RESUMO
AIM: to evaluate the safety and effectiveness of self-expandable metal stent placement for malignant gastric outlet obstruction (GOO). METHODS: a retrospective, analytic cohort study at a single, tertiary-care center. RESULTS: thirty-six patients that underwent stent placement for GOO of malignant origin were identified during the study period. Technical success was achieved in 36 (100 %) patients and clinical success was achieved in 31 patients (86.1 %). Before the procedure, 17 (54.8 %) patients had a gastric outlet obstruction score (GOOSS) of 0, which is a complete inability of oral intake. Twenty-three patients were alive 30 days after the procedure, two (8.6 %) patients had a GOOSS of 1, ten (43.3 %) had a GOOSS of 2 and eleven (47.9 %) had a GOOSS of 3. Abdominal pain was present in all 31 patients before the procedure and only seven (22.6 %) patients continued with abdominal pain 24 hours after the procedure. During follow-up, ten (30.3 %) patients developed complications related to the stents and none of them was fatal. Additional therapy due to partial occlusion of the stent was necessary in three patients. The stents functional duration had a median of 72 days (IQR 25-75 15-105 days) and was closely related to overall survival. CONCLUSION: palliative stenting for gastroduodenal obstruction is a safe, feasible and effective therapy to treat patients with malignant gastric outlet obstruction.
Assuntos
Obstrução da Saída Gástrica , Neoplasias Gástricas , Estudos de Coortes , Obstrução da Saída Gástrica/etiologia , Obstrução da Saída Gástrica/cirurgia , Humanos , Cuidados Paliativos , Estudos Retrospectivos , Stents , Resultado do TratamentoRESUMO
We report 2 cases of recurrent Campylobacter coli enteritis caused by macrolide- and fluoroquinolone-resistant strains in 2 patients with hypogammaglobulinemia, successfully treated with a prolonged course of fosfomycin-tromethamine with no side effects. Fosfomycin-tromethamine may be a feasible alternative therapy for recurrent enteritis caused by Campylobacter species resistant to first-line drugs.
Assuntos
Antibacterianos/uso terapêutico , Campylobacter/efeitos dos fármacos , Campylobacter/patogenicidade , Enterite/tratamento farmacológico , Fosfomicina/uso terapêutico , Trometamina/uso terapêutico , Agamaglobulinemia/tratamento farmacológico , Idoso de 80 Anos ou mais , Feminino , Humanos , Testes de Sensibilidade Microbiana , Pessoa de Meia-IdadeRESUMO
Superior mesenteric artery syndrome (SMAS) has been proposed as a rare cause of proximal bowel obstruction resulting from compression of the third portion of the duodenum secondary to narrowing of the space between the aorta and superior mesenteric artery. The main risk factors associated with SMAS are significant weight loss, corrective spinal surgery and congenital or acquired anatomic abnormalities. Its association with acute pancreatitis has been reported in very few cases. We present a critical review of this topic, with the report of a patient allegedly diagnosed of SMAS and acute pancreatitis.