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Percorrer por autor "Canhoto, Manuela"

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  • Refeeding syndrome in a patient with an obstructive pancreatic cancer : an emerging complication of artificial nutrition in the gastroenterology ward
    Publication . Patita, Marta; Nunes, Gonçalo; Canhoto, Manuela; Fonseca, Jorge
    Refeeding syndrome (RS) is a life-threatening condition first described in severe malnourished prisoners of the Second World War1. This syndrome is defined as electrolyte and fluid shifts associated with metabolic abnormalities developed during nutritional support. RS hallmark is hypophosphatemia, but also includes hypomagnesemia, hypokalemia, vitamin deficiencies, abnormal glucose metabolism and fluid retention. Prolonged fasting is the most important risk factor and RS may be precipitated by oral, enteral or parenteral nutrition4,5. The authors describe a case of RS in the gastroenterology ward exemplifying the importance of recognizing this underreported condition in patients with digestive pathology under nutritional therapy.
    2021-07Contributo em revista Acesso aberto Ver mais
  • A unique case of recurrent upper gastrointestinal bleeding caused by two metachronous Dieulafoy’s lesions: the role of EUS evaluation
    Publication . Brito, Mariana; Nunes, Gonçalo; Marques, Pedro Pinto; Canhoto, Manuela; Proença, Ana Luísa; Fonseca, Jorge
    Introduction: Dieulafoy’s lesion (DL) is a rare but important cause of acute, severe, life-threatening, and recurrent upper gastrointestinal bleeding (UGIB). It is frequently difficult to diagnose DL with upper GI endoscopy (UGIE), and endoscopic ultrasonography (EUS) may be valuable. There are only 2 reported bleeding cases caused by two synchronous DL but no reported cases of two metachronous DL. Case Report: A 28-year-old healthy male presented with acute severe UGIB. UGIE was inconclusive. Systematic EUS mapping identified a gastric DL. After several attempts of EUS-guided hemostasis, DL was marked using a through-the-scope clip and the patient underwent successful transcatheter arterial embolization (TAE). Three years later, a new severe UGIB episode was caused by a second gastric DL in a different location, which was identified and marked by EUS and further successfully treated through TAE. The patient maintained follow-up without evidence of further bleeding. Discussion/Conclusion: The authors report a unique case of severe, recurrent UGIB caused by two metachronous gastric DL lesions. The importance of systematic EUS scanning for diagnosis, treatment, and follow-up of DL is emphasized, as well as the potential influence in the outcome of other techniques like angiographic embolization.
    2021-05Contributo em revista Acesso aberto Ver mais