RESUMO
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Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/complicações , Pólipos/complicações , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/cirurgia , Pólipos/diagnóstico , Pólipos/cirurgiaRESUMO
Gastrointestinal bleeding is considered to be obscure when routine endoscopic techniques (esophagogastroscopy and colonoscopy) fail to identify the origin of the hemorrhage. These hemorrhages represent 5% of all gastrointestinal bleeding. Twenty-seven percent of these hemorrhages are due to small bowel disease and gastrointestinal stromal tumors (GIST) are a frequent cause, especially in middle-aged patients. We present three cases that illustrate the difficulty of diagnosing this clinical entity. We emphasize the use of minimally invasive techniques such as computed tomography and laparoscopic surgery in the complicated management of these patients. We believe that the use of these techniques could avoid the need for other more aggressive procedures and allow the application of early definitive surgical treatment with the advantages of laparoscopic surgery.
Assuntos
Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/cirurgia , Neoplasias do Jejuno/complicações , Neoplasias do Jejuno/cirurgia , Melena/etiologia , Sangue Oculto , Adulto , Angiografia , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Humanos , Neoplasias do Jejuno/diagnóstico por imagem , Laparoscopia , Masculino , Melena/diagnóstico , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Radiografia Abdominal , Tomografia Computadorizada por Raios XRESUMO
Se considera hemorragia digestiva oculta cuando las técnicas habituales endoscópicas (esofagogastroscopia y colonoscopia) no encuentran el origen de la hemorragia. Esta hemorragia supone el 5% de todas las hemorragias digestivas. El 27% de las hemorragias ocultas son por lesiones de intestino delgado; los tumores estromales (GIST) son una causa frecuente, fundamentalmente en pacientes de mediana edad. Presentamos 3 casos que reflejan la dificultad en el diagnóstico de este cuadro clínico y destacamos el empleo de técnicas poco invasivas, como la tomografía computarizada y la cirugía laparoscópica, en el complicado manejo de estos enfermos. Creemos que la incorporación de estas técnicas podría evitar otros procedimientos más agresivos y permiten aplicar el tratamiento definitivo quirúrgico de forma temprana con las ventajas de la cirugía laparoscópica (AU)
Gastrointestinal bleeding is considered to be obscure when routine endoscopic techniques (esophagogastroscopy and colonoscopy) fail to identify the origin of the hemorrhage. These hemorrhages represent 5% of all gastrointestinal bleeding. Twenty-seven percent of these hemorrhages are due to small bowel disease and gastrointestinal stromal tumors (GIST) are a frequent cause, especially in middle-aged patients. We present three cases that illustrate the difficulty of diagnosing this clinical entity. We emphasize the use of minimally invasive techniques such as computed tomography and laparoscopic surgery in the complicated management of these patients. We believe that the use of these techniques could avoid the need for other more aggressive procedures and allow the application of early definitive surgical treatment with the advantages of laparoscopic surgery (AU)
