Acta Gastroenterologica Latinoamericana最新文献

The gastrointestinal commitment is the six most frequentlocation of extrapulmonary tuberculosis. Often its acutecomplications constitute the main presentation form due toa late diagnosis.

Objectives: To review the presentation ofgastrointestinal tuberculosis as perforative acute abdomenand surgical resolution.

Material and method: Case 1. A31 year old female, with newly diagnosed pulmonary tuberculosis,discontinuous treatment. Two month later presentswith peritonitis acute abdomen. Laparotomy is done beingstated intestinal perforations. They performed resection andanastomosis terminal. The treatment with ant tuberculosisstarts. Good evolution. Case 2. A 30 years male patient, HIVand pulmonary tuberculosis with discontinuous treatment.He was admitted with abdominal pain and generalizedperitoneal reaction. Intestinal perforations is found at laparotomy.Biopsy and raffia intestinal is performed. Fourdays later suture dehiscence and new intestinal perforationsare found. Resection and ileostomy is performed. It evolutionwith distress and death. In both cases histopathology confirmedintestinal tuberculosis.

Conclusions: Because of thenonspecific symptoms of intestinal tuberculosis, is commonthe diagnosis through their acute complications and these are potentially lethalespecially in immunocompromised patients.The prompt treatment with anti tuberculosis drugs isthe limiting in elective surgery in selected cases.

Tuberculosis is the commonest cause of spinal infectionworldwide (9-46%). Tuberculosis spondylodiscitis causesmultifocal thoracic and lumbar spinal disease, and big paraspinaland psoas abscesses. It is more frequent in peopleunder 40 who had previous tuberculosis infection and fromcountries where the illness is endemic. Clinic is non-specificand sub-acute. We report the clinical case of a 29-year-oldpatient who suffered from pericardic tuberculosis in her childhoodand who presents a bilateral retroperitoneal abscessdue to tuberculosis spondylodiscitis. Her clinical debut beganwith left inguinal pain and an irreducible mass at this levelthat simulated an incarcerated inguinal hernia, whichis why surgery was indicated. Due to discrepancies betweenintraoperative findings and the initial diagnosis, the diagnosisand treatment strategy were changed. The purpose of thiscase report is to emphasize the challenge that the diagnosisof this pathology represents, due to low incidence in our environmentand poor clinical features, which results in latediagnosis and late management.

Intussusception is rare in adults and has different characteristicsfrom intussusceptions of children. Its clinical manifestationsare varied and often nonspecific, requiring a highindex of suspicion for diagnosis. Within the study methods,computed tomography has become fundamental in the studyof abdominal pain. This has a high sensitivity and specificityfor the diagnosis of intussusception. Most of the time thetreatment is surgical, and succeeded in identifying the underlyinglesions. We review the basics concepts, pathophysiology,imaging findings and frequent etiologies that can causeintussusception in adults.

Surgical injury of the biliary tract have increased in thelaparoscopic cholecystectomy era, anatomic variants of thebiliary ducts, mainly the type F, is likely to receive this kindof injury. Cholangiography helps to prevent such complications,so, we recommended the execution of this procedure ina routine way. Treatment usually is complex and requirestrained surgeons.

In Argentina there are no multicenter studies evaluating themanagement of patients with acute pancreatitis (AP) nationwide.

Objectives: The main objective of this study is toknow how the patients with AP are treated in Argentina.The secondary objective is to assess whether the results complywith the recommendation of the American College of GastroenterologyGuide.

Material and methods: Twenty threecenter participated in the study. They include in a databasehosted online consecutive patients with acute pancreatitisfrom june 2010 to june 2013.

Results: 854 patients enteredthe study. The average age was 46.6 years and 495(58%) belonged to the female sex. The most common cause(88.2%) of AP was biliary. Some prognostic system wasused in 99 % of patients and the most used was Ranson(74.5%). Were classified as mild 714 (83.6%) patientsand severe 140 (16.4%). Systemic complications occurredin 43 patients and local complications in 21. 86 patientsunderwent dynamic CT scans and 73 patients had pancreaticand / or peripancreatic necrosis. Mortality was1.5%. There was no difference in mortality in relation tothe size, complexity or affiliation of the center. The comply of key recommendations of the American College of GastroenterologyGuide was over 80%.

Conclusions: Thediagnosis and treatment of patients with AP in 23 healthcenters located throughout the country was optimal. Themanagement complied with most of the recommendationsof the American College of Gastroenterology Guide.

Colonic metastasis of breast cancer are extremely infrequent,being ductal subtype the most rarely affects the digestivetract, compared to lobular subtype. We present a case reportof a colonic metastasis of ductal breast cancer; found in thecontext of a screening colonoscopy. Besides we perform anarticle research about digestive tract metastasis of primarybreast cancer, finding very few published cases among theliterature about this ductal subtype behavior.

Infection by Helicobacter pylori affects over half of theworld’s population and is a public health issue. Its prevalenceis significantly higher in developing countries such as Brazil.It has been suggested that infection by H pylori can impactcalorie intake and homeostasis.

Aim: Analyze the influenceof infection by H pylori and of its eradication on nutritionalstatus and dietary intake.

Material and methods: The studyincluded 124 patients (48 of whom H pylori positive, 45 Hpylori negative, and 31 eradicated). Weight and height weremeasured to calculate the body mass index (BMI). Dietaryintake was assessed using a 24-hour diet recall (24hR) intwo occasions.

Results: Pre-obesity was the highest among theeradicated patients (p = 0.011). Homogenicity was foundin the dietary intake for the nutrients studied, except forsaccharose, whose intake was the lowest among the eradicatedgroup (p < 0.001).

Conclusions: Patients eradicatedfor H pylori had a higher rate of pre-obesity. The dietaryintake was similar among the groups for nearly all nutrientsassessed, except for saccharose, whose intake by eradicatedpatients was lower. This entails discussions about possiblyincluding the investigation of nutritional status and diet inthe routine procedures towards those who seek a diagnosis ofinfection by H pylori.