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

{"title":"[Severe acute pancreatitis secondary to the use of immune checkpoint inhibitors].","authors":"Lázaro Arango Molano, Andrés Sánchez Gil, Fabián Puentes Manosalva, Karla Patricia Gutiérrez de la Peña, Herney Solarte Pineda, Santiago Salazar Ochoa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>ICI-induced pancreatic injury is a rare subtype of immune-related adverse events. Although it is a relatively rare event and most patients who present it are asymptomatic, a subgroup of patients may present clinical and radiological manifestations typical of severe acute pancreatitis, with long-term sequelae of endo- and exocrine pancreatic function. Advanced age, the combination of ICIs, preexisting autoimmune diseases, and tumor type have been described as risk factors for developing this pathology. We report the case of a patient with metastatic renal cancer, a history of partial pancreatectomy, treated with checkpoint inhibitors, who developed severe acute pancreatitis with the formation of walled-off pancreatic necrosis after the third application. Other etiologies were ruled out; multidisciplinary management and endoscopic management with endosonographic drainage with apposition stent were provided, with a successful outcome and clinical recovery of the patient.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"82-87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783833","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":"[Fecal urgency: a key symptom in patients with inflammatory bowel disease].","authors":"Francisca Carvajal, Paulina Núñez, Daniela Simian, Karin Herrera, Camila Estay, Edith Pérez de Arce, Lilian Flores, Romina Fernández, Camila Maulén, Pamela San Martín, Rodrigo Quera","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fecal urgency (FU) is a common symptom in patients with inflammatory bowel disease (IBD), associated with a significant deterioration in quality of life (QoL) and clinical complications. However, it is often omitted as a parameter in classic disease activity indices.</p><p><strong>Objective: </strong>To evaluate the prevalence of FU and its relationship with inflammatory activity, fecal calprotectin, and QoL in patients with IBD.</p><p><strong>Materials and methods: </strong>Analytical, cross-sectional study in 268 patients treated between March and July 2023 in three centers in Santiago. Sociodemographic, clinical, and biomarker information was collected, evaluating QoL using the IBDQ-32 questionnaire and Patient-reported outcome using the IBD-Control 8 scale. Kruskal-Wallis and chi-square tests were applied for statistical analysis (p<0.05).</p><p><strong>Results: </strong>The prevalence of FU was 20%, being moderate-severe in one third of the cases. In patients with ulcerative colitis, 59% of those with UF were in symptomatic remission versus 98% without UF (p<0.001). In Crohn's disease, 74% with UF were in remission versus 100% without UF (p<0.001). Furthermore, patients with UF presented higher levels of FC and a significant deterioration in QoL (p<0.001).</p><p><strong>Conclusions: </strong>These findings highlight the need to include UF as a relevant parameter in the evaluation and management of IBD, given its impact on inflammatory activity and deterioration in QoL. Incorporating it could improve the comprehensive care of patients and optimize therapeutic strategies.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783825","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":"[Impact of inflammatory bowel disease on quality of life, anxiety, and depression: a multicenter study in Lima, Peru].","authors":"Juan Eloy Paredes-Méndez, Hugo Guillermo Cedrón-Cheng, Claudia Azañedo, Rossana Andrea Franco-Vásquez, Ana Lucía Mestanza-Rivasplata, Sonia Irene Junes Pérez, Henry Vargas Marcacuzco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic condition characterized by periods of activity and remission, with an uncertain and unpredictable course. It mainly affects the economically active population and may compromise physical, psychological, social, and occupational well-being.</p><p><strong>Objective: </strong>The aim of this study was to describe health-related quality of life and the presence of anxiety and depression in patients with IBD.</p><p><strong>Materials and methods: </strong>An observational, descriptive, cross-sectional study was conducted between April and December 2023. Patients older than 16 years with a confirmed diagnosis of IBD, at least six months of disease duration, and regular pharmacological treatment were included. The Inflammatory Bowel Disease Questionnaire-32 (IBDQ-32), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were administered.</p><p><strong>Results: </strong>Most patients (70%) reported a high quality of life, with no significant differences between ulcerative colitis and Crohn's disease. However, a significant reduction in health-related quality of life was observed in patients with active disease. Symptoms of depression were identified in 62.2% of patients, and anxiety in 58.1%, with both conditions being more frequent in patients younger than 30 years.</p><p><strong>Conclusions: </strong>Although most patients with IBD maintain a good quality of life, more than half experience symptoms of anxiety or depression, even during clinical remission. These findings highlight the importance of integrating mental health assessment and management as an essential component of comprehensive IBD care, in accordance with STRIDE II recommendations.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783849","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":"[Adolescent with severe liver disease and positive autoantibodies: when Wilson's disease presents as autoimmune hepatitis].","authors":"Gabriela Modrak, Flavia Gamla Farias, Julia Gheno Dos Santos, Moara Nascimento Aldrovandi, Vicente Stolnik Borges, Janaina Sant'Ana Fonseca, Monique Raddatz Reis Vilela, Fabiana Thomaz, Leonardo de Lucca Schiavon, Janaina Luz Narciso-Schiavon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Wilson's disease (WD) is an autosomal recessive disorder caused by mutations in the ATP7B gene, leading to impaired copper metabolism. Its clinical presentation is heterogeneous and may mimic autoimmune hepatitis (AIH), making timely diagnosis challenging, particularly in adolescents with severe liver disease of unknown origin. A retrospective descriptive study was conducted based on the medical record review of a patient diagnosed with WD and treated at a university referral hospital. The study was approved by the institutional ethics committee (CEPSH-UFSC, approval no. 7.775.798). A 17-year-old female presented with asthenia, jaundice, and behavior changes. Laboratory findings showed positive autoantibodies, hypergammaglobulinemia, and elevated liver enzymes. Imaging studies revealed chronic liver disease with splenomegaly and Kayser-Fleischer rings. She met criteria for probable AIH and WD according to the Leipzig scoring system. Treatment with prednisone and D-penicillamine led to progressive clinical and biochemical improvement. Genetic testing confirmed compound heterozygosity in the ATP7B gene (p.Pro1273Leu/p.Thr1031Ile). Wilson's disease can mimic autoimmune hepatitis and should be considered in adolescents presenting with severe liver disease and positive autoantibodies. Early recognition and disease-specific chelating therapy are essential to prevent irreversible liver damage.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"92-97"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783667","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":"[Functional constipation in schoolchildren and adolescents and its relationship with anxiety, quality of life and behavioral factors: systematic review and meta-analysis].","authors":"Juanita Nathalie Higuera Carrillo, William Yesid Jimenez Albarracin, Michelle Melissa Higuera Carrillo, Martha Baez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Functional constipation (FC) is a common problem in childhood. A bidirectional interaction within the brain gut axis has been described, as well as the presence of behavioural and emotional factors that may affect health-related quality of life (HRQoL).</p><p><strong>Objective: </strong>To evaluate the relationship between functional constipation and health-related quality of life, anxiety, and other behavioural factors in schoolchildren and adolescents.</p><p><strong>Materials and methods: </strong>A systematic review and meta-analysis was conducted of studies published between 1 January 2014 and March 2024 that evaluated the association between FC, HRQoL, anxiety, and other behavioural factors in the paediatric population. MeSH terms were used to search electronic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Of 128 references identified, four articles were included (three case control studies and one cross-sectional study), comprising a total of 2,820 children aged between 2 and 18 years. Of these, 9.89% had FC and 88.6% did not have FC. Children with FC showed poorer HRQoL, particularly in the social domain, and obtained higher scores on scales such as Child-PAQ, CBCL/4-18, and SDQ, suggesting meta-analysis showed a higher overall PedsQL score, with high heterogeneity among the included studies.</p><p><strong>Conclusions: </strong>Functional constipation in children and adolescents is associated with behavioural factors that negatively impact health-related quality of life. The findings suggest a greater presence of anxiety and depression symptoms in this population. Future studies should consider more balanced distributions between cases and controls and evaluate other individual characteristics. These findings highlight the importance of a comprehensive clinical approach that addresses both digestive and emotional or behavioural aspects.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"41-50"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783794","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":"[Primary anal melanoma with visceral dissemination: a case presentation].","authors":"Diego Armando Huanay-Martínez, Álvaro Bellido-Caparó, Carlos Garcia-Encinas, Alex Ventura-León","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Primary anal melanoma accounts for less than 2% of all melanomas and anal tumors. It is highly aggressive, and its nonspecific clinical presentation can delay diagnosis. Despite advances in immunotherapy, surgical resection remains the only curative treatment in early stages. We report a case of a patient presenting with rectal bleeding and an anal mass, without involvement of the skin, eyes, or gastrointestinal tract. Immunohistochemistry was positive for S-100 and Melan-A. Hepatic and pulmonary metastases were identified, and the clinical course was unfavorable.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 4","pages":"422-425"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967212","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":"[Changes in gastric cancer mortality in Peru before, during, and after the pandemic: a national interrupted time series analysisn].","authors":"Harold Benites-Goñi, Carlos A Huayanay-Espinoza, Alvaro G Oviedo-Rios, Rodrigo Motta, Victor Castro, Luis Huicho","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis and treatment of gastric cancer may have been affected during the COVID-19 pandemic, ultimately influencing mortality from this disease.</p><p><strong>Objective: </strong>To evaluate changes in gastric cancer mortality during the COVID-19 pandemic years.</p><p><strong>Materials and methods: </strong>An interrupted time series analysis was conducted to assess changes in gastric cancer mortality. Data were obtained from the National Death Information System. Three periods were compared: pre-pandemic (2017-2019), pandemic (2020-2021), and post-pandemic (2022-2023). Segmented regression models were used.</p><p><strong>Results: </strong>Before the pandemic, an average of 2,107 deaths per year was recorded. During 2020 and 2021, mortality increased by 39% and 118%, respectively. The highest peaks occurred between April and July 2020. An additional rise was observed during the early months of 2021. Although mortality progressively declined in 2023, pre-pandemic levels were not restored. The analysis showed that observed deaths consistently exceeded expected projections through late 2022.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic generated a temporary but significant increase in gastric cancer-related mortality in Peru.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 4","pages":"345-352"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967149","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 motor disorders in older adults: experience with high-resolution esophageal manometry at a referral center in Colombia].","authors":"Albis Hani, Valentina Dávila, Manuela Ossa, Jesús Villamizar, Raúl A Cañadas, Fredy Ávila, Fernando Yun","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced age is associated with a greater prevalence of oesophageal motor disorders due to increased lower oesophageal sphincter (LES) pressure and decreased peristaltic vigour. Secondary peristalsis is particularly affected by age, which may be related to increased oesophageal dysmotility in older adults.</p><p><strong>Objectives: </strong>To describe the most common oesophageal disorders in older adults undergoing high-resolution oesophageal manometry (HREM) according to the Chicago Classification V4.0.</p><p><strong>Materials and methods: </strong>An observational, descriptive, retrospective, cross-sectional study was conducted at San Ignacio University Hospital. Patients over 65 years of age who underwent HREM for various reasons between 2020 and 2025 were included.</p><p><strong>Results: </strong>Total number of patients included, age and age range. A total of 177 patients aged 65 years or older, with an age range of 68-76 years, were included. The main indication for HREM was dysphagia, present in 49.7% of patients, followed by reflux symptoms in 39%. The most frequent pathological manometric diagnosis was inconclusive outlet obstruction (14.1%), followed by ineffective oesophageal motility (9.6%) and achalasia (5.1%). A manometric diagnosis of ineffective oesophageal motility was made in 17.1% of patients with erosive gastro-oesophageal reflux disease (GERD).</p><p><strong>Conclusion: </strong>Older adults are more likely to have esophageal dysmotility, and outflow tract obstruction disorders are the most frequently identified in this population.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 4","pages":"353-358"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967207","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":"[Achalasia: UpToDate].","authors":"Sara Estefany Herrera Mendoza, Lázaro Arango Molano, Andrés Sánchez Gil","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Achalasia is a primary esophageal motility disorder characterized by the absence of peristalsis and failure of relaxation of the lower esophageal sphincter (LES). Its etiology remains uncertain, with proposed mechanisms including autoimmune, infectious, and genetic factors. To review recent advances in the diagnosis and management of achalasia, with emphasis on functional classification, the role of emerging technologies, and the most effective therapeutic strategies. A narrative review of the literature in English and Spanish was conducted, including scientific articles, clinical practice guidelines, and recent international consensus statements (AGA 2024, ESGE 2025). The Chicago Classification v4.0 has improved the diagnostic accuracy of esophageal motility disorders through high-resolution esophageal manometry (HRM), facilitating more precise therapeutic decision-making. The peroral endoscopic myotomy (POEM) has demonstrated high clinical efficacy, particularly in type III achalasia. The laparoscopic Heller myotomy remains a valid option, especially when combined with fundoplication, while pneumatic dilation should be reserved for selected cases. Emerging technologies such as the EndoFLIP (Endoluminal Functional Lumen Imaging Probe) allow for dynamic assessment of the LES during diagnostic and therapeutic procedures, optimizing surgical planning and treatment individualization, while reducing complications and improving clinical outcomes. The modern management of achalasia requires an individualized approach. Treatment selection should consider the functional subtype, institutional expertise, and patient preferences.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"45 4","pages":"398-407"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967159","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":"[Advances in the diagnosis of esophageal motor disorders: new tools and perspectives].","authors":"Jorge Espinoza-Ríos","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 4","pages":"343-344"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967185","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}