Antimicrobial Resistance of Helicobacter pylori in Gastric Biopsy Samples from Lima/Peru.

Background: Helicobacter pylori prevalence and gastric cancer rates are remarkably high in Peru. Effective antimicrobial regimens are essential for successful H. pylori eradication. We aimed at assessing antimicrobial resistance rates to first- and second-line therapeutic agents in H. pylori strains detected in gastric biopsy samples. Materials and Methods: Gastric biopsy samples (antrum and corpus) were collected from therapy-naive patients (n = 154). H. pylori presence in the samples was confirmed by histopathology. Genotypic resistance to clarithromycin and quinolones was determined by real-time PCR. Results: Histology results were 100% concordant with PCR results (97/154; 63% H. pylori-positive in both). In 6% (6/97) of the patients, we found discordant results of H. pylori infection in antrum and corpus samples from the same patient. Resistance rates to clarithromycin and quinolone were 34% (33/97) and 68% (56/82), respectively. Antimicrobial resistance to both antimicrobials was 30% (25/82). Conclusion: Antimicrobial resistance rates of H. pylori to clarithromycin and quinolones are very high in Lima, Peru. Many first- and second-line, empiric eradication regimens may not be recommended for Peruvian patients.

[Fulminating ischemic hepatitis induced by severe cardiac dysfunction: case report]. / Hepatitis isquémica fulminante inducida por disfunción cardiaca severa: reporte de caso.

Ischemic Hepatitis is an uncommon entity in daily clinical practice with a prevalence of 0.16 to 0.5% among patients admitted to a critical care unit, associated with an approximate 60% mortality rate. This liver disease is characterized by a rapid and marked increase (more than 20 times the normal value) of the level of transaminases secondary to a severe and persistent hepatic hypoperfusion caused by multiple etiologies, which may be transient when the triggering cause is timely identified and appropiately treated. The case of an elderly adult patient with a clinical, epidemiological and biochemical profile compatible with ischemic hepatitis secondary to severe cardiac dysfunction is presented below.

[Validation of an ammonia breath test for the diagnosis of Helicobacter pylori infection in patients with dyspepsia at Hospital Cayetano Heredia]. / Validación de una prueba de amonio en aliento para el diagnóstico de la infección por Helicobacter pylori en pacientes del Hospital Cayetano Heredia.

Objetive: To determine the diagnostic validity of an ammonia breath test for Helicobacter pylori infection in patients who undergo an upper gastrointestinal endoscopy at Hospital Cayetano Heredia. MATERIAL AND METHODS: From April to December 2014, 155 patients were evaluated with the ammonia breath test and compared with a histological evaluation of the gastric biopsies as the gold standard. Data were evaluated using Microsoft Excel and STATA 14 to build a ROC curve. RESULTS: The patients were predominantly female (71%), with a median age of 53 years (18-84) and a Helicobacter pylori prevalence of 51.6%. The ammonia breath test, when compared to the gastric biopsy has a 70% sensitivity, 36% specificity, 53.8% positive predictive value, 36% negative predictive value, 1.15 positive likelihood ratio and 0.75 negative likelihood ratio. According to the ROC curve, there is not an optimal cut off value and the area under the curve was 0.5517. CONCLUSIONS: The ammonia breath test evaluated on this study does not have diagnostic accuracy and is not recommended as a diagnostic tool for Helicobacter pylori infection.

Hepatitis isquémica fulminante inducida por disfunción cardiaca severa: reporte de caso / Fulminating ischemic hepatitis induced by severe cardiac dysfunction: case report

La hepatitis isquémica es una entidad infrecuente en la práctica clínica diaria con una prevalencia de 0,16 a 0,5% entre los pacientes admitidos en unidad de cuidados críticos, asociado a una mortalidad aproximada en el 60% de los casos. Esta hepatopatía se caracteriza por un incremento rápido y marcado (más de 20 veces el valor normal) del nivel de transaminasas secundario a una hipoperfusión hepática severa y persistente ocasionada por múltiples etiologías, que puede ser transitoria de identificarse y tratar la causa desencadenante oportunamente. A continuación presentamos el caso de un paciente adulto mayor con un cuadro clínico, epidemiológico y bioquímico compatible con hepatitis isquémica secundario a disfunción cardiaca severa.

Ischemic Hepatitis is an uncommon entity in daily clinical practice with a prevalence of 0.16 to 0.5% among patients admitted to a critical care unit, associated with an approximate 60% mortality rate. This liver disease is characterized by a rapid and marked increase (more than 20 times the normal value) of the level of transaminases secondary to a severe and persistent hepatic hypoperfusion caused by multiple etiologies, which may be transient when the triggering cause is timely identified and appropiately treated. The case of an elderly adult patient with a clinical, epidemiological and biochemical profile compatible with ischemic hepatitis secondary to severe cardiac dysfunction is presented below.

Validación de una prueba de amonio en aliento para el diagnóstico de la infección por Helicobacter pylori en pacientes del Hospital Cayetano Heredia / Validation of an ammonia breath test for the diagnosis of Helicobacter pylori infection in patients with dyspepsia at Hospital Cayetano Heredia

Objetivo: Determinar la validez diagnóstica de una prueba de amonio en aire espirado para la infección por Helicobacter pylori en pacientes a los que se le realiza una endoscopía digestiva alta en el Hospital Cayetano Heredia. Material y métodos: De abril a diciembre del 2014 se evaluó a 155 pacientes con una prueba de amonio en aliento y la evaluación histopatológica de las biopsias de estómago (considerada como el patrón de oro) tomadas durante la endoscopía. Los datos fueron analizados en Microsoft Excel y STATA 14 para construir una curva ROC. Resultados: Los pacientes fueron predominantemente mujeres (71%), con una edad media de 53 años (18-84) y una prevalencia de Helicobacter pylori de 51,6%. Al comparar la prueba de amonio en aire espirado con la prueba histológica se obtiene una sensibilidad de 70%, especificidad de 36%, valor predictivo positivo de 53,8%, valor predictivo negativo de 36%, índice de probabilidad positivo de 1,15 e índice de probabilidad negativo de 0,75. De acuerdo a la curva ROC, no se encontró un punto de corte óptimo con adecuados valores de sensibilidad y especificidad y el área bajo la curva es de 0,5517. Conclusiones: Esta prueba de amonio en aliento (aire espirado) no presenta poder diagnóstico y no se recomienda como una herramienta para el diagnóstico de la infección por Helicobacter pylori.

Objetive: To determine the diagnostic validity of an ammonia breath test for Helicobacter pylori infection in patients who undergo an upper gastrointestinal endoscopy at Hospital Cayetano Heredia. Material and methods: From April to December 2014, 155 patients were evaluated with the ammonia breath test and compared with a histological evaluation of the gastric biopsies as the gold standard. Data were evaluated using Microsoft Excel and STATA 14 to build a ROC curve. Results: The patients were predominantly female (71%), with a median age of 53 years (18-84) and a Helicobacter pylori prevalence of 51.6%. The ammonia breath test, when compared to the gastric biopsy has a 70% sensitivity, 36% specificity, 53.8% positive predictive value, 36% negative predictive value, 1.15 positive likelihood ratio and 0.75 negative likelihood ratio. According to the ROC curve, there is not an optimal cut off value and the area under the curve was 0.5517. Conclusions: The ammonia breath test evaluated on this study does not have diagnostic accuracy and is not recommended as a diagnostic tool for Helicobacter pylori infection.

[Autoimmune pancreatitis type 1: a case report]. / Pancreatitis autoinmune tipo 1: reporte de caso.

Autoimmune pancreatitis type 1 (AIP) is the pancreatic manifestation of IgG4-related disease. The most frequent presentation of AIP is with obstructive jaundice. For definite diagnosis of type 1 Autoimmune pancreatitis international consensus diagnosis criteria (ICDC) for AIP are used. ICDC criteria include pancreatic parenchymal imaging, ductal imaging, serology, other organ involvement, histology, and response to steroid. We report a 52-years-old woman with rheumatoid arthritis without treatment presented with two months of abdominal pain in up-right quadrant with moderate intensity. She also presented jaundice, acholia, xerophtalmia, xerostomia, and a weight loss of 5 pounds. On examination jaundice, symmetrically enlarged submandibular glands, and epigastric pain was observed. On laboratory, a cholestasis pattern and conjugated bilirubin predominance was found. CT Abdominal, CMR revealed a dilated common bile duct with a diffuse pancreatic enlargement with delayed enhancement. Immunological studies show a IgG4 610 u/l and ANA 1/640. The patient responds to steroid clinically and in the laboratorial values. In conclusion, autoimmune pancreatitis type 1 should be suspected in case of an obstructive jaundice with a pancreatic inflammatory image, and complete ICDC criteria for a definite diagnosis.

[Duodenal melanoma: a case report and review of the literature]. / Melanoma duodenal: reporte de caso y revisión de la literatura.

We report the case of a male patient of 75 years old who presents with abdominal pain, hyporexia, early satiety, general malaise and watery stools, admitted in emergency for an episode of syncope. On physical examination, hepatomegaly of 6cm below the right costal margin was detected. CT scan showed multiple liver metastases. An upper endoscopy found multiple hyperpigmented lesions on the second portion of the duodenum. Histology and immunohistochemistry studies concluded it was duodenal melanoma. Skin and ocular examination did not reveal associated neoplastic lesions.

[Gastric hemangioma as a cause of upper gastrointestinal bleeding]. / Hemangioma gástrico como causa de hemorragia digestiva alta.

Gastric hemangioma as a cause of upper gastrointestinal bleeding (UGIB) is a rare event. We present the case of an 83 years old male with a history of abdominal pain, vomiting and melena, along with an 8 Kg weight loss. The upper gastrointestinal endoscopy showed an elevated, ulcerated lesion in the gastric antrum with a visible vessel, for which he receives endoscopic therapy. In the abdominal computed tomography, a contrast enhancing, well-circumscribed mass attached to the gastric wall is observed. Due to the persistence of the UGIB, the patient suffers hemodynamic decompensation and undergoes exploratory laparotomy, where a vascularized mass is found. The pathology report informs a gastric cavernous hemangioma.

Porfiria cutánea tarda como manifestación extrahepática de hepatitis C crónica: reporte de un caso / Porphyria cutanea tarda as extrahepatic manifestation of chronic hepatitis C: a case report

Se presenta el caso de un paciente varón de 56 años quien es evaluado por presentar a nivel del dorso de ambas manos cicatrices hiperpigmentadas e hipopigmentadas, asociadas a quistes de milia. Se le realizó estudios del metabolismo de las porfirinas y biopsia cutánea de las lesiones los cuales resultaron compatibles con porfiria cutánea tarda. En el laboratorio inicial se encontró elevación de los valores de transaminasas, identificándose posteriormente infección crónica por virus de hepatitis C. Con la finalidad de tratar la infección viral y resolver el compromiso dérmico, considerado como manifestación extrahepática del virus hepatitis C, se inició tratamiento con interferón pegilado y ribavirina evolucionando favorablemente con respuesta viral rápida, carga viral no detectable hasta la actualidad (36 semanas de tratamiento), disminución del nivel de transaminasas séricas y mejoría de las lesiones dérmicas.

The present case is a 56 year old male who present hyperpigmented and hypopigmented scars in both hands, associated with the presence of milia cysts. It was studied the metabolism of porphyrins and skin biopsy of the lesions which were compatible with porphyria cutanea tarda. In the initial laboratory, elevated transaminases values were found and subsequently identified chronic infection of hepatitis C virus. In order to treat viral infection and resolve the dermal commitment; considered extrahepatic manifestation of hepatitis C virus, treatment was started with pegylated interferon and ribavirin, with favorably development and rapid viral response, with undetectable viral load until now (24 weeks of treatment), decreased level of serum transaminases and improvement of skin lesions.

Pancreatitis autoinmune tipo 1: reporte de caso / Autoimmune pancreatitis type 1: a case report

La pancreatitis autoinmune tipo 1 es una enfermedad de baja prevalencia siendo más frecuente en varones, se encuentra incluida dentro de las enfermedades relacionadas a IgG4. Esta patología puede debutar como un síndrome colestásico y el diagnóstico se realiza según los criterios del consenso internacional para pancreatitis autoinmune (ICDC) que incluye una imagen típica, serología, compromiso de otros órganos, histología y respuesta al tratamiento con corticoides. Presentamos el caso de una mujer de 52 años con antecedente de artritis reumatoide sin tratamiento que acude con tiempo de enfermedad de 2 meses caracterizado por dolor abdominal en hipocondrio derecho de moderada intensidad asociado a ictericia, coluria, hipocolia, xeroftalmia, xerostomía y pérdida de peso de 3 kg. Al examen físico se evidencia ictericia, hipertrofia simétrica de glándulas submandibulares, leve dolor en epigastrio. En los exámenes auxiliares existe patrón colestásico con hiperbilirrubinemia a predominio directo. En los estudios de imágenes se evidencia colédoco dilatado, con aumento difuso del volumen del páncreas con captación tardía de contraste. En el estudio inmunológico se evidenció IgG4 en 610 u/L y ANA 1/640. Se inició tratamiento con corticoides con respuesta clínica y de laboratorio favorable. En conclusión, se debe sospechar de pancreatitis autoinmune ante un cuadro de dolor abdominal y colestasis extrahepática con imágenes sugestivas de páncreas inflamatorio, en el que se deben complementar los criterios ICDC para confirmar el diagnóstico

Autoimmune pancreatitis type 1 (AIP) is the pancreatic manifestation of IgG4-related disease. The most frequent presentation of AIP is with obstructive jaundice. For definite diagnosis of type 1 Autoimmune pancreatitis international consensus diagnosis criteria (ICDC) for AIP are used. ICDC criteria include pancreatic parenchymal imaging, ductal imaging, serology, other organ involvement, histology, and response to steroid. We report a 52-years-old woman with rheumatoid arthritis without treatment presented with two months of abdominal pain in up-right quadrant with moderate intensity. She also presented jaundice, acholia, xerophtalmia, xerostomia, and a weight loss of 5 pounds. On examination jaundice, symmetrically enlarged submandibular glands, and epigastric pain was observed. On laboratory, a cholestasis pattern and conjugated bilirubin predominance was found. CT Abdominal, CMR revealed a dilated common bile duct with a diffuse pancreatic enlargement with delayed enhancement. Immunological studies show a IgG4 610 u/l and ANA 1/640. The patient responds to steroid clinically and in the laboratorial values. In conclusion, autoimmune pancreatitis type 1 should be suspected in case of an obstructive jaundice with a pancreatic inflammatory image, and complete ICDC criteria for a definite diagnosis

Melanoma duodenal: reporte de caso y revisión de la literatura / Duodenal melanoma: a case report and review of the literature

Se presenta el caso de un paciente varón de 75 años que acude por dolor abdominal, hiporexia, llenura precoz, malestar general y deposiciones líquidas, ingresando a emergencia por un episodio de síncope. Al examen físico se palpa borde hepático 6 cm por debajo del reborde costal derecho. Por ello se solicita estudios de imagen, hallando lesiones compatibles con metástasis hepáticas múltiples. Posteriormente se solicita endoscopía digestiva alta, hallando lesiones hiperpigmentadas múltiples en la segunda porción duodenal. El estudio histopatológico e inmunohistoquímico concluyó melanoma duodenal. El examen físico no reveló lesiones neoplásicas dérmicas u oculares asociadas.

We report the case of a male patient of 75 years old who presents with abdominal pain, hyporexia, early satiety, general malaise and watery stools, admitted in emergency for an episode of syncope. On physical examination, hepatomegaly of 6cm below the right costal margin was detected. CT scan showed multiple liver metastases. An upper endoscopy found multiple hyperpigmented lesions on the second portion of the duodenum. Histology and immunohistochemistry studies concluded it was duodenal melanoma. Skin and ocular examination did not reveal associated neoplastic lesions

[Validation of the rapid urease test for the detection of Helicobacter pylori in a Peruvian hospital]. / Validación del test rápido de la ureasa para la detección del Helicobacter pylori en el Hospital Nacional Cayetano Heredia, Lima, Perú.

OBJECTIVE: To validate a rapid urease test (RUT) in Cayetano Heredia Hospital (HCH) in Lima, Peru. MATERIALS AND METHODS: This is a prospective observational study that included 181 patients over 18 years old with dyspeptic symptoms. All of them underwent upper gastrointestinal endoscopy at the Department of Gastroenterology at HCH. They had not received, during the last four weeks, proton pump inhibitors (PPIs), bismuth or antibiotics. Two biopsies of antrum were taken, one to perform the TRU (Sensibacter pylori test®) and the other one for pathology, in order to determine by both methods the presence of H. pylori infection. TRU's results were compared with pathology ́s (gold standard). RESULTS: 181 patients, average age 52.8±13.5 years, were evaluated. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) at 20 minutes were 86.8%, 98.5%, 81.5% and 99% and at 24 hours 97.3%, 99.5%, 95.7% y 99.1% respectively. CONCLUSION: The rapid urease test is a reliable, accessible and easy to apply test for the diagnosis of H. pylori infection.

Penetrating gastric ulcer as a manifestation of multisystemic tuberculosis.

We present the case of a 30-year old female with a history of abdominal pain, fever, poor oral tolerance and weight loss for 6 months. An abdominal CT scan showed marked gastric dilatation due to extrinsic compression from lymphadenopathies around the second portion of the duodenum. The upper endoscopy revealed the presence of a penetrating gastric ulcer in the greater curvature. Biopsies of the lesions showed hystiocytes with granulomatous features and Acid Fast Bacilli (AFB) positive, and the cultures grew Mycobacterium tuberculosis sensitive to Isonazid and Rifampin. Subsequently anti-TB regimen was initiated achieving great clinical and endoscopic improvement.

Validación del test rápido de la ureasa para la detección del Helicobacter pylori en el Hospital Nacional Cayetano Heredia, Lima, Perú / Validation of the rapid urease test for the detection of Helicobacter pylori in a Peruvian hospital

Objetivos: Validar un test rápido de la ureasa (TRU) en el Hospital Cayetano Heredia (HCH) de Lima, Perú Materiales y métodos: Estudio observacional prospectivo. Se incluyó 181 pacientes mayores de 18 años de edad con síntomas dispépticos, que fueron sometidos a endoscopía digestiva alta en el Servicio de Gastroenterología del HCH y que no hubiesen recibido durante las últimas cuatro semanas inhibidores de la bomba de protones (IBPs), bismuto o antibióticos. Se tomó dos biopsias de antro una para hacer el TRU (Sensibacter pylori test®) y otra para anatomía patológica con el fin de determinar la presencia de la infección por H. pylori por ambos métodos. Finalmente se comparó el resultado de la anatomía patológica (patrón de oro) con el de TRU. Resultados: Se evaluó 181 pacientes, la edad promedio fue 52,8±13,5 años. La sensibilidad, especificidad, valor predictivo negativo (VPN), valor predictivo positivo (VPP) a los 20 minutos fueron de 86,8%, 98,5%, 81,5% y 99% y a las 24 horas 97,3%, 99,5%, 95,7% y 99,1% respectivamente. Conclusión: El TRU es un test confiable, accesible y de fácil aplicación para hacer el diagnóstico de la infección por H. pylori.

Objective: To validate a rapid urease test (RUT) in Cayetano Heredia Hospital (HCH) in Lima, Peru. Materials and methods: This is a prospective observational study that included 181 patients over 18 years old with dyspeptic symptoms. All of them underwent upper gastrointestinal endoscopy at the Department of Gastroenterology at HCH. They had not received, during the last four weeks, proton pump inhibitors (PPIs), bismuth or antibiotics. Two biopsies of antrum were taken, one to perform the TRU (Sensibacter pylori test®) and the other one for pathology, in order to determine by both methods the presence of H. pylori infection. TRU’s results were compared with pathology´s (gold standard). Results: 181 patients, average age 52.8±13.5 years, were evaluated. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) at 20 minutes were 86.8%, 98.5%, 81.5% and 99% and at 24 hours 97.3%, 99.5%, 95.7% y 99.1% respectively. Conclusion: The rapid urease test is a reliable, accessible and easy to apply test for the diagnosis of H. pylori infection.

Penetrating gastric ulcer as a manifestation of multisystemic tuberculosis / Úlcera gástrica penetrante como manifestación de tuberculosis multisistémica

We present the case of a 30-year old female with a history of abdominal pain, fever, poor oral tolerance and weight loss for 6 months. An abdominal CT scan showed marked gastric dilatation due to extrinsic compression from lymphadenopathies around the second portion of the duodenum. The upper endoscopy revealed the presence of a penetrating gastric ulcer in the greater curvature. Biopsies of the lesions showed hystiocytes with granulomatous features and Acid Fast Bacilli (AFB) positive, and the cultures grew Mycobacterium tuberculosis sensitive to Isonazid and Rifampin. Subsequently anti-TB regimen was initiated achieving great clinical and endoscopic improvement.

Se presenta un caso de una mujer de 30 años de edad con historia de dolor abdominal, fiebre, poca tolerancia oral y pérdida de peso por 6 meses. Un CT scan abdominal muestra dilatación marcada gástrica debido a una compresión extrínseca por adenopatías alrededor de la segunda porción del duodeno. Una endoscopía alta revela la presencia de una úlcera gástrica penetrante en la curvatura mayor. Las biopsias mostraron histiocitos con granulomatosis y bacilos acid fast positivos y en los cultivos crecieron micobacterium tuberculosis sensibles a isoniacidad y rifampicina. Subsecuentemente se inició el régimen anti TBC lográndose una mejoría clínica y endoscópica evidente.

[Porphyria cutanea tarda as extrahepatic manifestation of chronic hepatitis C: a case report]. / Porfiria cutánea tarda como manifestación extrahepática de hepatitis Ccrónica: reporte de un caso.

The present case is a 56 year old male who present hyperpigmented and hypopigmented scars in both hands, associated with the presence of milia cysts. It was studied the metabolism of porphyrins and skin biopsy of the lesions which were compatible with porphyria cutanea tarda. In the initial laboratory, elevated transaminases values were found and subsequently identified chronic infection of hepatitis C virus. In order to treat viral infection and resolve the dermal commitment; considered extrahepatic manifestation of hepatitis C virus, treatment was started with pegylated interferon and ribavirin, with favorably development and rapid viral response, with undetectable viral load until now (24 weeks of treatment), decreased level of serum transaminases and improvement of skin lesions.

[Venous tromboembolism in a patient with Crohn disease with ileal stenosis]. / Trombosis venosa profunda en un paciente con enfermedad de Crohnilealestenosante.

Inflammatory bowel disease is associated with extraintestinal manifestations. Among these manifestations is the venous tromboembolism which presents a risk three times more than that presented in general population. We report the case of a 61-year-old male with a history of abdominal pain, chronic diarrhea and fever, with leukocytosis, and fecal samples containing leukocytes, partial ileal stenosis with multiple ulcers in the enteroscopy, with histologic findings compatible with Crohn's disease. The patient has a good outcome with prednisone and maintenence azathioprine, presenting at the fifth month deep venous thrombosis of both lower extremities that resolvewith anticoagulation treatment.

¿Cómo manejan la infección por Helicobacter pylori los médicos gastroenterólogos del Perú? Estudio basado en una encuesta realizada en el 2014 / How do gastroenterologists in Peru deal with Helicobacter pylori infection? Study based on a survey conducted in 2014

Identificar el manejo de la infección por Helicobacter pylori usado por los gastroenterólogos peruanos mediante una encuesta. Material y métodos: Se presentó una encuesta sobre el manejo de Helicobacter pylori a los gastroenterólogos. Resultados: Se obtuvo 177 encuestas válidas (29,6% de la población). Entre los resultados principales se observó que 77,4% usa la endoscopía digestiva alta + biopsia (histología) para el diagnóstico, 95,5% opta por un inhibidor de la bomba de protones + amoxicilina + claritromicina como tratamiento de primera línea y 50,0% revalúa a sus pacientes para determinar erradicación 4-6 semanas luego de culminarlo. Conclusiones: La mayoría de gastroenterólogos en el Perú maneja adecuadamente la infección por Helicobacter pylori, aunque lo referente a la revaluación podría mejorar...

This study seeks to identify, through a survey, how Peruvian gastroenterologists deal with Helicobacter pylori infection. Material and Methods: Gastroenterologists answered a survey concerning diagnosis and treatment of Helicobacter pylori infection. Results: 177 valid answers were obtained (29.6% of the population). Within the main results, 77.4% use endoscopy + biopsy (histology) for diagnosis, 95.5% choose proton pump inhibitor + clarithromycin + amoxicillin as first line treatment and 50.0% check for eradication 4-6 weeks after treatment. Conclusions: Most gastroenterologists in Peru deal adequately with Helicobacter pylori infection, although follow-up aspects could be improved...

[How do gastroenterologists in Peru deal with Helicobacter pylori infection? Study based on a survey conducted in 2014]. / ¿Cómo manejan la infección por Helicobacter pylori los médicos gastroenterólogos del Perú? Estudio basado en una encuesta realizada en el 2014.

OBJECTIVE: This study seeks to identify, through a survey, how Peruvian gastroenterologists deal with Helicobacter pylori infection. MATERIAL AND METHODS: Gastroenterologists answered a survey concerning diagnosis and treatment of Helicobacter pylori infection. RESULTS: 177 valid answers were obtained (29.6% of the population). Within the main results, 77.4% use endoscopy + biopsy (histology) for diagnosis, 95.5% choose proton pump inhibitor + clarithromycin + amoxicillin as first line treatment and 50.0% check for eradication 4-6 weeks after treatment. CONCLUSIONS: Most gastroenterologists in Peru deal adequately with Helicobacter pylori infection, although follow-up aspects could be improved.