Volume 77 - 2014 - Fasc.4 - Case reports
Resolving bile reflux by lanreotide in patients with Roux-en-Y gastrojejunostomy
Reflux into the esophagus after partial or total gastrectomy is a well known problem. Even a Roux-en-Y reconstruction is not always a definitive solution. Bile reflux might occur and cause disabling symptoms, unresponsive to the classic anti-acid or anti- reflux therapy. Endoscopy and a Tc-99m-BrIDA hepatobiliary (HIDA) scan can be used to make the diagnosis. Clinical studies have shown that lanreotide (somatuline), which strongly inhibits many gastro-intestinal hormones, reduces the bile salts outputs.
We present a case of a patient with bile reflux after Roux-en-Y. After administration of lanreotide he had a good clinical improve- ment and mucosal healing on endoscopy. Lanreotide can be a good treatment option for bile reflux when classic treatment fails, but clinical trials with more patients will have to confirm this. (Acta gastroenterol. belg., 2014, 77, 377-378).
Henoch-Schönlein Purpura complicated with major gastro-intestinal hemorrhage
We report a case of Henoch-Schönlein Purpura in a 83-year old patient. The patient presented with a purpuric rash and arthralgia. During admission, he developed hematochezia and acute kidney injury. Because of protracted gastro-intestinal bleeding after initi- ating therapy with methylprednisolone and ileocaecal resection, azathioprine was started. Gastro-intestinal bleeding resolved, and renal function normalized. We present the clinical and pathological findings of Henoch-Schönlein Purpura, focusing on gastro-intesti- nal manifestations. (Acta gastroenterol. belg., 2014, 77, 379-382).
A rare case of hematemesis following gastro-duodenal strongyloides infection
We report the case of a 30-year old Black African man with a two-year history of nausea, abdominal discomfort and pruritus due to infection with Strongyloides stercoralis, which was successfully treated, but then complicated by the development of a bleeding pseudo-tumor in the duodenum. A review of the literature was performed. (Acta gastroenterol. belg., 2014, 77, 383-385).