RESUMO
There are many useful biomarkers for initial diagnosis and the management of inflammatory bowel disease. Serologic biomarkers have been traditionally used because they are widely disposable, but recently faecal biomarkers, especially faecal calprotectin, have acquired great importance as they have shown to be more precise when establishing suspicion of the disease and also as predictors of mucosal healing or persistence of inflammatory activity. Faecal calprotectin is a good tool for predicting abnormal endoscopic studies, but has limited specificity because its levels can be altered in many digestive diseases presenting with similar symptoms. The precision of faecal calprotectin is higher when associated with other altered parameters, especially with C-reactive protein, or with clinical scores of inflammatory activity. Finally, there are many new generation serologic and faecal biomarkers. Despite there not being much evidence about these yet, some of them have shown promising results in different studies.
Assuntos
Biomarcadores/metabolismo , Colite Ulcerativa/diagnóstico , Doença de Crohn/diagnóstico , Fezes/química , Complexo Antígeno L1 Leucocitário/análise , Anticorpos Anticitoplasma de Neutrófilos/metabolismo , Biomarcadores/análise , Sedimentação Sanguínea , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Colite Ulcerativa/metabolismo , Doença de Crohn/metabolismo , Microbioma Gastrointestinal/imunologia , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/metabolismo , Metaboloma , MicroRNAs/metabolismo , Sangue Oculto , Pró-Calcitonina/metabolismo , Proteômica , Piruvato Quinase/metabolismo , Proteína S100A12/metabolismo , Sensibilidade e EspecificidadeRESUMO
We present the case of a young man with a hepatic mass in which ultrasound gives great and immediate support for diferential diagnosis.
Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Abdome/diagnóstico por imagem , Adolescente , Carcinoma Hepatocelular/tratamento farmacológico , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Masculino , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Direct percutaneous endoscopic jejunostomy (DPEJ) is an infrequent procedure as it is not always easy to obtain transillumination, being this the main reason for failure of this technique. In patients with previous surgery, this procedure is more complex and there are only 6 reported cases in pediatric population. In our case, we provide the use of an endoscopic triangulation system with "T" pexies not used before in these cases. With this technique, we guarantee not to replace the introduction system afterwards, obtaining the placement of a balloon fixation system initially. We also provide several improvements that helped us developing the procedure: Placement of the jejunostomy through a gastrostomy; use of water column to avoid penetration in hollow viscus; use of a guide wire, and a triangulation pexy system.
