Acta Gastroenterologica Latinoamericana最新文献

{"title":"Evento intestinal inusual.","authors":"Jessica Milena Campo Rago, Manuela Laguna Kirof, Diana Rodríguez de la Hoz, Nebil Larrañaga","doi":"10.52787/agl.v55i1.466","DOIUrl":"10.52787/agl.v55i1.466","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"35-36"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670068","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":"[Identification of the Different Subtypes of Dyssynergic Defecation: A Descriptive Study in a Tertiary Care Hospital].","authors":"Mauro Santana, Tatiana Uehara, Esteban González Ballerga, Adriana Tevez","doi":"10.52787/agl.v55i1.473","DOIUrl":"10.52787/agl.v55i1.473","url":null,"abstract":"<p><strong>Introduction: </strong>Dyssynergic defecation is a functional disorder characterized by a lack of coordination between abdominal contractions and the relaxation of the anal sphincter, leading to chronic constipation. The main symptoms include a sensation of incomplete evacuation and excessive defecatory effort. Diagnosis requires excluding organic causes and evaluating alarm symptoms through digital rectal examination, high-resolution anorectal manometry, and balloon expulsion tests. Dyssynergic defecation is classified into four subtypes based on the manometric mechanisms involved.</p><p><strong>Objective: </strong>To describe the clinical and manometric characteristics of patients suspected of having dyssynergic defecation and estimate the proportions of the different subtypes.</p><p><strong>Materials and methods: </strong>Observational, descriptive, and retrospective study of 170 patients over 18 years of age diagnosed with dyssynergic defecation, evaluated at Hospital de Clínicas José de San Martín. High-resolution anorectal manometry was performed with a 12- circumferentially-oriented pressure sensors catheter and a balloon expulsion test. Manometric patterns were classified into four subtypes based on defecatory effort and sphincter relaxation.</p><p><strong>Results: </strong>The average age was 59.3 years (SD 15.7), and 80.6% of the patients were women. The distribution of the subtypes was as follows: type I (31.2%), type II (17%), type III (22.9%), and type IV (28.8%). No significant differences were found in age distribution (p = 0.558). Type IV dyssynergia had the highest proportion of women (95.9%, p = 0.015). The presence of symptoms such as incomplete evacuation, defecatory effort, and digitations varied between subtypes, but no statistically significant differences were found.</p><p><strong>Conclusion: </strong>The study confirms the clinical and manometric heterogeneity of patients with dyssynergic defecation. While some subtypes show a higher association with certain symptoms, the lack of significant differences suggests that other factors might influence the clinical presentation. High-resolution anorectal manometry remains key in the evaluation and classification of dyssynergic defecation.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670042","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":"[Diagnostic Imaging in the Developmental Anomalies of the Pancreas].","authors":"Diego Haberman, Mariano Volpacchio, Augusto Centellas, Fabrizio Acosta, Karen García, Joaquín Vidal","doi":"10.52787/agl.v55i1.462","DOIUrl":"10.52787/agl.v55i1.462","url":null,"abstract":"<p><p>Congenital anomalies of the pancreas result from failure of proper migration and/or fusion during embryologic development. They are usually diagnosed in adulthood, incidentally in imaging studies performed for other reasons. Some patients may develop symptoms such as abdominal pain or even relevant clinical conditions including gastric outflow tract obstruction, acute and recurrent pancreatitis. In this article we will review the imaging features of the most important congenital pancreatic anomalies, with emphasis on magnetic resonance cholangiopancreatography.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"15-25"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670080","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":"Coexisting Colon Cancer and Intestinal Malrotation: A Rare Anatomic and Oncologic Challenge.","authors":"Nicolás Lavorato, Alejandro Moreira Grecco, Tomás Flores, Rodrigo Morales, Gonzalo Hugo Zapata, Luis Ernesto Sarotto","doi":"10.52787/agl.v55i1.412","DOIUrl":"10.52787/agl.v55i1.412","url":null,"abstract":"<p><p>Intestinal malrotation is a rare congenital anomaly that occurs in approximately one in 500 to 6,000 live births and is characterized by abnormal rotation of the intestine during fetal development. Intestinal malrotation in adults is rare, occurring in only 0.17% of CT scans performed in this age group. The occurrence of colon cancer in a patient with intestinal malrotation raises important difficulties and technical factors to consider when diagnosing and treating colon cancer.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"53-56"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670071","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":"Desafío diagnóstico y manejo interdisciplinario en hemorragia digestiva alta de causa infrecuente.","authors":"Evelin Mariel Crocci, Sandra Basso, Analía Gubitosi, Cristina Nazar, Mauricio Paterno, Walter Fleitas Rumak, Natalia Zeytuntsian, Valeria Porto, María José Rohwain, María Paz Lacuadra, Silvina Goncalves, Elisa Alvarinhas, Fabio Muñoz","doi":"10.52787/agl.v54i4.450","DOIUrl":"10.52787/agl.v54i4.450","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"54 4","pages":"310"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669978","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":"[Colonoscopic Findings in Patients with a Positive Fecal Occult Blood Test: A Descriptive Study].","authors":"Edison Javier Moreira Granda, Santiago Regnasco, Josefina Romero, Itatí Guerríeri, Susana Misino, Diego Gariglio, Bárbara Chiussi, Hernán Bracone, Emilia Saá","doi":"10.52787/agl.v54i4.443","DOIUrl":"10.52787/agl.v54i4.443","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer is one of the most frequent neoplasms and a serious public health concern worldwide. In 2020, in Argentina, 15,605 new cases of colorectal cancer were registered and, in 2022, 7,217 deaths representing 12% of all deaths from malignant tumors. The National Program for the Prevention and Early Detection of Colorectal Cancer recommends that people between 50 and 75 years of age with no personal or family history of colorectal cancer, no history of inflammatory bowel disease, no suggestive symptoms, and no known risk factors should undergo biennial immunological fecal occult blood test. For at-risk groups, specific evaluations are performed based on their specific needs. A positive result of the immunologic fecal occult blood test requires a colonoscopy, the most sensitive test for early detection.</p><p><strong>Aim: </strong>To assess the rate of TSOMF-I with a positive result. To describe the percentage of patients who undergo VCC after a positive TSOMF-I result. To assess the adenoma detection rate and prevalence of CRC in patients with TSOMF-I-positive.</p><p><strong>Materials and methods: </strong>A retrospective analysis was perfomedr, in which data were collected from individuals between 50 and 75 years of age with positive immunologic fecal occult blood test and colonoscopies performed at Hospital Pirovano, Ciudad Autónoma de Buenos Aires, from January 1, 2020 to January 1, 2024.</p><p><strong>Results: </strong>A total of 717 patients were evaluated. A positive result on immunologic fecal occult blood test was observed in 21.6% (n=155) of the cohort, but only 42.6% (n=66) underwent colonoscopy. Findings were identified in 80% of cases, predominantly polyps (36.4%), internal hemorrhoids (34.8%), diverticulosis (18.1%) and angiectasis (4.5%). The prevalence of colorectal cancer was 3%, with an adenoma detection rate of 33.3%.</p><p><strong>Conclusion: </strong>This study showed a high prevalence of colorectal lesions, including adenomas and colorectal cancer, with figures that resemble those published by other international studies. The results obtained reflect the efficacy of immunological fecal occult blood test screening to identify relevant colorectal lesions. A key finding was that less than half of the patients with positive immunological faecal occult blood test underwent subsequent colonoscopy, which indicates the existence of important barriers to access to this study in our setting and reinforces the need to implement strategies to increase it. These findings are crucial to optimize colorectal cancer screening programs in Argentina, adapting them to the needs of the local population and improving public health outcomes.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"54 4","pages":"318-326"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669212","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":"[Tofacitinib as Rescue Therapy in a Patient with Severe Acute Ulcerative Colitis Refractory to Corticosteroids and Infliximab: A Case Report].","authors":"Camila Brizhttps, Agustín Di Santo, Federico Cassella","doi":"10.52787/agl.v54i4.406","DOIUrl":"10.52787/agl.v54i4.406","url":null,"abstract":"<p><p>Ulcerative colitis is a chronic inflammatory disease that can present with varying degrees of severity. The severe acute form occurs in up to 25% of patients, and its diagnosis is important for timely treatment and detection of complications. To date, clinical practice guidelines suggest first-line treatment with corticosteroids, second-line treatment with infliximab or cyclosporine, and surgical resolution in case of therapeutic failure. We present the clinical case of a 22-year-old female patient with severe acute ulcerative colitis as disease debut, refractory to treatment with corticosteroids and infliximab, who was treated with tofacitinib as rescue therapy.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"54 4","pages":"336-340"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669838","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":"[Between Guidelines and Gases: A Multicenter Evaluation of the Methodology, Diagnostic Accuracy and Quality of Hydrogen and Methane Breath Tests in Argentina].","authors":"Sofía Navar, Lisandro Pereyra, Juan Pablo Stefanolo, Leandro Steinberg, Federico Bentolila, Sergio Barril, Julieta Alonso, Andrés Palazzo, Abel Novillo, Nicolas Rovati, Vivian Vizcay, Federico Meuli, Deborah Balfour, Diego Guillermo Alonso","doi":"10.52787/agl.v54i4.449","DOIUrl":"10.52787/agl.v54i4.449","url":null,"abstract":"<p><strong>Introduction: </strong>The breath test is currently the most widely used tool for diagnosing small intestinal bacterial overgrowth. The rising prevalence of this condition has led to increased test utilization. However, concerns remain regarding its im plementation, including adherence to international guidelines related to methodology, diagnostic interpretation, and report quality.</p><p><strong>Aim: </strong>To assess the methodology, report quality, and diagnostic accuracy of breath tests for small intestinal bacterial overgrowth in Argentina, based on international guidelines.</p><p><strong>Material and methods: </strong>A multicenter observational study included 210 breath test reports from 8 centers across differ ent geographic regions of Argentina. The methodology used for test performance and report quality was evaluated based on 13 predefined criteria. Additionally, the concordance between the diagnoses reported by centers and those determined by an expert based on international guidelines was analyzed.</p><p><strong>Results: </strong>Significant heterogeneity in methodology and low ad herence to international guidelines were observed. Among the studies, 89% measured only H₂, while 11% included CH₄. Combined sampling intervals were used in 53%, and only 19% reached 180 minutes, with nearly 20% classified as in complete: only 10% specified diagnostic thresholds, and just 4% aligned with current guidelines. Diagnostic concordance was 87% for small intestinal bacterial overgrowth and 73% for intestinal methanogen overgrowth, with an average of 5 out of 13 quality criteria met.</p><p><strong>Conclusions: </strong>This study underscores the need to standardize breath test methodology and enhance adherence to international guidelines. Efforts should focus on improving report quality, unifying methodology, and increasing diagnostic accuracy for small intestinal bacterial overgrowth in Argentina.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"54 4","pages":"327-335"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670156","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":"[Ganglioneuroma of the Small Intestine Mimicking Crohn's Disease].","authors":"Paul Eduardo Lada, Paula Frávega, Fabián Caballero, Martín Sánchez, Christian Janikow, Julián Martínez Peluaga, Selene Molina, Florencia Matcosky, María Rosa Defago","doi":"10.52787/agl.v54i4.411","DOIUrl":"10.52787/agl.v54i4.411","url":null,"abstract":"<p><strong>Introduction: </strong>Intestinal ganglioneuromatosis is a rare benign neoplastic disease. It is usually described in children, in association with multiple endocrine neoplasia type 2b and neurofibromatosis type 1. Ganglioneuromatosis is rare in adults, where it usually occurs sporadically and in isolation.</p><p><strong>Case report: </strong>We present a patient with intestinal ganglioneuromatosis in whom the initial clinical and radiographic findings simulated Crohn's disease. A small bowel resection was performed due to endoscopic capsule occlusion. The immunohistochemical study of the resected segment suggested the diagnosis of small bowel ganglioneuroma.</p><p><strong>Conclusion: </strong>The clinical presentation of intestinal ganglioneuromatosis is variable. The patient may be oligosymptomatic or have an atypical presentation. This diagnosis should be considered when the most common causes of iron deficiency anemia have been excluded. Definitive diagnosis is possible after resection and pathologic analysis of the segment involved.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"54 4","pages":"341-345"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669253","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":"[[Evidence in Times of Artificial Intelligence]].","authors":"Diego Pérez de Arenaza","doi":"10.52787/agl.v54i4.453","DOIUrl":"10.52787/agl.v54i4.453","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"54 4","pages":"293-295"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670144","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}