RESUMEN
Aortoesophageal fistula is a very rare cause of upper gastrointestinal bleeding, however its interest lies in the high mortality rate associated with it. Due to this, early diagnosis and treatment of this entity is essential to increase survival. The typical symptoms known as the Chiari´s triad are only present in 45% of reported cases. We present the case of a patient with upper gastrointestinal bleeding due to an aortoesophageal fistula as well as the importance of endoscopic use for its differential diagnosis.
Asunto(s)
Enfermedades de la Aorta , Fístula Esofágica , Perforación del Esófago , Fístula Vascular , Humanos , Perforación del Esófago/diagnóstico por imagen , Perforación del Esófago/etiología , Fístula Vascular/complicaciones , Fístula Vascular/diagnóstico por imagen , Fístula Esofágica/etiología , Fístula Esofágica/complicaciones , Hemorragia Gastrointestinal/complicaciones , Enfermedades de la Aorta/etiología , Enfermedades de la Aorta/complicacionesAsunto(s)
Errores Diagnósticos , Glucagonoma/complicaciones , Neoplasias Pancreáticas/complicaciones , Psoriasis/diagnóstico , Enfermedades de la Piel/etiología , Biopsia , Diagnóstico Diferencial , Glucagonoma/diagnóstico por imagen , Glucagonoma/secundario , Glucagonoma/cirugía , Humanos , Neoplasias Hepáticas/secundario , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/cirugía , Enfermedades de la Piel/patología , Tomografía Computarizada por Rayos XAsunto(s)
Divertículo/complicaciones , Obstrucción Intestinal/etiología , Enfermedades del Yeyuno/etiología , Dolor Abdominal/etiología , Anciano de 80 o más Años , Divertículo/diagnóstico por imagen , Divertículo/cirugía , Resultado Fatal , Humanos , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/cirugía , Isquemia/etiología , Enfermedades del Yeyuno/diagnóstico por imagen , Enfermedades del Yeyuno/cirugía , Yeyuno/irrigación sanguínea , Masculino , Complicaciones Posoperatorias/etiología , Edema Pulmonar/etiologíaAsunto(s)
Carcinoma de Células Pequeñas/secundario , Carcinoma de Células Escamosas/secundario , Enfermedades del Íleon/etiología , Obstrucción Intestinal/etiología , Enfermedades del Yeyuno/etiología , Neoplasias del Yeyuno/secundario , Neoplasias Pulmonares/complicaciones , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Pequeñas/complicaciones , Carcinoma de Células Pequeñas/tratamiento farmacológico , Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/cirugía , Quimioradioterapia , Cisplatino/administración & dosificación , Etopósido/administración & dosificación , Resultado Fatal , Humanos , Enfermedades del Íleon/diagnóstico por imagen , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/cirugía , Enfermedades del Yeyuno/diagnóstico por imagen , Neoplasias del Yeyuno/complicaciones , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/terapia , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: Bariatric surgery aims to reduce weight and resolve the comorbidities associated with obesity. Few studies have assessed mid/long-term changes in lipid profile with sleeve gastrectomy versus gastric bypass. This study was conducted to assess and compare changes in lipid profile with each procedure after 60 months. METHODS: This was an observational, retrospective study of analytical cohorts enrolling 100 patients distributed into two groups: 50 had undergone gastric bypass (GBP) surgery and 50 sleeve gastrectomy (SG) surgery. Total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) levels were measured before surgery and at 1, 6, 12, 24, 36, 48, and 60 months. Weight loss and the resolution of dyslipidemia with each of the procedures were also assessed. RESULTS: Ninety-five of the 100 patients completed follow-up. At 60 months, TC and LDL levels had significantly decreased in the BPG group (167.42⯱â¯31.22â¯mg/dl and 88.06⯱â¯31.37â¯mg/dl, respectively), while there were no differences in the SG group. Increased HDL levels were seen with both procedures (BPG: 62.69⯱â¯16.3â¯mg/dl vs. SG: 60.64⯱â¯18.73â¯mg/dl), with no difference between the procedures. TG levels decreased in both groups (BPG: 86.06⯱â¯56.57â¯mg/dl vs. SG: 111.09⯱â¯53.08â¯mg/dl), but values were higher in the BPG group (Pâ¯<â¯.05). The percentage of overweight lost (PSP) was higher in the BPG group: 75.65⯱â¯22.98â¯mg/dl vs. the GV group: 57.83⯱â¯27.95â¯mg/dl. CONCLUSION: Gastric bypass achieved better mid/long-term results in terms of weight reduction and the resolution of hypercholesterolemia as compared to sleeve gastrectomy. While gastric bypass improved all lipid profile parameters, sleeve gastrectomy only improved HDL and triglyceride levels.
Asunto(s)
Cirugía Bariátrica , Derivación Gástrica , Lípidos/sangre , Obesidad Mórbida , Gastrectomía , Humanos , Lipoproteínas HDL/sangre , Obesidad Mórbida/cirugía , Estudios Retrospectivos , Triglicéridos/sangre , Pérdida de PesoAsunto(s)
Enfermedades de la Aorta/complicaciones , Enfermedades Duodenales/complicaciones , Hemorragia Gastrointestinal/etiología , Fístula Intestinal/complicaciones , Fístula Vascular/complicaciones , Aorta Abdominal , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND AND OBJECTIVE: Neuronal populations involved in the regulation of food intake, particularly the orexigenic (appetite-stimulating) hormone ghrelin, are found in the hypothalamus. Changes in plasma ghrelin levels have been observed following different bariatric surgery procedures, but the results from different studies are contradictory. Much remains unknown regarding the role of ghrelin in the weight loss process following bariatric surgery. Our objective was to describe the behaviour of fasting ghrelin levels, comparing the changes occurring between 2 different surgical techniques (gastric bypass versus vertical sleeve gastrectomy) and their correlation with weight loss. PATIENTS AND METHOD: A prospective, observational, analytic cohort study of 54 patients (27 for each surgical technique) with a 12-month follow-up period. We analysed demographic data, anthropometric data, comorbidities, weight loss and evolution of fasting ghrelin. RESULTS: The behaviour of acylated ghrelin was similar with the 2 surgical techniques, with no significant differences between gastric bypass and vertical sleeve gastrectomy. With both procedures, there was an increase in acylated ghrelin on day 5 and a subsequent decrease, and levels then gradually increased to reach values at 12 months that were higher than those reported preoperatively. This increase in ghrelin levels did not affect weight loss, since one year post-surgery, 30% weight loss was achieved with both types of surgery. CONCLUSIONS: We observed an increase in fasting acylated ghrelin levels at one year of follow-up with both surgical techniques, with 30% weight loss.
Asunto(s)
Ayuno/sangre , Gastrectomía/métodos , Derivación Gástrica , Ghrelina/sangre , Obesidad Mórbida/sangre , Obesidad Mórbida/cirugía , Pérdida de Peso , Adulto , Estudios de Cohortes , Correlación de Datos , Femenino , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Embolización Terapéutica/métodos , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Neoplasias Gástricas/complicaciones , Enfermedad Aguda , Cateterismo , Femenino , Hemorragia , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Gástricas/patologíaRESUMEN
Resumen Los pacientes diagnosticados de adenocarcinoma gástrico pueden desarrollar metástasis hepáticas o carcinomatosis peritoneal, pero la presencia de metástasis musculares es extremadamente infrecuente, con muy pocos casos descritos. Presentamos a una paciente de 44 años con una tumoración dolorosa en miembro superior izquierdo. Fue tratada un año antes de un adenocarcinoma gástrico con cirugía y quimioterapia. Mediante pruebas de imagen y biopsia, se le diagnosticó metástasis muscular única de adenocarcinoma gástrico, siendo intervenida realizando exéresis quirúrgica.
Abstract Patients diagnosed with gastric adenocarcinoma may develop liver metastases or peritoneal carcinomatosis, but the presence of muscle metastases is extremely rare, with very few cases reported. We present a 44-year-old female patient with a painful tumor in her left upper limb. She was treated with surgery and chemotherapy for gastric adenocarcinoma a year before. By imaging tests and biopsy, she was diagnosed with a single muscle metastasis from gastric adenocarcinoma and underwent surgical exeresis.
Asunto(s)
Femenino , Adulto , Adenocarcinoma , Músculo Esquelético , Metástasis de la Neoplasia , Neoplasias Peritoneales , Informe de Investigación , LiteraturaRESUMEN
Malignant atrophic papulosis is an uncommon vasculopathy affecting multiple systems and frequently associated with a poor prognosis. We describe a 56-year-old patient with this rare disorder whose death was the result of intestinal involvement. Clinical diagnostic features of malignant atrophic papulosis as well as the main therapeutic approaches suggested in the literature are presented herein.