RESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas/diagnóstico , Neoplasias Hepáticas/diagnóstico , Colestase/complicações , Antibacterianos/uso terapêuticoRESUMO
Background: in recent years many factors have been shown to influence dose received by the patient during ERCP. Therefore it is necessary to update radio induced cancer risk. Objectives: to calculate lifetime attributable risk of cancer during ERCP. To compare the risk with the most common X-ray examinations. Design: descriptive study with 393 consecutive ERCP performed at one center. Equipment used was Philips BV pulsera. In each exploration demographic and anthropometric variables of the patient were collected. Dosimetric quantities were calculated from exposure parameters. Effective dose was estimated using specific conversion factors. Organ doses and radio induced cancer incidence was estimated. Results: dose area product was 0.82 mGym2 (IQR 0.4-1.5) with an average fluoroscopy time of 2 minutes and 45 seconds. Entrance surface dose was 30.7 mGy (IQR 15-60.8) and effective dose was 0.44 mSv (IQR 0.2-0.9). Multivariate analysis identified that difficult papillary cannulation (β0.4; p = 0.009), patient age (β-0.01; p = 0.001) and therapeutic applied (β= 0.89; p < 0.001) influenced dose-area product. The ERCP dose would be equivalent to the radiation received by twenty chest radiographs and would be about fourteen times smaller than a barium enema or twenty times less than that received during an abdominal CT. Lifetime attributable risk of cancer incidence was 4.08 and 16.81 per million procedures in diagnostic and therapeutic ERCP respectively. Conclusions: from the radiological point of view, ERCP is a safe technique that uses low exposure levels compared to other explorations commonly used in medicine. It implies a reasonably low risk of radio induced cancer (AU)
Assuntos
Humanos , Masculino , Feminino , Neoplasias Induzidas por Radiação/complicações , Neoplasias Induzidas por Radiação/diagnóstico , Fluoroscopia/métodos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação , Estudos Transversais , Sinais e Sintomas , 28599 , Modelos LinearesRESUMO
No disponible
Assuntos
Masculino , Adulto , Humanos , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Combinação Amoxicilina e Clavulanato de Potássio/efeitos adversos , Citotoxinas , Colestase/induzido quimicamenteRESUMO
Los tumores estromales gastrointestinales (GIST) son una causa poco frecuente (< 1%) de hemorragia digestiva masiva. El tratamiento es fundamentalmente quirúrgico mediante la extirpación completa del tumor. Exponemos el caso de una mujer de 29 años de edad que acudió a urgencias al presentar un cuadro clínico compatible con hemorragia digestiva grave en forma de melenas. A la exploración física se apreció una masa abdominal indolora y no pulsátil. Tras realizar una endoscopia digestiva alta, una tomografía computarizada, una arteriografía y una intervención quirúrgica urgente, se llega al diagnóstico de GIST yeyunal
Gastrointestinal stromal tumors (GIST) are an infrequent cause (<1%) of severe gastrointestinal hemorrhage. Treatment is mainly surgical through complete tumoral resection. We report the case of a 29-year-old woman who presented to the emergency room with severe gastrointestinal bleeding manifested by melena. On physical examination the patient had a painless, palpable mass in the left abdomen. Esophagogastroduodenoscopy, computed tomography, angiography and urgent surgical intervention led to diagnosis of a jejunal GIST
