Acta gastroenterológica latinoamericana最新文献

{"title":"Paniculitis en pancreatitis aguda. Reporte de un caso y revisión de la literatura","authors":"Rómulo Vargas, Alan Felipe Ovalle Hernández, D. Escobar, Oscar David Lucero Pantoja","doi":"10.52787/IHBJ3544","DOIUrl":"https://doi.org/10.52787/IHBJ3544","url":null,"abstract":"Pancreatic panniculitis is a cutaneous manifestation that can occur as a complication of acute pancreatitis. We present the case of a patient who had an acute pancreatitis initially classified as mild, but, during the course of the disease, was associated with the presence of an exacerbation of pain together with erythematous, painful and well-defined dorsal lesions. In the tomographic control, the presence of the panniculitis and peri-pancreatic necrosis with periportal gas was confirmed. The patient had a clinical decompensation associated with the suspicion of compartment syndrome. For this reason, it was decided to perform an exploratory laparotomy. The presentation of pancreatic paniculitis is an infrequent manifestation, thus we consider pertinent the description of this case and its review in the literature.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114216552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solución del caso. Hallazgo incidental postrauma abdominal","authors":"Diana Marcela Romero de la Hoz, Margareth Mendoza Álvarez, M. E. Orozco, María De Vedia, Nicolás Roccatagliata, R. Cobeñas, N. Larrañaga","doi":"10.52787/TDOV4843","DOIUrl":"https://doi.org/10.52787/TDOV4843","url":null,"abstract":"","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117143241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dispepsia funcional y gastroparesia: ¿dos entidades superpuestas? De la fisiopatología a la terapéutica","authors":"María M. Manresa, Paula Cecilia Carboné, G. Diez","doi":"10.52787/BVBW1724","DOIUrl":"https://doi.org/10.52787/BVBW1724","url":null,"abstract":"Functional dyspepsia and gastroparesis represent the most common sensory-motor disorders of the upper gastrointestinal tract. Scientific advances in the last decade have shown that there is significant overlap between them. This review aims to address current knowledge about their pathophysiology, diagnosis and treatment. Functional dyspepsia is a medical condition that is characterized by one or more of the following symptoms: early satiety, postprandial fullness, and epigastric pain or burning. The pathophysiological mechanisms involved are: the gastroduodenal motility and sensory abnormalities, the immune dysfunction, the duodenal inflammation, the gastrointestinal infections, the alterations in the gastrointestinal microbiota and the dysfunction of the gut-brain axis. The Rome IV criteria make possible to establish a presumptive diagnosis of functional dyspepsia in most patients, although it continues to be a diagnosis of exclusion that requires the performance of an upper digestive video endoscopy to confirm it. The recommended therapeutic options are: the eradication of Helicobacter pylori, the proton pump inhibitors, the tricyclic antidepressants and prokinetics. Gastroparesis is a chronic disorder characterized by delayed gastric emptying in the absence of a mechanical obstruction. The pathophysiology is caused by neuromuscular abnormalities of gastric motor function. Gastric emptying scan is the current gold standard for diagnosis. The mainstays of treatment are restoration of hydration and nutrition, and pharmacological treatment with prokinetics and antiemetics.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127677172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Los criterios de Rosemont en ultrasonografía endoscópica: ¿son predictores de insuficiencia pancreática exocrina?","authors":"Marianela Arramón, A. Redondo, Pablo Cura, Fernando Baldoni, Ana Brizio, Cecilia Loudet, Francisco Tufare","doi":"10.52787/QWPO5827","DOIUrl":"https://doi.org/10.52787/QWPO5827","url":null,"abstract":"Endoscopic ultrasonography is the method of choice for detection of morphologic changes related to chronic pancreatitis. There are criteria, in the literature, that evaluate morphologic changes by endoscopic ultrasonography suggestive of chronic pancreatitis. The most widely used are the Rosemont criteria. Currently, the most effective diagnostic methods for exocrine pancreatic insufficiency are fat quantification (disused) and the 13C-mixed triglyceride breath test, not available in our country. However, the probability of diagnosis of pancreatic insufficiency can be estimated over the base of symptoms, malnutrition parameters, faecal elastase and signs of chronic pancreatitis in images. The aim of this study was to determine the correlation, probability and severity of exocrine pancreatic insufficiency, according to Rosemont criteria, in patients with chronic pancreatitis. A retrospective descriptive study was performed. Data were collected from patients between April of 2017 and April of 2018. The data gathered was based on pancreatic morphologic characteristics according to Rosemont criteria and related to the diagnosis of exocrine pancreatic insufficiency diagnosis based on the levels of stool elastase. Twenty one patients with chronic pancreatitis were included. The presence of hyperechogenic foci > 2 mm with posterior acoustic shadowing was associated with the presence of severe exocrine pancreatic insufficiency (p < 0.001). In our study, the association between parenchymal morphologic findings of chronic pancreatitis was significant in predicting exocrine pancreatic insufficiency. The role of endoscopic ultrasonography in predicting functional compromise in patients with chronic pancreatitis is promising.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125853972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis aguda por virus E con características de autoinmunidad. Reporte de un caso","authors":"Maria Laura Vecinday Garrido, María Laura Reyes Toso, Sebastián Raffa, Valeria Descalzi","doi":"10.52787/DTZY3014","DOIUrl":"https://doi.org/10.52787/DTZY3014","url":null,"abstract":"We analyze the case of a 49-year-old male patient who presented with clinical signs of acute hepatitis with an initial suspicion of autoimmune etiology. Laboratory findings demonstrated positive antinuclear antibody, anti-smooth muscle antibody and high serum gamma globulin. Histology of the liver biopsy revealed changes compatible with autoimmune hepatitis, which associated with an International Autoimmune Hepatitis Group score of 7, determined the initiation of treatment with Meprednisolone and Azathioprine. During the follow-up, we received positive serological results of immunoglobulin M against hepatitis E virus with detectable viremia by reverse transcription polymerase chain reaction technique, changing the diagnosis to acute hepatitis secondary to hepatitis E virus. Immunosuppression was suspended and the patient continued with clinical and biochemical improvement. In Argentina, hepatitis E virus testing is not routinely performed, however, to avoid misdiagnosis, this etiology should be ruled out in patients with acute hepatitis before labeling it as autoimmune hepatitis. This could reduce unnecessary treatment that could endanger our patients.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130274877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pull vs. wet: rendimiento diagnóstico y calidad de las muestras de las PAAF guiadas por USE en las masas sólidas del páncreas","authors":"C. Curvale, Ignacio Málaga, Paloma Rojas Saunero, Viviana Tassi, Enrique Martins, H. Hwang","doi":"10.52787/KNPG3537","DOIUrl":"https://doi.org/10.52787/KNPG3537","url":null,"abstract":"Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116224519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paciente con regurgitación: cómo estudiarla y cuáles son sus principales diagnósticos diferenciales","authors":"Mariela Dulbecco, Yolanda Marina Vargas Rodríguez, Mauricio Guzmán","doi":"10.52787/JAGJ4273","DOIUrl":"https://doi.org/10.52787/JAGJ4273","url":null,"abstract":"In gastroenterological practice, gastroesophageal reflux disease is one of the most frequent diagnoses. In this article the potential confounding of gastroesophageal reflux will be raised. According to the Montreal definition, “is a condition that develops when the reflux of stomach contents into the esophagus causes troublesome symptoms and/or complications.” However, it is becoming increasingly clear that sometimes symptoms suspected to be caused by gastroesophageal reflux disease are the expression of other functional and behavioral disorders or even structural lesions. From this complexity arise reflux confounding, where rumination and supragastric belching may present symptoms similar to gastroesophageal reflux disease, be initially treated with the proton pump inhibitor-based guidelines, and thus be mistakenly targeted. Likewise, regurgitation may be the symptomatic expression of different functional disorders and not exclusively a “typical” symptom of gastroesophageal reflux disease. Hence the need and the challenge for the treating physician to correctly identify the pathophysiological mechanisms responsible for the patient’s symptoms for a correct therapeutic approach.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134297511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constipación crónica. Conceptos actuales desde la fisiopatología hasta el tratamiento","authors":"K. García-Zermeño","doi":"10.52787/ZRRJ9030","DOIUrl":"https://doi.org/10.52787/ZRRJ9030","url":null,"abstract":"Chronic constipation is one of the most frequent gastrointestinal pathologies worldwide, and it negatively impacts the quality of life of patients. The objective of this narrative review is to present the most innovative and relevant information in relation to chronic constipation, from its pathophysiology to treatment. It is recognized that there are at least three subtypes of primary chronic constipation that are functional, that associated with irritable bowel and that related to evacuation disorders. It is considered that there are multiple causes of secondary chronic constipation, especially drugs and the entity called opioid-induced constipation is specifically detailed. The pathophysiological mechanisms of functional chronic constipation are multiple (they include motor and sensory alterations, dysbiosis, and structural and functional alterations of the pelvic floor) and frequently overlap. No test provides a complete description of defecation; therefore in general, a combination of these is generally used to assess motor and sensory structure and function. Advanced diagnostic studies of the function of the colon, rectum, and anus are recommended in patients with chronic constipation in whom the first-line treatment have failed. Regarding treatment, the usefulness of hygienic-dietary measures, exercise, fiber, the laxatives, the new drugs (such as prucalopride, lubiprostone, linaclotide, plecanatide), biofeedback therapy, probiotics, and other therapies fecal microbiota transplantation and surgery.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123774815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resultados de la cirugía en enfermedad inflamatoria intestinal: experiencia en un centro de atención terciaria","authors":"C. S. Ferrer, Víctor López Loma de Osorio, Isabel Pascual Migueláñez, Mario Álvarez Gallego, J. Martínez, Laura García Ramírez, E. Arranz, J. P. Cordón, M. Herranz, M. D. M. Arranz","doi":"10.52787/WKPS5116","DOIUrl":"https://doi.org/10.52787/WKPS5116","url":null,"abstract":"Introduction. The development of the therapeutic arsenal in inflammatory bowel disease has reduced the need for surgery in these patients. However, in certain cases, it continues to be the treatment of choice. In addition, the patients who required surgery intervention are more complex due to the therapy received (corticosteroids and immunomodulators) and the time of evolution of the disease. Materials and methods. We included patients under stable follow-up, in the Inflammatory Bowel Disease Unit of our center, who required surgery between January 2015 and November 2016 for treatment of the underlying pathology. Demographic and baseline disease variables were collected from each patient, as well as those related to the results and safety of the surgery, assessing both early and delayed complications. Results. During the study period, among the 998 patients with stable follow-up in the Inflammatory Bowel Disease Unit, 26 of them underwent surgery representing 2.6% of the sample. 85% of patients were on treatment with an immunomodulator (thiopurines, antiTNF or both) at the time of surgery. Five patients (20%) presented early postoperative complications, most of them mild (Claiven-Dindo I 79.2% and II 16.7%), of whom three (60%) were on combined treatment with azathioprine and an anti-TNF. No deferred complications of surgery were observed during its subsequent evolution. In the patients who underwent abdominal surgery, multivariate analysis showed that the presence of immunosuppressive treatment -at the time of surgery- increased the risk of suffering complications with an odds ratio of 1.66, and the treatment with biliologics, with an odds ratio of 1.457. None of the patients -in whom a complication occurred- were on corticosteroids treatment at the time of surgery. Conclusion. In our experience, the frequency surgery-related complications are low, despite the increasing use of immunosuppressive drugs in our patients.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125494332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compromiso del apéndice cecal por linfoma folicular grado 2. Reporte de un caso de presentación clínica atípica","authors":"Agustín Virgili, Carlos Wendichansky, Sara Gonorazky, M. Nieva","doi":"10.52787/EFYD8813","DOIUrl":"https://doi.org/10.52787/EFYD8813","url":null,"abstract":"The involvement of the appendix by lymphomas, both primarily or secondarily, is extremely rare; primary lymphomas account for less than 0.02% of gastrointestinal neoplasm. We present the rare case of a patient who debuts with low gastrointestinal bleeding as the main symptom. Colonoscopy found an extra mucosal tumour on the posterior aspect of the ceccum and bleeding from the appendicular orifice. Primary appendicular tumour is confirmed on multislice computed tomography and laparoscopic right hemicolectomy is performed. The patient had an uneventful postoperative course and was discharged on the 6th postoperative day. The pathology report shows a infiltration of the cecal appendix by grade 2 follicular lymphoma.","PeriodicalId":270053,"journal":{"name":"Acta gastroenterológica latinoamericana","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129981684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}