Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru最新文献

{"title":"Chromoendoscopy innovation: Could purple corn solution be a potential natural contrast agent for detecting colonic lesions?","authors":"Gustavo Kishimoto, Tamy Yamamoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Peru has a high incidence and mortality rate of stomach and colorectal cancers. While chromoendoscopy (CE) with indigo carmine dye is the gold standard for gastrointestinal tumor early detection, its accessibility is limited in Peru due to cost and infrastructure restrictions. This study explores the potential of a natural alternative: anthocyanin dye extracted from purple corn (PC), a widely consumed and accessible food source in Peru. A PC decoction was prepared by boiling the PC and adjusting the pH to 8. A 38-year-old male patient underwent colonoscopy, finding a rectal polyp followed by CE with both IC and PC solution (PCS). The PCS effectively stained the colonic mucosa, allowing for visualization of the lesion. In this report, PCS is presented as a potential cost-effective and readily available natural contrast agent for CE, particularly relevant for low-resource environments in Peru. Further research and collaboration are needed to address standardization and staining duration for more reliable and accurate results.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"176-179"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838069","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":"[Esophageal metastasis from primary colon adenocarcinoma: presentation of an unusual clinical case].","authors":"Fabian Eduardo Puentes Manosalva, Lázaro Arango Molano, Santiago Salazar Ochoa, Herney Solarte Pineda, Gian Núñez Rojas","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Colorectal cancer is one of the tumors with the highest incidence and mortality worldwide. Despite being considered a preventable pathology due to the modifiable risk factors and the appropriate use of screening strategies, there are currently still important barriers with respect to access to health services and adoption of the screening tests, which is reflected in a non-negligible percentage of patients with the presence of metastasis or unresectable disease at the time of diagnosis. The most frequent sites of metastasis in colorectal cancer are widely known, however, these patients may present metastatic lesions to unusual sites that have not been frequently reported in the literature. We present the unusual case of a patient with colon cancer with metastasis to the esophagus.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"188-191"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838061","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":"[From the stethoscope to ultrasound: POCUS (point-of-care ultrasound) in gastroenterology and hepatology].","authors":"Hugo Guillermo Cedrón Cheng","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"107-108"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838063","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":"[Diagnostic strategy following failed colonoscopy: endoscopic ultrasound-guided fine needle biopsy in colon cancer].","authors":"Calixto Duarte-Chang, Julio Zúñiga Cisneros, Ramiro Da Silva Rodriguez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Endoscopic ultrasound (EUS)-guided sampling is a safe and reliable method for obtaining pathological results of gastrointestinal and adjacent gastrointestinal lesions. Some colon lesions are located in the muscular layer or even in the serosa beneath the mucosa, so conventional colonoscopy with forceps biopsy is often negative. In patients with colon cancer, forceps biopsy during colonoscopy is the current standard diagnostic modality. However, there are cases that are difficult to confirm with forceps biopsy, such as stenosing tumors, or those originating from deep layers. Endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) is a useful alternative for diagnosis in these cases. We present the successful case of a 62-year-old male with a history of progressive weight loss and a colonic mass at the splenic flexure, whose colonoscopy was unsuccessful, therefore a FNB puncture by EUS was performed, via transgastric route, reaching a histological diagnosis of colon adenocarcinoma. This case highlights the feasibility of FNB by EUS in the acquisition of colonic lesions through the stomach in cases of inconclusive colonoscopy.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"180-183"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838060","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":"Differences in the detection of gastric premalignant conditions and its correlation with gastric cancer after a negative esophagogastroduodenoscopy in a low-risk gastric cancer country.","authors":"Pedro Genaro Delgado-Guillena, Víctor Jair Morales-Alvarado, Beatriz De-Riba-Soler, Gemma Llibre-Nieto, Indira Armas-Ramírez, Terry Guillena-Castañeda, Ivana Levy-Ríos, Mireya Jimeno-Ramiro, Joaquim Rigau-Cañardo, Albert García-Rodríguez, Esteve Llargués Rocabruna, Henry Córdova, Gloria Fernández-Esparrach","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer (GC), with nearly 90% being sporadic adenocarcinomas, is preceded by gastric premalignant conditions (GPC). Accurate detection of GPC during esophagogastroduodenoscopy (EGD) can enhance the identification of high-risk patients and improve early GC diagnosis. However, GPC detection rates during EGD vary among endoscopists, potentially leading to differences in GC rates after a negative EGD (GC post-EGD).</p><p><strong>Objective: </strong>This study aimed to assess the correlation between the GPC detection rate and the rate of GC post-EGD among endoscopists.</p><p><strong>Materials and methods: </strong>We conducted an observational study of EGDs at a community hospital between 2010 and 2019. GPC were defined as glandular atrophy, intestinal metaplasia, and dysplasia. EGDs were categorized into three groups: (i) benign, (ii) GPC, and (iii) malignant findings. GC post-EGD was defined as a diagnosis of gastric adenocarcinoma within three years of an EGD negative for malignancy. GPC detection rates and GC post-EGD were calculated for each endoscopist.</p><p><strong>Results: </strong>A total of 18,635 EGDs were performed by nine endoscopists. Gastric biopsies were obtained in 2,415 (13%) EGDs, identifying 533 GPCs (2.9%). The GC post-EGD rate was 1.26 per 1,000 EGDs. The detection rate of GPC varied between 1.8% and 5.8%, while GC post-EGD rates ranged from 0 to 3.36 per 1,000 EGDs. A negative correlation trend was observed between GC post-EGD and GPC detection rate (rs=-0.65, p=0.057), which was statistically significant for dysplasia (rs=-0.69, p=0.037).</p><p><strong>Conclusion: </strong>The detection rate of GPC-particularly dysplasia-showed a negative correlation with GC post-EGD in a community hospital within a low-risk setting during the period from 2010 to 2019.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"109-119"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838070","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":"[Case report: uveal melanoma with gastric metastases].","authors":"Carmelo Blasco, Carolina Miranda, Sergio Morínigo, Maisa Vallejos, Angélica Caballero","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Uveal melanoma is the most common ocular cancer in adults, originating from melanocytes in the uvea. Although rare, its high metastatic potential, primarily to the liver, poses a significant challenge to patient prognosis. Gastric metastasis, though infrequent, may indicate advanced disease, with an incidence of up to 60% in post-mortem studies. We present the case of a 47-year-old patient with a history of uveal melanoma who developed gastric and hepatic metastases, as well as brain lesions, ultimately leading to her death within a short period.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"198-201"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838058","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":"[Clinical practice guideline for the evaluation and management of upper gastrointestinal bleeding in EsSalud: 2024 Update].","authors":"Luis Cervera-Caballero, Ana Brañez-Condorena, Alejandro Piscoya, Nelly Vásquez-Valverde, Ericson Arcana-López, Javier Contreras-Turin, Daniel Vargas-Blácido, Alvaro Taype-Rondan, Joan Caballero-Luna, Fabiola Huaroto-Ramírez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This article summarizes the clinical practice guideline (CPG) for the evaluation and management of upper gastrointestinal bleeding (UGIB) in the Social Security of Peru (EsSalud).</p><p><strong>Methods: </strong>A guideline development group comprising medical specialists and methodologists, formulated clinical questions addressed by CPG. Systematic evidence searches were conducted for each question during 2024. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of the evidence and formulate the recommendations. The CPG was approved through Resolution No. 000022-IETSI-ESSALUD-2024.</p><p><strong>Results: </strong>This CPG addressed 11 clinical questions, divided into four topics: risk assessment, initial management, variceal UGIB management, and non-variceal UGIB management. Based on these questions, 11 recommendations (7 strong recommendations and 4 weak recommendations), 24 good clinical practices, and 2 flowcharts were formulated. For the 2024 guideline update, no new evidence was found to change the recommendations' direction or strength.</p><p><strong>Conclusion: </strong>This article summarizes the methodology and evidence-based conclusions from the CPG for evaluating and managing UGIB in EsSalud.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"202-212"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838059","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":"[Risk factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas].","authors":"Javier Targarona, Sebastián Legua-Pérez, Guillermo Coayla, Gilbert Roman, Eduardo Morales, Alexia Venturo, Luis Rivero, Diego Rivas, Roberto Carrasco","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to analyze the main clinical and epidemiological factors related to the risk of malignancy in intraductal papillary mucinous neoplasia of the pancreas in a cohort of patients seen at a referral clinic in Lima, Peru, based on the criteria of the IAP/Fukuoka guidelines.</p><p><strong>Materials and methods: </strong>This is a retrospective cohort study, which evaluated patients diagnosed with pancreatic IPMN from December 2015 to August 2023. They were classified according to involvement of the main branch, side branch, and mixed pancreatic ducts, considering aspects such as high-risk stigmata, concerning factors, age, sex, medical history, and others.</p><p><strong>Results: </strong>A total of 253 patients with pancreatic IPMN were included, 71.2% had side branch IPMNs, 9% had main branch IPMNs, and 19.8% were mixed. 49 patients (19.4%) underwent surgery at the time of diagnosis due to high-risk stigmata or factors concerning for malignancy. The remaining 204 patients were enrolled in a follow-up program for a mean of 31 months (6-100 months). During follow-up, a decision was made to operate on 38 of them. Of the 87 patients operated on, 36.7% presented invasive cancer and 11.4% high-grade dysplasia. The presence of a mural nodule greater than 5 mm increased the probability of malignancy 11.21 times; jaundice increased the risk of malignancy by more than 5 times. Wirsung duct dilation between 5 and 9.9 mm had a prevalence ratio (PR) of 2.12, and for dilation greater than 10 mm, a PR of 4.69 (p<0.05). The presence of three or more risk factors showed a PR of 6.77 in the bivariate analysis, and an adjusted prevalence ratio (aPR) of 17.11 in the multivariate analysis.</p><p><strong>Conclusion: </strong>Diagnosis and periodic monitoring of IPMNs allow for early detection of potentially malignant lesions, allowing for timely, often curative, surgery. However, there is currently no reliable way to diagnose and identify which cystic lesions already present or are likely to present malignant characteristics, thus providing clear indications for surgical intervention in these patients.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"120-130"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838067","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":"Perceived quality of life using IMPACT-III in a sample of Colombian children with IBD in remission: a cross-sectional study.","authors":"Viviana Parra-Izquierdo, Juan Sebastián Frías-Ordoñez, Fabián E Puentes M, Consuelo Romero-Sánchez, Diana Mora, Fernando Sarmiento, Johon Francisco Garcés Camacho, Carlos Cuadros, Melquisedec Vargas, Carolina Samper, Manuel Alonso Ardila-Báez, Mariastella Serrano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>No data on quality of life (QoL) in paediatric IBD in Colombia. The aim of this study was to determine QoL using the IMPACT-III questionnaire in a sample of patients from different centres.</p><p><strong>Materials and methods: </strong>Cross-sectional study of paediatric IBD patients followed in 3 centres in different cities, between June and November 2022. Eligible subjects were identified, information was collected on different dates, and the IMPACT-III questionnaire (score ranges from 35 to 175, with higher scores indicating better QoL) was administered once.</p><p><strong>Results: </strong>33 patients were included. 23/33 (69.7%) female, mean age 14.9 (range 6-17.9) years. 94% with inactive or mild disease. 20 patients with ulcerative colitis (UC), 13 with Crohn's disease (CD). The median score in UC was 147 (122-152), while in CD it was 126 (105-135). Systemic symptoms and emotional functioning were most affected, with median scores of 13 (12-14) and 27 (20-31) in UC and 11 (9-11) and 23 (20-26) in CD. No statistically significant differences were observed.</p><p><strong>Conclusions: </strong>The quality of life of children with IBD is challenging due to several factors. More support and education is needed for these patients.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"131-138"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838071","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":"[Interventional management of gastrointestinal and uterine bleeding in a patient with acute myeloid leukemia on induction therapy: case report].","authors":"Juan Sebastian Frias Ordoñez, Pablo Andrés Aux-Chaves, Wilmer Aponte Barrios, Fabian Enrique Neira-Escobar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bleeding involves morbidity and mortality in patients with acute myeloid leukemia (AML) receiving induction therapy. The concomitant presentation of gastrointestinal and uterine bleeding is rare as described in the literature, and its approach is not standardized. The following is an illustration of a case in which interventionism was effective and safe. A 44-year-old woman recently diagnosed with acute myeloid leukemia was started on induction therapy with cytarabine and idarubicin and presented 10 days after its initiation with rectorrhagia, melena and abnormal uterine bleeding. Due to clinical deterioration, she was transferred to the intensive care unit and required massive transfusion therapy. She needed angiotomography of the abdomen, with a probable area of active bleeding in the thin loop of the proximal jejunum, as well as contrasted resonance of the abdomen and pelvis, with multiple myomatosis and endometrial thickening. Abdominal arteriography was performed, requiring supra-selective embolization of the distal branch of the superior mesenteric artery supplying the jejunum. Subsequently, selective aorto-iliac arteriography was performed, proceeding to complete occlusion with coils of uterine arteries bilaterally. Post-procedure evolution, without new signs of bleeding. Imaging control ruled out complications. She completed the induction scheme and was discharged on the 45th day of hospitalization to continue the chemotherapy maintenance scheme on an outpatient basis. Early arteriography and embolization are viable, safe and effective procedures both for the management of gastrointestinal and uterine bleeding in patients with AML receiving induction therapy.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 2","pages":"192-197"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838064","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}