Acta Gastroenterologica Latinoamericana最新文献

{"title":"[Underwater Endoscopic Mucosal Resection in Non-pedunculated Colorectal Lesions: A Prospective Series in a Tertiary Center in Peru].","authors":"Henry Tomas Vargas Marcacuzco, Sonia Irene Junes Pérez, Waldir Paucar Huamán, Edith Melissa Villafuerte Mendez, Jorge Luis Fernández Luque, Jessica Tatheana Matheus Sairitupac","doi":"10.52787/agl.v55i3.530","DOIUrl":"10.52787/agl.v55i3.530","url":null,"abstract":"<p><strong>Introduction: </strong>Underwater endoscopic mucosal resection is an alternative technique to conventional endoscopic mucosal resection, with potential advantages in efficacy and safety. In Latin America, there are few reports on its application.</p><p><strong>Objective: </strong>To evaluate the effectiveness, feasibility, and safety of underwater endoscopic mucosal resection for non-pedunculated colorectal lesions in a Latin American series.</p><p><strong>Materials and methods: </strong>A prospective, observational study conducted between December 2023 and December 2024. Consecutive patients with non-pedunculated colorectal lesions ≥ 10 mm without endoscopic signs of deep submucosal invasion were included. Demographic data, lesion characteristics, technical success, resection type, histological findings, complications, and six-month recurrence were recorded.</p><p><strong>Results: </strong>Sixty patients with 67 lesions were included. The mean lesions size was 16.7 mm. The most common location was the right colon (56.7%), and the predominant morphology was granular LST (59.7%). Technical success was 100%, and en bloc resection was achieved in 91% of cases (96.5% for lesions ≤ 20 mm). Histology showed: tubular adenomas (47.7%), tubular adenomas with high-grade dysplasia (16.4%), serrated adenomas without dysplasia (4.4%), serrated adenomas with low-grade dysplasia (16.4%), and intramucosal adenocarcinomas (5.9%). Intraprocedural bleeding occurred in 11.9% and delayed bleeding in 2.9%, with no perforations. A significant association was found between lesion size and resection type (p < 0.001). Piecemeal resection was more frequent in lesions > 20 mm (RR 12.88; 95% CI: 2.75 - 60.43). At six months, control colonoscopy was performed in 85.1% of cases, with no evidence of recurrence.</p><p><strong>Conclusions: </strong>Underwater endoscopic mucosal resection proved to be effective, safe, and feasible, with high en bloc resection rates, and low rate of complications and absence of short-term recurrence.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"236-244"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670097","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":"[Diagnosis and Treatment of Eosinophilic Esophagitis].","authors":"Josealberto Sebastiano Arenas-Martínez, Jennifer L Horsley-Silva, Marcelo F Vela","doi":"10.52787/agl.v55i3.539","DOIUrl":"10.52787/agl.v55i3.539","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Eosinophilic esophagitis is a chronic inflammatory esophageal disease mediated by a type-2 immune response, mainly triggered by food allergens. Its incidence and prevalence have significantly increased in recent decades, making it a frequent cause of dysphagia and esophageal obstruction. The aim of this narrative review is to summarize current evidence of the diagnosis and treatment of EoE, with emphasis on clinical applications in Latin America.</p><p><strong>Material and methods: </strong>A narrative review of literature published in PubMed and complementary databases up to May 2025 was conducted. Original studies, systematic reviews, clinical practice guidelines, and international consensus statements relevant to the diagnosis and management of EoE were included.</p><p><strong>Results: </strong>Diagnosis requires integration of clinical practice with endoscopic and histological findings, supported by standardized diagnostic scores such as EREFS and EoEHSS. In terms of treatment, proton pump inhibitors, swallowed topical corticosteroids, and elimination diets represent first-line options. The introduction of biologic agents, particularly dupilumab, has expanded therapeutic strategies for patients with refractory disease. Endoscopic dilation is safe and effective in fibrostenotic cases. Long-term monitoring should combine clinical, endoscopic, and histological assessments, as symptoms by themselves do not reliably reflect inflammatory activity.</p><p><strong>Conclusion: </strong>EoE is a chronic condition that requires early diagnosis and comprehensive management. Despite therapeutic advances, challenges remain concerning the availability of specific drugs, reliable noninvasive biomarkers, and cost-effective monitoring strategies, which constitute priority areas for future research.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"188-202"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670135","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":"Masa oculta: reto diagnóstico en una adolescente con dolor abdominal agudo.","authors":"Ivonne Loaiza Pacheco, Diana Marcela Rodríguez De la Hoz, Manuela Laguna Kirof, Nebil Larrañaga, Eugenia Orozco","doi":"10.52787/agl.v55i3.506","DOIUrl":"10.52787/agl.v55i3.506","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"210-211"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670165","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":"Limitaciones metodológicas del artículo “Factores de riesgo para colecistitis aguda gangrenosa”.","authors":"Jimena Fabiola Palomares Rutte, Yamila Cilvia Chambi Mejía","doi":"10.52787/agl.v55i3.454","DOIUrl":"10.52787/agl.v55i3.454","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"176-179"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670128","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":"Invasive Fungal Infections in Decompensated Cirrhosis: A Clinical Case Series and Its Prognostic Implications.","authors":"Juan Francisco Maag, Ignacio Roca, Lucía Navarro, Manuel Barbero, Nicolás Domínguez, Omar Galdame, Fernando Cairo","doi":"10.52787/agl.v55i3.517","DOIUrl":"10.52787/agl.v55i3.517","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Systemic fungal infections are an under-recognized cause of morbidity and mortality in patients with decompensated liver cirrhosis. Our goal was to describe the clinical features, microbiological findings, and outcomes of invasive fungal infections in this population in the context of a liver transplant center.</p><p><strong>Materials and methods: </strong>We conducted a retrospective observational study of 16 adult patients with decompensated cirrhosis and culture-proven invasive fungal infections diagnosed between 2013 and 2024. Data were collected from electronic medical records and microbiology databases. Fungal pathogens were isolated from blood or ascitic fluid cultures. We analyzed demographics, cirrhosis etiology, antifungal treatment, and outcomes.</p><p><strong>Results: </strong>The mean age was 41 years, and 50% of patients were female. All patients had decompensated cirrhosis and a mean model for end-stage liver disease-sodium score of 25.7. Half of them met criteria for acute-on-chronic liver failure at diagnosis. The most frequent isolates were Candida albicans (37.5%) and Cryptococcus neoformans (37.5%). Ascites was present in 87.5% of patients; and 68.8% had received antibiotics, while 31.2% had received corticosteroids, within 30 days prior to diagnosis. In-hospital mortality was 62.5%, with a median survival of 11 days.</p><p><strong>Conclusions: </strong>Invasive fungal infections in decompensated cirrhosis are associated with high short-term mortality and often occur in patients who have been exposed to antibiotics or corticosteroids. Awareness of this complication and prompt initiation of antifungal treatment may improve outcomes. Multicenter studies are needed to define risk factors and optimize diagnostic and therapeutic strategies.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"212-218"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670106","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":"[Biliary Atresia Registry: First Report in Argentina].","authors":"Adriana Afazani, Rosana Pérez Carusi, Paula Bernale, Susana López, Miriam Cuarterolo, Ana Roca, Mirta Ciocca, Margarita Ramonet","doi":"10.52787/agl.v55i3.501","DOIUrl":"10.52787/agl.v55i3.501","url":null,"abstract":"<p><strong>Introduction: </strong>Biliary atresia is a disease with high morbidity and mortality, characterized by a fibrosclerosis and obstruction of the biliary ducts. Treatment is surgical and includes hepatic portoenterostomy and liver transplant. Early diagnosis is essential to ensure access to hepatic portoenterostomy within the first 30 - 45 days of life. In our country, we do not have national data on this pathology, which motivated the Hepatology Committee of the Argentine Society of Pediatrics to create a registry for this purpose. This report presents the results of incorporating a first center into the registry. This study allowed us to characterize a population of patients diagnosed with biliary atresia and treated at a high-complexity center in Argentina.</p><p><strong>Objective: </strong>The objective of this study was to describe the clinical, surgical, and evolutionary characteristics of the registered patients.</p><p><strong>Material and methods: </strong>This observational, descriptive, and retrospective study included patients diagnosed with biliary atresia treated at the Dr. Juan P. Garrahan Pediatric Hospital, born between January 1, 2015, and January 1, 2020. The diagnosis was based on clinical, biochemical, radiological, histological, and surgical findings. Hepatic portoenterostomy was performed according to Kasai technique or one of its variants.</p><p><strong>Results: </strong>Ninety-one patients from various regions of Argentina and abroad were included in the study. Of these, 55 children underwent surgical treatment (32 at the high-complexity institution and 23 at other centers). Sixty-three patients received liver transplants (31 as a first intervention and 32 after failure of hepatic portoenterostomy). There was a delay in the age of the patients at the time of diagnosis, and overall survival exceeded 80%, in coincidence with other case series.</p><p><strong>Conclusions: </strong>This is the first study in our country on biliary atresia that includes demographic, clinical-surgical, diagnostic, treatment, and short-term outcome data.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"229-235"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670127","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":"[[The Observational Study]].","authors":"Mirta Ciocca, Ricardo Mastai, Arturo Cagide","doi":"10.52787/agl.v55i2.489","DOIUrl":"https://doi.org/10.52787/agl.v55i2.489","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 2","pages":"70-78"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670016","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":"[Applicability of the London Classification to Characterize Defecation Disorders: a Retrospective Study in a Tertiary Care Center in Argentina].","authors":"Mauro Santana, María Marta Piskorz, Adriana Tevez, Fernanda Gutierrez Arispe, Carolina Acquafresca, Tatiana Uehara, Esteban González Ballerga, Jorge A Olmos","doi":"10.52787/agl.v55i2.492","DOIUrl":"10.52787/agl.v55i2.492","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic constipation and fecal incontinence are common functional pelvic floor disorders with a significant impact on quality of life. Although the London Classification standardizes anorectal manometric assessment, its application in Latin American populations is still limited.</p><p><strong>Objectives: </strong>To characterize anorectal manometric profiles according to clinical indication (constipation, fecal incontinence, or coexisting symptoms), using the London Classification.</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted on 413 adult patients who were evaluated using high-resolution anorectal manometry (Diversatek and ManoScan AR^®) at a tertiary care center. Clinical, manometric, and sensory variables were classified according to the four domains of the London Classification and analyzed. ANOVA and chi-square tests were used for group comparisons.</p><p><strong>Results: </strong>Patients with constipation had higher resting and voluntary contraction pressures of the anal canal, a higher prevalence of hypertonia and dyssynergia, and higher sensory thresholds. Patients with fecal incontinence presented hypotonia, hypocontractility, and altered coordination but not dyssynergia. Patients with coexisting symptoms exhibited mixed patterns. There were no significant differences in the prevalence of the inhibitory anal rectal reflex or rectal sensory disorders.</p><p><strong>Conclusion: </strong>The London Classification allowed the identification of specific pathophysiological patterns based on clinical phenotypes. These findings suggest its usefulness as a standardized diagnostic tool, with clinical implications for more accurate and personalized evaluation of defecation disorders.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 2","pages":"124-135"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670048","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":"[Successful Use of Biliary Stent in Deep Esophageal Laceration by Foreign Body in a 1-Year-Old Child].","authors":"Rosangela Ramírez-Barranco, Álvaro Andrés Gómez-Venegas, Mónica Contreras Ramírez","doi":"10.52787/agl.v55i2.479","DOIUrl":"10.52787/agl.v55i2.479","url":null,"abstract":"<p><p>Esophageal perforation is one of the most important lesions of the digestive system with serious complications and a high mortality rate, requiring an early diagnosis and timely management. The causes can be iatrogenic, traumatic, caustic or secondary due to foreign bodies. The present case reports deep esophageal laceration caused by a foreign body in an older infant treated with a fully covered biliary stent, with clinical and technical success.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 2","pages":"162-166"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670132","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":"[Prevalence of Infant Dyschezia: Experience of the Working Group on Disorders of the Gut-Brain Interaction of the Latin American Society of Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN)].","authors":"Carlos Alberto Velasco-Benítez, Diana Cárdenas-Sterling, Claudia Jimena Ortiz-Rivera, Edgar Játiva Mariño, Fátima Azereth Reynoso Zarzosa, Mariana Xail Espriu Ramírez, Jorge Alberto Macías-Flores, Roberto Arturo Zablah Córdova, Ricardo Ariel Chanis Águila, Trini Fragoso Arbelo, Miltón Mejía Castro, Yunuen Rivera Suazo","doi":"10.52787/agl.v55i2.485","DOIUrl":"10.52787/agl.v55i2.485","url":null,"abstract":"<p><strong>Introduction: </strong>According to the Rome IV Criteria infantile dyschezia has a worldwide prevalence of 2.0%, and according to the Rome III Criteria it ranges from 3.2% to 35.0% in Latin America.</p><p><strong>Objective: </strong>. To determine the prevalence of infant dyschezia and associated brain-gut axis disorders in Latin American infants under 9 months of age, according to the Rome IV Criteria.</p><p><strong>Materials and methods: </strong>This was a descriptive, observational, non-experimental prevalence-type study conducted in seven Latin American countries. The study included infants under 9 months of age diagnosed with infantile dyschezia using the Pediatric Gastrointestinal Symptom Questionnaire Rome IV and who were registered in the database of the Functional International Digestive Epidemiological Research Survey. Sociodemographic, family, clinical, enviromental, and nutritional variables were analyzed.</p><p><strong>Results: </strong>A total of 1,241 children (4.6 +/- 2.6 months; 53.3% male; 59.2% mixed-race) were included in the study. Infantile dyschezia was diagnosed in 2.9% of cases. The peak age of presentation was 4 months. The main gut-brain axes disorders found were colic (8.1%), regurgitation (7.6%), and constipation (7.1%). Overlapping disorders were found in 3.2% of cases. Infantile dyschezia was more common in the post-COVID-19 pandemic period, in public institutions, in patients treated by pediatric gastroenterologists, breastfed, and not bottle-fed (p < 0.05).</p><p><strong>Conclusion: </strong>The prevalence of dyschezia in Latin American infants under 9 months of age is slightly lower than the global reported rate, was higher during the post-COVID-19 pandemic period, and is mainly diagnosed in public institutions by a pediatric gastroenterologist.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 2","pages":"148-156"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670177","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}