Acta Gastroenterologica Latinoamericana最新文献

{"title":"[Annular Pancreas in Adults. A Case Report].","authors":"Hernando Marulanda Fernández, Juan Sebastián Frías Ordoñez, William Otero Regino","doi":"10.52787/agl.v55i1.424","DOIUrl":"10.52787/agl.v55i1.424","url":null,"abstract":"<p><strong>Introduction: </strong>Annular pancreas is a rare congenital anomaly detected after the development of complications or as an incidental finding. Its diagnosis and treatment are controversial.</p><p><strong>Case presentation: </strong>A 44-year-old woman with chronic episodes of mild epigastric pain, nausea and emesis, with increasing frequency over the past two months. An abdominal ultrasound showed a distended gallbladder without stones, and dilated extrahepatic bile ducts. An endoscopic retrograde cholangiopancreatography was performed, revealing a circumferential pancreatic duct in the head of the pancreas surrounding the second part of the duodenum. By injecting contrast medium through the major papilla, its drainage was observed through a second, adjacent pore. Suspecting annular pancreas, magnetic resonance cholangiopancreatography was performed, showing a complete annular pancreatic duct. In the presence of recurrent symptoms of abdominal pain, the patient was referred to hepatobiliary surgery for definitive surgical management.</p><p><strong>Conclusions: </strong>Annular pancreas is a diagnosis to be considered in adults in case of epigastric pain associated with non-specific symptoms. Advances in imaging methods make its diagnosis timely. Despite the lack of guidelines on treatment, this must be individualized on a case-by-case basis.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"57-61"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669925","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":"[[Win Ratio: A Different Way to Analyze Clinical Trials. Its Strengths and Weaknesses]].","authors":"Walter Masson","doi":"10.52787/agl.v55i1.477","DOIUrl":"10.52787/agl.v55i1.477","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669932","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":"[Contributions of Nuclear Medicine to Gastroenterology: Use of Gastric Emptying Scintigraphy and Other Studies in Functional Gastrointestinal Pathology].","authors":"Gerardo Rank","doi":"10.52787/agl.v55i1.472","DOIUrl":"10.52787/agl.v55i1.472","url":null,"abstract":"<p><p>The use of gastric emptying scintigraphy is the gold standard in clinical practice for evaluating gastric motility and confirming the diagnosis of gastroparesis. It provides physiologic information, allows quantification of findings, and is a non-invasive method. In addition, it can be repeated over time to assess therapeutic response. In the same way, the esophagus, small intestine and colon can be evaluated by nuclear medicine.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 1","pages":"26-34"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670060","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":"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}