Acta Gastroenterologica Latinoamericana最新文献

{"title":"Diagnóstico y tratamiento de la pancreatitis\u0000aguda en la Argentina. Resultados de un estudio\u0000prospectivo en 23 centros.","authors":"Carlos Ocampo,&nbsp;Gustavo Kohan,&nbsp;Fabio Leiro,&nbsp;Sandra Basso,&nbsp;Silvia Gutiérrez,&nbsp;Lorena Perna,&nbsp;Victor Serafini,&nbsp;Paul Lada,&nbsp;Tomas Lanceloti,&nbsp;Hugo García,&nbsp;Mariano Tolino,&nbsp;Gustavo Stork,&nbsp;Hugo Zandalazini,&nbsp;Luis Buonomo,&nbsp;José Mercade,&nbsp;Adrian Ferreres,&nbsp;Fernando Troubul,&nbsp;Alexander Latif,&nbsp;Roberto Klappenbach,&nbsp;Pablo Capitanich,&nbsp;Patricio Rainone,&nbsp;Pablo Sisco,&nbsp;Diego Zartarian,&nbsp;Sebastián Álvarez,&nbsp;Andrés Fraile","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Argentina there are no multicenter studies evaluating the\u0000management of patients with acute pancreatitis (AP) nationwide.</p><p><strong>Objectives: </strong>The main objective of this study is to\u0000know how the patients with AP are treated in Argentina.\u0000The secondary objective is to assess whether the results comply\u0000with the recommendation of the American College of Gastroenterology\u0000Guide.</p><p><strong>Material and methods: </strong>Twenty three\u0000center participated in the study. They include in a database\u0000hosted online consecutive patients with acute pancreatitis\u0000from june 2010 to june 2013.</p><p><strong>Results: </strong>854 patients entered\u0000the study. The average age was 46.6 years and 495\u0000(58%) belonged to the female sex. The most common cause\u0000(88.2%) of AP was biliary. Some prognostic system was\u0000used in 99 % of patients and the most used was Ranson\u0000(74.5%). Were classified as mild 714 (83.6%) patients\u0000and severe 140 (16.4%). Systemic complications occurred\u0000in 43 patients and local complications in 21. 86 patients\u0000underwent dynamic CT scans and 73 patients had pancreatic\u0000and / or peripancreatic necrosis. Mortality was\u00001.5%. There was no difference in mortality in relation to\u0000the size, complexity or affiliation of the center. The comply\u0000of key recommendations of the American College of Gastroenterology Guide was over 80%.</p><p><strong>Conclusions: </strong>The diagnosis and treatment of patients with AP in 23 health\u0000centers located throughout the country was optimal. The\u0000management complied with most of the recommendations\u0000of the American College of Gastroenterology Guide.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 4","pages":"295-302"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35069075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Port Laparoscopic Gastrostomy: description of a technique and initial experience.","authors":"Mariano Palermo,&nbsp;Mario Luis Domínguez,&nbsp;Pablo Acquafresca,&nbsp;Guillermo Duza,&nbsp;Mariano Giménez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Since the first classic descriptions of surgical\u0000gastrostomies for feeding by supra-umbilical medial\u0000incisions, patients were operated under general anesthesia,\u0000with prolonged time of surgery; these were patients in poor\u0000health status, undernourished due to inadequate intake or\u0000to neurological or tumor involvement, with prolonged hospitalization,\u0000both for the recovery of the intestinal motility\u0000as well as for the recovery of post-surgical wounds. Therefore,\u0000we describe a new minimally invasive technique as an alternative\u0000to the percutaneous or endoscopic gastrostomy, in\u0000patients where we are not allowed to place a nasogastric tube\u0000to insufflate the stomach. This is mostly seen in patients with\u0000tumors, which cause obstruction.</p><p><strong>Material and methods: </strong>Between July 2012 and June 2013, 8 patients underwent\u0000a single port laparoscopic gastrostomy. Five were females,\u0000mean age: 77 years (range: 67-87). In all the patients, it\u0000was impossible to place a nasogastric tube, due to obstructive\u0000tumor.</p><p><strong>Results: </strong>The mean time of the procedure was\u000045 minutes. Seven patients underwent tolerance of dextrose\u000010% through the catheter after 12 hours and one 24 hours\u0000after the procedures. Enteral feeding was indicated after the\u0000dextrose 10% tolerance was performed. No complications related\u0000to the procedure were observed.</p><p><strong>Discussion: </strong>Currently,\u0000the gold standard technique to perform a gastrostomy is the\u0000percutaneous or endoscopic approach. In patients with head\u0000and neck tumors, when it is not possible to insert a nasogastric\u0000tube to insufflate the stomach, a laparoscopic gastrostomy\u0000would be indicated. We describe a new technique, step by\u0000step, to perform less invasive laparoscopic surgery by a single\u0000port laparoscopic gastrostomy.</p><p><strong>Conclusion: </strong>The diameter\u0000created is the same as the one performed with an open technique,\u0000but in this case, with a minimally invasive approach,\u0000that allows us to start feeding the patient with a high quality\u0000of feeding, because of the wider lumen.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 4","pages":"280-7"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35064298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fístula gastroduodenal por textiloma extraído\u0000endoscópicamente.","authors":"Diego Daino,&nbsp;Guido Villa-Gómez Roig,&nbsp;Gustavo Vidales Mostajo,&nbsp;Geraldine Ramos Quisbert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this case we present a patient with chronic abdominal\u0000pain of a year of evolution, three months before being admitted\u0000to hospital the patient presented melaena and anaemia.\u0000Within the surgery antecedents it appears a caesarean 2 years\u0000before and a cholecystectomy a year before. In the endoscopy\u0000study a textiloma was observed coming up from the posterosior\u0000side of the antrum which, after its endoscopic removal,\u0000showed a gastro-duodenal fistula with a non-patent pylorus.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"217-20"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35069621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neumatosis intestinal.","authors":"Néstor Gómez Cuesta,&nbsp;Jorge Ayón Ho,&nbsp;Jama Stanley,&nbsp;Alba María Caviedes Merchán","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The intestinal pneumatosis is a clinical entity that is described\u0000as the presence of gas within the intestinal wall and\u0000portomesenteric venous complex as an air cysts without surrounded\u0000or no epithelial lining by a granulomatous infiltrate\u0000with giant cells multinucleic.1 It is a extremely rare\u0000clinical entity that has been characteristically associated with\u0000intestinal ischemia and high mortality. We present two cases\u0000of intestinal pneumatosis tomographic reports, admitted\u0000with clinical symptoms of intestinal obstruction. Recent advances\u0000in imaging techniques, mainly in multislice computed\u0000tomography (MSCT), allow a reliable and accurate early\u0000diagnosis of these findings.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"225-9"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35069623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pruebas neurofisiológicas en trastornos anorrectales.","authors":"Mercedes Amieva-Balmori,&nbsp;José María Remes Troche","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurophysiological studies of anorectal function provide useful\u0000information about the integrity of innervation and neuromuscular\u0000function. This information helps to understand the pathophysiological mechanisms leading to severe anorectal\u0000disorders function, such as fecal incontinence, pelvic floor\u0000disorders and dyssynergic defecation. These tests are commonly\u0000performed in patients referred to third level medical\u0000centers having negative evaluations or no response to conventional\u0000therapy. Proper use of these tests may reveal significant\u0000new knowledge of the underlying mechanisms that can lead\u0000to better management of these disorders. These techniques are\u0000complementary to other types of research such as imaging of\u0000the pelvic floor. In this review, the most accomplished neurophysiological\u0000studies, indications and clinical utility are\u0000analyzed. Several techniques are emerging and provide us\u0000with a better understanding of the brain-gut interactions.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"252-62"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35067983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avances en Gastroenterología\u0000Trasplante intestinal desde la clínica a la investigación\u0000traslacional: contribuciones de una unidad integral de\u0000insuficiencia intestinal, rehabilitación y trasplante.\u0000Seguimiento biomédico del proceso de trasplante intestinal y su correlación con los distintos\u0000eventos fisiopatológicos que atraviesa el paciente.","authors":"Gabriel E Gondolesi,&nbsp;Dominik Meier,&nbsp;Carolina Rumbo,&nbsp;Diego Ramisch,&nbsp;Constanza Echevarría,&nbsp;Fabio Nachman,&nbsp;Melisa Pucci Molineris,&nbsp;María Inés Martínez,&nbsp;Pablo Barros Schelotto,&nbsp;Ana Abdurrob,&nbsp;Héctor Solar,&nbsp;Martín Rumbo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One of the greatest achievements in gastroenterology and surgery\u0000of the last 50 years has been the capability to transplant\u0000different abdominal organs of the digestive system separately\u0000or as a whole. The complexity of the intestinal transplantation\u0000demands a multidisciplinary team engaged in the management\u0000of patients with intestinal failure responsible for\u0000defining the need for nutritional support, rehabilitation, or\u0000intestinal transplantation. This team should include a basic\u0000research area to provide answers to unresolved clinical problems.\u0000The aim of this work is to update the current status of\u0000intestinal transplantation, and to show the progress and results\u0000of our center; emphasizing our achievements in the clinical\u0000area, and the contributions of the translational research\u0000and mucosal immunology studies as part of the integral unit\u0000of intestinal failure, rehabilitation and transplantation. The\u0000data reported here demonstrate that the intestinal transplantation\u0000has been established as a therapeutic option in our\u0000country and Latin America, with long term results that have\u0000ranked our service at the level of the best centers in the world\u0000positioning us as referent in the specialty.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"233-51"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35067982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imagen tomográfica infrecuente en patología biliar.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"189, 273"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35067502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Los adenomas metacrónicos de colon presentan un\u0000patrón de desarrollo diferente en pacientes obesos.","authors":"Juan Lasa,&nbsp;Silvina Gándara,&nbsp;Liliana Spallone,&nbsp;Félix Trelles,&nbsp;Natalia Leibovich,&nbsp;Leandro Di Paola,&nbsp;Juan Viscardi,&nbsp;Diego Caniggia,&nbsp;Mariano Villarroel,&nbsp;María Ahumada,&nbsp;Saúl Berman,&nbsp;David Zagalsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>XSome authors have assessed the link between\u0000obesity and colon adenoma risk. Moreover, it has been reported\u0000that obesity could increase the risk of proximal adenoma\u0000development. Accordingly, obese patients may have a distinctive\u0000pattern of adenoma recurrence. AIM: To determine\u0000whether metachronous adenoma features differ between obese\u0000and non-obese subjects submitted to colonoscopy surveillance.</p><p><strong>Materials and methods: </strong>We prospectively evaluated all patients\u0000over 18 years old that underwent surveillance colonoscopy\u0000at our institution between June 2013 and June 2014.\u0000Date of prior colonoscopy was registered. A body mass index\u0000≥ 30 was used to define obesity. Analysis looking for variables\u0000significantly associated with metachronous adenoma was performed.\u0000Metachronous adenoma rate was compared between\u0000obese and non-obese subjects, as well as size, location, morphological\u0000and histopathological characteristics.</p><p><strong>Results: </strong>Overall,\u0000825 subjects were enrolled. Median time of surveillance colonoscopy\u0000was 38.9 months. Obesity was statistically more frequent\u0000in those subjects with metachronous adenomas (40% vs\u000025.71%, p < 0.001). On multivariate analysis, obesity [OR\u00001.7 (1.01-2.9)] and age [OR 1.02 (1-1.05)] were independently\u0000associated with metachronous adenoma presence. Obesity\u0000was also significantly associated with a higher risk of right\u0000colon adenomas [OR 2.4 (1.76-3.26)] and advanced adenoma\u0000[OR 1.99 (1.29-3.06)]. The risk is significantly higher\u0000in men and in those with a family history of colorectal cancer/adenoma.</p><p><strong>Conclusion: </strong>Obesity was associated with a higher\u0000risk of metachronous adenomas on surveillance colonoscopy. A\u0000higher risk of right-sided lesions and advanced adenomas was\u0000also found in this population.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"198-202"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35069618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aldosterone increases oxygen consumption of rectal\u0000epithelia of normal, sodium-deprived and sodiumloaded\u0000rats.","authors":"Fernando D Saraví,&nbsp;Karina A González Otárula,&nbsp;Graciela E Carra,&nbsp;Jorge E Ibáñez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The colonic epithelium is a classical aldosterone\u0000target, but the effect of the hormone on the oxygen\u0000consumption rate (QO2 ) of this tissue is unknown. Objectives.\u0000We aimed at assessing, in the rectal epithelium of\u0000rats fed with diets of different sodium content, the effect of\u0000epithelial sodium channel (ENaC) blockade on short-circuit\u0000current (ISC ) and QO2 , and the acute effect of aldosterone\u0000incubation on ISC and QO2 .</p><p><strong>Methods: </strong>Adult male rats\u0000were fed with normal, low or high-sodium diets for 8 days.\u0000Plasma sodium and serum aldosterone were measured. Isolated\u0000mucosa preparations from the rectal portion of the colon\u0000were mounted in Ussing chambers modified to measure\u0000ISC and QO2.</p><p><strong>Results: </strong>Baseline ISC and QO2 were highest\u0000in sodium-deprived rats. Both were proportionally reduced\u0000by amiloride (0.1 mM) in this group and in the normal\u0000sodium group, but not in sodium-loaded rats. In separate\u0000experiments, incubation with aldosterone (10 nM) for 7 h\u0000increased ISC and QO2 in all groups; increases were larger in\u0000the normal and sodium-loaded groups. Amiloride decreased\u0000both ISC and QO2 , abolishing the differences between groups.\u0000Linear regression of the decrease in QO2 and ISC after amiloride\u0000showed the steepest slope for the sodium-deprived group\u0000and the flattest one for the sodium-loaded group.</p><p><strong>Conclusions: </strong>Baseline epithelial QO2 of sodium-deprived and control\u0000rats is reduced by ENaC blockade. Aldosterone increased\u0000QO2 proportionally to ISC augmentation in all groups, but\u0000the coupling between aerobic metabolism and electrogenic\u0000transport seems more efficient in sodium-deprived animals.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"203-11"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35069619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total gastrectomy due to ferric chloride intoxication.","authors":"A Mesut Menéndez,&nbsp;Leonardo Abramson,&nbsp;Raúl A Vera,&nbsp;Guillermo E Duza,&nbsp;Mariano Palermo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The ferric chloride intoxication is frequently\u0000caused by accident. Its toxicity is generally underrated,\u0000which can lead to fatal evolution or irreversible consequences.\u0000In this case, the caustic condition of the substance is\u0000related to the toxic properties of iron.</p><p><strong>Case presentation: </strong>A 36-year-old male patient arrives by ambulance indicating\u0000sensory deterioration. He presents erosive injuries in the\u0000buccal cavity and in the oropharynx, brownish teeth and\u0000metabolic acidosis. Toxicology tests and ferritin blood dosage\u0000are requested, which show a result from 1400 mg/dl. The\u0000symptoms are interpreted as acute iron intoxication. Due to\u0000the unfavorable evolution of his condition, an abdominal\u0000and pelvic CT scan are performed, which show extensive\u0000pneumoperitoneum and free fluid in the abdominal cavity.\u0000An exploratory laparotomy, a total gastrectomy with esophagostomy\u0000and feeding jejunostomy, washing and drainage\u0000due to perforated gastric necrosis caused by caustic ingestion\u0000are performed.</p><p><strong>Discussion: </strong>In our country, there is a high\u0000rate of intoxication caused by iron compounds, although it\u0000is not statistically measured. Nevertheless, the ferric chloride\u0000intoxication is extremely infrequent. The ingestion of this\u0000product leads to complications, which are associated with the\u0000iron concentration and its condition as a caustic agent.</p><p><strong>Conclusions: </strong>The surgical indications in the presence of intoxication\u0000caused by iron compounds are: stomach evacuation\u0000of iron, gastric necrosis, perforation or peritonitis and stenosis.\u0000Early or prophylactic gastrectomy is contraindicated.\u0000However, if complications that require immediate surgical\u0000intervention arise, there should be no hesitation and the corresponding\u0000procedure should be performed.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"45 3","pages":"212-6"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35069620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}