Acta Gastroenterologica Latinoamericana最新文献

Celiac disease is an autoimmune enteropathy. The onlyknown treatment consists of a permanent adherence to a strictgluten-free diet, which represents an important challenge forpatients. Objective. To describe the gluten-free processedfood offer in food locals from 3 neighborhoods representativeof high, middle and low economic status in Buenos Aires,Argentina.

Methods: Cross-sectional study. Specially trainedmonitors performed a standardized direct assessment offood locals. Whenever direct observation was not possible,we interviewed the personnel as an indirect assessment. Weclassified dish offer in different categories, and evaluated theprocesses of food elaboration, storage and distribution.

Results: We included 112 food locals. Results for neighborhoodsrepresentative of high, middle and low economic status were,respectively: no gluten free dish available in 27.5% (45/62),27.0% (27/37) and 30.8% (9/13), (p = 0.96); adequateelaboration in 17.7%, 13.5% and 7.7%, (p = 0.61); appropriate food storage in 12.9% (8), 13.5% (5) and 7.7%(1); (p = 0.85); adequate distribution in 8.1%, 8.1% and0% (0), (p = 0.56). Conclusion. In 1 out of 4 food localsthere was not even one gluten free dish. In addition, therewas a lack of compliance with safety measures to avoid glutencross-contamination.

During the last twenty years Eosinophilic Esophagitis has becomeone the most important causes of esophageal disfunctionin children, food impactation in adolescents and youngadults, therapeutic failure in patients with gastroesophagealreflux disease (GERD) and the most frecuent eosinophilicdisease of the gastrointestinal tract. We present recommendationsfor the diagnosis and treatment of the disease based ina systematic review of the literature.

It is presented a 48 year-old male patient with antecedent ofa foreign body intake (a beer metallic top) 4 years ago, whorejected surgery at first previous a failed attempt of endoscopicextraction. Four years later he was admitted in the ThoraxNational Institute in an emergency, with acute respiratoryfailure and sepsis signs that were corrected quickly; lateron after failed surgical attempts of trachea-esophageal fistulacorrection and extraction of the foreign body, the patient wassent to BJIG where the endoscopic extraction of the foreignbody located in the trachea was carried out together with thecorrection of the trachea-esophageal fistula by means of implantation,in esophagus, of covered self-expanding prosthesis.

Syphilis is a chronic systemic infection mainly transmittedthrough sexual contact that shows a great variety of clinicalmanifestations. Liver involvement is an unusual complicationmainly reported in HIV patients. In this case reportwe present a case of a 42-year-old immunocompent manwith acute cholestatic hepatitis who was finally diagnosed ofluetic hepatitis. Liver disease was the only manifestation ofsyphilis infection difficulty it’s diagnostic. We emphasize theimportance of including syphilis in the differential diagnosisof abnormal liver function tests in patients at risk of sexuallytransmitted diseases due to its resolution with appropriateantibiotic treatment.

Unlabelled: Endoscopic radiofrequency ablation makes use of warm energy to ablate the esophagus's surface where the epithelial anomaly is located.

Patients and methods: 50 adults patients with the diagnosis of EB according to Vienna Classification were included.

Objectives: To evaluate the security and efficacy of ARF in patients with EB.

Results: 50 ARF treated patients were included with a medium follow up of 18 months. The median age was 58 years. 1.4 sessions of ARF perpatient were made to obtain EB erradication. The procedure morbidity was 6%, the more frequent complication was the esophageal stenosis (two cases). During the follow up, intestinal metaplasia recurrence was not observed.

Conclusions: In the experience of our team, ARF is a secure procedure with low morbidity. These observations added to the published results help to evaluate the currentfollow up protocols.

Colonic lipomas are a rare entity, even lessfrequent colonic lipomatosis (lipohyperplasia) of which we only found very few reports in literature (five cases). We report a case of colonic lipomatosis in a young adult that manifested as acute diverticulitis with perforation and rectalpolyposis requiring surgical resolution.

Hemobilia is defined as the presence of blood in the biliary tree characterized by the triad: jaundice, right hypochondrium pain (RH) and upper gastrointestinal bleeding (UGB). Among the etiologies highlighted in order of frequency there are: liver trauma (accidental and iatrogenic), inflammatory causes (acute and chronic cholecystitis), infections (cholangitis, liver abscesses, parasitic infections) and vascular diseases (aneurysms, vasculitis, arteriovenous malformations). There exist many complementary tests for the diagnosis of hemobilia, such as imaging (abdominal ultrasound, CT scan, angio CT), videoendoscopy, endoscopic retrograde cholangiopancreatography and angiography, the latter being considered the diagnostic tool and therapeutic modality of choice. We report the case of a 52-year-old male patient with hemobilia secondary to apseudoaneurysm ofthe hepatic artery, along with a review of the existing literature.

Recommendations for Hepatitis C screening based on risk factorsfor transmission proved to be ineffcient. Accordingly, the CDC recommended to screen all American individuals born between 1945-1965, based on data from population prevalence of infection. The effectiveness of implementing these recommendations in other contexts and/or populations can be estimated, in principle, knowing the age distribution of infected individuals. There is no data on population prevalence in our country. Yet we can know the age distribution of cases of Hepatitis C who accessed the health system. The aim of this paper is to analyze the distribution by birth cohort ofcases registered as "Hepatitis C" in the Sentinel Units for Viral Hepatitis in the 2007-2014 period. This will contribute to the identification, if any, ofa cohort in which case the recommendation of screening could be addressed, based on risk factors inherent to our country and our epidemiological reality. The age distribution of our cases was wider and younger than those of the population supporting the recommendation of the CDC and this suggests -beyond the difference in the populations being compared- is due to a range of risk factors and age at different infection between USA and Argentina. Thus, based on these results, the recommendation of the Argentine Consensus for Hepatitis C in 2013 to screen all individuals once in life is supported.