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Solución del caso. Las apariencias engañan 案件的解决。外表欺骗
Q4 Medicine Pub Date : 2021-03-22 DOI: 10.52787/YSNO2304
Carolina Rodríguez Bruno, Evelin Crocci, Ezequiel Balaban, Carla Sofía Ponce
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引用次数: 0
Bajos niveles de actividad de la lipasa ácida lisosomal y su relación con el desarrollo de la cirrosis de origen criptogénica/NASH: un estudio de cohorte 溶酶体酸性脂肪酶活性低及其与隐源性肝硬化/纳什发展的关系:一项队列研究
Q4 Medicine Pub Date : 2021-03-22 DOI: 10.52787/ZHJU9301
Luis Guillermo Toro Rendón, Luisa Fernanda Calle Tavera, Elizabeth Gutiérrez, Adriana Ocampo Mesa, J. Arbeláez
Introduction and objective. The deficiency of the Lysosomal acid lipase (LAL) activity has been related to cirrhosis due to non-alcoholic steatohepatitis (NASH). Many of the cirrhosis classified as cryptogenic are the evolution of liver disease due to fatty liver. The objective of the present study was to evaluate the lysosomal acid lipase (LAL) activity in the patients with liver cirrhosis of any etiology and establish whether low levels correlate with cryptogenic cirrhosis of origin cryptogenic or NASH. Methods. Was an analytical cohort study including 96 patients with cirrhosis of any etiology for which LAL activity was measured. Results. Fifty-five patients (58%) with cryptogenic cirrhosis or NASH were included and 41 with other etiologies. The fifty-three percent of the total population were women. The severity scores of liver disease were significantly higher in the patients with the cryptogenic cirrhosis or NASH: MELD (11.72 ± 7.3 vs 4,34 ± 5.7; p = 0.001) and Child-Pugh (7.26 ± 3.8 vs 7.26 ± 3.8; p = 0.004). LAL activity was significant lower (202.40 ± 98.8 vs 242.55 ± 121.9; p = 0.04) in the cirrhosis cryptogenic or NASH group. In the multivariate analysis, low LAL activity (< 150 nmol/spot/hour), was correlated with the presence of cryptogenic cirrhosis or NASH. Conclusions. The patients with cryptogenic cirrhosis or NASH have lower levels of LAL activity than those with cirrhosis of other etiologies. LAL activity below 150 nmol/spot/hour is predictive of the cryptogenic cirrhosis or NASH.
引言和目标。溶酶体酸性脂肪酶(LAL)活性的缺乏与非酒精性脂肪性肝炎(NASH)引起的肝硬化有关。许多被归类为隐性肝硬化的肝硬化是由脂肪肝引起的肝病的演变。本研究的目的是评估任何病因的肝硬化患者的溶酶体酸性脂肪酶(LAL)活性,并确定低水平是否与来源于隐性或NASH的隐性肝硬化相关。方法。是一项分析性队列研究,包括96名任何病因的肝硬化患者,对其LAL活性进行了测量。后果包括55名(58%)隐源性肝硬化或NASH患者和41名其他病因患者。妇女占总人口的53%。隐源性肝硬化或NASH患者的肝脏疾病严重程度评分显著较高:MELD(11.72±7.3 vs 4,34±5.7;p=0.001)和Child-Pugh(7.26±3.8 vs 7.26±38;p=0.004)。肝硬化隐源性或NASH组的LAL活性显著较低(202.40±98.8 vs 242.55±121.9;p=0.04)。在多变量分析中,低LAL活性(<150 nmol/点/小时)与隐性肝硬化或NASH的存在相关。结论。隐源性肝硬化或NASH患者的LAL活性水平低于其他病因的肝硬化患者。LAL活性低于150nmol/spot/hour可预测隐性肝硬化或NASH。
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引用次数: 0
Las apariencias engañan 外表具有欺骗性
Q4 Medicine Pub Date : 2021-03-22 DOI: 10.52787/FPKT6323
Carolina Rodríguez Bruno, Evelin Crocci, Ezequiel Balaban, Carla Sofía Ponce
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引用次数: 0
Empiema bacteriano espontáneo como complicación de la cirrosis hepática: ¿cuándo sospecharlo y cómo tratarlo? Presentación de casos 自发性细菌性脓胸作为肝硬化的并发症:何时怀疑,如何治疗?案例陈述
Q4 Medicine Pub Date : 2021-03-22 DOI: 10.52787/WLHQ8266
Martín Elizondo Barceló, Jimena Prieto Amorín, J. C. M. Presentado, Solange Gerona Sangiovanni
El empiema bacteriano espontáneo se define como la infección del hidrotórax hepático en los pacientes cirróticos. Es una causa rara de descompensación en la cirrosis, existiendo escasos reportes bibliográficos en la región, y su presencia marca un punto de inflexión en la evolución de la enfermedad con un mal pronóstico a corto plazo. Se presentan dos casos clínicos de pacientes con esta complicación que fueron derivados al Programa Nacional de Trasplante Hepático de Uruguay. Se realiza la revisión del tema jerarquizando aspectos de la presentación clínica, la fisiopatología y un enfoque terapéutico. Se hace una especial mención a la importancia del tratamiento antibiótico empírico basado en el sitio de adquisición de la infección, la epidemiología local y en la oportunidad de la resolución del hidrotórax hepático subyacente, dado el alto riesgo de complicaciones que pueden asociar los tratamientos invasivos.
自发性细菌性脓胸被定义为肝硬化患者的肝液胸腔感染。它是肝硬化失代偿的一种罕见原因,在该地区的文献报道很少,它的存在标志着疾病发展的转折点,短期预后很差。本研究的目的是评估肝移植患者的预后,并评估肝移植患者的预后。本文从临床表现、病理生理学和治疗方法等方面对该主题进行了回顾。由于侵袭性治疗可能导致并发症的高风险,根据感染获得部位、当地流行病学和潜在肝胸的及早消退,特别提到经期抗生素治疗的重要性。
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引用次数: 0
Solución del caso. Hallazgo radiológico infrecuente por una hiperpresión abdominal tras un traumatismo 案件的解决。创伤后腹部高压罕见的放射学发现
Q4 Medicine Pub Date : 2021-03-22 DOI: 10.52787/IXWG2588
María del Mar Roldán Alcázar, A. M. Maldonado, A. S. Gutiérrez, C. Cejudo
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引用次数: 0
Disfagia esofágica y múltiples impactaciones alimentarias 食管吞咽困难和多重食物嵌塞
Q4 Medicine Pub Date : 2020-12-14 DOI: 10.52787/DRSV9505
Jesús Rodríguez Barriga, Miriam Galich, L. Viola
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引用次数: 0
Sindrome de allgrove en niños. Reporte de 11 casos 儿童奥尔格罗夫综合征。报告11宗个案
Q4 Medicine Pub Date : 2020-12-14 DOI: 10.52787/ieua6903
María Carmen Álvarez López, Pedro Coello Ramírez, Elizabeth García Rodríguez, Mariana Ordoñez Cárdenas, Fátima Azereth Reynoso Zarzosa
Background. Allgrove Syndrome is a very rare genetic disease, which is inherited in an autosomal recessive way. The responsible gene is the AAAS, that encodes the protein ALADIN. It occurs most often in children of consanguineous parents. It is characterized by the classic triad of achalasia, alacrima, and adrenal insufficiency due to resistance to ACTH; the presence of two of the three previous manifestation events are required to establish the diagnosis. There is also a high frequency of the neurologic symptoms. Objective. Describe the clinical characteristics, age of presentation and evolution in 11 patients with Allgrove Syndrome. Methods. 11 clinical cases compatible with Allgrove Syndrome of presentation in childhood are retrospectively reviewed. Results. The average age at diagnosis was 5.9 years (range 1-16 years old). There was a predominance of the female sex (n = 7). The most common symptoms were postprandial vomiting and alacrima, present in 100% of the cases at the time of diagnosis. Adrenal insufficiency was not common; it was only documented in one patient. There was consanguinity between parents in 62.5% of the cases. Conclusions. Allgrove Syndrome is an uncommon cause of dysphagia, chronic vomiting and failure to grow in children. In case of any documented case of achalasia it is suggested to question in a directed way the presence of alacrima and adrenal insufficiency data such as seizures, hyperpigmentation of the skin and neurological alterations.
背景。Allgrove综合征是一种非常罕见的遗传病,以常染色体隐性遗传的方式遗传。负责的基因是AAAS,它编码蛋白质ALADIN。它最常见于近亲父母的孩子。它的特征是由ACTH抵抗引起的贲门失弛缓症、肺水肿和肾上腺功能不全的经典三联征;前三种表现事件中的两种是诊断所必需的。神经系统症状也有很高的频率。目标。描述11例Allgrove综合征患者的临床特点、发病年龄及发展。方法:回顾性分析11例儿童期表现符合Allgrove综合征的临床病例。结果。平均诊断年龄为5.9岁(范围1-16岁)。以女性为主(n = 7)。最常见的症状是餐后呕吐和泪斑,100%的病例在诊断时出现。肾上腺功能不全不常见;只有一个病人有记录。62.5%的病例存在亲缘关系。结论。奥尔格罗夫综合征是一种罕见的原因吞咽困难,慢性呕吐和生长失败的儿童。对于任何有记录的贲门失弛缓症病例,建议直接询问是否有肺水肿和肾上腺功能不全,如癫痫发作、皮肤色素沉着和神经系统改变。
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引用次数: 0
Abdomen agudo en un adolescente con poliposis juvenil. A propósito de un caso 患有幼年息肉病的青少年急性腹部。关于一个案例
Q4 Medicine Pub Date : 2020-12-14 DOI: 10.52787/uekp2937
Rubén Gustavo Muñoz Cedeño, Michelle Carolina Ricaurte Enríquez, Priscila Elizabeth Martínez Ballesteros, Viviana Paullán Saní, Gema Nathalye Rodríguez Chica
Juvenile polyposis syndrome is an autosomal-dominant condition disease characterized by multiple juvenile polyps in the gastrointestinal tract. These polyps may be present in the entire digestive tract; generally in the colon. We present the case of a 16-year-old adolescent with a history of polyps, who had had bowel resections for acute abdomen on two occasions (at 5 and 11 years of age). Endoscopic procedures were carried out, finding polyps and performing a polypectomy. After 24 hours, the patient presented proctorrhagia associated with acute abdominal pain by an obstruction, for which he was surgically intervened with an exploratory laparotomy where an intussusception was found.
青少年息肉病综合征是一种常染色体显性疾病,以胃肠道多发青少年息肉为特征。这些息肉可能存在于整个消化道;通常在结肠中。我们提出的情况下,一个16岁的青少年与息肉的历史,曾有肠切除两次急腹症(在5岁和11岁)。进行内镜检查,发现息肉并进行息肉切除术。24小时后,患者出现出血前并伴有梗阻引起的急性腹痛,为此进行了探查性剖腹手术,发现肠套叠。
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引用次数: 0
Solución del caso. Disfagia esofágica y múltiples impactaciones alimentarias 案例解决方案。食管吞咽困难和多重食物嵌塞
Q4 Medicine Pub Date : 2020-12-14 DOI: 10.52787/XEZY5437
Jesús Rodríguez Barriga, Miriam Galich, L. Viola
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引用次数: 0
Causa infrecuente de trastorno evacuatorio por puente mucoso rectal en una paciente con enfermedad de Crohn 克罗恩病患者直肠粘膜桥接排便障碍的罕见原因
Q4 Medicine Pub Date : 2020-09-28 DOI: 10.52787/HKUW6257
Lucía Secondo, Adrián Canavesi, Alejandra Arriola, Nicolás González
A case is presented of a 48-year-old patient, with a 28-year history of Crohn’s disease, with chronic constipation with outlet obstruction symptoms due to the presence of a mucosal bridge at the low rectum. Endoscopic treatment was performed with section of the bridge, without any complications, and with immediate resolution of the symptoms.
一例48岁患者,有28年克罗恩病病史,由于低位直肠粘膜桥的存在,出现慢性便秘伴出口梗阻症状。内镜治疗采用断桥,没有任何并发症,症状立即缓解。
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Acta Gastroenterologica Latinoamericana
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