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Volume 76 - 2013 - Fasc.4 - Case reports

Endoscopic removal of an Endoloop entrapped around a polyp in the right colon using Novel “threading technique"

Detachable Endoloops were first invented in 1986 (1) and became available for commercial use in the early 1990s (2). They were initially recommended for the con- trol of bleeding which was later extended for prophylaxis of post-polypectomy bleeding also (3-7). The most common complications associated with detachable Endoloops are failure of snare to close around a polyp and bleeding caused by accidental transection of polyps by aggressive snare closure (5). Failure of an Endoloop to deploy once it is tightened around a polyp stalk is a more worrisome complication with minimal manage- ment discussion reported in the literature.


Acute liver failure secondary to metastatic liver infiltration : case report and review of the literature

We present the case of a patient who died from multiple organ failure due to acute liver failure as a result of malignant hepatic infiltration by an adenocarcinoma. A review of the literature re- vealed that the clinical picture, laboratory examination, and imag- ing studies do not contribute to the diagnosis of this rare cause of liver failure. Therefore, liver biopsy should be considered early in the process, as this diagnosis is a contraindication for orthotopic liver transplantation. (Acta gastroenterol. belg., 2013, 76, 436-438).


A giant abdominal cyst with raised levels of carbohydrate antigen 19-9

A 53-year-old woman was admitted with upper abdominal discomfort. Clinical examination revealed a mass of the upper left quadrant. Computed tomography disclosed a giant cystic lesion of 19 × 16 cm compressing the body and tail of the pancreas as well as the left kidney. Endoscopic ultrasound showed an anechoic lesion with multiple septa. Diagnostic fine needle aspiration was performed. Intracystic carcinoembryonic antigen and lipase values were normal. However, carbohydrate antigen 19-9 level was elevated (3433 UI/ml) and cytologic examination was compatible with a pancreatic serous cystadenoma. Prompted by the symptoms and the lack of a definite diagnosis, the patient underwent cystectomy. Surprisingly the histological diagnosis was that of a benign renal cyst. To date, only one case of a giant renal cyst has been reported with high levels of CA 19-9. With this case report we would like to demonstrate that giant renal cysts may present high levels of CA 19-9 and mimic the endoscopic ultrasound aspect and cytologic features of pancreatic cysts. (Acta gastroenterol. belg., 2013, 76, 439- 440).