A 75-year-old male patient, with a history of digestive bleeding of unknown origin, underwent a study of the small intestine by capsule endoscopy. In two abdominal radiographs, the capsule endoscopy was not evident nor recovered. Thus, it was assumed that the capsule was expelled.Two years later, the patient presented dysphagia and consulted. A chest tomography revealed the presence of a Zenker's diverticulum with an image suggestive of a capsule endoscopy inside. Endoscopic extraction of the capsule was performed under general anesthesia and endotracheal intubation. During the procedure, Zenker's diverticulum was observed with the capsule inside, which was extracted with a Roth basket.

Background & aims Hepatorenal syndrome is a rare entity that is part of the complications of liver cirrhosis in its more severe stages. Without treatment, its mortality rate increases significantly. Terlipressin is considered to be the therapy of choice until the need of a liver transplant. The aim is to determine its prevalence, define patients' characteristics, triggers and 90-day survival, according to the type of managements established. Method This was a retrospective cohort study conducted in Colombia. It included patients with cirrhosis and acute kidney injury who met hepatorenal syndrome criteria, reaching 28 patients from 2007 to 2015. Groups were categorized according the type of hepatorenal syndrome and treatment. Demographic and trigger factors were evaluated to characterize the population. Treatment outcomes with terlipressin vs norepinephrine were analyzed up to a 90-day survival, using log Rank test. Continuous variables needed Student's T and Mann Whitney's U tests and categorical variables, Chi2 test. A value of p <0.05 and a power of 85% was considered. The data was analyzed in the SPSS version 23 software. Results 117 patients with cirrhosis developed renal injury; of these 23.9% were diagnosed with Hepatorenal Syndrome (67.8% type1; 32.1% type2). The presence of ascites was 100% in HRS2 and 84% in HRS1 (p = 0.296). The main trigger in both types was paracentesis greater than 5 liters in the last 4 weeks (39.3%). In total, 35% of the patients received renal replacement therapy and 14% underwent a hepatic transplant. Type 1 was more frequent (63% received terlipressin; 21% norepinephrine). The total complete response was 36%

Los tumores neuroendocrinos pancreáticos representan del 2-10 % de todos los tumores del páncreas y aproximadamente el 7 % de todos los tumores neuroendocrinos. Estos se clasifican como funcionales o no funcionales según la presencia o ausencia de síndromes clínicos asociados con la hipersecreción hormonal. Los insulinomas son los tumores neuroendocrinos pancreáticos funcionales más frecuentes (45 % de los casos) y la causa más frecuente de hipoglucemia hiperinsulinémica endógena persistente en adultos. Además, el 10 % de los tumores neuroendocrinos pancreáticos se asocian con neoplasia endocrina múltiple tipo 1. La insulinomatosis es una entidad clínica distinta en la que existen múltiples insulinomas. Objetivos: exponer los casos reportados hasta el momento de insulinomatosis y describir las causas genéticas, las características clínicas, el tratamiento, y el pronóstico de la insulinomatosis. Métodos: se realizó una búsqueda sobre insulinomatosis y los factores que controlan la proliferación de las células ? en las bases de datos PubMed, Medline y Google Scholar hasta Julio 2020. Resultados: 108 casos con insulinomatosis se han reportado hasta la fecha, siendo recurrente y rara vez malignos. Múltiples protooncogenes y supresores de tumores controlan de forma local y sistémica el crecimiento de las células ?; sin embargo, solo la mutación de MafA en p.Ser64Phe ha sido asociada. Conclusión: la insulinomatosis se caracteriza por la aparición sincrónica y metacrónica de insulinomas. Tiene un fenotipo histológico, clínico y genético diferente a los tumores neuroendocrinos pancreáticos; la mutación MEN-1 es negativa; puede ser esporádica o hereditaria; y MafA podría ser una mutación conductora.

Background Inflammatory Bowel Disease (IBD) includes Ulcerative Colitis (UC) and Crohn Disease (CD). In the last decade, there have been introduced therapeutic changes that have revolutionised the pharmacologic and surgical management of patients with IBD. The incidence of UC and CD has been increasing in Latin America but the exact prevalence is unknown. Our objective is to describe the demographic characteristics, clinical and therapeutic aspects of the IBD in patients that have presented in the University Hospital Fundación Santa Fe de Bogotá (UH-FSFB), Colombia. Methods Retrospective Descriptive Cohort Study. Clinical histories, pathology reports, and endoscopic results from data base HI-ISIS of the UH-FSFB and medical data between January 1996 and February 2019 were recollected, stored in Excel and analysed using IBM SPSS Statistics Visor. Patients with diagnosis of IBD were included. Patients with incomplete clinical histories were excluded. Results From 398 patients included in this study, 72.1% had UC, 25.6% CD and 2.3% Indeterminate Colitis. The average age of diagnosis was 43.54 years (range: 12–91). In both patients with UC and CD there were smaller proportions of men than women (0.9:1 for UC and 0.7:1 for CD). Of the patients with UC, 46.3% had been hospitalised. 37.2% presented with proctitis, 23.8% left colitis and 39% with pancolitis. 13.5% had an asymptomatic clinical disease, 22.4% mild, 15.3% moderate, and 48.8% severe. 12.9% received biological therapy (BT). 24.3% of patients received a second line BT. Fifteen per cent required surgical interventions (SI), of which there were no mortalities. 27% who were receiving BT required SI. Of the patients with CD, 82.4% required hospitalisation. 43.1% had an ileal, 9.8% colonic, 39.2% ileal- colonic, 0% isolated upper digestive and 21.6% perianal compromise. 34.3% had non-stenosing behaviour, 49% stenosing and 16.7% penetrating. 44.1% of patients with CD received BT of which 40% required a second line BT. 55.9% required SI, of which 1 mortality was reported. 71.1% who were receiving BT required a SI. Conclusion Our study contributes to the epidemiology and integral management required by patients with IBD in our environment. More studies are recommended that replicate our methodology in the population with IBD in both Colombia and Latin America.