RESUMO
A case of a patient with symptoms of gastric obstruction secondary to cholecystogastric fistula is presented and a brief review of the literature is done.(AU)
Assuntos
Humanos , Masculino , Idoso , Fístula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/diagnóstico por imagem , Fístula Gástrica , Endossonografia , Gastroscopia , Esofagite , Fístula Biliar/etiologia , Fístula Biliar/cirurgia , Doenças da Vesícula Biliar/cirurgia , Pacientes Internados , Exame Físico , Avaliação de SintomasRESUMO
A case of a patient with symptoms of gastric obstruction secondary to cholecystogastric fistula is presented and a brief review of the literature is done.
Assuntos
Fístula Biliar , Doenças da Vesícula Biliar , Fístula Gástrica , Humanos , Endossonografia , Fístula Biliar/diagnóstico por imagem , Fístula Biliar/etiologia , Fístula Biliar/cirurgia , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/cirurgia , Fístula Gástrica/diagnóstico por imagem , Fístula Gástrica/etiologiaRESUMO
We present the case of a 73-year-old woman who was admitted to hospital with a 6-day history of complete constipation, abdominal pain and vomiting. An abdominal CT scan is performed that shows a large colonic dilatation. In the sigmoid colon identifying a 43x20mm gallstone impaction and a solution of continuity between the gallbladder and the hepatic flexure with pneumobilia associated. Because the obstruction is located at the sigmoid colon, it was decided to perform an urgent colonoscopy. During the endoscopy, the gallstone was observed, which was successfully extracted using a Roth Net. The surrounding mucosa showed signs of mucosal damage and an extensive decubitus ulcer. After endoscopy, the patient presented resolution of the obstructive condition. During her admission, surgery was performed to resection the cholecystocolic fistula, cholecystectomy, and primary closure of the colon. However, the patient presented a torpid evolution with ascending colon perforation and necrotizing fasciitis in the surgical wound, finally dying of abdominal septic shock.
Assuntos
Cálculos Biliares , Íleus , Obstrução Intestinal , Doenças do Colo Sigmoide , Humanos , Feminino , Idoso , Cálculos Biliares/complicações , Íleus/etiologia , Doenças do Colo Sigmoide/diagnóstico , Obstrução Intestinal/etiologia , Colonoscopia/efeitos adversosRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia Gastrointestinal/etiologia , Intussuscepção/complicações , Neoplasias do Íleo/patologia , Lipoma/patologia , BiópsiaRESUMO
La enfermedad diverticular en la causa más frecuente de hemorragia digestiva baja. En la mayoría de las ocasiones el sangrado cesa sin ninguna intervención, pero en un 10-20 % de los casos es necesario tratar la hemorragia. Se han descrito varias modalidades de tratamiento endoscópico tras preparar el colon. Presentamos cinco casos de hemorragia diverticular severa tratados con inyección de adrenalina y hemoclips. Todas las colonoscopias se realizaron de urgencia y sin preparación del colon, con correcta visualización del punto de sangrado. Los pacientes evolucionaron favorablemente evitando otros procedimientos agresivos como una arteriografía o cirugía (AU)
Diverticular disease is the most frequent cause of lower gastrointestinal bleeding. Most of the times, bleeding stops without any intervention but in 10-20 % of the cases it is necessary to treat the hemorrhage. Several modalities of endoscopic treatment have been described after purging the colon. We present five cases of severe diverticular bleeding treated with injection of epinephrine and hemoclips. All the colonoscopies were performed without purging of the colon in an emergency setting, with correct visualization of the point of bleeding. Patients recovered well avoiding other aggressive procedures such as angiography or surgery (AU)