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A 76-year-old patient presents multiple comorbidities and gastrointestinal symptoms. The upper gastrointestinal endoscopy exam reveals distal stiffness esophageal mucosa. A biopsy was taking creating sloughing of 20 mm long by 6 mm wide with self-limited bleeding. Specimen is compatible with Esophagitis Dissecans Superficialis (EDS). This is a rare entity first described in 1800, characterized endoscopically by mucosal detachment in vertical strips like "gift paper tape", which is confirmed by pathology with a mucosa with "two tones", composed of a eosinophilic superficial layer and a normal-appearing basophilic area. It may be accompanied by minimal focal inflammation. The etiopathogenesis is not clear; however, it has a good response to proton pump inhibitors (PPIs). In our case, the patient presented all the characteristics of EDS, and given its low reported frequency, a review of the literature and discussion of this rare entity was performed.

Background: endoscopic dilation is considered as the treatment of choice for esophageal strictures. However, there are no studies in our region that have assessed the safety of the procedure., Objective: to assess the safety of esophageal dilation and the factors associated with the development of complications., Materials and Methods: a retrospective cohort was studied. All patients referred for esophageal dilation between January 2015 and June 2017 were included in the study. A complication rate was obtained and the association between nonadherence to the "rule of 3" and the development of complications was determined. Other predictive factors associated with complication development were also analyzed., Results: a total of 164 patients that underwent 474 dilations were included in the study. Surgical anastomosis stricture was the most prevalent etiology. A total of six complications occurred, including three perforations (0.63%), two bleeding events (0.42%) and one episode of significant pain that required post-procedure observation (0.21%). Endoscopic esophageal dilation without adherence to the "rule of 3" was not associated with a higher risk of complications. Balloon dilation was the only predictive factor for complications., Conclusions: esophageal dilation is a safe procedure. Nonadherence to the "rule of 3" does not appear to be associated with a higher risk of complications, including esophageal perforation.

Background: In Peru, there are still no local studies designed for evaluating the performance of clinical guidelines designed to stratify patients according to probability of choledocholithiasis., Objectives: To evaluate the performance of predictive criteria proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in diagnosis of choledocholithiasis., Materials and Methods: A retrospective cohort study conducted in a hospital in Lima (Rebagliati hospital). Were included all patients with suspected choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) between July 2014 and June 2015. Predictors of choledocholithiasis proposed by the ASGE and the diagnostic performance of the risk categories were evaluated., Results: 118 patients met the inclusion criteria. In multivariate analysis, only age >55 years (OR: 3.07 [95: 1.14-8.31], p = 0.027) and the finding of stones in the common bile duct by abdominal ultrasound (OR: 1.68 [95% CI: 1.09-2.59], p = 0.018) were associated with the presence of choledocholithiasis on ERCP. The performance of the high and intermediate risk categories were 75.82% and 70.37% respectively. The performance of the high-risk category improved to 85.90% using a second set of biochemical markers., Conclusions: The performance of the predictors and risk categories proposed by the ASGE in diagnosis of choledocholithiasis is acceptable in our hospital, according to the proposed standards; however, it must be further improved to prevent the use of diagnostic ERCP.

Objective: The present study was designed to determine the histological effect of Lepidium meyenii "Maca" on the gastric mucosa in patients with functional dyspepsia., Material and Methods: This study consists of a clinical case series, in which the effect of Maca on the gastric histopathology of 29 Peruvian patients diagnosed with functional dyspepsia was examined. The presence of H. pylori, as well as the degree and depth of the gastric mucosa inflammation was evaluated from biopsies obtained before and after the treatment based solely of Maca 3 grams per day for four weeks., Results: Average values of the degree and depth of mucosal inflammation before and after the treatment were compared showing no statistical difference among the samples. Sixteen patients were infected with H. pylori, and they remained infected after the treatment with Maca., Conclusions: A four week long treatment with Maca does not produce significant changes on gastric mucosa of patients with functional dyspepsia, neither on H. pylori eradication.