Jejunal volvules are a very rare condition, barely reported in the literature, that occur in relation to congenital (eg, intestinal duplication) or acquired disorders (eg, diaphragmatic hernias or tumors). In the event that it becomes complicated with an established intestinal ischemia, its prognosis is further overshadowed by the possible consequences of a complex surgery, given the high risk of short bowel syndrome. Being a PEG probe carrier does not seem to be related to the picture.A 43-year-old male with an uneventful history presented with fever and ingestion-triggered retrosternal chest pain of a three-day duration, which was aggravated by deep breathing and the supine position. When asked regarding the possible ingestion of a foreign body he recalled having accidentally swallowed tiny glass shards from a broken bottle.A 41-year-old patient presented to the Dermatology clinic with a papular rash on the trunk and orange-colored maculopapular lesions on the soles of both feet. This was associated with general symptoms including myalgia, fatigue, epigastric pain, nausea and vomiting. The patient had been taking omeprazole and cinitapride with little improvement.A 71-year-old female with liver cirrhosis underwent a capsule endoscopy (CE) due to middle gastrointestinal bleeding. A neoplastic stenotic lesion showing stigmata of a recent hemorrhage was observed in jejunum and the capsule was retained.Liver failure (LF) is a severe entity, which represents a diagnostic challenge for clinicians. Knowing the etiology of liver aggression is key for its management. We present a rare case of cholestatic LF secondary to primary AL (kappa-light chain) amyloidosis as a presentation associated to multiple myeloma.We present the case of an 87-year-old male with Parkinson’s disease, admitted to the Emergency Room due to acute abdomen, without leukocytosis or neutrophilia, with PCR of 0.74 and lactate of 2.5. The emergency abdominal computed tomography (CT) scan showed a pneumoperitoneum and significant intestinal pneumatosis on the small bowel loops in the right abdomen. There was a 3.2 cm slight dilation, without portal venous gas and an adequate opacification of the superior mesenteric artery and its main branches. An emergency laparotomy was performed that showed subserosal cysts in the jejunum and ileum, with no signs of transmural perforation. The patient was discharged after a good postoperative evolution.Paracentesis is a common and well accepted technique for its diagnostic-therapeutic profitability. This procedure is considered rapid, minimally invasive and safe, but we must not forget that it can lead to severe complications. In this letter we present two patients with hemorrhagic complications following paracentesis. Both cases were treated by percutaneous transarterial embolization. Likewise, in the absence of consensus on the prevention of complications and on their optimal management, we make some recommendations.Autoimmune liver diseases can overlap resulting in a new entity, phenotypically different from those pathologies that converge, and that demonstrates the complexity of our immune system. Sequential overlap syndrome is the consecutive presentation, separated by a variable period of time, of two liver autoimmune diseases, mostly autoimmune hepatitis and primary biliary cholangitis. This syndrome constitutes a challenge both in its diagnosis and in its treatment given the exceptional nature of its presentation. The theory of a mosaic of autoimmunity is proposed to describe this phenomenon.Splenic biopsy is a necessary diagnostic procedure. It has been proved that it is a safe procedure with a high diagnostic accuracy. However, the decision of percutaneous or endoscopic ultrasound-guided approach should be assessed taking into consideration patients’ characteristics and the experience of each center.We report the case of a patient with a Dieulafoy lesion within a duodenal diverticulum, showing the radiographic images. In this case the use of radiological techniques was of great help for diagnosis, bearing in mind that bleeding from this lesion may be intermittent and had not been revealed by the first endoscopic procedure. Since strong clinical suspicion persisted of active upper GI bleeding an angio-CT scan was performed, which allowed to orient diagnosis and rule out other causes of bleeding inaccessible to endoscopy.

chronic liver disease (CLD) patients often present thrombocytopenia (TCP) and when severe, it may prevent them from undergoing necessary invasive procedures due to an increased bleeding risk. The lack of scientific evidence makes it impossible to determine key aspects of the current management and associated healthcare burden of these patients in Spain.

to gain insight into the current situation of patients with CLD-associated severe TCP undergoing invasive procedures in Spain, based on the experience of clinical experts.

national Delphi study involving 32 medical experts.

the estimated prevalence of CLD-associated severe TCP is approximately 5,967, with an annual incidence of 1,148 new patients. Patients undergo a median of 1 (0-3) invasive procedures/year. Platelet transfusions (PTs) are the standard option to raise platelet counts and are associated with significant burden. The achievement of target platelet levels (≥ 50 x 109/l) after a transfusion is not routinely measured. The lack of effectivens and to advance in the search for alternatives to PTs.Advances in the knowledge regarding celiac disease have enabled the development of diagnostic markers, such as anti-tissue transglutaminase and anti-deaminated gliadin antibodies. The wide availability of these antibodies, genetic studies of HLA-DQ and duodenal biopsies constitute the pillars necessary for a definitive diagnosis. However, difficulties sometimes arise in both the diagnosis and follow-up of celiac patients, which cannot be resolved using these tools. This article reviews the scientific evidence and possible clinical utility of different biomarkers. Brimarafenib cell line This review is structured according to biomarkers that have been evaluated pathophysiologically in relation to intestinal damage or immune response and their potential clinical utility in the diagnosis and follow-up of celiac disease patients.