Factores asociados a la presencia de valores alterados de calprotectina fecal en pacientes con estudio endoscópico panentérico normal / No disponible

INTRODUCCIÓN: la calprotectina fecal es un parámetro útil a la hora de decidir si un paciente se puede beneficiar de la realización de estudios endoscópicos. No obstante, cierto número de individuos sintomáticos y con cifras elevadas de este marcador no tendrán lesiones endoscópicas. El objetivo de este estudio es determinar qué factores se asocian a cifras alteradas de calprotectina fecal en pacientes con estudios endoscópicos de intestino delgado y colon normales. MÉTODOS: estudio prospectivo y observacional de pacientes con síntomas digestivos. Se ha analizado la asociación de diferentes variables con cifras alteradas de calprotectina y estudios endoscópicos (cápsula de intestino delgado y colonoscopia) negativos. RESULTADOS: se incluyen 143 pacientes (98 mujeres - 68,5 %), con una edad media 40,06 ± 16,42 (15-82) años. El consumo de tabaco y la toma de antiinflamatorios no esteroideos se asoció a la presencia de cifras alteradas de calprotectina y estudios endoscópicos negativos (p: 0,029 y p: 0,006). Los valores medios de calprotectina fecal fueron significativamente mayores entre los fumadores, consumidores de antiinflamatorios y pacientes con test positivo de sobrecrecimiento bacteriano de intestino delgado. El tabaquismo (OR: 3,505; p: 0,028), la toma de antiinflamatorios (OR: 3,473; p: 0,021) y el sobrecrecimiento bacteriano (OR: 3,172; p: 0,013) son factores de riesgo independientes para presentar una calprotectina alterada sin lesiones endoscópicas. No se obtuvo asociación con ninguna otra variable. CONCLUSIONES: el consumo de tabaco y de antiinflamatorios no esteroideos tiene una fuerte asociación con la presencia de valores elevados de calprotectina en ausencia de lesiones endoscópicas. Se ha observado también asociación con el sobrecrecimiento bacteriano de intestino delgado

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Factors associated with the presence of abnormal levels of fecal calprotectin in patients with negative panenteric studies.

BACKGROUND: fecal calprotectin is a selection tool prior to endoscopic studies in patients with gastrointestinal symptoms. However, some symptomatic patients with altered fecal calprotectin will not have any endoscopic lesions. The aim of the study was to determine the factors associated with the presence of altered fecal calprotectin in patients with negative endoscopic studies of the colon and small bowel. METHODS: this was an observational, prospective study of patients with digestive symptoms. The association of different clinical factors with elevated fecal calprotectin in the absence of endoscopic lesions of the colon and small bowel were analyzed. RESULTS: 143 patients were included in the study, 98 were female (68.5 %) and the mean age was 40.06 ± 16.42 (15-82) years. Smoking and non-steroidal anti-inflammatory drug intake were associated with altered fecal calprotectin in patients with a negative endoscopy of the colon and small bowel (p = 0.029 and p = 0.006). The mean values of fecal calprotectin were significantly higher in smokers, users of non-steroidal anti-inflammatory drugs and patients with small intestine bacterial overgrowth. Smoking (OR: 3.505; p = 0.028), non-steroidal anti-inflammatory drugs intake (OR: 3.473; p = 0.021) and small intestine bacterial overgrowth (OR: 3.172; p = 0.013) were independent risk factors for altered fecal calprotectin in the absence of endoscopic lesions. No association was found for any of the other variables. CONCLUSIONS: smoking and the use of non-steroidal anti-inflammatory drugs are strongly associated with elevated levels of fecal calprotectin in symptomatic patients with a negative colonoscopy and capsule endoscopy of the small bowel. Small intestine bacterial overgrowth is also associated.

Retención sintomática de cápsula degradable Agile(R) / Symptomatic retention of the Agile(R) patency capsule

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Symptomatic retention of the Agile® patency capsule.

The Agile® capsule has shown to be useful when evaluating the patency of the small bowel in patients prior to capsule endoscopy studies. It is a safe tool and a low rate of complications have been reported, highlighting symptomatic retention, although references in literature are scarce and it is only observed in 1.2% of the procedures. We present the case of a symptomatic retention of this device in a patient with previously known colonic Crohn's disease in who a small bowel study was indicated and was sent for prior patency test.

Gastric schwannoma presenting as a casual ultrasonographic findings.

We present the case of a patient under study due to ascites in which a mass located on the gastric wall was observed during ultrasonography. Further studies (upper endoscopy and computed tomography) confirmed this finding. After an ultrasound-guided percutaneous biopsy, diagnosis of gastric schwannoma was made as intense S-100 expression was found. Surgery was rejected due to the bad clinical situation of the patient and because the mass was an asymptomatic benign tumor.

Schwannoma gástrico como hallazgo ecográfico casual / Gastric schwannoma presenting as a casual ultrasonographic findings

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Fibrolamellar hepatocellular carcinoma: a rare entity diagnosed by abdominal ultrasound.

We present the case of a young man with a hepatic mass in which ultrasound gives great and immediate support for diferential diagnosis.

Carcinoma hepatocelular fibrolamelar, una entidad infrecuente diagnosticada por ecografía abdominal / Fibrolamellar hepatocellular carcinoma: a rare entity diagnosed by abdominal ultrasound

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Hipertensión portal e ictericia colestásica como forma de presentación de una amiloidosis sistémica / Portal hypertension and cholestatic jaundice as a form of presentation of systemic amyloidosis

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Aneurisma gastroduodenal presentado como masa pancreática / Gastroduodenal artery aneurysm presenting as a pancreatic mass

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