Fecal incontinence in older patients. A narrative review. / Incontinencia fecal en el paciente anciano. Revisión de conjunto.

Fecal incontinence is one of the leading causes for the institutionalization of people in the last decades of life, associated with a great psychosocial and economic burden. The literature is scarce in this population group, due to the absence of universally accepted criteria to define "elderly patients" and difficulties in detection and diagnostic. The aim of this article was to conduct a narrative review of the main aspects related to fecal incontinence in older patients, providing management support. Toileting assistance, dietary change, controlling stool consistency and medical treatment can be used to treat these patients. Nevertheless, other therapies, such as biofeedback, neuromodulation or surgical treatment, can be considered in selected patients.

Incontinencia fecal en el paciente anciano. Revisión de conjunto / Fecal incontinence in older patients. A narrative review

La incontinencia fecal representa una de las principales causas de institucionalización en las últimas décadas de la vida de una persona, asociando además gran repercusión psicosocial y económica. La literatura muestra escasa evidencia cuando se trata de analizar de forma específica a este grupo de población, debido a la falta de uniformidad en la consideración de «paciente anciano» y en la dificultad de su detección y diagnóstico. El objetivo de este artículo ha sido realizar una revisión narrativa de los principales aspectos relacionados con la incontinencia fecal en el anciano y facilitar el manejo de estos pacientes. La asistencia para la defecación, las modificaciones dietéticas y el control de la consistencia de las deposiciones o el tratamiento farmacológico son en muchos casos medidas suficientes. No obstante, otras terapias como el biofeedback, la neuromodulación o el tratamiento quirúrgico no deben descartarse y han de ser valoradas de forma selectiva en pacientes ancianos

Fecal incontinence is one of the leading causes for the institutionalization of people in the last decades of life, associated with a great psychosocial and economic burden. The literature is scarce in this population group, due to the absence of universally accepted criteria to define "elderly patients" and difficulties in detection and diagnostic. The aim of this article was to conduct a narrative review of the main aspects related to fecal incontinence in older patients, providing management support. Toileting assistance, dietary change, controlling stool consistency and medical treatment can be used to treat these patients. Nevertheless, other therapies, such as biofeedback, neuromodulation or surgical treatment, can be considered in selected patients

[Exceptional iatrogenic ureteral rupture]. / Rotura ureteral iatrogénica de causa inusual.

Rupture of the ureter is an infrequent event that can have serious consequences. The most frequent cause is surgical iatrogenic ureter disease. Other possible causes are urological procedures and urographic studies. In our patient, which, to our knowledge, is the first to be reported in the literature, the ureteral rupture was produced by a traumatic urinary catheterism, because the balloon was filled inside the ureter. The normal presentation is nephritic colic, although acute abdomen is also a possibility. The possibility of ureteral rupture in abdominopelvic surgery or in urological techniques should be evaluated when patients present these clinical symptoms. Treatment is surgical, although in some cases conservative measures can be used.

Rotura ureteral iatrogénica de causa inusual / Exceptional iatrogenic ureteral rupture

La rotura del uréter es una entidad clínica poco frecuente que puede ocasionar graves consecuencias. Su causa más habitual es la iatrogenia durante una intervención quirúrgica. Otras posibles causas son las maniobras urológicas o urográficas. En nuestra paciente, como caso único publicado hasta el momento, la rotura se ocasionó por un sondaje urinario traumático, al hinchar el balón de la sonda en el interior de un uréter. Los síntomas de la rotura uretral son los de un cólico nefrítico, aunque en ocasiones puede simular un abdomen agudo. Es importante valorar la posibilidad de lesión uretral en pacientes intervenidos de cirugía abdominopélvica o sometidos maniobras urológicas que presenten esta clínica. El tratamiento es quirúrgico, aunque en algunos casos podrían considerarse medidas conservadoras (AU)

Rupture of the ureter is an infrequent event that can have serious consequences. The most frequent cause is surgical iatrogenic ureter disease. Other possible causes are urological procedures and urographic studies. In our patient, which, to our knowledge, is the first to be reported in the literature, the ureteral rupture was produced by a traumatic urinary catheterism, because the balloon was filled inside the ureter. The normal presentation is nephritic colic, although acute abdomen is also a possibility. The possibility of ureteral rupture in abdominopelvic surgery or in urological techniques should be evaluated when patients present these clinical symptoms. Treatment is surgical, although in some cases conservative measures can be used (AU)

Pequeño GIST duodenal comocausa de hemorragia digestivamasiva en un paciente joven / Small duodenal GIST as a cause of massive gastrointestinal bleeding in a young man

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