Sialendoscopy approach in treating juvenile recurrent parotitis: a systematic review.

BACKGROUND: Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling in children. The purpose of this systematic review was to determine the diagnostic and therapeutic effectiveness of sialendoscopy in children affected by JRP. METHODS: A systematic literature search was performed in PubMed, EMBASE, Scopus and the Cochrane Library until April 2022, without language restrictions or specified start date. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS). RESULTS: Our review included 524 patients and 646 sialendoscopies. The sample sizes of the different studies ranged from 3 to 77 subjects. Most authors performed sialendoscopy under general anesthesia. The mean percentage of recurrences observed was 25.1% (95% confidence intervals) (CI 23.6-26.6). There was a statistically significant relationship between the number of attacks/year and recurrences (p < 0.05). The percentage of recurrences according to the type of irrigation/flushing used ranged from 22.2% to 25.2%, with no significant differences between the use of corticosteroids alone (25.2% of recurrences), corticosteroids plus antibiotics (25% of recurrences) or saline alone (22.2% of recurrences). Sialoendoscopy has proved in all cases to be a valid method for the diagnosis of JRP, but it does not allow a reliable differential diagnosis with other autoimmune parotitis such as Sjögren's syndrome. CONCLUSION: According to our results, parotid sialoendoscopy was 74.9% effective as a primary treatment in the prevention of recurrent symptoms in JRP. The type of ductal irrigation used did not significantly influence the prognostic outcome.

Intestinal intussusception in adults: Location, causes, symptoms, and therapeutic management.

OBJECTIVE: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. MATERIALS AND METHODS: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged <16 years. Thus, 21 cases in adults (mean age, 57 years) were analyzed. RESULTS: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumours were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). CONCLUSIONS: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its aetiology and therapeutic management.

Invaginaciones intestinales en el adulto: localización, etiología, sintomatología y manejo terapéutico / Intestinal intussusception in adults: location, causes, symptoms, and therapeutic management

Objetivo: Las invaginaciones intestinales en adultos son de difícil diagnóstico debido a la inespecificidad de los síntomas. Sin embargo, la mayoría tienen una causa estructural que requiere tratamiento quirúrgico. El objetivo de este estudio es revisar sus características epidemiológicas, hallazgos en imagen y manejo terapéutico. Materiales y métodos: Estudio retrospectivo de las invaginaciones intestinales que precisaron ingreso hospitalario diagnosticadas en nuestro hospital entre 2016 y 2020. De un total de 73 casos fueron excluidos errores de codificación (n=6) y pacientes menores de 16 años (n=46), resultando 21 invaginaciones en adultos. Resultados: La edad media fue de 57 años, y el dolor abdominal fue la manifestación clínica más frecuente en el 38% de los casos (n=8). El diagnóstico mediante tomografía computarizada (TC), con la presencia “del signo de la diana”, alcanzó una sensibilidad del 100%, siendo la región ileocecal la localización más frecuente en un 38% de los pacientes (n=8). Un 85,7% de los casos (n=18) tenían una causa estructural y el 81% (n=17) requirió cirugía. Los resultados anatomopatológicos fueron concordantes con la TC en un 94,1%, siendo la etiología más frecuente la neoplásica: 35,3% benignas (n=6) y 64,7% malignas (n=9). Conclusiones: La TC es la prueba de elección en el diagnóstico de las invaginaciones intestinales y resulta determinante a la hora de identificar la etiología y decidir el manejo terapéutico.(AU)

Objective: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. Materials and methods: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged<16 years. Thus, 21 cases in adults (mean age, 57 y) were analyzed. Results: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumors were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). Conclusions: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its etiology and therapeutic management.(AU)

Intestinal intussusception in adults: location, causes, symptoms, and therapeutic management. / Invaginaciones intestinales en el adulto: localización, etiología, sintomatología y manejo terapéutico.

OBJECTIVE: Intestinal intussusception is difficult to diagnose in adults because the symptoms are nonspecific. However, most have structural causes that require surgical treatment. This paper reviews the epidemiologic characteristics, imaging findings, and therapeutic management of intussusception in adults. MATERIALS AND METHODS: This retrospective study identified patients diagnosed with intestinal intussusception who required admission to our hospital between 2016 and 2020. Of the 73 cases identified, 6 were excluded due to coding errors and 46 were excluded because the patients were aged<16 years. Thus, 21 cases in adults (mean age, 57 y) were analyzed. RESULTS: The most common clinical manifestation was abdominal pain, reported in 8 (38%) cases. In CT studies, the target sign yielded 100% sensitivity. The most common site of intussusception was the ileocecal region, reported in 8 (38%) patients. A structural cause was identified in 18 (85.7%) patients, and 17 (81%) patients required surgery. The pathology findings were concordant with the CT findings in 94.1% of cases; tumors were the most frequent cause (6 (35.3%) benign and 9 (64.7%) malignant). CONCLUSIONS: CT is the first-choice test for the diagnosis of intussusception and plays a crucial role in determining its etiology and therapeutic management.

Imaging acute pancreatitis. / Pancreatitis aguda en imágenes.

OBJECTIVES: Acute pancreatitis is common; the clinical course of this potentially severe condition varies widely. This paper aims to review the role of different imaging techniques in the management of acute pancreatitis, describe the main imaging findings for this entity, and explain the terms and criteria used to classify them. CONCLUSIONS: Imaging techniques play a key role in the management of acute pancreatitis, from diagnosis and staging to identifying and treating complications, as well as in determining the underlying causes of the condition. For these reasons, radiologists should know the advantages and limitations of each imaging technique in the evaluation of acute pancreatitis, be familiar with the wide spectrum of imaging findings associated with it, and how to use the specific terminology derived from the Atlanta classification to ensure the standardization and quality of reports.