RESUMEN
OBJECTIVE: To analyze the epidemiology, associated risk factors, clinical presentation, diagnostic methods, treatment, and evolution of patients diagnosed with superior mesenteric venous thrombosis (SMVT) at an university hospital in Madrid. EXPERIMENTAL DESIGN: Retrospective and descriptive study. We review the medical records of patients with this diagnosis in our hospital from January 1998 to December 2002. Data were processed by using the SPSS vs. 11 software. PATIENTS: All thirteen subjects diagnosed with SMVT in that period were included. RESULTS: Associated risk factors included tumoral conditions (5 patients), acute abdominal pathology (2), polyglobulia (1), prothrombin gene mutation (1), and anticardiolipin antibodies (1). No predisposing factor was found in 3 patients. Clinical presentation for all patients was abdominal pain, with nausea and vomiting being the second symptom in frequency (7). The diagnosis was reached by abdominal CT (9), arteriography (2), ultrasounds (1), and histology after intestinal resection (1). Treatment with only anticoagulation was initiated in 4 patients, whereas anticoagulation and surgery were performed in 5 cases. In 4 subjects no specific treatment was prescribed and only palliative measures were established due to a baseline end-stage condition. Five patients died, and four of them had a neoplasic condition as associated risk factor. Mortality in our series was 38.5%. CONCLUSIONS: SMVT is a very rare disease that is often associated with neoplasic pathology, which influences its high mortality. Due to non specific symptoms, imaging is essential for the diagnosis and the detection of associated risk factors. In our series, computed tomography imaging was the most profitable test.
Asunto(s)
Oclusión Vascular Mesentérica/patología , Trombosis de la Vena/patología , Anciano , Anciano de 80 o más Años , Anticoagulantes/uso terapéutico , Femenino , Humanos , Masculino , Oclusión Vascular Mesentérica/tratamiento farmacológico , Oclusión Vascular Mesentérica/cirugía , Venas Mesentéricas/patología , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Trombosis de la Vena/tratamiento farmacológico , Trombosis de la Vena/cirugíaAsunto(s)
Candidiasis , Esofagitis/etiología , Adulto , Antifúngicos/uso terapéutico , Antituberculosos/uso terapéutico , Candidiasis/complicaciones , Candidiasis/diagnóstico , Candidiasis/tratamiento farmacológico , Esofagitis/complicaciones , Femenino , Fluconazol/uso terapéutico , Humanos , Radiografía Torácica , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/diagnóstico por imagen , Tuberculosis Pulmonar/tratamiento farmacológicoRESUMEN
A 69-year-old female was admitted to our hospital because of asthenia, anorexia and 20 kg weight loss. An ultrasound study and computerized tomography (CT) imaging revealed a mesenteric mass and laparotomy was performed. The diagnosis was mesenteric tuberculosis with jejunal involvement. This represents an atypical onset of tuberculosis in a non-immunosuppressed patient.
Asunto(s)
Yeyuno , Linfadenitis Mesentérica/diagnóstico , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Gastrointestinal/diagnóstico , Tuberculosis Ganglionar/diagnóstico , Anciano , Femenino , Humanos , Enfermedades del Yeyuno/diagnóstico , Enfermedades del Yeyuno/microbiología , Linfadenitis Mesentérica/microbiología , Tuberculosis Gastrointestinal/microbiología , Tuberculosis Ganglionar/microbiologíaRESUMEN
Ventricular diverticulum are small outpouchings, in the cardiac wall, which are mostly described as a part of malformation syndromes. This finding is infrequent in asymptomatic patients with no pathology in the thoraco abdominal line. The case we present shows a diverticulum in the cardiac apex in a male patient with no cardiological clinic manifestations and with an abnormal electrocardiogram. At present, magnetic resonance is the best diagnostic test, for this kind of malformation, and is also the most reliable in the follow-up of these patients.