Browsing by Author "Antunes, Artur Gião"
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- Fever and haematochezia: an unusual associationPublication . Antunes, Artur Gião; Peixe, Bruno; Guerreiro, HoracioA 72-year-old male patient presented to the emergency room for haematocheziafollowed bysyncope. In the past 2 days he had fever and asthenia. From his medical records, we registered a peripheral vascular disease, with an aortobifemoral bypass graft placed 12 years prior; 6 years later, the graft had a thrombosis event and the patient was submitted to an axillofemoral bypass graft. On physical examination, he had haemodynamic instability and fever (38°C); the abdominal examination showed no abnormalities. Laboratory tests were as follows: haemoglobin: 10.7 g/L, white cell count: 17.7×109/ L; international normalized ratio (INR): 6.26; C reactive protein: 202 mg/L; blood urea nitrogen (BUN): 44 U/L; and creatinine: 1.91 mg/dL. After haemodynamic resuscitation, given the clinical presentation and the hypothesis of secondary aortoenteric fistula (AEF), a CT angiography was performed (figure 1). Although no active bleeding was detected, the aortobifemoral bypass graft was found to be adjacent to the third part of duodenum, but at a level at which the lumen of the aorta was partially thrombosed. Also, an effacement of the fat plane between the graft and the adjacent portion of the duodenum was noticed.
- Gastric siderosis as a cause of dyspepsiaPublication . Antunes, Artur Gião; Cadillá, Jesus; Guerreiro, HoracioA 66-year-old man was referred to our clinic due to a new onset of postprandial fullness and early satiety. He had a relevant personal history of myelodysplastic syndrome with lifelong regular blood transfusions resulting in a transfusional haemosiderosis (heart failure, pulmonary haemosiderosis, cirrhosis and diabetes).
- Olmesartan-induced enteropathy: an unusual cause of villous atrophyPublication . Eusébio, Marta; Caldeira, Paulo; Antunes, Artur Gião; Ramos, André; Velasco, Francisco; Cadill, Jesús; Guerreiro, HoracioWe report a case of a 63-year-old-man presenting with chronic diarrhea and weight loss while on olmesartan treatment for hypertension. Investigation showed multiple nutritional deficiencies associated with diffuse intestinal villous atrophy. Serologies for celiac disease were negative and other causes of villous atrophy were excluded. Olmesartan as a precipitant agent was suspected and withdrawn. Clinical improvement occurred in days with no need for other therapeutic measures. Follow-up at three months showed clinical remission and almost complete recovery of intestinal atrophy. Olmesartan is an angiotensin receptor blocker commonly prescribed for the management of hypertension. Spruelike enteropathy associated with this drug is a recently described entity with few cases reported. It presents with chronic diarrhea and intestinal villous atrophy and should be included in its differential diagnosis. This case intends to alert clinicians for the possibility of this event in a patient on treatment with this drug.
- Pancreatitis and cholangitis following intraductal migration of a metal clip 5 years after laparoscopic cholecystectomyPublication . Antunes, Artur Gião; Peixe, Bruno; Guerreiro, HoracioA 58-year-old male was admitted at our hospital for severe epigastric pain, nausea and vomiting. On physical examination patient was sweaty, restless and with marked tenderness in the epigastrum.
- Russell body gastritis in an Hp-negative patientPublication . Antunes, Artur Gião; Cadillá, Jesus; Velasco, FranciscoA 79-year-old woman with a longstanding gastrooesophageal reflux disease was admitted to the emergency room for haematemesis without other symptoms.