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

{"title":"Endoscopic vacuum therapy for treatment of large distal anastomotic dehiscence after colorectal surgery.","authors":"Rodrigo Mansilla-Vivar, Sebastian Manuel Milluzzo, Eugenia Vittoria Pesatori, Paola Cesaro, Alessandra Bizzotto, Mauro Lovera, Nicola Olivari, Cristiano Spada, Eduardo Segovia","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Management of anastomotic dehiscences following colorectal surgery is a topic of debate. In this context, endoluminal vacuum therapy offers promising results.</p><p><strong>Objective: </strong>To analyze the efficacy and feasibility of endoluminal vacuum therapy in distal anastomotic dehiscences after colorectal surgery.</p><p><strong>Materials and methods: </strong>This study is a descriptive case series that evaluates patients with anastomotic dehiscences over a period of 18 months. All patients were treated with Endo-sponge® (Braun Medical, Hessen, Germany).</p><p><strong>Results: </strong>Fourteen patients were included in the final analysis. The indications for endoluminal vacuum therapy were Hartmann's stump insufficiency (n=6), anastomotic leakage after laparoscopic total mesorectal excision (n=4), and anastomotic dehiscence after transanal total mesorectal excision (n=4). A total of 204 sponges were placed per patient (median 12.5, range 1-33). Complete resolution was achieved in 9 patients (57.1%) in a mean time of 108 days (range 15-160 days). In the sub-analysis, patients with acute dehiscence (<3 months) achieved complete resolution in 80% (8/10), whereas no patient with chronic defects reached resolution (0/4). A low complication rate (7%) was recorded.</p><p><strong>Conclusion: </strong>Endoluminal vacuum therapy appears to be a feasible and safe treatment with a high success rate in patients with large acute colorectal anastomotic defects.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629578","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":"[Procedure, reading and interpretation of capsule endoscopy].","authors":"Valeria Atenea Costa, Begoña González-Suárez, Maria Teresa Galiano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The capsule endoscopy (CE) is a minimally invasive diagnostic imaging technique, consisting of a disposable capsule that travels through the digestive system, transmitting images to a data recorder. CE has emerged as a tool for exploring the small intestine, however, the lack of standardization in interpretation and terminology has been a challenge in the medical community. This article proposes guidelines for the performance, reading, and interpretation of CE, highlighting its utility in various indications.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629562","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":"Successful management of hepatitis B and C coinfection: a case report.","authors":"Jeffrey Freidenson-Bejar, Alvaro Bellido-Caparo, Martin Tagle","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report the case of a patient with chronic hepatitis B and C managed with direct-acting antivirals in an outpatient setting. Chronic hepatitis B was first treated with entecavir before initiating treatment for chronic hepatitis C. The patient achieved viral suppression for hepatitis B and sustained virological response for hepatitis C. As direct-acting antivirals become more available, healthcare practitioners should be familiar with managing patients with chronic coinfection.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629592","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":"[Conventional colonoscopy vs. cap-assisted colonoscopy: there are differences in colonoscopy performance?]","authors":"Calixto Duarte-Chang, Julio Zúñiga Cisneros, Ramiro Da Silva Rodriguez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Colonoscopy is the standard method for colorectal cancer diagnosis. Despite the use of multiple devices, polyp and adenoma detection results have been inconsistent.</p><p><strong>Objectives: </strong>The main aim of this research is to determine if there have been differences between conventional colonoscopy (CC) and cap-assisted colonoscopy (CAC) in the diagnosis performance to detect adenomas.</p><p><strong>Materials and methods: </strong>This is a prospective randomized clinical trial that compares the diagnostic performance of CC and CAC in detecting adenomas in a public reference hospital.</p><p><strong>Results: </strong>We randomly assigned 131 patients to either CC (n=64) or CAC (n=67). Cap-assisted colonoscopy was associated with shorter cecal intubation times (6 min vs. 7,5 min, p=0.005) and a higher chance of intubating the ileum (RR = 1.62; 1.21-2.17). There was no statistical difference in the adenoma detection rates (RR: 1.62; 1.21-2.17) or polyp detection rates (RR: 1.07; 0.602-1.919) between CC and CAC.</p><p><strong>Conclusion: </strong>Cap-assisted colonoscopy was associated with a shorter duration of cecal intubation and a higher probability of ileum intubation. We did not find statistical differences in the adenoma detection rates. In the CAC arm, there was a trend to detect more adenoma in the right colon, although this difference was not statistically significant.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629542","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":"[Porto sinusoidal vascular disease: an unusual cause of digestive bleeding].","authors":"Stalin Yance, Pedro Montes, Fernando Arevalo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Portal hypertension (PHT) is defined as an increase in pressure at the level of the portal vein above 5 mmHg, the most common cause being liver cirrhosis. Among the presinusoidal intrahepatic causes of PHT with portal venular involvement, what was traditionally known as idiopathic non-cirrhotic portal hypertension (NCIH) is described, with the requirements of excluding those patients who did not present PHT, as well as those with the presence of liver cirrhosis and thrombosis. portal venous vein (PVT). Currently, the diagnostic criteria for this entity have been reconsidered, and its name, being known as porto-sinusoidal vascular disease (PSVD), also does not exclude patients with PHT or the presence of underlying liver disease. Liver biopsy continues to be the gold standard for diagnosis. The clinical manifestations are derived from PHT and the management is similar to the complications that occur in patients with liver cirrhosis. The case of a male patient is presented who presents with symptoms of digestive bleeding, with findings of esophageal varices in upper endoscopy in addition to a study of viral, autoimmune liver disease and negative deposits, with a conclusive liver biopsy of porto-sinusoidal vascular disease.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634724","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":"[Pan American Crohn's and Colitis Organization (PANCCO) and the Interamerican Society of Endoscopy (SIED) consensus on endoscopy in inflammatory bowel disease].","authors":"Viviana Parra-Izquierdo, Fabio Leonel Gil-Parada, Fabian Juliao-Baños, Carolina Pavez-Ovalle, William Otero-Regino, Juan Sebastian Frías-Ordoñez, Asadur Tchekmedyian, Juan Eloy Paredes-Méndez, Rodrigo Dorelo, Kenneth Ernest-Suárez, Marcos Leites Madera, María Teresa Galiano, Ximena Pazos, María Luisa Jara Alba, Carla María Dias de Oliveira, Keyla Villa Ovalles, Rodrigo Queraz, María Carolina Miranda, Lázaro Antonio Arango Molano, Fabian Eduardo Puentes Manosalva, Cyrla Zaltman, Cristian Florez-Sarmiento, Cristina Flores, David Andrade Zamora, Fernando Fluxa, Guillermo Veitia","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopy plays a fundamental role in inflammatory bowel disease (IBD), and becomes essential in diagnosis, treatment monitoring, and detection and management of complications.</p><p><strong>Materials and methods: </strong>The Pan American Crohn's and Colitis Organization (PANCCO) and the Inter-American Society of Endoscopy (SIED) appointed 22 Latin American experts in IBD to develop a consensus study using the modified Delphi method, based on the best available evidence. A working group of 22 members from 9 countries identified 15 topics and formulated 98 statements, who participated in 2 rounds of voting. It was defined as agreement of ≥80% of experts for each statement.</p><p><strong>Results: </strong>After the voting of all the statements, 8 statements were obtained that did not reach 80% consensus among the participants, so the questions were reconsidered in the Coordinating Committee of the consensus with the participation of the expert reviewers of these questions and 7 final statements were voted again by all the experts in a second round and 1 was eliminated with consensus. After two rounds of voting, the experts reached consensus with literature review with the best available evidence, the most important issues were developed with scientific evidence supporting each of the statements around the topic of endoscopy in IBD.</p><p><strong>Conclusions: </strong>Consensus statements were developed and based on the best available evidence about endoscopy in inflammatory bowel disease.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634723","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":"[Experience with endoluminal functional luminal probe (EndoFLIP) at San Ignacio University Hospital, Bogota, Colombia].","authors":"Albis Hani, Valentina Ursida, Raúl Cañadas, Carlos Lombo, María Del Carmen Figueredo, Socorro Moreno Luna","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The EndoFLIP (for its acronym in English: endoluminal functional luminal probe) is a system that measures in real time the compliance index of the gastroesophageal junction and secondary esophageal peristalsis, based on the principle of impedance planimetry. Although this technology is relatively new and its diagnostic usefulness is still being evaluated, its use in clinical practice is increasingly recognized, fundamentally in those patients where there is no conclusive manometric diagnosis of esophageal motor pathology, mainly esophagogastric junction outflow obstruction and achalasia.</p><p><strong>Objective: </strong>The aim of the present study is to describe the experience with EndoFLIP at the San Ignacio University Hospital in Bogotá, Colombia.</p><p><strong>Material and methods: </strong>Descriptive observational case series study, which included patients over 18 years of age who had undergone EndoFLIP at the San Ignacio University Hospital from 2021 to 2022, either in-hospital or outpatient, with a clear indication of performance of the study, previously discussed in the multidisciplinary Gastroenterology Board.</p><p><strong>Results: </strong>A total of 27 patients with an average age of 55 years were included in the study, of which 20 were women (74%) and 7 men (26%). The most frequent indication of the study was an inconclusive diagnosis of outflow tract obstruction identified in high-resolution esophageal manometry according to Chicago 4.0 criteria (14 patients), followed by hypercontractile esophagus (4 patients) and ineffective esophageal motility (3 patients). When evaluating the contractile response, it was found that 9 patients with an inconclusive diagnosis of outflow tract obstruction had a normal response, 3 absent and one altered; and in the patients with an inconclusive diagnosis of achalasia, one of them had a borderline contractile response and two had no response. All patients with a previous diagnosis of absent contractility had an equally absent contractile response in EndoFLIP.</p><p><strong>Conclusion: </strong>Endoluminal functional luminal imaging is a technique that evaluates biomechanical properties such as distensibility, volume, pressure and even diameters of sphincter regions such as the gastroesophageal junction, pylorus and anus. Its usefulness has been highlighted for several indications, the most important being manometrically inconclusive diagnoses of esophageal motor disorders such as achalasia and outflow tract obstruction, pathologies that have a significant impact on the quality of life of patients and whose diagnosis is essential to be able to provide the best treatment option.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634719","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":"[Gastrointestinal bleeding as debut of complicated celiac disease].","authors":"Ronald Albán, Florencia Calcagno, Alberto Fabiusus, Wilson Albán, Alvaro Piazze","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Celiac disease (CD) is an autoimmune malabsorption syndrome that presents with intolerance to gluten (gliadin), a protein found in wheat. The most common symptoms are diarrhea, steatorrhea, weight loss, weakness, vitamin and mineral deficiency. The probability of developing complicated CD is relatively low, among its main manifestations we have refractory sprue, T-cell lymphoma and ulcerative jejunitis (UY) of which a few cases develop gastrointestinal bleeding. Furthermore, we present the case of a 51-year-old patient who developed intestinal hemorrhage due to complicated CD, where upper digestive video endoscopy (VEDA), video colonoscopy (VCC), capsule endoscopy (CE) and biopsy of the jejunum and ileum were performed confirming the diagnosis of CD along with ulcerative jejunoileitis.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634721","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":"[Fulminant acute liver failure secondary to severe dengue in a child: case report].","authors":"Jesús Domínguez-Rojas, Lizbeth Cabrera-Rojas, Tommy Prado-Gómez, Noé Atamari-Anahui","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dengue is a common infectious disease in tropical areas such as Peru. This virus can cause underreported and potentially fatal complications such as acute liver failure. We report the case of a 7-year-old boy who presented with fever, headache, and abdominal pain. On ultrasound, we found hepatomegaly and labs severe thrombocytopenia and elevated transaminases. During hospitalization he was diagnosed with severe dengue and developed acute liver failure, kidney injury, and encephalopathy. Although intensive care management and assisted ventilation, he developed multiple organ dysfunctions with fluid refractoriness and capillary leak. Acute liver failure secondary to severe dengue is a rare complication with an unfavorable outcome.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634720","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":"Irritable bowel syndrome in medical students from Lima, Peru, during the COVID-19 pandemic, using virtual questionnaires according to the Rome IV criteria: prevalence and associated factors.","authors":"Roberto Medina Pérez, Rubbens Chavarria Ocmin, Jorge Espinoza-Rios, Frine Samalvides-Cuba","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, characterized by changes of the intestinal habit associated with abdominal pain. This study analyzed factors associated with this pathology during the COVID-19 pandemic, and it was seen that the impact of IBS was higher in young women who had ongoing studies in the medical field.</p><p><strong>Objectives: </strong>Determine the prevalence of IBS in medical students and explore the associated factors with the increase of its symptoms, through the use of digital tools.</p><p><strong>Materials and methods: </strong>Descriptive observational study with exploration of associations, with non-probabilistic sampling, until reaching the minimum sample of 110 participants with a confidence interval of 95%, finally having a total sample of 131 students, distributed in 3 proportional and representative subgroups of the last 3 years of study of the medical career from a university from Lima, Peru. The inclusion criteria were students of both sexes and legal age, who gave their consent to participate and did not have risk factors for GI disease. Once the study was approved, the link of a validated virtual questionnaire was shared through the institutional email. To explore the associated factors, the Chi-square test was used with a statistical significance of p < 0.05.</p><p><strong>Results: </strong>Responses were obtained from 195 students; 64 (32.82%) of them had at least one exclusion criteria, finally having a sample size of 131; 64 (48.85%) were women, and 52 (39.69%) were from 7th year. Using the Rome IV criteria, 23 participants were classified as having IBS, which indicates a prevalence of 17.56%, 14 (60.87%) of them were women and 10 (43.48%) were from the 7th year (last year of study of the medical career in Peru). It was observed that 1 in 3 students (32.06%) had chronic abdominal pain, and 1 in 2 (53.44%) reported having a history of Major Depression or Generalized Anxiety Disorder. Of the total, 51 (38.93%) had a history of having a positive COVID-19 test result. Regarding the associated factors, a significant association was only found between IBS and the diarrhea type, classified according to the Bristol Scale.</p><p><strong>Conclusions: </strong>The prevalence of IBS in medical students was 17.56%, the highest compared with studies in the general population and in medical students using Rome IV criteria. Of the associated factors, the clinical presentation of diarrhea, according to the Bristol scale, was associated with IBS.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634766","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}