Volume 78 - 2015 - Fasc.4 - Case reports
Occult HBV reactivation induced by ibrutinib treatment : a case report
Ibrutinib is a small molecule that has been recently developped for the treatment of B cell malignancies. Common side effects are diarrhoea, nausea, fatigue, infections, neutropenia and thrombocy- topenia. Here we report the first case of Hepatitis B virus reactiva- tion in a 80 years old chronic lymphocytic leukaemia patient receiv- ing ibrutinib, suggesting that such treatment must be associated with HBV screening. (Acta gastroenterol. belg., 2015, 78, 424-426).
Hemosuccus pancreaticus caused by rupture of a splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis : an uncommon cause of gastro- intestinal bleeding
We present a case of a 52-year old female patient with inter- mittent gastrointestinal bleeding and iron deficiency anaemia. Repeated endoscopic investigation revealed no diagnosis, but contrast-enhanced computed tomography showed a splenic artery pseudoaneurysm secondary to chronic alcoholic pancreatitis. A distal pancreatectomy and splenectomy was performed.
Hemosuccus pancreaticus is an uncommon cause of gastrointes- tinal bleeding, most frequently associated with chronic pancreati- tis. Erosion of a peripancreatic artery by a pseudocyst can cause a pseudoaneurysm and rupture occurs in up to 10% of the cases. Bleeding from a pseudocyst wall or rupture of an atherosclerotic or traumatic aneurysm is rare. Angiography, contrast-enhanced com- puted tomography and endoscopic findings can be diagnostic in the majority of cases. Angiographic embolization or surgery are both therapeutic options depending on underlying nonvascular pancre- as related indications requiring surgery. We discuss diagnostic pitfalls and current therapeutic strategies in the management of this disease. (Acta gastroenterol. belg., 2015, 78, 427-430).
Ossification of a rectal tumor : an uncommon finding
The authors report the case of a 29-year-old woman with -partially- calcified- stage- cT4N2M0- mucoid- adenocarcinoma- of- the mid-rectum. Concomitant neoadjuvant chemoradiotherapy was administered.-Preoperative-CT-scan-and-MRI-demonstrated-stable disease with a marked increase of its mineralized component. -Histology- confirmed- a- mucoid- adenocarcinoma- with- ossified -matrix.-Osteocytes-were-identified-in-the-tumor.-TNM-(5th-edition) staging-was-ypT3N2M1.
This-case-illustrates-heterotopic-ossification-of-a-rectal-tumor,-a fairly-uncommon-finding.-The-mechanism-of-heterotopic-bone-for- mation within gastrointestinal adenocarcinoma has not been fully elucidated. The impact of this particular feature on patient out- come is unknown. (Acta gastroenterol. belg., 2015, 78, 431-435).
