ABSTRACT
Celiac disease (CD) is a chronic inflammatory disease which develops in genetically predisposed individuals. Is caused by the ingestion of wheat gluten and related proteins of rye and barley that leads to inflammation. This disorder is recognizedas a disease, that may be diagnosed to any age and affects many organ systems. CD is the most common food-sensitive enteropathy in humans, with a prevalenceof 1% in the general population of adults and children. The common presentation symptoms and signs of CD include diarrhea, abdominal distention, abdominal pain, weight loss, fatigue, and malnutrition but an atypical manifestation include anemia, osteoporosis, neurological symptoms, hipoproteinemia, hipocalcemia and hipertransaminasemia. The only accepted treatment for CD is a nutriional therapy with a gluten-free diet for lifelong. The sensitivity and specificity of the tests for both endomysial and anti-tissue transglutaminase antibodies is greater than 90% for diagnosing CD. Duodenal biopsy is still considered by most authors the "gold standard" in the diagnostic process and it should always be performed when clinical suspicion is high, irrespective of the results of serologic testing. In 10% of cases the diagnosis is difficult because of a lack of correlation among serology, clinical and histological findings...
Subject(s)
Humans , Autoimmune Diseases , Celiac Disease , GlutensABSTRACT
Comunicamos el caso de un paciente de 32 años, sexo masculino, que consultó por melena intermitente y síndrome anémico de dos años de evolución, sin otros antecedentes patológicos de importancia. El laboratorio reveló anemia hipocroma, sin trastornos de la coagulación. Los exámenes endoscópicos altos y bajos del tubo digestivo no demostraron lesiones sangrantes y la cintigrafía evidenció un sangrado a nivel de intestino delgado. La arteriografía mesentérica selectiva demostró un hemangioma en porción terminal del íleon. Se realizóresección del segmento intestinal comprometido, evolucionando favorablemente, sin reincidencia de sangrado hasta la fecha. Efectuamos una revisión de la literatura principalmente dedicada a la incidencia de esta patología y al enfoque de pacientes que se presentan con un sangrado digestivo de origen oscuro.
A 32 years old man presenting with two years of intermittent episodes of melena and anemia, without other pathological conditions. The laboratory results showed an hypochronic anemia. Coagulation studies were normal. No bleeding lesions were observed at upper and lower endoscopy. A scintigraphic study showed evidences of bleeding at the small bowel. Mesenteric angiography reported an ileal hemangioma. A resection of the lesion was performed without further bleeding until now. A review of the subject was done, looking for the incidence and behavior, in relation of the case, and patients with intestinal bleeding of obscure origin.
Subject(s)
Humans , Male , Adult , Hemangioma, Cavernous/complications , Hemangioma, Cavernous/diagnosis , Gastrointestinal Hemorrhage/etiology , Intestine, Small/pathology , Intestinal Neoplasms/complications , Intestinal Neoplasms/diagnosis , Hemangioma, Cavernous/surgery , Treatment OutcomeABSTRACT
Realizamos un estudio restrospectivo de las hemorragias digestivas altas (HDA) que consultaron a nuestro servicio; entre los años 1998-2003. El objetivo del presente trabajo fue determinar las principales causas de sangrado digestivo alto en nuestra región y conpararlo con la bibliografía mundial. La exploración endoscópica constituye el estudio de elección en la HDA. Evaluamos 2387 esófagogastroduodeno fibroscopías (EGDF) efectuadas durantes los últimos cinco años, de las cuales 402 (16,8 por ciento) correspondieron a HDA. Las edades oscilaron entre 16-88 años (edad promedio 56). La gastroduodenitis aguda 45,28 por ciento (182 casos) fue la causa más frecuente de sangrado del tracto digestivo superior. La segunda fue la úlcera gástrica 12,1 por ciento (49 casos), seguida de la duodenal 11,9 por ciento (48 casos). Respecto a la incidencia estacional hubo un mayor predominio en otoño 36,31 por ciento (146 casos). En el 5,2 por ciento (21 casos) no se llegó al diagnóstico etiológico debido a la mala preparación o a sangrado activo; sin embargo en 18 casos de éste grupo se lo pudo ubicar topográficamente, el resto requirió una segunda endoscopía para su diagnóstico.
Subject(s)
Adolescent , Adult , Male , Humans , Female , Middle Aged , Duodenal Diseases , Esophageal Diseases , Gastrointestinal Hemorrhage , Stomach Diseases , Gastrointestinal Hemorrhage , Retrospective StudiesABSTRACT
We want to introduce the case of an 18 year old male patient who consulted us because of proctorrhage, straining and rectal tenesmus. Diagnosis was rectal tumor which pathological anatomy revealed an adenocarcinoma of cells in seal ring shape, suggesting a probable gastric origin. The high endoscopy evidenced multiple polyps, less than a centimeter wide found in the cardiac orifice, body and antrum, with the same histology. All these findings were confirmed during the exploratory laparotomy. We thought it was interesting to report this case because of the clinical presentation, unusual in this type of gastric cancer.