Publications by authors named "Bruno Peixe"

Background: Cecal perforation from barotrauma is a rare complication of colonoscopy, even with the use of CO₂ insufflation, which is generally preferred over room air due to its rapid absorption and reduced patient discomfort.

Case Report: A 64-year-old woman with hypertension and dyslipidemia underwent a routine colonoscopy with CO₂ insufflation. Multiple diverticula were noted, and upon reaching the cecum, several parallel linear lesions with spontaneous bleeding, consistent with "cat scratch" colon, were observed.

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A 60-year-old female with chronic pancreatitis and a history of splenectomy presented with epigastric pain, vomiting, and asthenia. Elevated pancreatic enzymes and CT imaging revealed a pseudocyst in the pancreatic head with suspected communication to the portal vein, confirmed by MR Cholangiopancreatography and endoscopic ultrasound (EUS). EUS-guided puncture revealed high amylase levels.

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Diagnosing IgG4-related sclerosing cholangitis (IgG4-SC) presents significant challenges, especially when serum IgG4 levels are normal and other organs are not involved. We report a case of a 51-year-old patient with typical symptoms of biliary obstruction, including jaundice and abdominal pain. Despite normal serum IgG4 levels, imaging suggested cholangiocarcinoma, leading to extensive surgical intervention.

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We present a case of gastro-jejunal anastomotic stenosis due to the progression of malignant disease, successfully treated endoscopically by placing a lumen-apposing metal stent. This case illustrating the successful use of a lumen-apposing metal stent in a complex clinical scenario. This approach can significantly improve patient outcomes, especially in those who are poor surgical candidates or have advanced disease.

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Article Synopsis
  • Splenic artery pseudoaneurysm (SAP) is a serious and uncommon condition that can occur as a complication of pancreatitis, posing a significant risk of rupture and death.
  • Timely diagnosis and treatment are essential, often using endovascular methods like embolization.
  • A case study of a 46-year-old woman with chronic pancreatitis highlighted successful treatment of a ruptured SAP with hydrocoil embolization, leading to her full recovery.
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Capsule endoscopy (CE) is considered the first-line for the investigation of OGIB after conventional non-diagnostic endoscopic examinations. A detection rate of lesions outside the small bowel segment has been reported to range from 3.5% to >30%.

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Carcinoid tumors are rare neoplasms, most frequently found in the gastrointestinal tract, responsible for the production of neuroendocrine mediators. Carcinoid syndrome is even rarer and consists of a set of symptoms characteristic of the release of these mediators into the systemic circulation. We present an interesting case of a patient with carcinoid syndrome as a late manifestation of a gastric neuroendocrine tumor with, highlighting the importance of knowing how to identify the carcinoid syndrome.

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A 59-year-old Portuguese Caucasian man with a history of heavy alcohol intake and no significant medical history presented with ascites, weight loss and general malaise. The ascitic fluid analysis showed 921 cells/mm with mononuclear predominance (93.6%), elevated total proteins and a slightly elevated serum-ascites albumin gradient.

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Article Synopsis
  • The study evaluates two new prognostic scores, CLIF Consortium ACLF score (CLIF-C ACLFs) and CLIF-C Acute Decompensation score (CLIF-C ADs), in predicting mortality in patients with liver failure.
  • The analysis was conducted on 779 cases of decompensated cirrhosis, revealing mortality rates of 17.7% at 30 days and 37.3% at 90 days, with both new scores showing moderate predictive accuracy.
  • Overall, the newer CLIF-C scores did not outperform traditional models, except for CLIF-C ADs, which was more effective than MELD for predicting 30-day mortality.
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