Volume 75 - 2012 - Fasc.3 - Case reports
Pericarditis with massive pericardial effusion : an unusual complication of primary biliary cirrhosis
Primary Biliary Cirrhosis (PBC) is a debilitating autoimmune condition associated with a constellation of extrahepatic inflamma- tory manifestations accentuating its morbidity and mortality. Pericarditis and pericardial effusion had been rarely associated with and inadequately characterized in PBC. We present a challen- ging case of inflammatory pericarditis and life-threatening massi- ve pericardial effusion in a 49 year old patient with PBC. This com- plication should be more recognized and appropriately treated to avoid progression to cardiac tamponade. (Acta gastroenterol. belg., 2012, 75, 354-356).
Neuroendocrine tumor of the cystic duct
Neuroendocrine tumours of the extrahepatic bile ducts are extremely rare with less than 70 cases having been reported in the literature. Neuroendocrine tumours are neoplasms of variable malignant potential that arise from the embryonic neural crest cells. They most commonly occur in young females and usually present with painless jaundice. Preoperative diagnosis is seldom made and neuroendocrine tumours are usually incidentally found during abdominal surgical intervention for other indication. Due to their indolent biological behaviour aggressive surgical treatment is recommended. We present a case of an incidentally discovered neuroendocrine tumour of the cystic duct in a 41 year old woman following laparoscopic cholecystectomy for symptomatic gallblad- der microlithiasis. The present case is the 8th case of cystic duct NET and the 63rd of extrahepatic bile duct NET. While a rare location for a NET, it is important to report cases of biliary tract neuroendocrine tumours in order for their pathogenesis and physi- cal history to be clarified. (Acta gastroenterol. belg., 2012, 75, 357- 360).
Concomitant herpetic and eosinophilic esophagitis - a causality dilemma
Eosinophilic and herpetic esophagitis are listed as independent causes of dysphagia, especially in young adult males. However, herpetic esophagitis rarely affects immunocompetent individuals. We report the case of a young, not immunocompromised patient, admitted because of severe dysphagia secondary to herpes simplex virus esophagitis. After complete resolution, an endoscopic and histologic reevaluation established the diagnosis of eosinophilic esophagitis. The potential association between the two conditions is discussed. (Acta gastroenterol. belg., 2012, 75, 361-363).
Acute intestinal anisakiasis : CT findings
Small bowel anisakiasis is a relatively uncommon disease that results from consumption of raw or insufficiently pickled, salted, smoked, or cooked wild marine fish infected with Anisakis larvae. We report a case of intestinal anisakiasis in a 63-year-old woman presenting with acute onset of abdominal complaints one day after ingestion of raw wild-caught herring from the Northsea. Computed tomography (CT) scanning demonstrated thickening of the distal small bowel wall, mucosa with hyperenhancement, mural stratification, fluid accumulation within dilated small-bowel loops and hyperemia of mesenteric vessels. In patients with a recent history of eating raw marine fish presenting with acute onset of abdominal complaints and CT features of acute small bowel inflammation the possibility of anisakiasis should be considered in the differential diagnosis of acute abdominal syndromes. (Acta gastroenterol. belg., 2012, 75, 364-365).
