Intraabdominal Urokinase for the Treatment of Secondary Bacterial Peritonitis in Cirrhosis.

Bacterial peritonitis with loculated ascites in patients with liver cirrhosis can be a therapeutic challenge. We present the case of a patient with liver cirrhosis undergoing pre-transplant evaluation, diagnosed with bacterial peritonitis secondary to urgent surgical intervention Imaging studies identified markedly loculated ascites, with a poor response despite broad-spectrum antibiotic therapy. The use of intraabdominal urokinase was a safe and effective adjuvant treatment for the resolution of this complication.

Active microscopic colitis precipitated by fluoxetine.

Microscopic colitis is a form of chronic and recurrent inflammatory bowel disease characterized by non-bloody, watery diarrhea, macroscopically normal colonic mucosa, and characteristic histopathological findings. Some drugs have been described as triggers of colonic inflammation in predisposed individuals, while others may exacerbate microscopic colitis that evolves on its own. We present the case of a patient diagnosed with active microscopic colitis in relation to taking fluoxetine at high doses.

Prolapsed hyperplastic gastric polyp: an uncommon cause of acute pancreatitis.

A 68-year-old male presented to the Emergency Department with a one-month history of intermittent epigastrium pain. Laboratory tests revealed leukocytosis and elevated lipase (4129 UI/l), with normal liver function, so he was admitted for its first episode of acute pancreatitis. Abdominal ultrasound showed liver steatosis, without cholelithiasis or bile duct dilatation.

Persistently elevated alkaline phosphatase without hepatopathy? Literature review.

Elevated alkaline phosphatase (ALP) levels are found in multiple hepatobiliary diseases and in bone diseases. ALP can also originate in the intestine and placenta. Very few cases of persistent elevations of IALP or in the context of benign familial intestinal hyperphosphatasemia (BFIH) without underlying pathology have been reported in the literature.

Hepatic subcapsular hematoma post-endoscopic retrograde cholangiopancreatography requiring embolization.

Endoscopic retrograde cholangiopancreatography (ERCP) placement of biliary stents is the procedure of choice for bile duct strictures. Complications of endoscopic retrograde cholangiopancreatography have a low incidence. Hepatic subcapsular hematoma is uncommon but potentially serious.

Liver abscess as a atypical presentation of hepatocellular carcinoma.

We present the case of a 64-year-old male with a history of chronic liver disease due to hepatitis C virus, with a sustained viral response after oral antiviral treatment and without follow-up for 5 years. He was admitted after a one-month history of constitutional symptoms, low-grade fever, abdominal pain and a palpable epigastric tumor. Analysis showed marked elevation of acute phase reactants (48,000 leukocytes and C-reactive protein of 19mg/dl) and dissociated cholestasis.

Ustekinumab for corticodependent immune-mediated colitis by pembrolizumab, an alternative for patients with concomitant liver injury.

Pembrolizumab, a programmed cell death receptor (PD-1) inhibitor, have improved the prognosis in several types of cancer. Despite the important clinical benefits, checkpoint inhibition have been associated with inflammatory and immune-related side effects (irAE).

Comparison of satisfaction degree of patients treated at the Inflammatory Bowel Disease Unit (IBDU) of Hospital Universitario 12 de Octubre between previous face-to-face care and telephone care during the COVID-19 pandemic.

The aim of the IBDU is to provide comprehensive care for patients with IBD (1,2). During the COVID-19 pandemic, telephone medical consultations and telemedicine training sessions were implemented to ensure patient safety (3). The aim of this study was to determine whether there was a difference in the degree of satisfaction between face-to-face and telephone care, as well as in the annual patient sessions.

EBV-positive mucocutaneous ulcer - Only in immunosuppressed patients?

We report the case of a 42-year-old male without a previous medical history who presented with hematochezia, tenesmus, and weight loss over two months. An ulcerated lesion located on the pectineal line, covering the entire circumference, was identified by colonoscopy. Histologically, there was a lymphoplasmacytic infiltrate and histiocytes with atypical Hodgkin-like lymphoid cells, and the immunohistochemistry tested positive for EBV.