Acta Gastroenterologica Latinoamericana最新文献

{"title":"[Chylou Peritonitis Secondary to a Lymphocele of the Thoracic Duct due to Blunt Trauma].","authors":"Evelin Mariel Crocci, Mirta Vera, María Emilia De Armas, Mauricio Rodrigo Paternó, Ronald Ríos Parrado, Jesica Franco, Lorena Colque, Lilian Castro, Sandra Lencinas","doi":"10.52787/agl.v55i3.445","DOIUrl":"10.52787/agl.v55i3.445","url":null,"abstract":"<p><p>Chylous peritonitis, which is caused by the accumulation of chyle in the abdominal cavity, is a rare cause of acute surgical abdomen. It has a milky appearance due to its high triglyceride content. It can originate from different mechanisms, including congenital malformations and injury or obstruction of the lymphatic ducts. Due to its low incidence, there is no clear diagnostic or therapeutic approach, adding further complexity to the condition. We present a clinical case of a 37-year-old female patient with a history of blunt cervical trauma that progressed to abdominal distension and peritoneal reaction. This led to surgical intervention and the finding of chyloperitoneum.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"257-261"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670153","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":"[Literature Review: Acute Pancreatitis].","authors":"Sara Pérez-Brotons, Enrique de-Madaria","doi":"10.52787/agl.v55i3.541","DOIUrl":"10.52787/agl.v55i3.541","url":null,"abstract":"<p><p>Acute pancreatitis is one of the leading causes of hospital admissions for gastrointestinal disease worldwide. Its incidence has increased in recent years, significantly impacting healthcare costs. It is an acute inflammatory process of the pancreas accompanied by abdominal pain, nausea, and vomiting. The most common causes are gallstones and alcohol abuse, though there are other, less frequent causes. A diagnosis of acute pancreatitis requires the fulfillment of at least two of three criteria: typical abdominal pain, amylase or lipase levels three times higher than the upper limit of normal, and/or compatible imaging findings. The disease can progress from mild forms with rapid resolution to severe cases that can lead to local and systemic complications and multiple organ failure. This condition significantly impacts morbidity and mortality. The latter occurs in 24% of mild cases and up to 50% of severe cases. Since there is no specific treatment for acute pancreatitis, its management is based on supportive measures and addressing the underlying cause to prevent further episodes.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"203-209"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670121","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":"[Obliteration of Gastric Varices using Endoscopic Ultrasound with Endocoils, with or without Cyanoacrylate. A Case series].","authors":"Gabriel Mosquera-Klinger, Alejandro Concha-Mejía, Jhon Jaime Carvajal, Liliana Restrepo, Manuel Alonso Ardila-Báez","doi":"10.52787/agl.v55i3.502","DOIUrl":"10.52787/agl.v55i3.502","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric varices affect between 17% and 25% of patients with portal hypertension, and bleeding is a serious complication with high mortality. Although the standard treatment has been direct injection of cyanoacrylate by endoscopy, this can cause significant adverse effects in the patient and even damage to the endoscopic equipment. Therefore, this study describes the experience in managing gastric varices using endocoils, with or without cyanoacrylate, guided by endoscopic ultrasound.</p><p><strong>Material and methods: </strong>A series of cases of patients with gastric varices treated with endocoil insertion, with or without cyanoacrylate injection, guided by endoscopic ultrasound, at two high-complexity institutions in Bogotá and Medellín, Colombia. The study period was from March 1, 2022, to July 31, 2024.</p><p><strong>Results: </strong>Fifteen adult patients with gastric varices were included; 60% women, with a mean age of 63.3 years and a BMI of 29.1. 93% of the patients had chronic liver disease, mainly due to metabolic hepatic steatotosis or alcohol. IGV1 varices were observed in 10/15 patients and GOV2 varices in 5/15 patients, with an average variceal size of 15.1 mm. Between one and two endocoils were used per patient, and in six cases complementary cyanoacrylate was applied. The clinical success rate was 100% and the technical success rate was 93%. No serious complications were reported.</p><p><strong>Conclusion: </strong>Treatment with EUS - guided endocoils, with or without cyanoacrylate injection under EUS guidance, is an innovative and effective technique, considered the treatment of choice for acute gastrointestinal bleeding and secondary prophylaxis in patients with GV. This case series showed high clinical and technical success rates, along with a low incidence of complications, suggesting that it is a safe procedure.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 3","pages":"219-228"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670189","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":"[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}