Melanoma with gastric metastases.

An 81-year-old woman with a history of malignant melanoma who presented with dyspnea and fatigue was found to have metastases to the stomach detected on endoscopy. Primary cutaneous malignant melanoma with gastric metastases is a rare occurrence, and it is often not detected until autopsy because of its non-specific manifestations.

Complete esophageal obstruction following endoscopic variceal band ligation.

Variceal hemorrhage is a potential complication of portal hypertension. Besides medical management, endoscopic variceal band ligation (EVBL) has emerged as a promising prophylactic tool proving to be superior to sclerotherapy. EBVL is a simple procedure associated with minor complications and short recovery time.

Cholestatic liver disease. Recognizing the clinical signs.

Cholestatic liver disease in women is most often seen as primary biliary cirrhosis, an autoimmune disease that may take many years to cause symptoms and is often a challenge for physicians to identify. Primary sclerosing cholangitis is a cholestatic liver disease with a more straightforward presentation. Most commonly seen in men, this disease may rapidly progress to cirrhosis or to a third common cholestatic disease, cholangiocarcinoma.