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1.
Rev. esp. enferm. dig ; 115(12): 679-681, Dic. 2023.
Artigo em Inglês, Espanhol | IBECS | ID: ibc-228701

RESUMO

El sobrecrecimiento bacteriano intestinal (SIBO, por sus siglas en inglés) es una entidad descrita desde hace varias décadas, pero que en los últimos años ha cobrado un especial interés por parte de los profesionales médicos y por la población general, probablemente por el aumento de la disponibilidad de pruebas diagnósticas y por la extensa difusión que se le ha dado a esta enfermedad a través de los medios de comunicación y redes sociales. En vista de la gran cantidad de información disponible en la actualidad y en ocasiones discrepante, entre la Sociedad Española de Patología Digestiva (SEPD) y la Asociación Española de Neurogastroenterología y Motilidad (ASENEM) hemos realizado un documento de posicionamiento para establecer líneas de diagnóstico y tratamiento del SIBO con la información científica actualizada.(AU)


Assuntos
Humanos , Masculino , Feminino , Doenças do Sistema Digestório/diagnóstico , Intestino Delgado/parasitologia , Bactérias , Gastroenteropatias/complicações , Tratamento Farmacológico , Diagnóstico por Imagem
2.
Rev. esp. enferm. dig ; 115(12): 717-718, Dic. 2023. ilus
Artigo em Inglês | IBECS | ID: ibc-228709

RESUMO

An 83-year-old female, suffering from abdominal pain, nausea, and vomiting, was admitted to our hospital. Gas-liquid level and tumor was not seen on the abdominal computed tomography scan. Instead, two high density balloon which were 2.7cm(distal) and 3.3cm(proximal) in diameter separately were shown (Figure A) in small intestine. The balloons proved to be part of ileus tube and iohexol which was incorrectly injected into the balloons caused a blockage in the tube. During colonoscopy, we were surprised to find that the distal balloon had passed through the ileocecal valve and we punctured it easily (Figure B). However, affected by the broken distal balloon, we could not reach another one. Finally, we cut off the connector fixed to the face and instructed the patient to take some oral paraffin oil and exercise appropriately. The next day, the balloons were discharged with the symptoms alleviated. It is rare for iatrogenic foreign body to cause ileal obstruction).(AU)


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Náusea , Vômito , Dor Abdominal , Intestino Delgado/anormalidades , Intestino Delgado/cirurgia , Pacientes Internados , Exame Físico , Gastroenteropatias , Doenças do Sistema Digestório
3.
Rev. esp. enferm. dig ; 115(12): 727-728, Dic. 2023. graf
Artigo em Inglês | IBECS | ID: ibc-228718

RESUMO

Breath tests with glucose, lactulose or lactitol are useful for diagnosis of small intestinal bacterial overgrowth (SIBO). Nevertheless, they have suboptimal sensitivity and specificity and, indeed, are positive in a considerable number of patients with irritable bowel syndrome (IBS). The complexity in the management of patients with functional intestinal disorders and the availability of these tests are leading to frequent diagnoses of SIBO. Intestinal Fatty-Acid Binding protein (I-FABP) is a protein present in the cytosol of intestinal epithelial cells. Its plasmatic levels have been related to different enteropathies and, therefore, could be a marker of early intestinal damage with unconfirmed clinical utility. Hence, we have studied the plasmatic I-FABP level of patients who are requested a lactitol test to confirm SIBO and related it to clinical and laboratory characteristics and SIBO test results.(AU)


Assuntos
Humanos , Síndrome do Intestino Irritável/diagnóstico , Intestino Delgado/microbiologia , Hidrogênio/metabolismo , Ácidos Graxos
4.
Rev. esp. enferm. dig ; 115(12): 739-740, Dic. 2023. ilus
Artigo em Inglês, Espanhol | IBECS | ID: ibc-228729

RESUMO

We report the case of a middle-aged man who had undergone two diagnostic laparoscopies with no significant findings after he was attended at the emergency department with cramping pain, abdominal distention and vomiting, with radiological images simulating a small bowel obstruction. After multiple hospitalisations and an extensive set of tests, including a genetic study, he was diagnosed with chronic pseudo-obstruction, an uncommon, unrecognides syndrome with high morbidity. Being aware of this pathology can make it easier to diagnose, and thereby, we can avoid unnecessary surgical interventions, because its management and treatment are mainly based on pharmacological therapy. After a proper diagnosis our patient's progression was satisfactory due to the treatment introduced, with no further hospitalisations.(AU)


Assuntos
Humanos , Masculino , Adulto , Obstrução Intestinal/diagnóstico por imagem , Laparoscopia , Pseudo-Obstrução Intestinal/diagnóstico por imagem , Apendicectomia , Intestino Delgado , Vômito , Dor Abdominal , Pacientes Internados , Exame Físico , Resultado do Tratamento
5.
Rev. esp. enferm. dig ; 115(12): 750-751, Dic. 2023. ilus
Artigo em Inglês, Espanhol | IBECS | ID: ibc-228740

RESUMO

Melanoma is a cancer that frequently metastasises to the small bowel, but most cases are asymptomatic and are diagnosed postmortem. Therefore, CT and PET CT cannot detect all lesions and conventional endoscopic study only detects 10-20% of lesions. In this study, we present the case of a 68-year-old patient with a history of cutaneous melanoma and a diagnosis of intestinal melanoma. Thanks to capsule endoscopy, two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected, allowing a much more effective surgical planning. Capsule endoscopy is an innovative technique that improves preoperative diagnosis, as it is able to detect bowel segments that cannot be inspected by conventional endoscopy. It also has a better resolution than conventional CT, improving sensitivity in the detection of lesions.(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cápsulas Endoscópicas , Intestino Delgado , Melanoma/diagnóstico por imagem , Endoscopia Gastrointestinal , Neoplasias Intestinais/cirurgia , Pacientes Internados , Exame Físico , Resultado do Tratamento
7.
Radiología (Madr., Ed. impr.) ; 65(4): 291-297, Jul-Ago. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-222506

RESUMO

Introducción: La invaginación intestinal es la introducción de un segmento de asas intestinales en otro segmento adyacente. A diferencia de la población pediátrica, cuya etiología es principalmente idiopática, en el adulto se asocia con mayor frecuencia a patologías graves. El uso cada vez mayor de estudios imagenológicos en la evaluación abdominal ha llevado a mayor detección de invaginaciones intestinales sin enfermedad subyacente, en las que no es posible determinar una causa de base. El objetivo de este estudio fue revisar la presentación clínica, estudio y tratamiento en pacientes con diagnóstico imagenológico de invaginación intestinal en ecografía o tomografía computarizada de abdomen. Método: Se realizó un estudio descriptivo retrospectivo a partir de los informes radiológicos de ecografías y tomografías computarizadas de abdomen obtenidas en un periodo de 10 años en una institución hospitalaria. Resultados: Se obtuvieron 40 casos. En el 10% de ellos, la invaginación intestinal fue un hallazgo incidental en un estudio por otra causa. En el 68% de los casos no se identificó una causa subyacente, demostrándose resolución espontánea en el 75% de los casos con estudio posterior. El síntoma más frecuente fue el dolor abdominal, presente en el 60% de los pacientes. La ubicación más habitual fue entero-enteral en el 90% de los casos. Solo en el 8% de los casos la invaginación intestinal se atribuyó a una causa maligna. Hubo resolución quirúrgica en 7 pacientes. Conclusión: El aumento en el uso de imágenes para el estudio abdominal ha demostrado que existe un porcentaje importante de invaginaciones intestinales que son idiopáticas y que presentarán resolución espontánea.(AU)


Introduction: Intussusception is the insertion of a bowel loop segment into an adjacent segment. Unlike in children, where the condition is mainly idiopathic, intussusception in adults is more often associated with severe disease. The growing use of imaging studies to evaluate the abdomen has resulted in a higher rate of detection of cases of intussusception without underlying disease in which it is not possible to determine the cause. This study aimed to review the clinical presentation, evaluation, and treatment of patients in whom abdominal ultrasonography or computed tomography diagnosed intussusception. Method: We retrospectively reviewed radiology reports of abdominal ultrasound and computed tomography studies done at our hospital in a 10-year period. Results: In the 40 cases found, intussusception was an incidental finding in 10%. No underlying cause was identified in 68%, and posterior imaging studies showed spontaneous resolution in 75%. The most common symptom was abdominal pain, being present in 60%. Intussusception affected only the small bowel in 90% of cases (entero-enteric intussusception). Intussusception was attributed to malignancy in only 8% of cases. In 7 patients, intussusception was resolved surgically. Conclusion: The increased use of abdominal imaging has shown that a significant proportion of cases of intussusception are idiopathic and resolve spontaneously.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Intestino Delgado/diagnóstico por imagem , Achados Incidentais , Dor Abdominal , Radiologia , Estudos Retrospectivos , Epidemiologia Descritiva , Ultrassonografia/estatística & dados numéricos , Tomografia Computadorizada por Raios X/estatística & dados numéricos
8.
Rev. esp. enferm. dig ; 115(1): 45-46, 2023. ilus
Artigo em Inglês | IBECS | ID: ibc-214677

RESUMO

A 72-year-old man was referred to us for evaluation of asymptomatic masses in the liver that had been detected on ultrasonography performed during a physical screening. The level of neuron-specific enolase was elevated (56.97 ng/mL; normal level, 15.7-17.0 ng/mL). Other tumor markers were normal, including alpha fetoprotein, carcinoembryonic antigen and cancer antigen 199. No tumor was found through chest CT scan, gastroscopy and colonoscopy. Abdominal MR demonstrated multiple masses with irregular central necrosis, which appeared as marked hyperintensity on T2WI. Most lesions showed rim-like enhancement at portal venous phase. Pathological examination of tissue obtained by means of percutaneous biopsy indicated that the tumor was composed of small cells which were arranged in nests and trabeculae, the nuclei were round with little cytoplasm, and nuclear division was present (hematoxylin-eosin stain (AU)


Assuntos
Humanos , Masculino , Adulto , Enteroscopia de Balão Único , Linfoma Folicular/diagnóstico por imagem , Neoplasias Intestinais/diagnóstico por imagem , Intestino Delgado , Seguimentos
13.
Rev. esp. enferm. dig ; 114(12): 740-741, diciembre 2022. ilus
Artigo em Inglês | IBECS | ID: ibc-213527

RESUMO

Caso clínico de paciente con cápsula endoscápica retenida en divertículo de Zenker, recuperada 2 años después de que se sometió al estudio. (AU)


Assuntos
Humanos , Masculino , Idoso , Intestino Delgado , Radiografia Abdominal , Transtornos de Deglutição , Divertículo de Zenker
14.
Rev. esp. enferm. dig ; 114(12): 747-748, diciembre 2022. ilus
Artigo em Inglês | IBECS | ID: ibc-213533

RESUMO

We report the case of a jejunum neuroendocrine neoplasm with liver metastases, the lesion showed somatostatin receptor expression in the junction of duodenum and jejunum without enlarged lymph nodes in 68Ga-DOTA-NOC PET/CT scan, definitive diagnosis and treatment depend on double-balloon enteroscopy and laparoscopy. This is a meaningful and thought-provoking process. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Intestino Delgado , Enteroscopia de Balão , Laparoscopia , Terapêutica , Diagnóstico
15.
Rev. esp. enferm. dig ; 114(12): 762-763, diciembre 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-213548

RESUMO

La linfangiectasia intestinal primaria es un trastorno raro asociado a una enteropatía pierde-proteínas. Las principales manifestaciones son las derivadas de la hipoalbuminemia. Para lograr el diagnóstico se necesita la imagen endoscópica típica de la linfangiectasia intestinal y el aumento de las cifras de alfa-1-antitripsina en las heces de 24 horas. El tratamiento es básicamente dietético. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Hipoalbuminemia , Edema , Linfangiectasia , Cápsulas Endoscópicas , Intestino Delgado
17.
Rev. esp. patol ; 55(4): 240-244, Oct-Dic. 2022. ilus
Artigo em Inglês | IBECS | ID: ibc-210612

RESUMO

Organoid (hypermature) teratomas are highly specialized teratomas showing organ formation, most frequently from the digestive tract or bronchial wall. We present four cases of ovarian organoid teratomas, one with a distinguishable mandible with teeth, one with small intestine, one with large intestine containing a well differentiated neuroendocrine tumor and another with both large intestine and bronchial wall. These tumors have a distribution similar to conventional teratomas and usually behave benignly, although cases of malignancy have been reported.(AU)


Los teratomas hipermaduros u organoides son teratomas altamente especializados en los que existe formación de órganos. Los más comunes son del tracto digestivo y de la pared bronquial. Presentamos cuatro casos de teratomas organoides del ovario: uno con formación de mandíbula con estructuras dentales, otro con intestino delgado, otro con intestino grueso con un tumor neuroendocrino bien diferenciado, y otro intestino grueso y pared bronquial. Estos tumores son de comportamiento benigno, aunque se han descrito casos con malignización. Pueden ocurrir en cualquier lugar donde se localicen los teratomas convencionales.(AU)


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Teratoma/diagnóstico por imagem , Organoides , Ovário , Tumores Neuroendócrinos , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Intestino Grosso , Intestino Delgado , Patologia , Serviço Hospitalar de Patologia
18.
Rev. esp. patol ; 55(4): 249-253, Oct-Dic. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-210614

RESUMO

Los liposarcomas son el grupo más común de las neoplasias mesenquimatosas malignas. Suelen aparecer en las extremidades y en el retroperitoneo. Es excepcional su localización intestinal. Se presenta el caso de un varón de 75 años que fue hospitalizado por anemia severa, en cuya TC se objetivó un engrosamiento de asa yeyunal de 5cm sospechoso de neoplasia. Se realizó resección parcial de intestino delgado. Macroscópicamente se identificó una tumoración polipoide ulcerada de 12×6cm. Microscópicamente se observó una neoplasia bien delimitada, ulcerada, de transición abrupta con una mucosa circundante normal, compuesta por lipoblastos pleomórficos sobre un fondo sarcomatoso. Existen muy pocos casos publicados de liposarcomas intestinales, la mayoría de los cuales eran liposarcomas bien diferenciados o desdiferenciados. Se presenta el caso de un liposarcoma pleomórfico de intestino delgado por su excepcional localización y la importancia en su diagnóstico diferencial.(AU)


Liposarcomas are the most common group of malignant mesenchymal neoplasms. They usually occur in the extremities and the retroperitoneum and only rarely in the intestine. We report the case of a 75-year-old man presenting with severe anaemia. A CAT scan revealed a 5cm thickening of the jejunal loop, arousing the suspicion of a neoplasm. A partial resection of the small intestine was performed. Macroscopy showed a 12×6cm ulcerated, polypoid mass. Microscopically, a well circumscribed, ulcerated tumour was seen, which had well-defined margins with the surrounding normal mucosa. It consisted of pleomorphic lipoblasts within a sarcomatous background. Very few cases of intestinal liposarcomas have been published and the majority report well-differentiated or undifferentiated liposarcomas. We present a case of a pleomorphic liposarcoma of the small intestine, which is an unusual location and emphases the importance of a comprehensive differential diagnosis.(AU)


Assuntos
Humanos , Masculino , Idoso , Pacientes Internados , Exame Físico , Anamnese , Avaliação de Sintomas , Lipossarcoma , Intestino Delgado/lesões , Diagnóstico Diferencial , Fumantes , Hipertensão , Diabetes Mellitus , Neoplasias , Patologia , Serviço Hospitalar de Patologia , Dislipidemias
20.
Med. clín (Ed. impr.) ; 159(2): 85-89, julio 2022. tab
Artigo em Inglês | IBECS | ID: ibc-206305

RESUMO

IntroductionProgression of carcinoid syndrome (CS) to carcinoid heart disease (CHD) is difficult to predict. This retrospective analysis evaluates the use of chromogranin A (CgA), a biomarker widely used in the diagnosis of neuroendocrine tumours (NET), in monitoring CS and disease progression.Patients and methods108 patients with confirmed CS, selected from a group of 351 patients with neuroendocrine neoplasms of the small intestine (SI-NENs), including NETG1 well 40% and NETG2 60% moderately differentiated NET. CgA concentration was measured during initial diagnosis and clinical follow up in 84 patients, 27 of them subsequently developed CHD. The patient's overall survival (OS) was evaluated using the Kaplan-Meier method.ResultsPatients with CHD, were found to have significantly shorter OS than patients with CS but without CHD (67.22 vs. 73.03 months). Univariate and multivariate analyses revealed that initial high concentration of CgA and/or increased concentration of CgA is significantly associated with decreased median OS in patients with CS (p<0.05).ConclusionCgA has potential as a clinically useful biomarker in reporting disease status and predicting outcome in patients with CS and with CHD. (AU)


IntroducciónLa progresión hacia la afectación cardiaca en el síndrome carcinoide (SC) es difícil de predecir. En el presente análisis retrospectivo se evaluó el uso de la cromogranina A (CgA), un biomarcador ampliamente utilizado en el diagnóstico de los tumores neuroendocrinos (TNE), en el seguimiento del SC y en la progresión de la enfermedad.Pacientes y métodosSe incluyeron 108 pacientes con SC confirmado, seleccionados de un grupo de 351 pacientes con tumores neuroendocrinos del intestino delgado (TNE-ID). El 40% de pacientes tenían un TNE G1 bien diferenciado y un 60% un TNE G2 moderadamente diferenciado. Los niveles de CgA se determinaron en el momento del diagnóstico y durante el seguimiento en 84 pacientes, 27 de los cuales desarrollaron afectación cardiaca. La supervivencia global de los pacientes se evaluó mediante el método de Kaplan-Meier.ResultadosLos pacientes con afectación cardiaca tuvieron una supervivencia global significativamente más corta que aquellos sin ella (67,22 frente a 73,03 meses). El análisis univariado y multivariado mostró que los niveles inicialmente altos de CgA y/o los niveles elevados de CgA durante la evolución se asocian de forma significativa con una menor supervivencia global en los pacientes con SC (p<0,05).ConclusiónLa CgA constituye un biomarcador clínicamente útil para evaluar la progresión de la enfermedad y la afectación cardiaca en pacientes con SC. (AU)


Assuntos
Humanos , Biomarcadores , Biomarcadores Tumorais , Doença Cardíaca Carcinoide/complicações , Doença Cardíaca Carcinoide/diagnóstico , Intestino Delgado/patologia , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/patologia , Cromogranina A , Estudos Retrospectivos
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