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Volume 79 - 2016 - Fasc.1 - Letters

Portosystemic encephalopathy in an 86-year-old patient : a clinical challenge

Abernethy malformations are rare vascular abnormalities, clas- sified into two types : type 1 if the portal vein is absent, type 2 when the portal blood is diverted into vena cava through a hypoplastic portal vein. These conditions present symptoms related to porto- systemic shunting, and usually become clinically evident in chil- dren or young adults. Here we report the first case of Abernethy malformation diagnosed in an 86-year-old female patient affected by portosystemicencephalopaty. (Acta gastroenterol. belg., 2016, 79, 58-59).


Magnetic compression anastomosis for post-traumatic disconnected bile duct

An 18-year-old male underwent to an emergent open cholecystectomy in another hospital after blunt abdomi- nal trauma and referred to our hospital for further biliary interventions with a diagnosis of liver laceration and ic- terus (total bilirubin : 27.2 mg/dL ; normal < 1.2 mg/dL). Magnetic resonance cholangiopancreatography showed disconnection between left hepatic duct and common he- patic duct. We decided to perform magnetic compression anastomosis [MCA] technique using the recently intro- duced (1) through-the- scope magnet (OBF, Istanbul, Turkey). The magnet is nickel-coated, cylindrical neo- dymium- iron-boron earth magnet each with a diameter of 2.4 mm and a length of 5 mm. Magnets have a hole in their centers to permit the advancing of a 0.038-inch guidewire. They have side holes at the distal sides for the attachment of a retrieval loop. Written informed consent was obtained from the patient.


Is there a difference between patients with rectal hyposensitivity having either constipation or anal incontinence ?

Rectal hyposensitivity (RH) is a clinical condition to define the increased sensory threshold pressures to rectal balloon distention in anorectal manometry practice. Although the pathogenesis is still not clear, it can be sub- categorized into primary (dysfunction of afferent path- ways) or secondary (altered rectal mechanics). RH can be associated with either constipation or incontinence (1). Rectal hyposensitivity is observed in about 45 percent of patients with fecal incontinence, whereas rectal hyposen- sitivity is observed in about 30 percent of patients with constipation (2).


Reactivation of Resolved Hepatitis B virus Infection before the Relapse of Lymphoma : Immunosuppressive effect of the Lymphoproliferative disorders ?

Hepatitis B virus (HBV) infection is a heterogeneous disease with distinct phases determined mainly by the interaction between virus replication and host immune response. HBV reactivation can occur spontaneously, developing resistance to antiviral treatment while the patient is undergoing treatment, after cessation of antiviral drugs, or be triggered by immunosuppressive drugs and chemotherapy. HBV reactivation can be severe and sometimes fatal because of liver failure. Here we report a patient with resolved HBV infection who presented with reactivation before being diagnosed with a relapse of non-Hodgkin lymphoma. (Acta gastro-enterol. belg., 2016, 79, 63-64).


Ciprofloxacin induced pancreatitis : Has this condition been overlooked ?

Ciprofloxacin is used extensively for various infec- tious conditions, and its most common adverse effects are vomiting and abdominal pain. Acute pancreatitis (AP) has also been reported as an adverse effect related to ciprofloxacin (1,2), but ciprofloxacin-induced pancre- atitis (CIP) is a very rare condition. Thus, CIP might be overlooked in some cases. Herein, we present a rare case of CIP.


Fracture of an indwelling biliary catheter : a word of caution

A 52-year-old patient was referred for percutaneous biliary drainage because of biliary obstruction, associated with recurrent malignant disease. She had a history of a hilar cholangiocarcinoma for which a hepaticojejunostomy was performed 4 years previously.