Rev Esp Enferm Dig
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Recent studies have shown that the adrenal gland is the fourth most common site of HCC extrahepatic metastasis; despite this, the incidence of right adrenal metastasis of HCC is unclear. EUS-guided FNA of the right adrenal gland is technically possible and safe, and should be considered in cases of right adrenal tumors with no diagnostic criteria by imaging test.
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Letter Case Reports
Meckel's diverticulum perforated by a fishbone. An unusual presentation.
Finding a Meckel's diverticulum during a laparotomy is rare, operating on a patient for a complication of diverticulum is rare, but if this complication is the result of a perforation of the diverticulum by a foreign body, then we are in the presence of a medical curiosity.
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Case Reports
Paraesophageal hernia and gastric volvulus: an uncommon etiology of vomiting and upper gastrointestinal bleeding.
The authors report the case of a 75 year-old woman admitted to the emergency room with abdominal pain and coffee ground vomiting. Marked epigastric distension with tenderness and signs of severe dehydration were present. Upper GI endoscopy showed a black esophagus covered by a large amount of dark fluid, diffuse hyperaemia and superficial erosions. ⋯ The patient was discharged without further complications. Acute gastric volvulus is a rare entity that may manifest with vomiting due to gastric outlet obstruction and gastrointestinal bleeding associated with mucosal ischemia and sloughing. Emergency surgery wass required to resolve symptoms and prevent complications.
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Illicit drug trafficking within the body ("body packers") represents a medical-legal problem currently on the rise. Endoscopic removal of drug packets is not generally recommended because of the risk of packet rupture and subsequent overdose on the spilled substance. A 40-year-old male presented with abdominal pain and diaphoresis following the ingestion of 30 g of hashish as a means of illegal trafficking, remaining in police custody during his hospital stay.
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Bleeding complications are well known in the context of acute pancreatitis however, intramural hematomas of the superior gastrointestinal tract are rare. The treatment of choice, in absence of active bleeding or other complications, must be conservative, resulting in spontaneous resolution of the hematoma in most of the cases.