Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru最新文献_第3页

Management of early rectal cancer with massive submucosal invasion using endoscopic intermuscular dissection: a case report. 内镜下肌间剥离术治疗早期直肠癌伴粘膜下肿大浸润1例。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Romario Ruiz, Paulo Bardalez-Cruz, Luis Marin-Calderón, Maria Kapsoli, Harold Benites-Goñi

{"title":"Management of early rectal cancer with massive submucosal invasion using endoscopic intermuscular dissection: a case report.","authors":"Romario Ruiz, Paulo Bardalez-Cruz, Luis Marin-Calderón, Maria Kapsoli, Harold Benites-Goñi","doi":"","DOIUrl":"","url":null,"abstract":"The management of early rectal cancer is shifting toward organ-preserving strategies. Endoscopic submucosal dissection (ESD) achieves en bloc resections for low-risk T1 lesions, while surgery remains the gold standard for deep submucosal invasion due to the risk of nodal metastasis. Endoscopic intermuscular dissection (EID) has emerged as an alternative in selected high-risk patients. We report the case of a 71-year-old man with chronic kidney disease and ischemic heart disease, in whom a 15 mm sessile rectal lesion with features of deep invasion was detected. EID achieved complete resection without complications, and MRI confirmed cT1-2N0 disease. Histopathology revealed moderately differentiated adenocarcinoma with deep invasion, lymphovascular invasion, and grade 2 tumor budding. Given surgical contraindications, active surveillance was chosen after multidisciplinary discussion. At six months, the patient remains recurrence-free. Unlike conventional ESD, EID allows dissection between the inner circular and outer longitudinal muscle layers, improving deep margins in sm2-sm3 lesions. Evidence suggests that lymphovascular invasion, tumor budding, and poor differentiation are the strongest predictors of nodal metastasis. In selected patients, EID may provide curative resection while avoiding major surgery. Careful risk stratification and multidisciplinary evaluation are essential to balance oncologic safety and organ preservation.","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"71-73"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783795","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}

引用次数: 0

[Cutaneous manifestations in patients with inflammatory bowel disease]. 【炎症性肠病患者的皮肤表现】。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Daniel Barquero-Orias, Ariana Ramirez-Zumbado, Keren Castro-López, Kenneth Ernest-Suárez

引用次数: 0

[Beyond the gut: articular involvement in inflammatory bowel disease]. [超越肠道：炎症性肠病的关节参与]。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Viviana Parra Izquierdo, Juan Sebastián Frías-Ordoñez, María Consuelo Romero

{"title":"[Beyond the gut: articular involvement in inflammatory bowel disease].","authors":"Viviana Parra Izquierdo, Juan Sebastián Frías-Ordoñez, María Consuelo Romero","doi":"","DOIUrl":"","url":null,"abstract":"Extraintestinal manifestations (EIMs) are a key component of the clinical burden of inflammatory bowel disease (IBD), with articular involvement being the most common and one of the main contributors to functional impairment and reduced quality of life. Despite its clinical relevance, its pathogenesis remains incompletely understood. Current evidence supports the existence of a gut-joint axis, involving immune dysregulation, genetic susceptibility, and alterations in the intestinal microbiota. Articular involvement in IBD encompasses a broad spectrum of manifestations, including both peripheral and axial forms, with heterogeneous clinical presentations that may precede, accompany, or occur independently of intestinal activity. This variability contributes to diagnostic delays and under-recognition in clinical practice. In this context, early identification of clinical features and a deeper understanding of the underlying mechanisms are essential to improve diagnostic accuracy and therapeutic strategies. This article aims to provide an updated review of the literature on articular involvement in IBD, integrating recent advances in pathophysiology and highlighting key clinical aspects for its suspicion, diagnosis, and management.","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"51-57"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783733","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}

引用次数: 0

Quality indicators for colonoscopy in Peruvian national hospitals: a multicenter cross-sectional study. 秘鲁国立医院结肠镜检查质量指标：一项多中心横断面研究。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Diego A Leon-Quispe, Patricia Valera-Luján, Edson Gudiel-Palomino, Grecia Claussen-Portocarrero, Luis Yllescas-Estela, Evelyn León Estela, Thessia Varona Luna, Sharon Z C Aldave Chirinos

{"title":"Quality indicators for colonoscopy in Peruvian national hospitals: a multicenter cross-sectional study.","authors":"Diego A Leon-Quispe, Patricia Valera-Luján, Edson Gudiel-Palomino, Grecia Claussen-Portocarrero, Luis Yllescas-Estela, Evelyn León Estela, Thessia Varona Luna, Sharon Z C Aldave Chirinos","doi":"","DOIUrl":"","url":null,"abstract":"Objectives: To evaluate colonoscopy quality indicators in Peruvian national public hospitals and to estimate the polyp detection rate (PDR) corresponding to adenoma detection rate (ADR) benchmarks of 25% and 35%.Materials and methods: A multicenter retrospective study was conducted using colonoscopy reports from July 2023 to June 2024. Rates of adequate bowel preparation and cecal intubation, as well as withdrawal time, polypectomy technique, PDR, and ADR were evaluated.Results: A total of 3,758 colonoscopies performed by 63 endoscopists were analyzed. The rate of adequate bowel preparation was 91.1%, and the cecal intubation rate was 95.6%. The withdrawal time was not reported in 75% of procedures without polyp detection. Only 30.2% of polyps measuring 4-9 mm were removed using cold snare polypectomy. The overall PDR was 41.3%, and the overall ADR was 22.8%. The adenoma-to-polyp detection rate quotient was 0.56; a PDR of 62.5% corresponded to an ADR of 35%, and a PDR of 44.7% to an ADR of 25%.Conclusions: Colonoscopy quality in Peruvian national public hospitals showed adequate rates of bowel preparation and cecal intubation but suboptimal ADR values and deficient documentation practices, underscoring the need to implement targeted strategies to improve colonoscopy quality.","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"34-40"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783843","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}

引用次数: 0

[Cholestatic jaundice revealing pylephlebitis associated with mesenteric venous thrombosis]. 胆汁淤积性黄疸显示肾盂炎伴肠系膜静脉血栓形成。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Siomara Aransuzú Chávez-Sánchez, Rubén Hessen Escobar-Montes, Álvaro Bellido-Caparó, Fernando Alonso Mejía-Cordero, Carmen Anita Del Villar-Alarcón, José Antonio Chávez-Peche

引用次数: 0

[Severe acute pancreatitis secondary to the use of immune checkpoint inhibitors]. [使用免疫检查点抑制剂继发的严重急性胰腺炎]。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Lázaro Arango Molano, Andrés Sánchez Gil, Fabián Puentes Manosalva, Karla Patricia Gutiérrez de la Peña, Herney Solarte Pineda, Santiago Salazar Ochoa

引用次数: 0

Access barriers and ethical challenges of therapeutic decision-making in patients with inflammatory bowel disease and prior malignancy: a case series. 炎性肠病和既往恶性肿瘤患者治疗决策的准入障碍和伦理挑战：一个病例系列。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

Larissa Leandro Medeiros, Thales Queiroz Souza, Maria Luiza Cronemberger de Faria, Ricardo Jacarandá de Faria, Zuleica Barrio Bortoli, Ana Carolina Benvindo Lopes, Bruno Augusto Alves Martins, Marcos de Vasconcelos Carneiro, Caio Cardozo Jorge

{"title":"Access barriers and ethical challenges of therapeutic decision-making in patients with inflammatory bowel disease and prior malignancy: a case series.","authors":"Larissa Leandro Medeiros, Thales Queiroz Souza, Maria Luiza Cronemberger de Faria, Ricardo Jacarandá de Faria, Zuleica Barrio Bortoli, Ana Carolina Benvindo Lopes, Bruno Augusto Alves Martins, Marcos de Vasconcelos Carneiro, Caio Cardozo Jorge","doi":"","DOIUrl":"","url":null,"abstract":"Objectives: To report a case series of patients with inflammatory bowel diseases and a history of malignancy and to analyze how this condition influenced therapeutic decision-making presents a challenging scenario.Materials and methods: This was a retrospective observational study analyzing 11 patients with inflammatory bowel disease and malignant neoplasms followed at an inflammatory bowel disease outpatient clinic of a university hospital. Clinical, therapeutic, and oncologic findings are reported descriptively based on medical record review.Results: Seven patients (64%) had ulcerative colitis, and six (55%) were female, with a mean age of 47 years. Extra-intestinal neoplasms predominated. Six patients (55%) received advanced therapy near the time of cancer diagnosis; reintroduction was possible in four cases. Judicial action was required for two patients.Conclusions: Clinical decision-making in patients with inflammatory bowel disease and a history of malignancy is an individualized process, based on multidisciplinary discussion, bioethical considerations, and the most reliable available evidence, even in the face of state-imposed logistical obstacles. Continuous updating of Clinical Protocols and Therapeutic Guidelines is essential to ensure equitable access to the most appropriate and non-harmful treatment for this patient group.","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 1","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783773","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}

引用次数: 0

[Fecal urgency: a key symptom in patients with inflammatory bowel disease]. [大便急症：炎症性肠病患者的关键症状]。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

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

{"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":"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.Objective: To evaluate the prevalence of FU and its relationship with inflammatory activity, fecal calprotectin, and QoL in patients with IBD.Materials and methods: 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).Results: 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).Conclusions: 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.","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}

引用次数: 0

[Impact of inflammatory bowel disease on quality of life, anxiety, and depression: a multicenter study in Lima, Peru]. [炎症性肠病对生活质量、焦虑和抑郁的影响：秘鲁利马的一项多中心研究]。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

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

{"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":"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.Objective: The aim of this study was to describe health-related quality of life and the presence of anxiety and depression in patients with IBD.Materials and methods: 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.Results: 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.Conclusions: 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.","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}

引用次数: 0

[Adolescent with severe liver disease and positive autoantibodies: when Wilson's disease presents as autoimmune hepatitis]. [青少年严重肝病和自身抗体阳性：当威尔逊氏病表现为自身免疫性肝炎时]。

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru Pub Date : 2026-01-01

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

{"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":"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.","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}

引用次数: 0