No association between Helicobacter pylori and Mycobacterium tuberculosis infections among gastrointestinal clinic attendees in Lima, Peru.

Helicobacter pylori (HP) infection can cause hypochlorhydria, a positive risk factor for Mycobacterium tuberculosis (MTB) infection. This study examined the association between HP and MTB infections among persons attending the Policlinico Peruano Japonés Gastrointestinal Clinic in Lima, Peru. From 23 June 2000 to 18 August 2000, consenting 18-55 year olds who attended the clinic for gastric biopsy gave blood for HP serologic testing, underwent tuberculin skin testing (TST) and completed a social and medical history. Of 128 participating patients, 78 (61%) were TST positive for MTB, and 107 (84%) were infected with HP by serology. Of the patients who were HP positive, 67 (63%) developed positive TST reactions compared to 11 (52%) of 21 HP-seronegative subjects (OR 1.29; 95% CI 0.54-3.11; P = 0.6). There was no association after adjusting for covariates of H. pylori infection (OR 0.78; 95% CI 0.23-2.71; P = 0.7). However, study power was limited by high prevalence of the two infections.

[MANAGEMENT OF PANCREATIC ABSCESS] / Absceso Pancreático.

Pancreatic abscess is an infrequent local complication of acute severe pancreatitis with high mortality. Its late manifestation includes: high fever, crescent abdominal pain, leukocytosis, and an evident mass in one third of patients. Diagnosis by image tests could detect this lesion but the only method to determine the presence of infection is the examination of the fluid obtained by guided percutaneous aspiration or by surgery. Germs involved belong to intestinal flora, specially coliforms. The most effective treatment is drainage by surgery or percutaneous method accompanied by a wide spectrum antibiotic.

[Endoscopic retrograde cholangiopancreatography and sphincterotomy in parasitic diseases]. / Pancreatocolangiografía retrógrada endoscópica y esfinterotomía en las parasitosis.

We report six patients with billary duct obstruction due to parasites (Fasciola hepatica, ascariasis and hydatid cyst) that were diagnosed and managed with the endoscopic approach. This is the first national paper which highlights the importance of endoscopic retrograde cholangiopancreatography in the management of this parasitosis. Despite choledocholithiasis as the most common cause of extrahepatic jaundice, biliary tree parasitosis must be considered in the differential diagnosis.