ABSTRACT
El dolor abdominal crónico es muy frecuente en la edad pediátrica. Los criterios de Roma III permiten hacer el diagnóstico de las diferentes entidades con dolor abdominal funcional, en base a la sintomatología, y no como de exclusión. Actualmente se propone una etiología biopsicosocial, que obliga a una aproximación integrada para ofrecer tratamiento centrado en la sintomatología de cada paciente pudiendo combinarse cambios en la alimentación, fármacos e intervenciones psicosociales. Aunque la mayoría de los pacientes mejora al tranquilizarlos y con el tiempo, una proporción significativa sigue con sintomatología intensa y discapacitante en la adultez.
Chronic abdominal pain is common in childhood. Rome III criteria allows the diagnosis of different entities with functional abdominal pain, based on by symptoms, rather than exclusion. The biopsychosocial etiology proposed currently, requires an integrated approach to provide focused treatment to each patient's symptoms and may combine changes in food, drugs and psychosocial interventions. Although most patients will improve with reassurance and time, a significant number of patients continue to have intense and disabling symptoms in adulthood.
Subject(s)
Humans , Acute Disease , Diagnosis, Differential , Abdominal Pain/therapy , DyspepsiaSubject(s)
Humans , Male , Female , Child , Inflammatory Bowel Diseases , Diagnosis, Differential , Inflammatory Bowel DiseasesABSTRACT
Wilson's disease is an inherited disorder of copper metabolism. We report 16 patients (6 males) with the disease; 6 had hepatic involvement and 3 were asymptomatic. The age onset was 9 years for hepatic and 17 years for neurologic involvement. The mean delay in diagnosis was 14 months. Chronic hepatitis, cirrhosis and fulminant hepatic failure were the clinical forms of liver disease. Patients with neurologic disorders had behavioral disturbances and extrapyramidal manifestations such as dystonia and parkinsonism. Patients had a good response to penicillamine, except 3 that died of liver complications, in whom the treatment was delayed or discontinued. We conclude that this metabolic disease must be suspected in pubertal children and in adults of less than 30 years old with liver disease of unknown origin or behavioral alterations associated to an extrapyramidal syndrome
Subject(s)
Humans , Male , Female , Adolescent , Adult , Child, Preschool , Hepatolenticular Degeneration/diagnosis , Penicillamine/administration & dosage , Hepatolenticular Degeneration/classification , Hepatolenticular Degeneration/drug therapy , Neurologic Manifestations , Liver Function Tests/methodsABSTRACT
Se describe una paciente de 6 meses de edad con colitis ulcerosa. Las manifestaciones clínicas consistían en deposiciones sanguinolentas, fiebre, pérdida de peso, anemia significativa, leucocitosis, velocidad de eritrosedimentación globular aumentada e hipoalbuminemia. Los estudios bacteriológicos y copropararitológicos seriados descartaron infección. El enema baritado precipitó deterioro clínico de la paciente, requiriendo intervención quirúrgica. El examen histológico reveló abscesos de las criptas, pseudopólipos, distorsión de las criptas y disminución de las células caliciformes. El tratamiento con sulfasalazina y el manejo nutricional ha sido exitoso