The HRR is a noninvasive, objective, and simple method that could be used to diagnose and grade hepatic steatosis.

-Context -The association between Helicobacter pylori infection and colon neoplasia has been the subject of recent investigations which have produced controversial results. Objective -To evaluate the prevalence of H. pylori infection in patients with colonic adenomas and also in patients whose colonoscopy exams were normal. Methods -After colonoscopy, the individuals were distributed into two groups: patients with colon adenomas (cases) and patients whose colons were normal (controls). The groups were similar regarding age and gender. The individuals of both groups were subjected to a dosage of IgG antibody against H. pylori. The dosage was applied according to the solid phase, chemiluminescent immunometric assay. The chi-square test was used to analyze the data. Results -There were 30 men and 64 women in each group (94 cases and 94 controls). The mean age of the cases was 59.79 ± 12.25 years and that of the controls was 58.98 ± 11.55 years. The H. pylori serology was positive for 66 (70.21%) of the cases and for 51 (54.25%) of the controls. There was a significant difference (P = 0.024). The odds ratio was 1.98 (CI 95%, 0.82-3.15). The prevalence of H. pylori in cases and controls according to gender, histological type and location of the colon lesions showed a significant difference only among women (P = 0.03), among patients with tubular adenomas (P = 0.03), and in those with distal adenomas (P = 0.038). Conclusion -There is a positive association between H. pylori infection and colonic adenomas. This association is more evident in women, especially for tubular adenomas and distal colonic location. HEADINGS -Helicobacter pylori. Adenoma. Colonic neoplasms. Helicobacter infections.

OBJETIVO: Avaliar a correlação entre a dopplerfluxometria da veia hepática direita e o grau de esteatose, inflamação e fibrose à biópsia na doença hepática gordurosa não alcoólica. MATERIAIS E MÉTODOS: Foi realizada ultrassonografia com Doppler em 80 pacientes, sendo 40 portadores de doença hepática gordurosa não alcoólica, também submetidos à biópsia. Quarenta controles normais saudáveis, sem fatores risco para doença hepática gordurosa não alcoólica foram submetidos a ultrassonografia com Doppler. O padrão ao Doppler da veia hepática direita foi classificado em trifásico, bifásico e monofásico. Os espécimes de biópsia foram classificados conforme o grau de esteatose, inflamação e fibrose. RESULTADOS: O fluxo foi trifásico em 38 (95%) dos controles e em 9 (56,3%) dos pacientes com esteatose discreta, enquanto nos com esteatose acentuada o padrão foi monofásico em 60%. Encontrou-se diferença significante na distribuição dos padrões ao Doppler (p < 0,01). Houve correlação negativa e significante entre o padrão ao Doppler da veia hepática direita e grau de esteatose (r = -0,57; p < 0,01). CONCLUSÃO: A alteração do padrão ao Doppler da veia hepática direita em pacientes com doença hepática gordurosa não alcoólica pode sugerir redução da complacência vascular consequente a infiltração gordurosa.

-Context -Hepatitis C is an important cause of chronic liver disease worldwide. The grading of hepatic fibrosis in chronic hepatitis C is important for better clinical management. However, until now, liver biopsy is the only test accepted for this purpose, despite their contraindications and complications. New methods for non-invasive assessment of hepatic fibrosis are under investigation. One proposal is the Doppler ultrasound, as a non-invasive, widely available and inexpensive. Objective -To compare Doppler parameters of portal vein in patients with chronic hepatitis C with a healthy control group and to correlate these parameters with fibrosis degree obtained by liver biopsy. Methods -Fifty patients with chronic hepatitis C submitted to liver biopsy and 44 healthy controls had Doppler of the portal vein performed, with the calculation of the portal venous index. We conducted a comparison between the averages of the two groups of portal venous index. For the correlation between portal venous index and fibrosis was employed the Spearman test. Results -There was a difference between the average portal venous index between controls (0.33 ± 0.07) and patients (0.23 ± 0.09) with P<0.001. No difference was observed between the portal venous index in patients with chronic hepatitis C who have significant fibrosis or not. The correlation between the portal venous index and fibrosis degree was reverse and moderate (r =-0.448 P<0.001). The area under the ROC curve was 78.4% (95% CI: 68.8% to 88%). The cutoff for the portal venous index was 0.28 with sensitivity of 73.5% and specificity of 71.1%. Conclusion -The portal venous index was useful in distinguishing healthy patients from patients with CHC. However, there was no significant difference in the quantification of degree of fibrosis.

Arq Gastroenterol • 2022. v. 59 nº 2 abr/jun • 321 Main textAcute liver chemistry elevations occur frequently in patients with coronavirus disease 2019 (COVID-19) (1) . An unusual condition of secondary sclerosing cholangitis in critically ill patients has been recognized as a novel entity after COVID-19 infection (2) and recently named post-COVID-19 cholangiopathy. It is characterized by marked cholestasis associated with ongoing jaundice that persists long after pulmonary and renal recovery (3) . This E-VIDEO describes a SpyGlass ® cholangioscopy in a post-Covid-19 cholangiopathy patient.A 65-year-old men with diabetes, hypertension, and chronic lymphocytic leukemia, under hematologic follow-up, was hospitalized for COVID-19 associated acute respiratory distress syndrome 10 months prior, and underwent mechanical ventilation for 13 days under Fentanyl, Midazolam, and Ketamine sedation. 10 days after hospital admission, he presented progressive increase of canalicular enzymes without transaminases or ultrasound abnormalities. At day 33 he was discharged, and his laboratory bloody tests included alkaline phosphatase of 807, gamma glutamyl transferase of 1831, and total bilirubin of 1.3. 1 month later he presented jaundice and progressive bilirubin increase, being started ursodeoxycholic acid without improvement. Endoscopic retrograde cholangiopancreatography (ERCP) revealed rarefaction of intrahepatic bile ducts (FIGURE 1), and removal of biliary casts (FIGURE 2). Patient did not show improvement of the condition, and cholangioscopy was indicated to endoscopically evaluate the bile duct and verify its viability. The procedure demonstrated scar retraction areas (FIGURE 3), as well as dark endothelial shedding, removed with Spybite®. In the confluence of the hepatic ducts, edema and diffuse ischemic pattern (FIGURE 4) was noted with retractions that cause important stenosis extending to intrahepatic segments (FIGURE 5).