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1.
Rev Esp Enferm Dig ; 2023 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-37929945

RESUMO

We present the case of a young patient with acute pancreatitis (AP) secondary to osteosarcoma metastasis. It is necessary to assess tumor etiology in the study of any acute pancreatitis without clear cause. Pancreatic metastases are rare and difficult to diagnose and differentiate from other primary tumors such as neuroendocrine tumors (NET). It is essential to have a high degree of clinical suspicion and the use of radiological and endoscopic ultrasound imaging techniques.

2.
Rev Esp Enferm Dig ; 2023 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-37706476

RESUMO

A 50-year old male with acute necrotizing pancreatitis had an unfavorable evolution in the third week of disease, with development of large volume ascites and walled-off necrosis affecting the head and body of pancreas, suspected to be infected, with viable parenchyma in the tail of pancreas. Endoscopic ultrasound guided drainage of the collection was performed through placement of a lumen apposing metal stent. Selective cannulation of main pancreatic duct was only possible though the minor papilla and after contrast media injection a type 1 pancreas divisum and partial disruption of dorsal pancreatic duct were diagnosed.

3.
Rev Esp Enferm Dig ; 115(4): 190-191, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35469407

RESUMO

A 38-year-old male with medical history of HIV group C3 with voluntary abandonment of antiretroviral therapy, was hospitalized due to general deterioration, abdominal pain, diarrhea and rectal bleeding without signs of acute abdomen. The patient presented anemia, renal and hepatic dysfunction, and metabolic acidosis. Abdominal CT and CT angiography were performed without observing signs of perforation or active bleeding. In the same year, he was also diagnosed of intestinal Cryptosporidiosis, cutaneous Kaposi's sarcoma and disseminated infection by Mycobacterium avium (MA) with lung, liver and bone marrow involvement. Panendoscopy was performed, showing violaceous lesions on the soft palate. In the stomach and duodenum, he presented multiple, large, well-defined and occasionally confluent red-violet lesions Colonoscopy did not show macroscopic alterations.


Assuntos
Infecções por HIV , Sarcoma de Kaposi , Masculino , Humanos , Adulto , Mycobacterium avium , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/patologia , Infecções por HIV/complicações , Colonoscopia , Hemorragia Gastrointestinal
4.
Rev Esp Enferm Dig ; 115(7): 368-373, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36043537

RESUMO

INTRODUCTION: conflicting results have been reported regarding the influence of the annual volume of endoscopic retrograde cholangiopancreatography (ERCP) on outcome. OBJECTIVE: to evaluate the influence of case volume on ERCP outcomes. PATIENTS AND METHODS: an analysis of a prospective database was performed, comparing the outcomes of ERCP in three consecutive periods defined by the number of endoscopists performing ERCP: five endoscopists in period I (P1), four in period II (P2) and three in period III (P3). Only patients with biliary ERCP in accessible and naïve papilla were included. Primary variables were cannulation rates and adverse effects (AE). The American Society of Gastrointestinal Endoscopy (ASGE) complexity grades III and IV were considered as highly complex procedures. RESULTS: a total of 2,561 patients were included: 727 (P1), 972 (P2) and 862 (P3). There were no differences in age and sex between groups (p > 0.05). The cannulation rate was significantly higher in P2 and P3: 92.4 % vs 93.3 % vs 93 % (p = 0.037). The AE rate was 13.8 %, 12.6 % and 10.3 % (p > 0.05), respectively. The rate of post-ERCP pancreatitis was significantly lower in P3: 8.5 %, 7.3 % and 5 % (p = 0.01). The rate of complex procedures was 12 %, 14.8 % and 27 % (p < 0.0001), respectively. Two endoscopists participated in all periods and only one had significantly improved outcomes. Cannulation and post-ERCP pancreatitis rates remained significantly better in P3 after adjusting for sex, complexity and endoscopist. CONCLUSION: a higher annual volume of ERCP per endoscopist was associated with a higher rate of cannulation and a lower rate of post-ERCP pancreatitis, despite the greater complexity of the procedures. These beneficial effects seem to differ between endoscopists.


Assuntos
Sistema Biliar , Pancreatite , Humanos , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica/métodos , Cateterismo/efeitos adversos , Cateterismo/métodos , Pancreatite/epidemiologia , Pancreatite/etiologia , Pancreatite/prevenção & controle , Doença Iatrogênica
5.
Rev Esp Enferm Dig ; 114(7): 437-438, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35240850

RESUMO

Small bowel adenocarcinoma is a rare tumor accounting for only 0.3-0.4% of all gastrointestinal tumors, with duodenal adenocarcinoma being the most common subtype. In most patients, it presents with nonspecific signs and symptoms, often leading to a delay in diagnosis. Therefore, it is essential to establish an adequate initial clinical suspicion to carry out an adequate diagnostic approach, being necessary to perform both radiological and endoscopic diagnostic techniques.


Assuntos
Adenocarcinoma , Neoplasias Duodenais , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Neoplasias Duodenais/patologia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Humanos , Intestino Delgado/patologia
6.
Gastroenterol Hepatol ; 36(4): 264-7, 2013 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-23228815

RESUMO

Esophageal lichen planus (ELP) is a rare condition with unknown prevalence that can sometimes be underestimated due to the subtle and nonspecific findings of diagnostic workup. Oral lesions rarely extend to the esophageal mucosa, but when they do, the most frequent symptoms are dysphagia and odynophagia. There is often a significant delay in diagnosis and inadequate treatment. We report the case of a 59-year-old woman diagnosed with ELP, successfully treated with rituximab, a chimeric monoclonal antibody that depletes CD20+B cells. To our knowledge, this is only the second report of this treatment in ELP.


Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Doenças do Esôfago/tratamento farmacológico , Imunossupressores/uso terapêutico , Líquen Plano/tratamento farmacológico , Alopecia/complicações , Androstadienos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Atrofia , Doenças do Esôfago/complicações , Estenose Esofágica/etiologia , Esofagite Péptica/complicações , Esofagite Péptica/tratamento farmacológico , Esôfago/patologia , Feminino , Fluticasona , Humanos , Líquen Plano/complicações , Líquen Plano Bucal/complicações , Pessoa de Meia-Idade , Mucosa/patologia , Prednisona/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Rituximab , Terapia de Salvação , Subpopulações de Linfócitos T/imunologia , Líquen Escleroso Vulvar/complicações
7.
Rev Esp Enferm Dig ; 104(5): 237-41, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22662775

RESUMO

INTRODUCTION: insufflation with carbon dioxide (CO2) during endoscopies compared to air is associated with a decrease in abdominal discomfort after the examination, because CO2 is readily absorbed through the small intestine and eliminated by the lungs. AIM: the objective of this randomized clinical trial was to assess the effect of CO2 insufflation on pain and abdominal distension after an ileo-colonoscopy (I) and after an ileo-colonoscopy plus gastroscopy (I+G). MATERIAL AND METHODS: we included a total of 309 patients in the study and all endoscopies were performed under sedation with propofol. Two hundred fourteen patients underwent an I (132 with CO2 / 82 with air) and 95 underwent an I+G (53 with CO2 / 42 with air). Abdominal pain was studied at 10, 30 and 120 minutes of exploration and abdominal perimeter difference before and after the procedure. RESULTS: both in group I and in group I+G, the use of CO2 translated into an average of abdominal pain significantly lower (p < 0.05). Similarly, a smaller increase in waist circumference was found among group I and group I+G, in patients where CO2 was used (p < 0.05). CONCLUSION: the insufflation of CO2 instead of air during the performance of endoscopy significantly reduces the discomfort and abdominal pain after an ileo-colonoscopy and after a gastroscopy + ileo-colonoscopy.


Assuntos
Dor Abdominal/prevenção & controle , Ar , Dióxido de Carbono , Colonoscopia/métodos , Gastroscopia/métodos , Insuflação/métodos , Dor Abdominal/etiologia , Idoso , Colonoscopia/efeitos adversos , Dilatação Patológica/etiologia , Dilatação Patológica/prevenção & controle , Método Duplo-Cego , Feminino , Gastroscopia/efeitos adversos , Humanos , Insuflação/efeitos adversos , Masculino , Pessoa de Meia-Idade
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