Impactación de un cuerpo extraño en un paciente con enfermedad de Crohn / Impacted foreign body in a patient with Crohn's disease

La enfermedad de Crohn (EC) se puede complicar con la aparición de estenosis intestinal. Las estenosis que no responden al tratamiento médico habitualmente requieren cirugía. La dilatación endoscópica con balón es una alternativa a la cirugía.A continuación se presenta el caso de un paciente con EC y una estenosis de la válvula ileocecal asintomática que se manifestó como un cuadro oclusivo secundario a la impactación de un cuerpo extraño (semilla de níspero). Se realizó una dilatación endoscópica y la extracción del cuerpo extraño. En este trabajo se lleva a cabo una revisión de la literatura médica en relación al tratamiento endoscópico de las estenosis intestinales secundarias a la EC (AU)

Crohn's disease is often complicated by intestinal strictures. Symptomatic strictures refractory to medical therapy usually require surgery. Endoscopic balloon dilatation is an alternative to surgery. We report the case of a patient with CrohnŒs disease with asymptomatic ileocecal stricture, which was identified after intestinal obstruction due to an impacted foreign body. The patient underwent endoscopic dilatation and the foreign body was extracted. We provide a review of the literature on endoscopic balloon dilatation of intestinal strictures in Crohn's disease (AU)

[Severe tubulo-interstitial nephritis secondary to 5-ASA]. / Nefropatía tubulointersticial grave secundaria a 5-ASA.

We report a new case of chronic interstitial nephritis in a patient with ulcerative colitis diagnosed in 2002 who was originally treated with 5-ASA. Three years later deterioration of renal function was apparent with an increase in serum creatinine, which was normal before treatment. Withdrawal of 5-ASA led to partial improvement of renal function. In patients with a delayed diagnosis of kidney damage, recovery of renal function is incomplete and, in some cases, the patient even requires some form of renal replacement therapy. We stress the importance of monitoring renal function in patients diagnosed with inflammatory bowel disease treated with this drug.

Nefropatía tubulointersticial grave secundaria a 5-ASA / Severe tubulo-interstitial nephritis secondary to 5-ASA

Presentamos un nuevo caso de nefritis intersticial crónica de una paciente con colitis ulcerosa diagnosticada en 2002, que desde el principio fue tratada con 5-ASA. Tres años más tarde apareció un deterioro de la función renal con un incremento de los valores de creatinina sérica, los cuales eran normales antes del tratamiento. La función renal mejoró parcialmente tras la supresión del tratamiento. En los pacientes con un retraso en el diagnóstico del daño renal, la recuperación de la función renal no es completa, e incluso, en algunos casos, el paciente necesita alguna forma de terapia de reemplazo renal. Queremos recordar la importancia del registro de la función renal en pacientes diagnosticados de enfermedad inflamatoria intestinal en tratamiento con este fármaco(AU)

We report a new case of chronic interstitial nephritis in a patient with ulcerative colitis diagnosed in 2002 who was originally treated with 5-ASA. Three years later deterioration of renal function was apparent with an increase in serum creatinine, which was normal before treatment. Withdrawal of 5-ASA led to partial improvement of renal function. In patients with a delayed diagnosis of kidney damage, recovery of renal function is incomplete and, in some cases, the patient even requires some form of renal replacement therapy. We stress the importance of monitoring renal function in patients diagnosed with inflammatory bowel disease treated with this drug(AU)

[Ileal perforation secondary to intestinal endometriosis]. / Perforación ileal secundaria a endometriosis.

Endometriosis is defined as the presence of endometrial tissue outside the uterus. The bowel is not often affected. There are no specific clinical findings for intestinal endometriosis. It is typically asymptomatic, but sometimes can present with abdominal pain, diarrhoea, constipation or intestinal obstruction. Ileal perforation is a rare complication of intestinal endometriosis and only a few cases have been reported in the literature. Intestinal endometriosis can mimic many gastrointestinal diseases, such as irritable bowel syndrome, inflammatory bowel disease, infections and neoplasms. The diagnosis is made by laparoscopy or laparotomy. We present a case of a woman with intermittent abdominal pain and ileal perforation secondary to intestinal endometriosis.

Perforación ileal secundaria a endometriosis / Ileal perforation secondary to intestinal endometriosis

La endometriosis es la presencia de tejido endometrial fuera del útero. La afección del intestino por endometriosis es una entidad poco frecuente y suele ser asintomática o presentarse de forma inespecífica con dolor abdominal, diarrea, estreñimiento u obstrucción intestinal. La perforación intestinal es poco frecuente, y hay pocos casos publicados en la literatura médica. La endometriosis intestinal puede imitar a un gran número de enfermedades digestivas, como el síndrome del intestino irritable, la enfermedad inflamatoria intestinal, infecciones o neoplasias. El diagnóstico se suele realizar a través de laparoscopia o laparotomía. Presentamos el caso de una paciente con dolor abdominal recurrente y posterior perforación ileal, secundaria a endometriosis

Endometriosis is defined as the presence of endometrial tissue outside the uterus. The bowel is not often affected. There are no specific clinical findings for intestinal endometriosis. It is typically asymptomatic, but sometimes can present with abdominal pain, diarrhoea, constipation or intestinal obstruction. Ileal perforation is a rare complication of intestinal endometriosis and only a few cases have been reported in the literature. Intestinal endometriosis can mimic many gastrointestinal diseases, such as irritable bowel syndrome, inflammatory bowel disease, infections and neoplasms. The diagnosis is made by laparoscopy or laparotomy. We present a case of a woman with intermittent abdominal pain and ileal perforation secondary to intestinal endometriosis