastinum, an abdominal location is unusual.

Lesiones serradas en pacientes con enfermedad inflamatoria intestinal / Serrated Lesions in patients with Inflammatory Bowel Disease

Introducción: recientemente se ha descrito una nueva entidad histológica serrada en pacientes con enfermedad inflamatoria intestinal (EII) conocida como "cambio epitelial serrado" (CES). En los últimos estudios parece que hay una fuerte asociación entre la presencia de CES y displasia. Caso clínico: se presenta el caso clínico de un varón de 62 años en programa de cribado de displasia-cáncer colorrectal con cromoendoscopias periódicas con hallazgos compatibles con CES. Discusión: en aquellos pacientes que presentan varias lesiones serradas en las cromoendoscopias de cribado, sobre todo si son extensas y mal definidas, la realización de una colectomía profiláctica parece una opción razonable ante la posibilidad de aparición de displasia de alto grado o CCR en el seguimiento

Background: a new serrated histologic finding has recently been discovered in patients with inflammatory bowel disease (IBD), known as serrated epithelial change (SEC). Recent studies suggest that SEC is strongly associated with dysplasia. Case report: the case was a 62-year-old male in a dysplasia-colorectal cancer screening program with periodic chromoendoscopies, with CES findings in the previous chromoendoscopy studies. Discussion: a prophylactic colectomy seems a reasonable option for patients with several serrated lesions identified via chromoendoscopy screening. Particularly, if they are extensive and poorly defined, due to the possibility of developing high-grade dysplasia or colorectal cancer (CRC) during surveillance

Serrated Lesions in patients with Inflammatory Bowel Disease.

BACKGROUND: a new serrated histologic finding has recently been discovered in patients with inflammatory bowel disease (IBD), known as serrated epithelial change (SEC). Recent studies suggest that SEC is strongly associated with dysplasia. CASE REPORT: the case was a 62-year-old male in a dysplasia-colorectal cancer screening program with periodic chromoendoscopies, with CES findings in the previous chromoendoscopy studies. DISCUSSION: a prophylactic colectomy seems a reasonable option for patients with several serrated lesions identified via chromoendoscopy screening. Particularly, if they are extensive and poorly defined, due to the possibility of developing high-grade dysplasia or colorectal cancer (CRC) during surveillance.

Linitis plástica de colon secundaria a metástasis de carcinoma lobulillar infiltrante de mama / Linitis plastica of the colon due to metastases of invasive lobular breast carcinoma

Las metástasis colónicas secundarias a neoplasia de mama son infrecuentes. El subtipo lobulillar infiltrante es el que suele metastatizar con mayor frecuencia debido a su diseminación peritoneal. Se presenta el caso clínico de una mujer de 67 años intervenida quirúrgicamente con posterior radioterapia y quimioterapia adyuvante de neoplasia de mama subtipo lobulillar hace diez años. La paciente se encuentra actualmente en remisión clínica. Se le realiza colonoscopia debido a síndrome general de reciente comienzo con hallazgos compatibles con linitis plástica colónica secundaria a infiltración por células neoplásicas de carcinoma lobulillar infiltrante (CLI) de mama. En conclusión, la linitis plástica colónica puede ser una nueva forma de presentación de las metástasis colónicas secundarias a CLI de mama

Colon metastases from breast carcinoma are relatively rare and the invasive lobular subtype tends to metastasize more frequently due to its peritoneal dissemination. A 67-year-old female with a lobular subtype breast neoplasm was treated via a surgical resection ten years previously, with subsequent radiotherapy and adjuvant chemotherapy. She is currently in clinical remission. A colonoscopy was performed due to a recent onset cachexia syndrome, which identified diffuse linitis plastica of the colon. Biopsies confirmed that it was secondary to infiltration by cancer cells of invasive lobular breast carcinoma (ILBC). In conclusion, linitis plastica of the colon may be a new presentation of colon metastases from ILBC

Linitis plastica of the colon due to metastases of invasive lobular breast carcinoma.

Colon metastases from breast carcinoma are relatively rare and the invasive lobular subtype tends to metastasize more frequently due to its peritoneal dissemination. A 67-year-old female with a lobular subtype breast neoplasm was treated via a surgical resection ten years previously, with subsequent radiotherapy and adjuvant chemotherapy. She is currently in clinical remission. A colonoscopy was performed due to a recent onset cachexia syndrome, which identified diffuse linitis plastica of the colon. Biopsies confirmed that it was secondary to infiltration by cancer cells of invasive lobular breast carcinoma (ILBC). In conclusion, linitis plastica of the colon may be a new presentation of colon metastases from ILBC.