Endoscopic ultrasound performed by a surgical approach in a patient with a pancreatic lesion and stenosing esophageal adenocarcinoma.

Endoscopic retrograde cholangiopancreatography (ERCP) performed in situations of altered anatomy has been described. Thus, in cases of Roux-en-Y gastric by-pass, several approaches have been documented for performing ERCP: by enteroscopy, guided by laparoscopic approach through the gastric remnant, and direct transgastric guided by endoscopic ultrasound through a stent between the reservoir or alimentary loop and the gastric remnant. However, there are clinical situations in which the anatomy is not altered, but there may be pancreatic lesions subsidiary to study by endoscopic ultrasound in situations where the endoscope cannot pass through the esophagus.

Proton pump inhibitors (PPIs) and cancer. What should patients with gastroesophageal reflux disease candidates for PPIs therapy who refuse to comply with treatment know?

The relationship of proton pump inhibitors (PPIs) with gastric cancer is not clear. However, more and more patients with gastroesophageal reflux disease (GERD) who are candidates for therapy with PPIs reject such treatment. This situation is largely caused by global access to information, especially on the internet, where some news has recently been published linking PPIs to the development of gastric cancer.

Protocolization of multicenter clinical studies in the digital era. Is useful data centralization by a data-manager?

Introduction: In multicenter studies, the protocolization of data is a critical phase that can generate biases.The objective is to analyze the concordance and reliability of the data obtained in a clinical multicenter study between the protocolization in the center of origin and the centralized protocolization of the data by a data -manager.

Methods: National multicenter clinical study about an infrequent carcinoma.

Lymphoepithelioma-like gastric adenocarcinoma. Descriptive case series.

Lymphoepithelioma-like gastric adenocarcinoma is characterised by a large reactive lymphoplasmacytic infiltrate in the stroma and islets of undifferentiated cells, which express intense and widespread Epstein-Barr virus (EBV). This tumour type has higher survival rates than other gastric cancers, a more proximal location and less lymphatic spread. Our aim is to describe the clinical and pathological characteristics of our series of lymphoepithelioma-like gastric adenocarcinoma.

Submucosal infiltrate of Anisakis larvae. A rare cause of intestinal obstruction.

Patient aged 71 with a history of type 2 diabetes mellitus. He came to the emergency department for abdominal pain and vomiting. Laboratory tests showed an increase in acute phase reactants.

Pilot study: a detailed analysis of the timing of immuno-inflammatory indices in gastric cancer, and their assessment together with TNM as supplementary prognostic factors.

An analysis of the prognostic impact of up to 36 immuno-inflammatory indices at 3 different times during the diagnostic-therapeutic process for gastric cancer. The dependent variable was disease-free survival at 3 years. The independent factors obtained were combined with TNM to provide an improved prognostic model.

Large cell neuroendocrine carcinoma at the esophagogastric junction. An extremely rare entity.

We present the third case described to date of large cell neuroendocrine carcinoma located at the esophagogastric junction (LCNEC). Esophageal neuroendocrine tumours account for 0.03-0.

Recurrence of gastric schwannoma.

Gastric schwannoma can be malignant in 13.8% of cases. The prognosis of malignant schwannoma is usually poor, characterized by a rapidly progressive disease course and a poor response to chemotherapy.

Evolution of two unusual radiological findings in a patient with mesenteric ischemia.

Portal pneumatosis has been considered an ominous sign associated with intestinal ischemia, with a mortality rate of up to 90% as long as it is associated with sepsis. However, the prognosis of mesenteric ischemia depends on the etiology rather than the presence of portal pneumatosis. We present a patient with portal pneumatosis that disappeared 24 hours after the first surgery, but irreversible ischemic lesions were established in the terminal ileum.

Peritoneal tuberculosis mimicking colonic carcinomatosis.

Pulmonary Tuberculosis (TB) has increased in Spain in recent years due to multiple factors. Peritoneal tuberculosis represents the sixth cause of extrapulmonary tuberculosis, accounting for 11% of tuberculosis cases. We report a 28-year-old male from Mali, who arrived at our hospital with an acute abdomen due to intestinal perforation with a computed tomography scan (CT) performed peritoneal tuberculosis mimicking primary carcinomatosis.

Intra-abdominal abscess caused by Streptococcus constellatus in an immunocompetent patient.

Streptococcus constellatus is a Gram-positive commensal bacterium of the oropharyngeal, gastrointestinal and urogenital flora. It can cause abscesses in different parts of the body, especially in immunocompromised patients. We present the clinical case of a 33-year-old female patient with a previous history of one anastomosis gastric bypass, among others.

Importance of immunohistochemistry in the differential diagnosis of gastric mesenchymal tumors.

Although morphology is the key to histological diagnosis, gastric mesenchymal tumors can share very similar growth and cellularity patterns, sometimes being indistinguishable. Therefore, immunohistochemical techniques are going to be crucial in the definitive diagnosis. The objective of this work is to perform an immunohistochemical differential diagnosis of gastric mesenchymal tumors.

Dual esophageal compression secondary to two vascular abnormalities.

We report the case of a 65-year-old male with hypertension, diabetes and hypercholesterolemia, who presented due to pyrosis and regurgitation. A CT scan incidentally identified esophageal compression at two sites because of vascular abnormalities, which was asymptomatic. The proximal compression was due to a Kommerell's diverticulum (Fig.

Surgical indication for right hemicolectomy in goblet cell adenocarcinoma of the appendix.

We have read with interest the article by Pérez Montiel CA et al., in which goblet cell adenocarcinoma (GCA) is described as a cause of acute appendicitis. Although the article is brilliant in terms of histopathological description of the appendiceal GCA, the surgical indication for right hemicolectomy should be analyzed in depth due to the great controversy that exists in the scientific literature.

Surgical treatment of buried bumper syndrome in patients with Parkinson´s disease and duodenal levodopa/carbidopa infusion therapy.

We read with interest the article by Garrido Durán C, et al. in which endoscopic aspects of duodenal levodopa/carbidopa therapy in the treatment of advanced Parkinson's disease were analyzed. In this article, buried bumper syndrome (BBS) is documented in 5.

Results of treatment of papillary thyroid microcarcinoma adapted to risk of recurrence.

Background: The incidence of papillary thyroid microcarcinoma (PTMC) is increasing.

Objective: To analyze the long-term prognosis of PTMC.

Method: Study population: patients with a histopathological diagnosis of PTMC (size ≤ 1 cm) treated according to the risk of recurrence of the Latin American Thyroid Society.

Differences between residual and primary choledocholithiasis in cholecystectomy patients.

Introduction: choledocholithiasis can be primary from stones originally formed in the choledocho or secondary from stones that have migrated from the gallbladder to the choledocho. The objective of this study was to determine the clinical differences between both types of choledocholithiasis in cholecystectomy patients.

Material And Methods: a comparative and retrospective study was performed of cholecystectomy patients who presented choledocholithiasis.

Metastatic melanoma of the gallbladder: an uncommon finding.

Melanoma metastasizes to the gastrointestinal tract in 2-4% of cases. In addition, it is the tumor that most frequently metastasizes to the gallbladder (50-67% of metastasis at this level). Even so, these metastases are infrequent.

Acute calculous cholecystitis in a patient with suprahepatic gallbladder, hepatic hypoplasia and Chilaiditi's sign.

Chilaiditi's sign is the interposition of small bowel or colon between the liver and diaphragm. This incidental finding is seen in 0,025-0,28% of the chest and abdominal radiographies. Predisposing factors include the absence, laxity or elongation of the suspensory ligaments of the transverse colon, redundant colon or elevation of the right hemidiaphragm.