Acta Gastroenterologica Latinoamericana最新文献

{"title":"[Biodegradable Pancreatic Stent in Endoscopic Resection of an Ampulloma in Argentina: A Case Report].","authors":"Guido Orbe, Agustín Di Santo, Camila María Briz, Jonnathan Efrain Rios Garzon, Luis Viola","doi":"10.52787/agl.v56i2.518","DOIUrl":"https://doi.org/10.52787/agl.v56i2.518","url":null,"abstract":"<p><p>Periampullary tumors are characterized by their low incidence and are often incidental findings during endoscopic procedures performed for other reasons. Among these, ampullary adenomas carry a potential for malignant transformation, making early detection and timely treatment essential. The choice of resection method primarily depends on the size of the lesion and the degree of deep-layer infiltration, factors that may hinder endoscopic resection and lead to the need for surgical management. Endoscopic resection is usually performed via endoscopic retrograde cholangiopancreatography, and the placement of a pancreatic stent is an effective preventive measure to reduce the risk of post-procedural pancreatitis, one of the most common complications. We present the first documented case in Argentina of endoscopic resection of an ampullary adenoma with placement of a biodegradable pancreatic stent.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"243-247"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy and Safety of Endoscopic Clousure of Gastrointestinal Fistulas Using a New Endoscopic Suturing System (X-Tack) in Colombia: A Case Series].","authors":"Javier Alberto Preciado Aponte, Eligio Antonio Álvarez Almanza, Elkin Julián Suárez Angarita, Alejandro Concha Mejía, Laura Gaitán Lucena, Manuel Alonso Ardila Báez","doi":"10.52787/agl.v56i2.627","DOIUrl":"https://doi.org/10.52787/agl.v56i2.627","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal fistulas are uncommon but potentially severe conditions associated with infectious collections, bleeding, sepsis, malnutrition, and increased morbidity and mortality. Advances in therapeutic endoscopy have expanded the options for minimally invasive treatment. Endoscopic treatment has become a first-line therapeutic strategy for colorectal anastomotic leaks and fistulas. For esophageal and gastric fistulas, esophageal stents remain a widely used alternative; however, their tolerability may be limited by the location of the defect. The X-Tack™ endoscopic suturing system (Boston Scientific), introduced in 2020, allows for the clousure of anatomical defects through the working channel of the endoscope without requiring scope withdrawal, facilitating access to complex anatomical locations and larger defects.</p><p><strong>Patients and methods: </strong>We present a case series of nine gastrointestinal fistula defects in eight patients treated in Colombia. The locations included the proximal esophagus, stomach, duodenum, colon, and rectum. In all cases, the X-Tack™ endoscopic suturing system was used as part of the therapeutic strategy employed to manage the defects.</p><p><strong>Results: </strong>The mean age of the patients was 56.5 years, and 62.5% were male. The most common location was the esophagus (50%). The predominant suture pattern was \"Z\" (87.5%). In all cases, endoscopic closure of the treated defect was achieved, with no procedure-related adverse events and clinical resolution during the reported follow-up period.</p><p><strong>Conclusions: </strong>In this case series, the X-Tack™ system was used as part of a multimodal therapeutic strategy for the management of complex gastrointestinal fistulas at different anatomical locations. Its use allowed for the closure of the treated defects without procedure-related complications and with clinical resolution, suggesting that it may represent a feasible and safe treatment option in selected patients. Prospective studies with a larger number of patients are needed to more precisely define its role within the therapeutic algorithm for gastrointestinal fistulas.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"232-242"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esofagitis eosinofílica en una población latinoamericana: resultados de un estudio observacional basado en el registro institucional de un centro de referencia.","authors":"J Argüero, L Bayarri, L Bono, Ana Braslavsky, J P Santino, M L González, M M Marcolongo, C A S Parisi","doi":"10.52787/agl.v56i2.631","DOIUrl":"https://doi.org/10.52787/agl.v56i2.631","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic esophagitis is poorly characterized in Latin America. We aimed to estimate its prevalence and describe its clinical, endoscopic, and histologic features, treatments, remission, and associated factors.</p><p><strong>Materials and methods: </strong>Cross-sectional analysis of a retrospective-prospective registry. The study included adults with confirmed eosinophilic esophagitis between 2014 and 2025, defined by symptoms of esophageal dysfunction and ≥15 eosinophils per high-power field. Factors associated with histologic remission were explored using logistic regression.</p><p><strong>Results: </strong>A total of 129 adults were included (72.9% male; median age, 43 years). Prevalence was 36 per 100,000 health plan members (95% CI, 27 - 47), and median diagnostic delay was 8.21 months. Dysphagia (75.1%) and food impaction (63.2%) were the predominant symptoms. Frequent endoscopic findings included furrows (30.4%), edema (24.9%), and rings (23.4%); 49% had a normal endoscopy. Treatments included proton pump inhibitors (88%), topical corticosteroids (45%), and an elimination diet (39%). Clinical remission was 51.2% and histologic remission was 34.3%. Food sensitization was associated with histologic remission (adjusted odds ratio, 3.31; 95% CI, 1.26 - 8.73; p = 0.015). Among those who achieved histologic remission, 28% continued to have an incomplete clinical response.</p><p><strong>Conclusion: </strong>The local prevalence was at the lower end of the pooled global estimate (40.04; 95% CI, 31.10 - 48.98) and below the 2017 - 2022 estimate (74.42; 95% CI, 39.66 - 109.19), and lower than contemporary estimates from the United States and Spain, with methodological and population-related caveats. Normal endoscopies reinforce the need for biopsies when eosinophilic esophagitis is suspected. Histologic remission in one-third of cases highlights the need to optimize treatment and follow-up.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"196-207"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cystic Teratoma of Pancreas. Diagnostic Challenge and Therapeutic Management].","authors":"Emmanuel Peton, José María Barbetta, Luciana Ferreyra, Fernando Vandonselar, Silvina Amione, Dagmar Osycka Salut","doi":"10.52787/agl.v56i2.528","DOIUrl":"https://doi.org/10.52787/agl.v56i2.528","url":null,"abstract":"<p><p>Pancreatic teratoma is an extremely rare benign congenital neoplasm. We present the case of a 61-year-old female patient who consulted for a 3 month history of abdominal pain. An abdominal ultrasound was performed, which revealed a hypoechoic nodular formation in duodenopancreatic topography, with a focal echogenic internal area with defined contours. A CT scan was requested, which reported a hypodense nodular formation at the level of the uncinate process with areas of fatty density and focal calcification measuring 34 mm x 42 mm in close contact with the mesenteric vein. It was decided to complement diagnostic studies with magnetic resonance and endoscopic ultrasound with a puncture biopsy, without findings of malignancy. The laboratory tests showed normal tumor markers. A converted laparoscopic cephalic pancreaticoduodenectomy was performed, with the pathology anatomy reporting morphological findings consistent with mature cystic teratoma.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"248-253"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuando la endoscopía impresiona, pero la biopsia tranquiliza: descamación mucosa esofágica extensa.","authors":"Julio Otero Figar, Francisco Javier Pérez Rastrollo, Inés Magide Yáñez, Mario Álvarez Díez, Fernando Fernández Cadenas","doi":"10.52787/agl.v56i2.632","DOIUrl":"https://doi.org/10.52787/agl.v56i2.632","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"173"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Early-onset Colorectal Cancer: Epidemiological and Clinical Characteristics and Survival Analysis in a Hospital Cohort].","authors":"Rubén Balmaceda, Tomás Valentín D'Angelo, Martín Máximo López, Martín Galvarini, Leonardo Affronti, Javier Kerman","doi":"10.52787/agl.v56i2.622","DOIUrl":"https://doi.org/10.52787/agl.v56i2.622","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer in adults under 50 years of age, known as early-onset colorectal cancer, has shown a progressive increase in incidence worldwide. This age group is usually excluded from screening programs.</p><p><strong>Objectives: </strong>To describe the epidemiological and clinical characteristics and survival outcomes of patients with early-onset colorectal cancer treated at a referral center.</p><p><strong>Materials and methods: </strong>A retrospective cohort study that included patients up to 49 years of age with a histological diagnosis of colorectal adenocarcinoma treated between 2015 and 2024. Clinical variables, tumor location, TNM stage, and survival were analyzed.</p><p><strong>Results: </strong>A total of 56 patients were included, with a median age of 42 years (IQR 13.3). The most frequent tumor location was the right colon (32.1%). Fifty-seven percent had advanced-stage disease and 33.9% had metastases at diagnosis. The median overall survival was 78 months, with a 5-year survival rate of 59.3%. The presence of metastases at diagnosis was independently associated with poorer survival (HR 2.38; 95% CI 1.08 - 5.26; p = 0.031), and age under 40 years showed a trend toward poorer prognosis (HR 2.17; 95% CI 0.95-5.00; p = 0.065).</p><p><strong>Conclusion: </strong>Although the right colon was the most common individual site, no clear predominance of any tumor site was observed. The cohort was characterized by a high proportion of advanced disease at diagnosis and an overall survival rate lower than that reported in other series. Metastatic disease was the main determinant of survival, and patients younger than 40 years of age tended to have a poorer prognosis.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"216-225"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[[From Pretest to Clinical Decision: The Value of Risk Reclassification]].","authors":"Santiago Decotto, Ana Miceli, Rodolfo Pizarro","doi":"10.52787/agl.v56i2.664","DOIUrl":"https://doi.org/10.52787/agl.v56i2.664","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"127-130"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Endoscopic and Therapeutic Profile of Pediatric Patients with Caustic Ingestion: A Seven-Year Experience at a High-Complexity Pediatric Hospital].","authors":"Karina Arco, Wilma Geraige, Mariana Torres, Paula Roitman, Romina Miranda","doi":"10.52787/agl.v56i2.629","DOIUrl":"https://doi.org/10.52787/agl.v56i2.629","url":null,"abstract":"<p><strong>Introduction: </strong>Ingestion of caustic substances in children can cause esophagogastric injuries with significant sequelae, particularly esophageal stenosis. Early upper gastrointestinal endoscopy allows for grading the injury according to the Zargar endoscopic classification and guiding follow-up.</p><p><strong>Objective: </strong>To describe the endoscopic and therapeutic profile of pediatric patients who ingested caustic substances and were treated between 2018 and 2024 at a referral pediatric hospital.</p><p><strong>Materials and methods: </strong>Observational, retrospective, and descriptive study. Patients under 14 years of age who underwent emergency upper gastrointestinal videoendoscopy due to suspected or clinically confirmed ingestion of caustic substances (January 2018 - December 2024) were included. Lesions were classified according to the Zargar endoscopic classification (0, I, IIa, IIb, III). Gastric involvement and the need for treatment (dilations, intralesional triamcinolone injection, or surgery) were recorded.</p><p><strong>Results: </strong>A total of 161 patients were analyzed (mean age 3 years; 65.8% male). At the initial endoscopy, no lesions were detected in 60 patients (37.3%); Zargar I was observed in 39 (24.2%), Zargar II in 53 (32.9%), and Zargar III in 9 (5.6%). Gastritis was noted in 25 cases (15.5%), mainly in Zargar II-III lesions. Esophageal dilations were required in 32 patients (19.8%): 25/53 (47.2%) with Zargar II lesions and 7/9 (77.8%) with Zargar III lesions. Five patients (3.1%) were identified with refractory stenosis (intervals ≤ 21 days). Fifteen patients received intralesional triamcinolone, although no conclusive benefit was observed in reducing the number of dilations. Two patients (1.2%) required surgical treatment (gastric ascension).</p><p><strong>Conclusions: </strong>In this series, Zargar II lesions were the most common among significant lesions and were associated with a significant proportion of dilations. Early endoscopic stratification allows for the anticipation of the need for intervention and follow-up. In our experience, intralesional triamcinolone did not show a conclusive benefit.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"226-231"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[[Re-Engagement of Hepatitis C Patients Lost to Follow-Up: A Multicenter Study from Argentina]].","authors":"Fernando Cairo, Nicolás Domínguez, Andrea Curia, Lucía Navarro, Manuel Barbero, Ayelen Trillo, Daniel Calfunao, Rodrigo Belloni, Anselmo Adrián Bologna, Estefanía Burgos, Melina Susana, Silvia Mabel Borzi, Omar Andrés Galdame, Esteban González Ballerga, Ignacio Roca","doi":"10.52787/agl.v56i2.604","DOIUrl":"https://doi.org/10.52787/agl.v56i2.604","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"174-184"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the Burden of Cannabis in Cirrhosis: A Propensity-Matched Real-World Analysis.","authors":"Fnu Alvina, Chidera N Onwuzo, Azhar Hussain, Adaora Ojiugo Moka, Rashid Abdel Razeq, Somtochukwu Onwuzo","doi":"10.52787/agl.v56i2.592","DOIUrl":"https://doi.org/10.52787/agl.v56i2.592","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis use is increasingly prevalent among patients with liver disease, its clinical impact on outcomes in cirrhosis remains unclear. This study evaluates the association between cannabis use disorder and clinical complications in patients with cirrhosis.</p><p><strong>Methods: </strong>We conducted a retrospective study using the TriNetX network. Adults aged 18-89 years with cirrhosis were divided into two cohorts: those with cannabis use disorder(n = 46,347) and those without (n = 888,138). Propensity score matching (1:1) was performed using demographics and key laboratory values. The final matched sample consisted of 46,168 patients in each group.Outcomes were assessed over a 1-year follow-up and included all-cause mortality, critical care admission, respiratory complications, dyselectrolytemia, and hypoalbuminemia.</p><p><strong>Results: </strong>Patients with cannabis use disorder had significantly higher odds of all-cause mortality (OR 1.086, 95% CI 1.052-1.121), critical care admission (OR 1.400, 95% CI 1.348-1.453), pneumonia (OR 1.212, 95% CI 1.158-1.268), pneumothorax (OR 1.160, 95% CI 1.041-1.293), and hypoalbuminemia (OR 1.074, 95% CI 1.035-1.114). Hyponatremia (OR 1.241, 95% CI 1.191-1.293), hyperkalemia (OR 1.102, 95% CI 1.053-1.154) and hypokalemia (OR 1.302, 95% CI 1.248-1.359) were more frequent in the cannabis group. Non-significant associations were noted for hemothorax (OR 1.074, 95% CI 0.922-1.251) and empyema (OR 0.945, 95% CI 0.805-1.109).</p><p><strong>Conclusion: </strong>These observational findings suggest that documented cannabis use disorder may identify a higher-risk subgroup among patients with cirrhosis, but they do not establish causality. Clinicians may consider evaluating cannabis use when conducting risk assessment and counseling. Further prospective research is needed to better define the mechanisms and long-term impact of cannabis in advanced liver disease.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"56 2","pages":"208-215"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}