ABSTRACT
Objetivo: Evaluar la efectividad del drenaje percutáneo de las colecciones complicando pancreatitis agudas (PA) de causa enfrecuente. Material y método: Se evaluron 131 pacientes con pancreatitis aguda complicada con colecciones líquidas que fueron evacuados mediante drenaje percutáneo. Del todo de esta serie 19 pacientes sufrieron PA por causas infrecuentes. Los indicaciones para el drenaje guiado por imágenes fueron la presencia de dolor, obstrucción de la vía biliar o digestiva, y sepsis. Los catéteres fueron removidos cuando existió mejoría clínica del paciente con desaparición del dolor, normalización de las enzimas pancreáticas en sangre, ausencia de fístula en el sinograma y un volumen de drenaje menor a 10 ml cada 24 horas. Resultados: Las colecciones pancreáticas complicando pancreatitis de causa infrecuente fueron resueltas con drenaje percutáneo en 15 de los 19 pacientes (79 por ciento). No hubo complicaciones relacionadas con el procedimiento. Cuatro pacientes murieron: falla multiorgánica, 3 pacientes; embolismo pulmonar, 1 paciente. Conclusión: El resultado de los drenajes percutáneos en pacientes con PA de causa infrecuente medida como la resolución de las colecciones pancreáticas fue similar a los del resto de la serie. El manejo percutáneo de las colecciones pancráticas complicando pancreatitis de causa infrecuente fue un procedimiento eficáz para su resolución. La severidad de la pancreatitis más que la causa aparece como el factor determinante de la duración del drenaje y su resultado
Subject(s)
Adult , Male , Humans , Female , Adolescent , Middle Aged , Catheterization , Drainage , Pancreatitis , Acute Disease , Ascitic Fluid , Pancreatitis , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To show our experience and results in Virtual Colonoscopy (VC). MATERIAL AND METHOD: Five hundred patients with personal or familial history of colorectal carcinoma and/or adenomas, or any kind of coloproctologic symptoms were studied. VCs were practiced using a helical CT scanner (300 patients) and a multislice CT scanner (200 patients) a few hours after Conventional Colonoscopy (CC), considered the gold standard. The patients were evaluated in a prospective blind study, to determine sensitivity and specificity of VC. Findings were classified as: 1) normal studies; 2) studies with pathological findings. This one was subdivided into: 2a) Lesions below 5 mm., 2b) Lesions between 5-9 mm., 2c) Lesions above 9 mm. RESULTS: VC detected 253 normal studies whereas CC only detected 233. The sensitivity and specificity for each subgroup were: 2a) 87.8% and 86.9%; 2b) 95.6% and 91.4%; 2c) 100.0% and 100.0% respectively. CONCLUSION: VC is a feasible and useful method for evaluating the entire colon. It is well tolerated, it has no complications and a high sensitivity and specificity for elevated lesions, especially the ones above or equal to 5 mm.
Subject(s)
Middle Aged , Humans , Male , Female , Adult , Colonic Polyps , Colonoscopy , Colorectal Neoplasms , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity , Single-Blind MethodABSTRACT
OBJECTIVE: To define the role of virtual gastroscopy (VG) in the detection of elevated lesions comparing its results with conventional endoscopy (CE) as the gold standard method. MATERIALS AND METHODS: Between December 2000 and July 2001, 19 patients were evaluated. The age ranged between 41 and 72 (mean 58.8 years old). VG and CE were performed in all the patients during the same week. VG were carried out with a multislice CT scanner (Mx 8000, Marconi Medical Systems). The technical parameters used were 3 mm with slices and 1.5 mm reconstruction intervals. The acquisition time was 22 seconds. Images were sent to a workstation (MxView, Marconi Medical Systems) where they were reprocessed in three different ways: 1) Bidimensionally 2) Tridimensionally 3) Virtual Endoscopy Findings of VG were compared with CE. RESULTS: VG detected 39 lesions, whereas CE detected 40 lesions. There were 39 true-positive findings, 2 true-negative findings, 0 false-positive findings and 1 false-negative findings. The Sensitivity (Se) was 97.5%; Specificity (Sp) was 100%, positive predictive value 100% and Negative predictive value 66%. CONCLUSIONS: VG is a new non-invasive method with high Se and Sp in the detection of elevated lesions. The actual role of VG consist in identification of gastric lesions and possibility to diagnose gastric disease