High ulcerative colitis and Crohn's disease ratio in a population-based registry from Córdoba, Argentina.

BACKGROUND: Few studies have described the epidemiology and clinical behavior of inflammatory bowel disease (IBD) in South America. The aim of this study was to report on the prevalence, phenotype, and treatment of patients with IBD diagnosis in Capital Department of the Province of Córdoba, Argentina. METHODS: Data from adult patients (≥ 18 years-old) with IBD diagnosis that attended 12 public or private centers between 05/2014 and 05/2019 were included in a common registry. RESULTS: A total of 655 patients were included (females: 53.4%). The ratio of ulcerative colitis (UC) (n = 561) to Crohn's disease (CD) (n = 88) was 6.38, with age-adjusted IBD prevalence being 70.1 (95% confidence interval 70.08-70.12) cases/100,000 habitants. Extraintestinal manifestations were diagnosed in 22.8% of patients, and left-side colitis (46%) was the most frequent extension in UC patients. In CD patients, colonic involvement (55.7%) and non-stricturing/non-penetrating behavior (74%) were the most frequent presentations. Biologic therapy was used in 36.4% of CD patients and 9.1% of UC patients (P<0.001). CONCLUSION: In this population registry study, IBD prevalence was similar to that reported in other series in the region. A higher UC/CD ratio was observed due to the lower prevalence of CD compared to similar studies in South America.

[Pilot test for Helicobacter pylori detection with ammonia breath test]. / Prueba piloto para la detección de Helicobacter pylori con test de amoníaco en aire espirado.

BACKGROUND: In Argentina we have little access to the more sensitive and specific non-invasive diagnostic methods for the detection of Helicobacter pylori (HP), such as the urea breath test. The upper gastrointestinal videoendoscopy, with biopsy for histological analysis and rapid urease test remains as the usual method in our country, but the cost is high and the accessibility is also limited. For this reason we propose to develop a new fast, accurate, accessible and inexpensive method for measuring the concentration of expired NH in order to achieve a diagnosis of active infection. OBJECTIVE: To determine the utility of a non-invasive method for detecting HP through the measurement of ammonia in the breathing. MATERIALS AND METHODS: We studied 3 patients older than 21 years, attending the Gastroenterology clinic. All patients who meet the inclusion criteria were evaluated with an upper gastrointestinal videoendoscopy and gastric biopsies (antrum, body and incisura angularis). Samples were analyzed by histopathological examination and urease test. The subjects with both negative tests (non-infected) or positive (infected) were selected for ammonia measurement in exhaled air. RESULTS: The prevalence of HP infection was 60.9% (14 patients). Ten of these patients had significant differences between the baseline ammonia and the ammonia after urea ingestion, yielding a specifcity of 88.9% and a sensitivity of 71.43%, with a Jouden index higher than 50%. CONCLUSION: Although the experience must be carried forward, the results of this pilot study suggest that the measurement of ammonia in breath test after ingestion of unmarked urea would be applicable as a diagnostic test for HP, taking into account its low cost and easy management compared to conventional non-invasive methods.

Fístula gastroduodenal por textiloma extraído endoscópicamente.

In this case we present a patient with chronic abdominal pain of a year of evolution, three months before being admitted to hospital the patient presented melaena and anaemia. Within the surgery antecedents it appears a caesarean 2 years before and a cholecystectomy a year before. In the endoscopy study a textiloma was observed coming up from the posterosior side of the antrum which, after its endoscopic removal, showed a gastro-duodenal fistula with a non-patent pylorus.

Manejo endoscópico de una fístula traqueoesofágica benigna secundaria a un cuerpo extraño.

It is presented a 48 year-old male patient with antecedent of a foreign body intake (a beer metallic top) 4 years ago, who rejected surgery at first previous a failed attempt of endoscopic extraction. Four years later he was admitted in the Thorax National Institute in an emergency, with acute respiratory failure and sepsis signs that were corrected quickly; later on after failed surgical attempts of trachea-esophageal fistula correction and extraction of the foreign body, the patient was sent to BJIG where the endoscopic extraction of the foreign body located in the trachea was carried out together with the correction of the trachea-esophageal fistula by means of implantation, in esophagus, of covered self-expanding prosthesis.