Revista Espanola De Enfermedades Digestivas最新文献

{"title":"Ischemic cholangiopathy secondary to endoscopic treatment of bleeding duodenal ulcer.","authors":"Silvia Fernández Noël, Oana Anisa Nutu, Carmelo Loinaz Segurola, Iago Justo Alonso","doi":"10.17235/reed.2024.10939/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10939/2024","url":null,"abstract":"<p><p>Case report of a patient with a duodenal ulcer, initially treated with sclerosing agents, as is common practice for most bleeding ulcers. However, the evolution following this treatment is unusual. The patient developed secondary ischemic cholangitis, leading to extensive aerobilia and secondary portal pneumatosis, accompanied by inflammatory changes in the head of the pancreas. All of this occurred as a result of ischemia caused by the sclerosing agents.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The usefulness of barium enema using a water-soluble contrast medium as an emergency examination.","authors":"Hiroki Kato, Makoto Kobayashi, Ryota Tagawa, Shintaro Tominaga, Akihiro Maruyama, Hirotaka Takeshima, Hiroshi Nakayabu","doi":"10.17235/reed.2024.10968/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10968/2024","url":null,"abstract":"<p><strong>Background: </strong>Colorectal obstruction is a critical condition requiring prompt diagnosis and intervention. Gastrografin, a water-soluble contrast agent, combines diagnostic and therapeutic benefits, facilitating bowel cleansing and enhancing intestinal motility. This study assessed the safety and effectiveness of Gastrografin enemas in emergency settings.</p><p><strong>Methods: </strong>From 2013 to 2023, 40 patients with suspected colorectal obstruction identified through imaging studies, including CT, underwent Gastrografin enemas. The contrast agent was diluted 3-4 times with warm water and administered using an automatic injector. Antispasmodic agents were routinely administered, and air insufflation was avoided to minimize complications. Glycerin enemas were used as needed, and no oral laxatives were administered.</p><p><strong>Results: </strong>Out of 40 patients, 14 were diagnosed with impaired intestinal transit caused by colorectal cancer, with 13 undergoing colonoscopy. The use of Gastrografin revealed the expulsion of fecal masses, provided a clear visual field, showed minimal adhesion to the scope, and allowed successful access to the lesion in all cases. In 17 cases, the lesions were attributed to intestinal hypomotility or fecal masses without stenosis. However, the administration of Gastrografin enhanced intestinal peristalsis, leading to the expulsion of fecal masses after the examination and subsequent symptom relief. The remaining 9 cases were categorized as follows: 5 cases of stenosis due to cancer seeding or invasion into adjacent organs, 3 cases of deformity-induced colonic stenosis caused by diverticula, and 1 case of sigmoid colon prolapse associated with inguinal hernia.</p><p><strong>Discussion: </strong>Gastrografin is frequently used as an alternative to barium for enteroscopy when there is an obstruction of passage. Its high fluidity allows the contrast medium to flow smoothly, making it effective for advancing through the intestine. Additionally, Gastrografin is highly beneficial as a pretreatment for endoscopy due to its ability to enhance intestinal motility, provide excellent cleansing effects, and maintain transparency. in conclusion, gastrografin enemas are a safe, effective option for diagnosing and managing colorectal obstruction, especially as preparation for emergency colonoscopy. Further studies should evaluate its broader clinical applications.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous endoscopic manual suturing for colorectal anastomotic fistula closure.","authors":"José Manuel Palma García, Raúl Honrubia López, Beatriz Tormo Lanseros, Carmen Rodríguez Haro, María Hernández, Carmen Jiménez Ceinos, Carmen Comas Redondo","doi":"10.17235/reed.2024.10904/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10904/2024","url":null,"abstract":"<p><p>A 54-year-old male underwent a low anterior resection in 2015 for rectal adenocarcinoma. He presented to the emergency department with a two-week history of fever, perianal pain, an erythematous, warm, and actively draining mass. Physical examination revealed a perianal abscess in the left posterior gluteal region, with a palpable internal fistulous orifice 3 cm from the anal margin. Abdominal and pelvic CT and MRI demonstrated a discontinuity in the distal sigmoid colon pre-anastomotic, communicating with a perirectal abscess and an extrasphincteric fistulous tract towards the left ischioanal fat. Despite initial antibiotic therapy with amoxicillin/clavulanic and poor clinical response, colonoscopy revealed a 10 mm, erythematous, and friable fistulous orifice at the anastomosis. Histopathology did not reveal any adenomatous or dysplastic tissue. Vacuum-assisted closure was attempted but was unsuccessful due to technical difficulties and the small size of the cavity. Given the characteristics of the fistula, we proceeded with continuous manual suturing after argon application, achieving complete closure of the fistulous opening. However, after two weeks, there was a sluggish evolution. A follow-up colonoscopy showed persistence of the fistulous orifice with suture material, although radiologically there was a clear decrease in the abscess. Finally, after one month of hospitalization with a stable fistula but no definitive resolution, a planned surgical intervention was decided.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory bowel disease vs strongyloidiasis.","authors":"Teresa García Ballester, Sheila González Padilla, Marta Maia Boscá-Watts, Víctor Merino Murgui, Carlos Abril García, Carles Suria Bolufer, Paloma Poyatos García, Isabel Pascual Moreno","doi":"10.17235/reed.2024.10971/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10971/2024","url":null,"abstract":"<p><p>We report the case of a 38-year-old woman with a 10-year history of ulcerative proctosigmoiditis. Two months after traveling to Morocco, she developed gastrointestinal symptoms accompanied by eosinophilia in blood tests. Four months later, she progressed to systemic illness with pulmonary involvement. A colonoscopy revealed aphthous ileitis with nonspecific histology suggestive of Crohn's Disease (CD). Ultimately, serology confirmed Strongyloides stercoralis infection. Strongyloidiasis is underdiagnosed in Spain, and its differentiation from CD presents a diagnostic challenge.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leiomyosarcoma of the colon. An uncommon condition.","authors":"Cristóbal Perán Fernández, Alberto Sánchez Espinosa, Laura Abellán Garay, Álvaro Martínez Manzano, Agustín Cano Maldonado, Purificación Calero García, Ana Lage Laredo, María Balsalobre Salmerón","doi":"10.17235/reed.2024.10964/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10964/2024","url":null,"abstract":"<p><p>The gastrointestinal leiomyosarcoma is a rare tumor of the colon that arises from the smooth muscle cells of the intestinal wall. It is a very aggressive tumor with a poor prognosis.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jaundice as the onset of paracoccidioidomycosis.","authors":"Teresa García Ballester, Sheila González Padilla, Rosana Villagrasa Manzano, Antonio Ferrández Izquierdo, David Martí-Aguado, José Sánchez Serrano, Vicente Sanchiz Soler, Isabel Pascual Moreno","doi":"10.17235/reed.2024.10970/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10970/2024","url":null,"abstract":"<p><p>We report the case of a 24-year-old man from Brazil presenting with jaundice and epigastric pain. Abdominal CT and endoscopic ultrasound (EUS) revealed a mass in the pancreatic-duodenal groove, intrahepatic duct dilation, and lymphadenopathy, initially suggestive of lymphoproliferative syndrome. However, cytopathological analysis of EUS-guided fine needle aspiration (EUS-FNA) of the lymph nodes confirmed paracoccidioidomycosis. This case highlights the need to consider endemic mycoses, such as paracoccidioidomycosis, in the differential diagnosis of generalized lymphadenopathy, especially in patients from endemic regions.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of intestinal obstruction: jejunal ALK positive anaplastic large-cell lymphoma.","authors":"Boying Liu, Fu Guan, Shengbing Wang","doi":"10.17235/reed.2024.10994/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10994/2024","url":null,"abstract":"<p><p>A 32-year-old man had recurrent abdominal pain and vomiting for 2 weeks. Physical examination revealed a 4×2-cm abdominal tough mass with unclear boundaries. Palpation caused mild tenderness without rebound pain. Computed tomography (CT) showed a proximal jejunal mass with incomplete small-bowel obstruction , and double-balloon enteroscopy showed a large protruding proximal jejunal mass covered with dirt and a narrow lumen ; an enteroscope would not pass through. Pathological diagnosis by insufficiently deep endoscopic biopsy is difficult. After multidisciplinary discussion, surgical resection was performed. Histopathology revealed a malignant tumor . Immunohistochemical results: CD30 (+), ALK (+), EMA (+), GrB (+), CD2 (+), CD43 (+), TIA-1 (+), and silver staining (+). Sarcoma 86 fusion-gene detection showed NPM1-ALK gene rearrangement. The patient was diagnosed with anaplastic large-cell lymphoma (ALCL) and underwent chemotherapy.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phytobezoar-induced intestinal obstruction relieved via enteroscopy.","authors":"Xinyi Wu, Wenjia Zhang, Min Xia","doi":"10.17235/reed.2024.10976/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10976/2024","url":null,"abstract":"<p><p>Phytobezoar-induced intestinal obstruction is a rare condition caused by previous gastric surgery and consumption of tannin-containing foods. Laparoscopy used to be a common treatment to relieve intestinal obstruction due to phytobezoars. We reported a rare case of phytobezoar-induced intestinal obstruction caused by over-consuming fresh hawthorns, and successfully treated with enteroscopy. This case report confirmed the feasibility of enteroscopy to treat phytobezoar-induced intestinal obstruction.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of the maXium high-frequency surgical device in colorectal EMR.","authors":"Hiroki Kato, Makoto Kobayashi, Ryota Tagawa, Shintaro Tominaga, Akihiro Maruyama, Hirotaka Takeshima, Hiroshi Nakayabu","doi":"10.17235/reed.2024.10969/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10969/2024","url":null,"abstract":"<p><strong>Purpose: </strong>High-frequency surgical devices with various functionalities are widely used in Europe and Japan. In this study, we evaluated the effectiveness of the maXium HF surgical device manufactured by KLS Martin (Germany) during endoscopic mucosal resection (EMR).</p><p><strong>Materials and methods: </strong>The maXium device offers multiple preconfigured modes for incision and coagulation tailored to different surgical procedures. Endoscopists can intuitively select the appropriate mode using icons on the front panel. For polypectomy and EMR, the device uses the Polyp I/II mode, which alternates between incision and coagulation waves. This mode is characterized by a relatively short incision wave duration, even at increased power settings. During polypectomy and EMR, incomplete coagulation of vessel margins may occur if a vessel is resected in a single pass with excessive clamping, potentially leading to post-procedural bleeding. We examined the number of incision wave applications and hemostatic interventions performed prior to resection in 110 colorectal lesions from 35 patients who underwent polypectomy or EMR at our institution between August and December 2018 using the maXium device. Hemostasis was achieved using radiofrequency coagulation via hemostatic forceps and snare tips.</p><p><strong>Results: </strong>The 110 resected lesions were classified as follows: 8 lesions were type Ip, 23 were type Isp, 59 were type Is, and 20 were type IIa. Lesion sizes were categorized as 0-5 mm (24 lesions; mean energizations: 2.1; hemostatic interventions: 2/24, 8%), 5-10 mm (72 lesions; mean energizations: 2.6; hemostatic interventions: 4/72, 5%), 10-15 mm (11 lesions; mean energizations: 2.8; hemostatic interventions: 2/11, 18%), and 15-20 mm (2 lesions). Resection was achieved in a single incision wave in 8 cases (7.8%). No cases of delayed hemorrhage or perforation were observed. The number of lesions resected with a single current application during EMR was relatively low.</p><p><strong>Conclusion: </strong>Due to its low incidence of intraoperative bleeding, the maXium device demonstrates significant utility for EMR, a procedure commonly performed in routine clinical practice.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A unique achalasia patient complicated by neuropathies associated with nutritional deficiencies.","authors":"Ziang Gao, Deliang Liu, Tianjiao Duan, Tianying Duan","doi":"10.17235/reed.2024.10937/2024","DOIUrl":"https://doi.org/10.17235/reed.2024.10937/2024","url":null,"abstract":"<p><p>This paper reported a rare case of achalasia patient postoperatively experiencing a series of neurologic symptoms, diagnosed as severe B vitamin deficiencies caused by central and peripheral damage.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}