RESUMEN
In this report, we discuss a case of an 18 year-old woman with obscure gastrointestinal bleeding (OGIB) revealed to be originated from a Meckel's diverticulum. OGIB is defined as persistent or recurrent bleeding from a difficult to identify source and accounts for approximately 5% of all cases of GI bleeding. Lesions in the small bowel most commonly cause it. OGIB represents one of the most challenging disorders faced by gastroenterologists due to its evasive nature and difficulty in identifying the exact source of the bleeding. Recent technological advances such as capsule endoscopy, balloon-assisted enteroscopy, spiral enteroscopy and CTE have significantly improved our ability to diagnose and manage these patients. We report this case to assess the importance of laparoscopy that nowadays is the only procedure that successfully detected the site of bleeding in up to 100% of cases. KEY WORDS: Enterorrhagia, Gastrointestinal bleeding, Meckel's diverticulum, Obscure gastrointestinal bleeding.
RESUMEN
BACKGROUND AND OBJECTIVE: Scar management is a long-term process. A variety of modalities have been employed and, depending on scar type, treatment may be invasive and/or conservative. The purpose of this study was to evaluate a new CO2 laser resurfacing for post-traumatic and pathological scars and to compare this device with classic dermabrasion. The new fractionated ultrapulsed CO2 laser (Ultrapulse Encore, Lumenis Ltd., Santa Clara, CA) is equipped with two types of scanners: the first, ActiveFX, is non-sequential while the second, DeepFX, is sequential and produces microspot. MATERIALS AND METHODS: From September 2008 to November 2008, a study on 60 patients was performed. The patients (average age 47.3 years) enrolled in this study had severely scarred skin and were divided into two groups of 30 people. All patients were Caucasian with skin type II or III. Each scar was photographed and scored by the authors using the Manchester Scar Scale (MSS). Follow-up ranged from 12-15 months. RESULTS: Sixty patients were analyzed in two homogeneous groups. Significant improvement in skin tone, texture and appearance of skin was noted in all patients treated with CO2 laser, lower improvement resulted with dermabrasion. Both subjects and investigators noted similar aesthetic improvement. No major complications were found for both groups and minor complications included transient erythema and edema. CONCLUSION: Fractional ultrapulsed CO2 laser resurfacing has proven to be both safe and effective. The efficacy and favorable side effects profile for this technology, with low incidence of pigmentary changes, make it a viable alternative for the treatment of moderate-to-severe scars.
