Volume 76 - 2013 - Fasc.3 - Letters
oesophageal bezoar induced by black beans successfully removed by associating endoscopy and oral sodium bicarbonate
Bezoar in the oesophagus is infrequent. There is no report about raw black beans as possible cause. Black beans are the folk prescription for treating chronic consti- pation in China. We report a case of oesophageal bezoar in a patient with normal oesophagus.
Proton pump inhibitors and risk of hepatocellular carcinoma : a case-control study in Taiwan
Proton pump inhibitors (PPIs) are effective drugs that are frequently used for the management of peptic ulcer and gastro-esophageal reflux disease as well as for the elimination of Helicobacter infection. However, the long-term use of PPIs has been shown to cause hypergas- trinemia (1,2). Experimental and clinical studies have also shown that hypergastrinemia might correlate with the risk for gastro-intestinal cancers, with the exception of hepatocellular carcinoma (HCC) (3-5). Few studies on the association between PPIs use and HCC risk are avail- able.
Cyclic vomiting in a young patient with superior mesenteric artery syndrome
Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by duodenal compression through aorto-mesenteric clamp, also known as the Wilkie's syndrome. In SMAS passage is blocked in the lower part of the duodenum by vascular compression. Precipitating factors include increased lordoses, loss of abdominal muscle tone, rapid weight loss (2), abdominal surgery, or intrabdominal inflammatory conditions that may compress the mesenteric vessels. Symptoms are usually non specific and intermittent and include post- prandial epigastric fullness, bloating, nausea, vomiting, and abdominal pain that are usually relieved by the prone or knee-to-chest position (3). Diagnosis is based on im- aging techniques that include X-ray passage series of the upper gastrointestinal tract and angiographical visualiza- tion of the superior mesenteric artery and determination of its angle of branching from the aorta. Retrocolic duo- denojejunostomy has proven to be the most satisfactory surgical treatment for this lesion (4).
A 54-year-old woman was admitted to our hospital after two episodes of massive rectal bleeding. Her past medical history was significant for insulin-dependent diabetes mellitus, hypertension, diverticular disease, rheumatic arthritis, hypothyroidism, and dyslipidemia. In addition to anti-hypertensive drugs and anti-diabetic drugs, she was taking anti-platelet and non-steroidal anti- inflammatory drugs. There was no previous history of gastrointestinal hemorrhage.
Ischemic proctitis in a diabetic patient
Ischemic colitis is the most common form of intestinal ischemia, which results from lack of blood flow in the absence of mechanical obstruction. Acute ischemic coli- tis usually occurs in the descending and sigmoid colon. The rectum is affected very rarely because of its abun- dant collateral blood supply. Ischemic proctitis is usually related to a derangement in the central circulation from congestive heart failure, arrhythmia, hypotension or va- soconstrictive drugs (1). In this report we present a case of ischemic proctitis in a patient with non-insulin-depen- dent diabetes mellitus (NIDDM).