The role of endoscopy in caustic ingestion in the pediatric population: experience in a tertiary center.

INTRODUCTION: caustic ingestion in children is rare but has potentially serious consequences. AIM: to analyze the clinical and endoscopic features and the type of caustic ingested in our population. METHODS: the upper endoscopies performed in this setting, as well as the characteristics of patients and caustics, were analyzed from 2010 to 2018. RESULTS: fifty-one endoscopies were performed (48 cases of witnessed intake or high suspicion and three with a low suspicion) in patients with a mean age of 2.55 years. Alkali ingestion was more frequent (88.2 %) and 56.9 % of the endoscopies were normal, which was more frequent among those who ingested bleach (72 %). Alkali tended to produce more esophageal injuries (31.1 %) and acids tended to produce esophageal (20 %) and esophageal-gastric injuries (20 %). Four patients developed esophageal stenosis during follow-up. DISCUSSION: even though more than half of the studies were normal, endoscopy is important in the diagnosis and prognosis of these patients.

Mediolisis arterial segmentaria de arterias esplácnicas: causa infrecuente de dolor abdominal / Segmental arterial mediolysis in splanchnic arteries: an uncommon cause of abdominal pain

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Segmental arterial mediolysis in splanchnic arteries: an uncommon cause of abdominal pain.

Segmental arterial mediolysis is an uncommon arterial disease that primarily involves splanchnic arteries; abdominal pain is the most common clinical manifestation. We report the case of a 53-year-old male with postprandial diffuse abdominal pain of one month's standing. Physical examination was uneventful, and laboratory tests revealed no abnormal findings. Abdominopelvic CT/Angio-CT showed an increased caliber of the superior mesenteric artery resulting from eccentric circumferential wall thickening. The patent lumen had a segment with fusiform aneurysmal dilatation, 7 x 26 mm long. These vascular changes extended along a number of distal jejunal branches, which also presented complete lumen obliteration. Abdominal arteries were free from signs of arteriosclerotic disease. Findings were consistent with segmental arterial mediolysis.

Aspectos diagnósticos y terapéuticos de la afectación del intestino delgado en la hipertensión portal / Diagnostic and therapeutic features of small bowel involvement in portal hypertension

La enteropatía es la menos conocida de entre las complicaciones de la hipertensión portal y consiste en una serie de cambios en la mucosa del intestino delgado que dan lugar a la aparición de lesiones vasculares e inflamatorias sobre la misma. Aunque puede ser un cofactor importante en la anemia de la población cirrótica, y a pesar de que en la actualidad es posible realizar un diagnóstico de la misma de modo simple y no invasivo gracias a los estudios de cápsula endoscópica, es rara vez tenida en consideración en el manejo de los pacientes con hipertensión portal. Aspectos como su patogenia o su incidencia real siguen sin ser aclarados, y tampoco existen consenso ni recomendaciones en las guías de práctica clínica sobre su diagnóstico o tratamiento. Se ha realizado una revisión narrativa de la literatura disponible sobre los aspectos más importantes de esta entidad (AU)

Enteropathy is a lesser known complication of portal hypertension and consists of different changes in the mucosal layer of the small bowel which lead to the appearance of vascular and inflammatory lesions. It can be an important co-factor in the development of anemia in the cirrhotic population, and nowadays an easy and non-invasive diagnosis can be made thanks to capsule endoscopy. However, it is rarely considered in the management of patients with portal hypertension. Some aspects such as pathogenesis or incidence remain unclear and no specific recommendations are included in the guidelines regarding diagnosis or treatment. A review of the available literature was performed with regards to the most relevant aspects of this entit (AU)

Diagnostic and therapeutic features of small bowel involvement in portal hypertension.

Enteropathy is a lesser known complication of portal hypertension and consists of different changes in the mucosal layer of the small bowel which lead to the appearance of vascular and inflammatory lesions. It can be an important co-factor in the development of anemia in the cirrhotic population, and nowadays an easy and non-invasive diagnosis can be made thanks to capsule endoscopy. However, it is rarely considered in the management of patients with portal hypertension. Some aspects such as pathogenesis or incidence remain unclear and no specific recommendations are included in the guidelines regarding diagnosis or treatment. A review of the available literature was performed with regards to the most relevant aspects of this entity.

Legionella de adquisición comunitaria. ¿Es necesario incluir una nueva recomendación a pacientes de enfermedad inflamatoria intestinal en tratamiento con inmunomoduladores? / Community-acquired pneumonia by Legionella pneumophila. Do we need to include new recommendations for inflammatory bowel disease patients under immunomodulators?

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Community-acquired pneumonia by Legionella pneumophila. Do we need to include new recommendations for inflammatory bowel disease patients under immunomodulators?

We present the case of a community-acquired pneumonia by Legionella Pneumophila in a 31-year-old patient with Crohn's disease under anti-TNF agents. Following this and other similar cases reported in literature, we propose to include recommendations to prevent this infection in patients starting treatment with immunosuppressant drugs through simple measures regarding the control of water in the patients' home.