[Colorectal polyps: update on diagnosis]. / Pólipos colorectales: actualización en el diagnóstico.

Histological diagnosis determines the clinical behavior of colorectal polyps. Recently new types of polyps have been described and the classification has become wider and more complex. Our aim is update the current concepts in the knowledge of colorectal polyps.

Pólipos colorectales: actualización en el diagnóstico / Colorectal polyps: update in the diagnosis

El diagnóstico histológico de los pólipos colorrectales determina la conducta que tomará el médico especialista con el paciente. Con la aparición de nuevos pólipos en los últimos años, la clasificación histológica se ha tornado más compleja y amplia. Nuestro objetivo es actualizar los conceptos en el diagnóstico histológico de pólipos de colon de una manera clara y de fácil comprensión, especialmente para gastroenterólogos y patólogos.

Histological diagnosis determines the clinical behavior of colorectal polyps. Recently new types of polyps have been described and the classification has become wider and more complex. Our aim is update the current concepts in the knowledge of colorectal polyps.

Incremento de linfocitos intraepiteliales en pacientes con sindrome de intestino irritable / Increase of intraepithelial lymphocytes in patients with irritable bowel syndrome

Diversos trabajos reportan aumento en el número de linfocitos intraepiteliales (LIE), mastocitos y células enterocromafines en pacientes con Sindrome de Intestino Irritable (SII). Muchos de estos hallazgos se basan en el uso de inmunohistoquímica que son de poca disponibilidad en hospitales generales. El objetivo del presente trabajo es estudiar los hallazgos histológicos en la biopsia de colon sólo con histoquimica en pacientes con SII comparándolos con un grupo sin SII. Fueron incluidos 25 pacientes: 16 (64%), con criterios diagnósticos de SII y 9 (36%), sin SII. Se encontró un mayor número de LIE en el grupo de SII (p=0,002). Un grupo de pacientes con criterios Roma III (41,9%) presentó LIE en el rango de Colitis Linfocitica por lo que fueron excluidos de este estudio. No se encontró diferencia estadísticamente significativa en el número de mastocitos, células enterocromafines y eosinofilos.

Several studies have shown increased numbers of intraepithelial lymphocytes (IEL), mast cells, enterochromaffin cells in colonic mucosa of patients with Irritable Bowel Syndrome (IBS). Many of these findings are based is based on immunohistochemistry results, which is not available in general hospitals. Our objective is to study the histological findings observed in colon biopsies from patients with IBS compared with a group without IBS, using only histochemistry. Twenty five (25) patients were included: 16 with IBS and 9 without IBS. We found increased numbers of IEL in patients with IBS (p=0,002). A group of patients with IBS(41.9%) who fulfilled histological criteria for lymphocytic colitis were excluded. There was no significant difference in mast cells, enterochromaffin cells or eosinophils.

[Increase of intraepithelial lymphocytes in patients with irritable bowel syndrome]. / Incremento de Linfocitos Intraepiteliales en Pacientes con Sindrome de Intestino Irritable.

Several studies have shown increased numbers of intraepithelial lymphocytes (IEL), mast cells, enterochromaffin cells in colonic mucosa of patients with Irritable Bowel Syndrome (IBS). Many of these findings are based is based on immunohistochemistry results, which is not available in general hospitals. Our objective is to study the histological findings observed in colon biopsies from patients with IBS compared with a group without IBS, using only histochemistry. Twenty five (25) patients were included: 16 with IBS and 9 without IBS. We found increased numbers of IEL in patients with IBS (p=0,002). A group of patients with IBS (41.9%) who fulfilled histological criteria for lymphocytic colitis were excluded. There was no significant difference in mast cells, enterochromaffin cells or eosinophils.

Low serological positivity in patients with histology compatible with celiac disease in Perú.

OBJECTIVE: To study the frequency of positive serology for celiac disease (CD) in patients with duodenal biopsies suggestive of this disease. MATERIAL AND METHODS: Cross sectional study. We included patients with duodenal biopsies histologically compatible with CD and antigliadin, antiendomysial and IgA antitransglutaminase antibodies. We defined a "case" of CD if there was a positive biopsy and either antiendomisial or antitransglutaminase positive antibodies. RESULTS: Thirty one patients were included in our study. Six were antiendomysial positive and 5 antitransglutaminase positive while the antigliadin was positive in 14 cases. Therefore, out of 31 patients only 10 had a serology compatible with CD and only one had positive both antibodies, antiendomysial and antitransglutaminase. CONCLUSIONS: a) We have found that most of the duodenal biopsies compatible with CD are not diagnosed with positive serology; and b) we found a low correlation between serological diagnostic tests.

[Inflamatory polyps of the colon an evaluation]. / Polipos inflamatorios de colon: reporte de casos y revisión de literatura.

AIM: We report our experience with Inflammatory Polyps of the Colon. METHODS: Retrospective study including all polyps diagnosed at the Arias Stella Pathology Institute, Lima in the year 2008. Inflammatory polyps were diagnosed as polyp composed of reactive epithelium without dysplasia, inflamed granulation tissue. RESULTS: We found 887 polyps of which 2.3% were inflammatory polyps. One out of three were located in the sigmoid colon, and 63% had no underlying colonic disease. CONCLUSION: Inflammatory polyps are rare among colonic polyps and most patients have no accompanying colonic disease.

Pólipos Inflamatorios de Colon Reporte de Casos y Revision de Literatura / Inflamatory polyps of the colon an evaluation

OBJETIVOS: Reportar nuestra experiencia con los pólipos inflamatorios de colon. METODOLOGIA: Estudio retrospectivo que incluyó todos los pólipos colónicos diagnosticados en el Instituto Arias Stella, Lima en el año 2008. Los pólipos Inflamatorios fueron definidos como todo pólipo compuesto por criptas distorsionadas tapizadas porepitelio sin displasia, tejido de granulación e inflamación. RESULTADOS Encontramos 887 pólipos de los cuales los pólipos Inflamatorios (20) representaron el 2,3 por ciento, del total 30 por ciento de ellos se presentaron en colon sigmoides y la mayoría (63 por ciento) no presentaron patología concomitante. CONCLUSIÓN Los pólipos Inflamatorios son raros entre los pólipos colónicos y la mayoría de los pacientes no tienen patología colónica acompañante.

AIM: We report our experience with Inflammatory Polyps of the Colon. METHODS: Retrospective study including all polyps diagnosed at the Arias Stella Pathology Institute, Lima in the year 2008. Inflammatory polyps were diagnosed as polyp composed of reactive epithelium without dysplasia, inflamed granulation tissue. RESULTS: We found 887 polyps of which 2.3 per cent were inflammatory polyps. One out of three were located in the sigmoidcolon, and 63 per cent had no underlying colonic disease. CONCLUSION: Inflammatory polyps are rare among colonic polyps and most patients have no accompanying colonic disease.

[Colon biopsy--histological characteristics in different types of chronic colitis]. / Biopsia de colon: características histológicas en diferentes tipos de colitis crónica.

In the last few years a variety of new forms of chronic colitis have been described with defined histological characteristics. It is important both for the gastroenterologists and pathologists to be acquainted with this new clinic pathological entities. The present article is a review of the anatomo-pathological characteristics of the different types of colitis.

Biopsia de Colon: Características Histológicas en diferentes tipos de Colitis Crónica / Biopsy of Colon: histological features in different types of Chronicle Colitis

En los últimos años han aparecido diferentes tipos de colitis con características histológicas definidas. Es importante que tanto el gastroenterólogo como el patólogo estar actualizados respecto a estas nuevas entidades clínico-patológicas. El presente trabajo es un artículo de revisión sobre las características histopatológicas de los diferentes tipos de colitis.

In the last few years a variety of new forms of chronic colitis have been described withdefined histological characteristics. It is important both for the gastroenterologists andpathologists to be acquainted with this new clinic pathological entities.The present article is a review of the anatomo-pathological characteristics of the differenttypes of colitis.

[E-cadherin molecular expresion in the diffuse and intestinal types of gastric adenocarcinoma. A report from Lima, Peru]. / E-cadherina: expresión molecular en carcinomas de estómago de tipo difuso y tipo intestinal. Estudio realizado en Lima, Perú.

OBJECTIVE: Signet ring carcinoma of the stomach is well known to be more aggressive and infiltrating than adenocarcinoma. Different studies have proposed that signet ring cell carcinoma would be more infiltrating because of the loss of E-cadherin expression, this cadherin is a class of protein cell membrane protein which plays an important role in cell-adhesion. METHODS: We carried out a transversal comparative study, in order to measure the E-cadherin expression in 10 cases of signet ring cell and in 10 cases of adenocarcinoma, with help of immunohistochemistry. RESULTS: We found a bigger expression of E-cadherin in adenocarcinomas (100%) than signet ring cell carcinoma (40%), this difference was significative using Fisher test (p = 0,011). The loss of E-cadherin would explain the bigger infiltrating capacity in comparison to adenocarcinoma.

[in vitro comparison of liquid antacids of commercial use]. / Comparación in vitro de antiacidos líquidos de uso comercial.

The aim of our study was to compare the capacity of several liquid antacids to elevate the pH of a hydrochloric acid solution. An experimental model was designed to measure this capacity in different commercially available liquid antacids. Change in pH of an HCl solution was registered when each of the liquid antacids was added. We found differences between the 4 MgOH - ALOH antacids. Minimal difference was found between the 2 commercially available magaldrates.

[Cholelithiasis in patients with liver cirrhosis]. / Colelitiasis en pacientes con cirrosis hepática.

We retrospectively studied 67 cirrhotic patients hospitalized in the service of gastroenterology of Hospital Daniel A. Carrión, Callao, Perú, between June 1993 and July 1995, aimed to determine the frequency of cholelithiasis and its main clinical and epidemiological features. Twelve out of 67 cirrhotic patients (17.91%) had cholelithiasis. 24% of women and 14.3% of men were affected (p > 0.05). The mean age of women and men were 57.33 and 57.5 years old respectively (range: 41-67 years old). The frequency of cholelithiasis did not increase with age and the proportionally most affected age group was 41-50 years (33.33%). Alcoholic etiology was the most often in cirrhotic patients with cholelithiasis (41.67%). The severity of liver disease influenced in the cholelithiasis frequency (p = 0.001) and 33.33% of patients with gallstones were in grade C of Child Pugh Score. Two thirds of patients were asymptomatic. We conclude: 1. Cholelithiasis in our cirrhotic patients more prevalent than in general population (17.91% vs 0.7-5%). 2. Age did not influence in cholelithiasis prevalence in our cirrhotic patients. 3. The severity of liver disfunction influenced in highly significant way (p = 0.001) on cholelithiasis prevalence. 4. Cirrhotic patients with gallstones had mostly (66.67%) an asymptomatic course.

Estrongiloidiasis en pacientes alcohólicos y métodos diagnósticos / Strongyloidiasis in alcoholic patient and diagnostic methods

A 206 pacientes que ingresaron al Centro de Rehabilitación para alcohólicos del Instituto Nacional sobre Alcoholismo y farmacodependencia, entre junio y diciembre de 1989, se les realizó un exámen coproparasitoscópico completo: frotis directo, sedimentación éter-formol, y técnica de Kato y de Baermann. Strongyloides stercoralis fue el parásito que se detectó con mayor frecuencia, encontrándose en 36 pacientes. Con respecto a la eficiencia de los diferentes métodos en el diagnóstico de S. stercoralis, la técnica de Baermann permitió detectar el 97.2 por ciento de los casos, el frotis directo el 55.6 por ciento y la técnica de éter-formol solo un 25 por ciento. Nuestros resultados sustentan la tesis de que el método de Baermann es la técnica diagnóstica más eficiente en el diagnóstico de la estrongiloidiasis, en comparación con el frotis directo y la técnica de sedimentación éter-formol.

Diagnóstico laparoscópico: un estudio retrospectivo de 259 casos / Laparoscopic diagnostic: a retrospective review of 259 cases

El rol que se le asigna a la laparoscopía en el manejo de las enfermedades hepáticas ha cambiado debido al uso de la biopsia dirigida por imágenes. La laparoscopía, sin embargo, permite la inspección directa de la superficie hepática y de la cavidad abdominal así como también la toma de biopsia. Con la finalidad de evaluar la utilidad de la laparoscopía y específicamente el valor diagnóstico de la visualización directa de la superficie hepática, nosotros retrospectivamente recolectamos información en 259 pacientes que se les realizó endoscopía. Se evaluó la contribución de los hallazgos laparoscópicos para el manejo de los pacientes y el valor del diagnóstico laparoscópico comparado con la histología. La laparoscopía tuvo un rendimiento diagnóstico de 74 por ciento. El diagnóstico visual fue más exacto en pacientes con cáncer hepático (86 por ciento), pero fue moderado en los pacientes con peritonitis tuberculosa (78.5 por ciento) y cirrosis (69 por ciento). Nosotros concluimos que la laparoscopía continúa siendo un procedimiento de gran valor diagnóstico especialmente en los casos donde se requiere evaluar exactamente la arquitectura hepática, con baja morbilidad y sin mortalidad