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Peroral endoscopic myotomy (POEM) is an innovative achalasia treatment procedure that involves myotomy of the lower esophageal sphincter through a submucosal tunneling approach, combining the efficacy of surgical myotomy with the benefit of being a less invasive treatment. At this time, no data are available of POEM in Portugal. This study aimed to examine the safety and short-term outcomes of POEM in a Portuguese center.Fifty POEM were performed on 49 consecutive patients at our institution between January 2017 and January 2020. A prospective study of a consecutive series of patients was conducted, including procedure time, myotomy location and length, adverse events and clinical success. An Eckardt score of ≤3 after POEM was deemed as a successful outcome. Gastroesophageal reflux disease (GERD) was evaluated based on symptoms and on upper endoscopy, which was performed at 3-6 months postoperatively to check for reflux esophagitis.POEM was successfully completed in all cases: 70% (Our results confirm the safety and excellent short-term efficacy of POEM in a Portuguese center. This supports POEM as one of the first-line achalasia therapies in Portugal when performed by experienced operators.A miotomia endoscópica peroral (POEM) é um procedimento terapêutico inovador da acalásia que envolve a miotomia do esfíncter esofágico inferior através de uma abordagem por tunelização da submucosa, combinando a eficácia da miotomia cirúrgica com o benefício de ser um tratamento menos invasivo. Atualmente não existem dados disponíveis relativamente à aplicação do POEM em Portugal. Este estudo teve como objetivos examinar a segurança e os resultados a curto-prazo do POEM num centro português.Cinquenta POEM foram realizados em 49 doentes consecutivos na nossa instituição entre Janeiro 2017 e Janeiro 2020. Foi realizado um estudo prospetivo numa série consecutiva de doentes, incluindo tempo do procedimento, localização e extensão da miotomia, eventos adversos e sucesso clínico. O sucesso clínico foi definido como um score de Eckardt ≤3 após o procedimento. A doença do refluxo gastroesofágico (DRGE) foi avaliada com base na sintomatologia e na realização de endoscopia alta entre os 3 e 6 meses pós-procedimento.O POEM foi realizado com sucesso em todos os casos: 70% (Os resultados confirmam a segurança e a excelente eficácia no curtoprazo do POEM num centro português, suportando o POEM como uma das terapêuticas de primeira linha para a acalásia em Portugal quando realizada por operadores experientes.

Alcoholic hepatitis should be suspected in every patient with excessive chronic alcohol consumption and recent onset of jaundice. Diagnosis of alcoholic hepatitis is based on clinical and laboratory findings, and confirmed by a liver biopsy when available. Several scores are available to assess severity and prognosis of alcoholic hepatitis. The 1-month mortality of patients with severe alcoholic hepatitis, as defined by Maddrey's discriminant function, is 20-30%. Therefore, severe alcoholic hepatitis should be treated with a 28-day course of oral prednisolone after systematic screening for infection. In this review, we discuss diagnosis of alcoholic hepatitis, the different scores to assess severity of the disease, indications for corticosteroid therapy and alternative therapeutic options for non-responders to medical therapy.

A 69-year-old male presented with a 5-day history of backache, asthenia, and fever. At admission, hemoglobin was 6.4 g/dL and there was no gastrointestinal bleeding. His medical history was remarkable for an endovascular aneurysm repair performed 10 years before, with implantation of a bilateral aorto-iliac graft.

A 73-year-old man presented to the emergency department with a 3-day history of abdominal pain, constipation and low-grade fever following a sushi meal. He had no relevant medical history. His physical examination was remarkable for lower right quadrant abdominal pain associated with rebound