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Volume 67 - 2004 - Fasc.3 - Case reports

Percutaneous transluminal angioplasty of the inferior right hepatic vein for the treatment of Budd-Chiari Syndrome

Budd-Chiari Syndrome is one of the several causes of portal hypertension and is characterised by hepatomegaly, ascites and abdominal pain. The treatment requires either medical or inter- ventional / surgical procedures. A case of Budd-Chiari Syndrome with a membranous web that causes obstruction in the ostium of the inferior right hepatic vein is reported here which was treated by percutaneous transluminal angioplasty (PTA). The patient was asymptomatic and off medication and there was no recurrence after 18-months follow-up. (Acta gastroenterol. belg., 2004, 67, 306- 308).

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Liver abscess : a rare but an important complication that must be considered in Crohn's disease

Liver abscess is a quite rare complication in Crohn's disease. Early diagnosis and differentiation of pyogenic abscess from amoebic abscess are as important as the choosing of proper treat- ment in the management of liver abscess. Herein, 28-year-old man with Crohn's disease developing liver abscess is presented. He was treated with surgical drainage. (Acta gastroenterol. belg., 2004, 67, 303-305).

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Pericarditis due to interferon-a therapy during treatment for chronic hepatitis C

Pericarditis due to interferon alpha therapy during treatment for chronic hepatitis C. We report a patient with pericarditis during therapy with interferon alpha 2b for chronic hepatitis C viral infection. We review interferon alpha therapy and hepatitis C virus side-effects on the cardiovascular system. (Acta gastroenterol. belg., 2004, 67, 301-302).

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Carcinoma of Papilla Vateri presenting as recurrent acute pancreatitis

Tumors of the Papilla of Vater can cause several clinical symp- toms, the most prominent being jaundice, weight loss, anorexia, fever, abdominal pain and itching (1). Acute pancreatitis as a pre- senting symptom of ampullary carcinoma is rare. Few previous cases have been described in the literature (2,3). The prognosis of patients with jaundice is unfavorable in comparison with non icteric patients at the time of diagnosis (4) due to different staging, hence more complications, but not due to different histology. We report here a case of recurrent pancreatitis that was the only presentation of Vater ampullary carcinoma diagnosed by endo- scopic ultrasound followed by duodenoscopy with guided biopsy. Recurrent pancreatitis without identifiable cause, particularly in elderly patients, could suggest tumor of the head of pancreas or the periampullary region among other causes such as intraductal papillary mucinous tumor, microlithiasis etc. An endoscopic ultra- sound can allow earlier diagnosis and mandates biopsy in these cases. (Acta gastroenterol. belg., 2004, 67, 309-310).

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