Asunto(s)
Endoscopía del Sistema Digestivo/métodos , Hallazgos Incidentales , Gastropatías/patología , Xantomatosis/patología , Biopsia con Aguja , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Linfoma de Células B/diagnóstico , Linfoma de Células B/terapia , Persona de Mediana Edad , Estadificación de Neoplasias , Medición de Riesgo , Índice de Severidad de la Enfermedad , Gastropatías/diagnóstico , Xantomatosis/diagnósticoRESUMEN
The association between gastric carcinoma and lymphoma is rare. Confocal laser endomicroscopy is a new diagnostic tool that allows the identification of cellular and vascular architecture during endoscopy. This is the first report of an in vivo early gastric carcinoma diagnosis by confocal laser endomicroscopy in a patient successfully treated for a primary gastric diffuse large-B-cell lymphoma.
Asunto(s)
Adenocarcinoma/diagnóstico , Endoscopía del Sistema Digestivo/métodos , Linfoma de Células B Grandes Difuso/diagnóstico , Microscopía Confocal/métodos , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Protocolos de Quimioterapia Combinada Antineoplásica , Terapia Combinada , Detección Precoz del Cáncer , Gastrectomía , Humanos , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/cirugía , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/tratamiento farmacológico , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/cirugía , Estómago/patología , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
Anterior resection of the rectum is a frequent surgical procedure. However, abnormal bowel habits following this procedure are frequently reported. The functional evaluation of these patients is usually limited to the anorectal area. By means of colonic manometry, we have evaluated a patient with frequent urge for defecation and increased bowel frequency following anterior resection of the rectum with straight coloanal anastomosis and almost normal anorectal function. Analysis of the tracing revealed a reduction of contractile segmental activity and much more high-amplitude propagated contractions than which occur in healthy subjects. These high-amplitude propagated contractions, representing the manometric equivalent of mass movements, were always in association with urge for defecation and, sometimes, with loose stools. High-amplitude simultaneous contractions were also observed. We feel that the surgical resection of a potential physiological brake may be responsible for these observations.
Asunto(s)
Colon/fisiopatología , Neoplasias del Recto/cirugía , Recto/cirugía , Anciano , Humanos , Masculino , Manometría/métodos , Cuidados Posoperatorios , Complicaciones PosoperatoriasRESUMEN
Selective serotonin reuptake inhibitors are frequently employed to treat depression. However, although rarely, coagulation abnormalities have been described following the use of these compounds, and these effects appear to be enhanced by simultaneous use of nonsteroidal anti-inflammatory drugs. We describe a case of reversible symptomatic duodenal compression caused by a retroperitoneal hematoma after ingestion of sertraline and nimesulide.
Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Enfermedades Duodenales/etiología , Hematoma/inducido químicamente , Obstrucción Intestinal/etiología , Espacio Retroperitoneal/diagnóstico por imagen , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Sertralina/efectos adversos , Sulfonamidas/efectos adversos , Depresión/tratamiento farmacológico , Interacciones Farmacológicas , Enfermedades Duodenales/diagnóstico por imagen , Femenino , Hematoma/complicaciones , Hematoma/diagnóstico por imagen , Humanos , Obstrucción Intestinal/diagnóstico por imagen , Persona de Mediana Edad , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Sertralina/uso terapéutico , Tomografía Computarizada por Rayos XRESUMEN
Chronic constipation is one of the more frequent functional gastrointestinal symptoms. The more severe cases not infrequently undergo a major surgical approach. However, there is still a need for a better diagnostic and therapeutic approach, since the results are still unpredictable, probably due to a poor selection of candidates. This article focuses on the current diagnostic approach to chronic constipation, with an emphasis on the possible role of colonic manometry to help better choose those patients that may benefit from surgery.
