ABSTRACT
Introducción: En el marco de referencia de cada especialidad médica, resulta un aspecto clave ofrecer un listado consensuado del tipo y número de prácticas que caracteriza el quehacer profesional de una especialidad. Es así que, el objetivo de este estudio es definir un listado de procedimientos mínimos para asegurar la competencia en Endoscopía Digestiva en base a un proceso de consenso estructurado, así como explorar las opiniones de referentes expertos en endoscopía digestiva sobre la formación de médicos endoscopistas en la Argentina y la necesidad de certificación de competencias. Materiales y métodos: Para esta investigación se realizó un estudio prospectivo de metodología mixta, a partir de la implementación del método Delphi, como técnica de investigación cualitativa grupal, seguido de la implementación de una encuesta estructurada. Resultados: El listado consolidado final incluyó 17 procedimientos considerados fundamentales para la certificación de la competencia en endoscopía digestiva. Dado la dispersión en el rango del número mínimo necesario para alcanzar la competencia se definió utilizar la mediana. En el caso de la endoscopía digestiva alta el número de procedimientos mínimo acordado fue de 200, mientras que en el caso de la videocolonoscopía fue de 150. Conclusión: Este listado es una pieza fundamental en el desarrollo de un marco formativo a nivel nacional en endoscopía digestiva, así como en un programa de certificación de la competencia (AU)
Subject(s)
Humans , Clinical Competence , Endoscopy, Digestive System , Prospective Studies , Delphi TechniqueABSTRACT
INTRODUCTION: As part of the training framework for medical specialities, it is vital to provide an agreed list of the type and number of practices involved in the professional work of a given specialty. Thus, the purpose of this study is to define a list of minimum procedures to ensure competence in Gastrointestinal Endoscopy based on a structured and agreed upon process, as well as to explore the opinions of experts in gastrointestinal endoscopy on the training of endoscopy physicians in Argentina and the need to certify competencies. MATERIALS AND METHODS: a mixed-method prospective study was carried out using the Delphi method as a qualitative group research technique, followed by the implementation of a structured survey. RESULTS: The final consolidated list included 17 procedures considered essential for certification of competence in gastrointestinal endoscopy. Median was used given the range in the minimum number of procedures required to achieve competence. In the case of upper gastrointestinal endoscopy, the minimum number of procedures agreed was 200, while in the case of colonoscopy it was 150. CONCLUSION: This list is a fundamental element to develop a national training framework in gastrointestinal endoscopy, as well as a competence certification program.
Subject(s)
Autoimmune Diseases , Bile Duct Neoplasms , Cholangiocarcinoma , Cholangitis, Sclerosing , Autoimmune Diseases/diagnosis , Bile Duct Neoplasms/diagnosis , Bile Ducts, Intrahepatic , Cholangiocarcinoma/diagnosis , Cholangitis, Sclerosing/diagnostic imaging , Diagnosis, Differential , Humans , Immunoglobulin GABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Aneurysm, False/etiology , Hepatic Artery/injuries , Cholecystectomy, Laparoscopic/methods , Cholecystitis/surgery , Cholangiopancreatography, Endoscopic Retrograde/methods , Postoperative ComplicationsABSTRACT
Iatrogenic vascular injuries of the hepatic artery are infrequent and a serious complication of LC. There is no doubt about the many advantages of LC when compared to open cholecystectomy. Despite this, there is an increase in the reported incidence (0.3%-1.0%) of biliary and vascular injuries. Most arterial complications are due to direct injury or diathermy shortening on surgical clips and HAP is one of them. We present a case of a 39-year old male patient who presented with this complication and how it was resolved.
Subject(s)
Aneurysm, False/etiology , Cholecystectomy, Laparoscopic/adverse effects , Hepatic Artery , Postoperative Complications/etiology , Adult , Aneurysm, False/complications , Humans , Jaundice/etiology , MaleABSTRACT
No disponible
Subject(s)
Humans , Female , Infant , Adenoma/pathology , Intestinal Neoplasms/pathology , Ileal Neoplasms/pathology , Gastrointestinal Hemorrhage/etiology , Intestinal Polyps/diagnostic imaging , Capsule Endoscopy/methodsABSTRACT
Lower gastrointestinal bleeding is a common pathology with diverse causes depending on the patients´ age. The most common causes in adults are polyps, neoplasias, diverticular disease and angiodysplasia. In neonates, necrotizing enterocolitis and volvulus, and anal fissures and bowel intussusception in infants. Polyps are reported as a cause of bleeding only in children of preschool age.
Subject(s)
Adenocarcinoma/complications , Gastrointestinal Hemorrhage/etiology , Ileal Neoplasms/complications , Adenocarcinoma/pathology , Female , Gastrointestinal Hemorrhage/pathology , Humans , Ileal Neoplasms/pathology , InfantSubject(s)
Ascariasis/therapy , Ascaris lumbricoides , Biliary Tract Diseases/parasitology , Biliary Tract Diseases/therapy , Echinococcosis, Hepatic/therapy , Echinococcus granulosus , Fascioliasis/therapy , Adolescent , Adult , Aged , Animals , Ascariasis/diagnostic imaging , Biliary Tract Diseases/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Echinococcosis, Hepatic/diagnostic imaging , Fascioliasis/diagnostic imaging , Female , Humans , Male , Middle AgedSubject(s)
Bile Ducts/surgery , Cholestasis, Extrahepatic/surgery , Gastric Outlet Obstruction/surgery , Gastroenterostomy/methods , Jejunum/surgery , Stomach/surgery , Cholestasis, Extrahepatic/etiology , Endosonography , Gastric Bypass/methods , Gastric Outlet Obstruction/etiology , Humans , Male , Middle Aged , Palliative Care/methods , StentsABSTRACT
Las duplicaciones de las vías digestivas son anomalías congénitas infrecuentes, que se pueden localizar en cualquier parte del tubo digestivo, y son más comunes en los hombres. Hasta en un tercio de los pacientes, se acompañan de otras anomalías congénitas. Se han postulado tres teorías para explicar la causa de las duplicaciones: la de la recanalización de la luz intestinal, la del accidente vascular intrauterino y la de la unión o "hermanamiento" incompleta. Se clasifican en duplicaciones quísticas, cuando se comunican con la luz intestinal normal, y en duplicaciones tubulares, cuando no lo hacen; según algunas series, las primeras corresponden de 70 a 75 % de los casos informados y, las segundas, del 25 al 30 %. Poseen tres características esenciales, que son: estar unidas a cualquier segmento del tubo digestivo y con una irrigación sanguínea común; tener una capa muscular, y poseer un revestimiento epitelial que, generalmente, corresponde a la mucosa del mismo trayecto. Los síntomas más comunes son dolor abdominal inespecífico, náuseas, vómitos, hemorragia gastrointestinal, invaginación, obstrucción, ictericia y pancreatitis. El diagnóstico se basa, especialmente, en estudios imagenológicos, desde la radiografía simple hasta la resonancia magnética, siendo de gran importancia la ecografía prenatal. El tratamiento quirúrgico es la principal opción terapéutica, en la cual se usa cada vez más la vía laparoscópica
Alimentary tract duplications are rare congenital lesions that can occur anywhere in the gastrointestinal tract. Three hypotheses about their etiology had been proposed, The luminal recanalization theory, the intrauterine vascular accident theory, and the abortive twinning theory. According to some series, three quarters of gastrointestinal duplications are cystic with no communication to the adjacent alimentary tract, while the remaining are tubular and may communicate with the intestinal lumen.They have three essential characteristics: they are attached to any segment of the gastrointestinal tract and with the same blood supply, having a muscular layer and possessing an epithelial lining that corresponds generally to the mucosa of the same path. The most common symptoms are nonspecific abdominal pain, nausea, vomiting, gastrointestinal hemorrhage, invagination, obstruction, jaundice and pancreatitis. The diagnosis is based mainly on imaging studies, ranging from simple radiography to nuclear resonance, with prenatal ultrasound being of great importance. Surgical treatment is the main therapeutic option, being increasingly used the laparoscopic route
Subject(s)
Humans , Gastrointestinal Tract , Diagnosis , Duodenum , Intestine, SmallABSTRACT
Biliary cast syndrome (BCS) is an unusual complication of liver transplantation (LT). The pathophysiology is not known, and it is thought to develop because of mucosal damage in the bile duct related to obstruction, ischemia, or bacterial infection. It occurs in 2.5-18% of LT patients and is associated with increased graft failure, need for retransplantation, and mortality. Here we report on a case of BCS of late appearance after LT who was successfully treated by endoscopic means.