Background and Objectives: The aim of the study was to determine the association between presences of fatty pancreas (FP) with the features of metabolic syndrome (MeS) in patients with non–alcoholic fatty liver disease (NAFLD) and to establish a new noninvasive scoring system for the prediction of FP in patients with NAFLD. Material and Methods: 143 patients with NAFLD were classified according to FP severity grade into the two groups and evaluated for diagnostic criteria of MeS. All patients underwent sonographic examination with adiposity measurements and the liver biopsy. Liver fibrosis was evaluated semi-quantitatively according to the METAVIR scoring system and using non-invasive markers of hepatic fibrosis. Results: Waist circumference (WC) was predictive for increased risk of FP in NAFLD patients. Elevated fasting plasma glucose, total cholesterol, serum amylase and lipase levels were associated with presence of severe FP (p value = 0.052, p value = 0.007, p value = 0.014; p value = 0.024, respectively). Presence of increased amounts of mesenteric fat was associated with severe FP (p value = 0.013). The results of this study demonstrated highly significant association between NAFLD and presence of FP. The model for predicting the presence of FP was designed with probability value above 6.5. Conclusion: Pancreatic fat accumulation leads to worsening of pancreatic function which in turns exacerbates severity of metabolic syndrome associated with both, NAFLD and NAFPD.

Introduction. The most common causes of subocclusive disorders are the adhesion, Crohn's disease and small bowel neoplasms. Plasmablastic lymphoma (PBL) is an aggressive distinct subtype of diffuse large B-cell non-Hodgkin lymphoma initially reported in the oral cavity of the HIV infected individuals. Case report. We presented a male patient with PBL of the small intestine as a rare cause of intestinal subocclusion, without HIV infection and negative serology for hepatitis C, hepatitis B, and Epstein-Barr infection. A 73-year-old male was admitted to our Center due to the one-year history of abdominal pain, weigh loss, non-bloody diarrhea, night sweating and pruritus. The patient underwent the ileocolonoscopic examination with the accompanying biopsy specimens. The results, based on the histopathological and immunohistochemical pattern, confirmed a diagnosis of PBL. Following the chemo-therapy treatment, our patient underwent the resection of ileum. The postoperative histopathological report confirmed PBL as the final diagnosis. The patient was treated for the following 6 months with the chemotherapy according to the cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) protocol. Fatal outcome was due to acute myocardial infarct. Conclusion. PBL of the small intestine is a rare and unusual cause of subocclusive events. In our patient, an accurate histopathological verification of the detected changes in the ileum was of crucial importance for further treatment.Uvod. Najčešći uzroci subokluzivnih poremećaja u adheziji, Kronova bolest i neoplazme tankog creva. Plazmablastni limfom (PBL) je tip agresivnog difuznog krupnoćelijskog B nehočkinskog limfoma, koji je prvi put opisan u usnoj duplji kod HIV pozitivnih bolesnika. Prikaz bolesnika. U radu je prikazan bolesnik sa PBL tankog creva kao retkim uzrokom subokluzije, bez HIV infekcije i sa negativnom serologijom za hepatitis B, hepatitis C i infekciju Epštajn-Barovim virusom. Muškarac, star 73 godine, primljen je u naš Centar zbog jednogodišnje istorije bolova u trbuhu, gubitku telesne mase, dijareje (bez krvi), noćnog znojenja i svraba. Bolesniku je urađena kolonoskopija sa terminalnom ileoskopijom, pri kojoj je uzeta biopsija sluznice terminalnog ileuma. Rezultati patohistološkog i imunohistohemijskog ispitivanja su potvrdili dijagnozu PBL. Posle hemioterapije, bolesniku je urađena resekcija ileuma. Rezultat postoperativne patohistološke analize je potvrdio dijagnozu PBL. Bolesnik je lečen po protokolu CHOP (ciklofofamid, doksorubicin, vinkristin i prednizolon) tokom šest meseci. Fatalan ishod je nastupio zbog infarkta miokarda. Zaključak. Mada redak i neuobičajen, uzrok subokluzivnih tegoba može biti PBL ileuma. Kod našeg bolesnika krucijalni značaj za dalje lečenje je imala tačna patohistološka verifikacija promena aktiviranih u ileumu.

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Introduction. Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder with estimated prevalence of one in 5,000 to 10,000. The disease has age-related penetrance and the HHT signs and symptoms occur and worsen with age. A diagnosis of HHT is based on the Curacao`s criteria. Case report. We report a case series of 6 patients diagnosed with HHT, 5 with definite and one with probable diagnosis according to the Curacao criteria. In 5 patients, the recurrent epistaxis occurred in adolescence as the first presentation while one patient presented with melena. The diagnosis was delayed in 5 patients and the presence of HHT was diagnosed during or after the fifth decade. In 4 patients, the overt gastrointestinal bleeding occurred in the later course of the disease. The asymptomatic pulmonary circulation arteriovenous malformations were detected in 2 patients. The cerebral arteriovenous malformations were not detected. Conclusion. Hereditary hemorrhagic telangiectasia is a rare disorder affecting multiple organs. It should be considered in the adolescents with recurrent epistaxis and in the differential diagnosis of anemia with signs of the gastrointestinal bleeding in order to shorten the delay in the diagnosis and subsequently improve the outcome of the disease.Uvod. Nasledna hemoragijska teleangiektazija (HHT) je redak autosomno-dominantni poremaćaj sa prevalencijom javljanja 1 na 5,000 do 10,000. Bolest je uzrasno zavisna i HHT simptomi i znaci se rano javljaju i pogoršavaju sa godinama. Dijagnoza se postavlja na osnovu Curaco kriterijuma. Prikaz bolesnika. Ovo je serijski prikaz šest bolesnika sa HHT, pet sa definitivnom i jednog sa verovatnom dijagnozom HHT na osnovu Curaco kriterijuma. Kod pet bolesnika ponavljane epistakse su se javile u adolescentnom dobu kao prva manifestacija bolesti, dok je prvi znak bolesti kod jednog bolesnika bila melena. Kod pet bolesnika dijagnoza HHT postavljena je tek u toku i nakon pete decenije života. Kod četiri bolesnika manifestno gastrointestinalno krvarenje se javilo u daljem toku bolesti. Asimptomatske arteriovenske malformacije plućne cirkulacije uočene su kod dva bolesnika. Cerebralne arteriovenske malformacije nisu uočene ni kod jednog bolesnika. Zaključak. Nasledna hemoragijska teleangiektazija je retka bolest koja zahvata više organa. Na ovu bolest bi trebalo misliti kada adolescent imaju ponavljane epistakse i diferencijalno dijagnostički kod anemija sa znacima gastrointestinalnog krvarenja, a u cilju pravovremenog postavljanja dijagnoze bolesti i poboljšanja ishoda iste.