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1.
Rev. Méd. Clín. Condes ; 31(5/6): 472-480, sept.-dic. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1224143

ABSTRACT

Actualmente, existe una mayor evidencia acerca de los efectos positivos de la actividad física, y en especial del ejercicio, sobre algunas enfermedades del sistema gastrointestinal, lo cual tiene relación principalmente con su rol antiinflamatorio a nivel sistémico. Sin embargo, es necesario considerar algunas variables del ejercicio, tales como el volumen e intensidad de éste. Específicamente, el realizar ejercicios de larga duración y alta intensidad, asociados a estados de deshidratación, postprandiales y con altas temperaturas ambientales, podría contribuir a la expresión fisiológica del síndrome gastrointestinal inducido por el ejercicio y a la aparición y/o empeoramiento de los síntomas en las enfermedades del tracto gastrointestinal. Si se controlan dichas variables, realizar ejercicio aeróbico de moderada intensidad y, adicionalmente, durante menos de 60 minutos, serían seguros para disminuir el riesgo y controlar de mejor manera los síntomas de algunas patologías gastrointestinales.


Currently, there is an increase evidence about the beneficial effects of physical activity, particularly of physical exercise in some diseases of the gastrointestinal system, related to its systemic anti-inflammatory role. However, it is necessary to consider some of the exercise variables such as volume and exercise intensity. Specifically, the execution of long duration and high intensity exercises, together with a state of dehydration, postprandial and high environmental temperature, could contribute to the physiological expression of the exercise-induced gastrointestinal syndrome and the expression and/or worsening of gastrointestinal diseases symptoms.


Subject(s)
Humans , Exercise/physiology , Gastrointestinal Diseases
2.
Rev. méd. Chile ; 148(7): 1039-1043, jul. 2020. graf
Article in Spanish | LILACS | ID: biblio-1139408

ABSTRACT

Biological therapy dramatically changed the management of Ulcerative Colitis (UC). However, a significant number of these patients fail to respond or have secondary loss of response to this strategy. In this clinical situation, the options include intensification of anti-TNF therapy, the use of a second anti-TNF or being switched to another drug class. Among the later, tofacitinib, an oral small molecule directed against the JAK/STAT pathway, is safe and effective in inducing and maintaining remission in patients with moderate-severe UC. We report two patients with UC refractory to conventional treatment and biological therapy, who responded successfully to the use of tofacitinib.


Subject(s)
Humans , Male , Middle Aged , Piperidines/therapeutic use , Pyrimidines/therapeutic use , Colitis, Ulcerative/drug therapy , Protein Kinase Inhibitors/therapeutic use , Colitis, Ulcerative/diagnostic imaging , Colonoscopy , Treatment Outcome
4.
Rev. méd. Chile ; 148(3): 362-370, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1115800

ABSTRACT

Biomarkers in inflammatory bowel disease are an essential tool in clinical practice. They allow a non-invasive evaluation of patients and thus guide decision-making at different stages of the disease, including diagnostic suspicion, severity assessment, relapse prediction, and treatment response. Although biomarkers in blood such as erythrocyte sedimentation rate and C-reactive protein, are the most commonly used biomarkers, because their low cost and accessibility, they lack specificity. Currently, fecal biomarkers offer greater reliability, applicability, and specificity. Fecal calprotectin is the most commonly used marker. This review discusses the advantages and disadvantages of biomarkers in inflammatory bowel disease, as well as their clinical applications and new biomarkers currently under research.


Subject(s)
Humans , Inflammatory Bowel Diseases , Blood Sedimentation , Biomarkers , Reproducibility of Results , Leukocyte L1 Antigen Complex , Feces
5.
Arq. gastroenterol ; 57(1): 100-106, Jan.-Feb. 2020. graf
Article in English | LILACS | ID: biblio-1098049

ABSTRACT

ABSTRACT In patients with ulcerative colitis refractory to medical therapy, total proctocolectomy and posterior ileal-anal pouch anastomosis is the standard surgical therapy. One of the possible complications is pouchitis. Depending on the duration of the symptoms, it can be classified as acute, recurrent, or chronic. The latter, according to the response to therapy, can be defined as antibiotic-dependent or refractory. The treatment of pouchitis is based on the use of antibiotics and probiotics. Thiopurine and biological therapy have been suggested in patients with refractory pouchitis. Special care should be taken in the endoscopic surveillance of these patients, especially if they present risk factors such as dysplasia or previous colorectal cancer, primary sclerosing cholangitis or ulcerative colitis for more than 10 years.


RESUMO Em pacientes com colite ulcerativa refratária à terapia médica, a proctocolectomia total e anastomose de bolsa ileal-anal posterior é a terapia cirúrgica padrão. Uma das possíveis complicações é a pouchite. Dependendo da duração dos sintomas, pode ser classificado como aguda, recorrente ou crônica. Esta última, de acordo com a resposta à terapia, pode ser definida como dependente de antibióticos ou refratária a eles. O tratamento da pouchite baseia-se no uso de antibióticos e probióticos. A thiopurina e a terapia biológica têm sido sugeridas em pacientes com pouchite refratária. Um cuidado especial deve ser tomado na vigilância endoscópica desses pacientes, especialmente se apresentarem fatores de risco, como displasia ou câncer colorretal anterior, colangite esclerosante primária ou colite ulcerativa por mais de 10 anos.


Subject(s)
Humans , Colitis, Ulcerative/surgery , Proctocolectomy, Restorative/adverse effects , Pouchitis/etiology , Acute Disease , Chronic Disease , Risk Factors
7.
Rev. chil. infectol ; 36(4): 536-540, ago. 2019. tab
Article in Spanish | LILACS | ID: biblio-1042673

ABSTRACT

Resumen La infección por Clostridioides (previamente Clostridium) difficile se ha convertido en un problema de salud importante debido al aumento en su incidencia, gravedad y recurrencia. En este último escenario, una edad mayor de 65 años ha sido asociada a una evolución más desfavorable. Factores de riesgo como la presencia de una inmunidad alterada, co-morbilidades, malnutrición, polifarmacia y cambios en la microbiota intestinal explicarían este mayor riesgo a mayor edad. El trasplante de microbiota fecal (TMF) es una estrategia efectiva en el tratamiento de la infección recurrente por Clostridioides difficile cuando la terapia estándar fracasa. Guías publicadas recientemente sugieren que esta estrategia puede ser utilizada a partir de la segunda recurrencia. Sin embargo, escasos estudios han evaluado los resultados del TMF en pacientes mayores de 65 años y para nuestro conocimiento existe una escasa experiencia nacional en este grupo de pacientes. Presentamos dos casos de TMF en pacientes octogenarios con una infección recurrente por Clostridioides difficile, con una evolución satisfactoria a largo plazo.


Clostridioides (formerly Clostridium) difficile infection has become a major health problem due to the increase in its incidence, severity, and recurrence. In this last scenario, age over 65 has been associated with a more unfavorable evolution. Risk factors such as the presence of altered immunity, comorbidities, malnutrition, polypharmacy, and changes in the intestinal microbiota would explain this higher risk in this group of patients. On the other hand, fecal microbiota transplantation (FMT) is an effective strategy in the treatment of recurrent Clostridioides difficile infection when standard therapy fails. Recently published guidelines suggest that this strategy can be used from the second recurrence. However, few studies have evaluated the results of the FMT in patients over 65 years old, and for our knowledge, there is limited national experience in this group of patients. We present two cases of TMF in octogenarian patients with a recurrent infection due to Clostridioides difficile, with satisfactory recovery at the long term.


Subject(s)
Humans , Female , Aged, 80 and over , Clostridium Infections/therapy , Diarrhea/microbiology , Fecal Microbiota Transplantation , Recurrence
8.
Rev. méd. Chile ; 147(2): 212-220, Feb. 2019. tab
Article in Spanish | LILACS | ID: biblio-1004334

ABSTRACT

Environmental factors may influence the development of Inflammatory Bowel Disease and modify its natural history. The objective of this review is to evaluate current evidence about environmental factors associated with the disease. A better knowledge about the pathogenesis of the disease can lead to better treatment strategies and suggestions to prevent the disease.


Subject(s)
Humans , Inflammatory Bowel Diseases/etiology , Environmental Exposure/adverse effects , Tobacco/adverse effects , Inflammatory Bowel Diseases/epidemiology , Risk Factors , Probiotics , Diet/adverse effects , Protective Factors , Obesity/complications
9.
Rev. méd. Chile ; 146(11): 1241-1251, nov. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-985697

ABSTRACT

Background: Primary non-response and secondary loss of response (LOR) are significant problems of biological therapy for inflammatory bowel disease (IBD). Therapeutic drug monitoring (TDM) in IBD patients receiving these drugs can improve outcomes. Aim: To measure serum infliximab levels and anti-infliximab antibodies (ATI) in patients with IBD post-induction phase and during maintenance therapy assessing the clinical course of IBD. Patients and Methods: Prospective study of IBD patients receiving infliximab between July 2016-May 2017. Group-A included patients who received induction therapy while Group-B included patients who were in maintenance therapy. TDM was performed in serum samples collected at weeks-14 and 30 in Group-A and before the infliximab maintenance dose in Group-B. Clinical scores, fecal calprotectin and endoscopic score were also evaluated. Results: Of 14 patients in Group-A, 57% achieved endoscopic response. Median serum infliximab concentrations at week-14 and 30 were 2.65 AU/mL (0.23-32.58) and 2.3 AU/mL (0.3-16.8), respectively. Patients with mucosal healing had non-significantly higher median infliximab concentrations at week- 14, as compared to week 30 (median 3.2 vs 2.2 AU/ml, respectively, p 0.6). ATI >10 ug/mL were found in one and seven patients at week-14 and 30, respectively. At 52 weeks of follow-up, four patients (31%) had LOR. Group-B included 36 patients, 33% had LOR. Median serum concentrations of infliximab were 1.4 AU/mL (0.27-7.03). No significant differences in serum infliximab concentration were observed between patients in remission and those with inflammatory activity. Seventeen patients had ATI >10 ug/mL. Conclusions: Clinical algorithms using TDM might help to optimize the pharmacological therapy of IBD.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Gastrointestinal Agents/therapeutic use , Colitis, Ulcerative/drug therapy , Crohn Disease/drug therapy , Drug Monitoring/methods , Infliximab/therapeutic use , Reference Values , Severity of Illness Index , Gastrointestinal Agents/blood , Enzyme-Linked Immunosorbent Assay , Colitis, Ulcerative/diagnostic imaging , Crohn Disease/diagnostic imaging , Prospective Studies , Reproducibility of Results , Colonoscopy , Treatment Outcome , Statistics, Nonparametric , Infliximab/blood
10.
Rev. méd. Chile ; 146(8): 823-830, ago. 2018. tab
Article in Spanish | LILACS | ID: biblio-978764

ABSTRACT

Background: Most cases of Clostridium difficile infection (CDI) respond to a standard course of antibiotics, however recurrent CDI is becoming common and alternative therapeutic strategies are needed. In this scenario, fecal microbiota transplantation (FMT) has been suggested. Aim: To describe the efficacy and safety of FMT for the treatment of recurrent CDI. Patients and Methods: Review of medical records of all patients with recurrent CDI treated with FMT between April 2013 and April 2017. Demographic and clinical data were abstracted including details of treatment prior to FMT, rate of FMT treatment success and clinical course during follow-up period. Telephone surveys were conducted to determine patient satisfaction. Results: Eight patients aged 19 to 82 years (six women) underwent FMT. They experienced a median of four previous episodes of CDI (range 3-8). The mean duration of CDI was 18 days (range 3-36) before FMT. All procedures were performed by colonoscopy. Effectiveness with one session of FMT was 100%. During the follow-up period (median 24 months, range 7-55), two patients developed CDI, one of them after using antibiotics. Adverse events were reported in three patients. Two had bloating and one patient with Crohn's disease and a history of bacteremia had an episode of Escherichia coli bacteremia. All patients would use FMT again if necessary. Conclusions: FMT through colonoscopy appears to be a safe, effective and long-lasting therapy in cases of recurrent CDI.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Colonoscopy , Clostridium Infections/therapy , Fecal Microbiota Transplantation/methods , Recurrence , Clostridioides difficile , Treatment Outcome , Feces/microbiology , Fecal Microbiota Transplantation/adverse effects , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/therapeutic use
11.
Rev. méd. Chile ; 145(11): 1421-1428, nov. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902462

ABSTRACT

Background Imaging with F18-fluorodeoxyglucose PET/CT is used to determine sites of abnormal glucose metabolism and can be used to characterize and localize many types of tumors. Aim To assess the prevalence of multiple primary malignant neoplasms (MPMN) detected by PET/CT in cancer patients. Material and Methods F18-fluorodeoxyglucose PET/CT scans performed to 800 patients with a newly diagnosed cancer or with already treated tumors were retrospectively reviewed. In patients whose examination described incidental findings not related to the primary tumor, a research was done about further laboratory, imaging or pathological studies. Results In 188 PET/CT scans (23%) an incidental finding was found. Of these, 66 (35%) were considered as MPMN, 12 as atypical metastases of a known primary tumor, 14 as false positive images (inflammatory or physiologic uptake) and 29 as benign or low grade tumors. In 67 cases (36% of all incidental tumors), the finding was not confirmed. Seven percent of patients with a newly diagnosed tumor had a synchronic MPMN detected by PET/CT. Nine percent of patients with treated tumors developed a metachronous MPMN during their follow up. The most common incidental tumors were thyroid cancer in 15 cases, kidney cancer in 13, lung cancer in 10, colorectal carcinoma in 9, breast cancer in 6, prostate cancer in 4, non-Hodgkin lymphoma in 3 and pancreatic cancer in 2. Conclusions A MPMN is detected by PET/CT in a significant number of cancer patients.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Carcinoma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Neoplasms, Multiple Primary/diagnostic imaging , Carcinoma/classification , Carcinoma/complications , Adenocarcinoma/classification , Adenocarcinoma/complications , Adenocarcinoma/diagnostic imaging , Cross-Sectional Studies , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Early Detection of Cancer/methods , Neoplasms, Multiple Primary/classification , Neoplasms, Multiple Primary/complications
12.
Rev. méd. Chile ; 145(10): 1342-1348, oct. 2017. graf
Article in Spanish | LILACS | ID: biblio-902449

ABSTRACT

Primary colorectal lymphoma is a rare form of presentation of gastrointestinal tract lymphomas. Inflammatory bowel disease and its treatment are risk factors for its development. We report a 47-year-old male patient with Ulcerative Colitis of two years of evolution, treated initially with azathioprine and later on with infliximab. Due to a relapse in symptoms after the second dose of infliximab, a new coloncoscopy was performed showing a rectal ulcerative lesion, corresponding to a large cell Non-Hodgkin's Lymphoma. The patient was successfully treated with RCHOP chemotherapy (Rituximab cyclophosphamide doxorubicin vincristine prednisone). He is currently in disease remission.


Subject(s)
Humans , Male , Middle Aged , Rectal Neoplasms/etiology , Rectal Neoplasms/pathology , Colitis, Ulcerative/drug therapy , Lymphoma, Large B-Cell, Diffuse/etiology , Lymphoma, Large B-Cell, Diffuse/pathology , Immunosuppressive Agents/adverse effects , Rectal Neoplasms/diagnostic imaging , Azathioprine/adverse effects , Vincristine/administration & dosage , Biopsy , Gastrointestinal Agents/adverse effects , Prednisone/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/administration & dosage , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Cyclophosphamide/administration & dosage , Rituximab/administration & dosage , Infliximab/adverse effects , Positron Emission Tomography Computed Tomography
13.
Rev. méd. Chile ; 145(10): 1319-1329, oct. 2017. tab
Article in Spanish | LILACS | ID: biblio-902446

ABSTRACT

The clinical presentation of ulcerative colitis at the moment of diagnosis is variable, and its clinical course is difficult to predict. It can range from a quiescent to a refractory chronic course that may require hospitalization and surgical procedures. It can also have complications such as colorectal cancer. In this review we discuss the role of demographic, clinical, endoscopic, histological and associated factors, which can help to predict the clinical course of the disease at the moment of diagnosis, and to individualize therapy according to this clinical risk. Accurate identification of patients with a newly diagnosed ulcerative colitis who are at high risk of an unfavorable outcome is still a challenge. However, an effective evaluation allows an early diagnosis, a timely and effective treatment.


Subject(s)
Humans , Male , Female , Colitis, Ulcerative/diagnosis , Prognosis , Severity of Illness Index , Biomarkers , Colitis, Ulcerative/surgery , Colitis, Ulcerative/pathology , Sex Factors , Risk Factors , Age Factors , Colectomy/statistics & numerical data , Risk Assessment
14.
Rev. chil. infectol ; 34(5): 518-519, oct. 2017. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1042641

ABSTRACT

There are no evidence-based guidelines about prophylaxis against Pneumocystis jiroveci pneumonia in inflammatory bowel disease. We report a case of P. jiroveci pneumonia in patient with Crohn's disease receiving infliximab and methotrexate. This case emphasizes the importance of considering the possibility of this infection in inflammatory bowel disease patients treated on biological therapy.

15.
Rev. méd. Chile ; 145(9): 1129-1136, set. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902597

ABSTRACT

Background: Different strains of invasive Escherichia coli (E. coli), isolated from intestinal mucosa of patients, are related to the pathogenesis of inflammatory bowel diseases (IBD). Aim: To evaluate an association between intracellular E. coli and IBD; its clinical characteristics and use of steroids. Material and Methods: Sixty one patients with Crohn's disease and 83 with ulcerative colitis were studied. To determine the intracellular E. coli content, colonoscopy biopsies of these patients and 29 control subjects were processed using the gentamicin protection assay. Differences in the bacterial content between patient groups were evaluated using Mann-Whitney test, while the association between presence of E. coli with endoscopic activity, location/extension and use of corticosteroid as anti-inflammatory treatment were evaluated with Fisher's exact test or Chi-square test. Results: E. coli strains were detected in 36.1, 39.3 and 10.3% of patients with ulcerative colitis, Crohn's disease and controls, respectively. The number of bacteria per biopsy in Crohn's disease and ulcerative colitis was significantly higher than in controls (p < 0.01 between patients and controls). In ulcerative colitis, significant associations were found between the presence of bacteria and disease location and use of corticosteroids. In Crohn's disease, no association was found. Conclusions: IBD are associated with the presence of intracellular E. coli strains in the intestinal mucosa, suggesting an alteration in the microbiota or loss of integrity of the epithelial barrier. The association of intracellular E. coli with clinical features and the use of corticosteroids in ulcerative colitis suggests that different factors could promote colonization or proliferation of these bacteria.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Colitis, Ulcerative/microbiology , Crohn Disease/microbiology , Escherichia coli/isolation & purification , Intestinal Mucosa/microbiology , Reference Values , Colony Count, Microbial , Colitis, Ulcerative/drug therapy , Crohn Disease/drug therapy , Case-Control Studies , Prospective Studies , Adrenal Cortex Hormones/therapeutic use , Statistics, Nonparametric , Anti-Inflammatory Agents/therapeutic use
16.
Rev. méd. Chile ; 145(8): 1083-1088, ago. 2017. graf
Article in Spanish | LILACS | ID: biblio-902589

ABSTRACT

Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition that requires early recognition, hospitalization and adequate treatment. Currently, the use of infliximab in ulcerative colitis (UC) is recommended in the case of severe disease refractory to corticosteroids, once that superimposed bacterial or viral infections (such as cytomegalovirus or Clostridium difficile) have been excluded. However, conventional weight-based regimens of infliximab might be insufficient for patients with ASUC. Accelerated infliximab induction regimen may increase its serum concentration levels and efficacy by reducing early colectomy rates in these patients. We report a 34 year old female presenting with an ASUC. She was initially treated with hydrocortisone 300 mg/day and mesalazine enemas 4 g/day with an unfavorable clinical response. At the fifth day of therapy, an accelerated induction therapy with infliximab was started in doses of 10 mg/kg at weeks 0, 1 and 4. After the second dose, there was a favorable response with reduction of abdominal pain, stool frequency and hematochezia. She was discharged with prednisone and azathioprine. After a year of starting infliximab, the patient remains in clinical remission.


Subject(s)
Humans , Female , Adult , Gastrointestinal Agents/therapeutic use , Colitis, Ulcerative/drug therapy , Infliximab/therapeutic use , Biopsy , Colitis, Ulcerative/pathology , Colitis, Ulcerative/diagnostic imaging , Acute Disease , Colonoscopy , Treatment Outcome , Leukocyte L1 Antigen Complex/analysis , Feces
17.
Rev. méd. Chile ; 145(4): 538-543, abr. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-902508

ABSTRACT

Anti-tumor necrosis factor-α (TNF) agents have dramatically changed the management of Crohn’s Disease (CD). However, a significant number of these patients do not respond at all or cease to respond to antibodies against TNF. In this clinical situation, the options include intensification of anti-TNF therapy by either increasing the dose or by shortening the administration interval, the use of a second anti-TNF or medications with a different mechanism of action. Among the later, Natalizumab, a humanized IgG4 monoclonal antibody against α4β1 and α4β7 integrins, is safe and effective in inducing and maintaining remission in active CD patient’s refractory to anti-TNF. In spite of this, Natalizumab use has been limited because of an increased risk of progressive multifocal leukoencephalophaty which results from reactivation of the John Cunningham (JC) virus. However, the presence of antibodies against JC virus in serum can be used to reduce the risk for this complication. We report three patients with Crohn’s disease refractory to treatment with infliximab, who responded successfully to the use of Natalizumab.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Crohn Disease/drug therapy , Natalizumab/therapeutic use , Immunosuppressive Agents/therapeutic use , Treatment Outcome , Natalizumab/adverse effects , Immunosuppressive Agents/adverse effects
18.
Rev. méd. Chile ; 145(3): 397-401, Mar. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-845554

ABSTRACT

Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohn’s disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure. It resolved with medical treatment and prolonged antibiotic therapy.


Subject(s)
Humans , Male , Aged , Crohn Disease/complications , Diverticulitis/etiology , Jejunal Diseases/etiology , Acute Disease , Diverticulitis/diagnostic imaging , Jejunal Diseases/diagnostic imaging
19.
Rev. méd. Chile ; 145(2): 201-208, feb. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-845526

ABSTRACT

Diverticulosis and diverticular disease of the colon are common conditions in Western countries. The incidence and prevalence of these diseases are increasing and becoming significant for health systems. A growing body of knowledge is shifting the paradigm of the pathogenesis and treatment of diverticular disease. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors leading to diverticular disease. The risk of developing diverticulitis among individuals with diverticulosis is lower than 10 to 25%. Studies indicate that diverticular disease may become a chronic disorder in some patients, not merely an acute illness. Contrary to the advice from international guidelines, studies have not shown that a high-fiber diet protects against diverticulosis. The evidence about the use of antibiotics in uncomplicated diverticulitis is sparse and of low quality. In relation to surgery, studies support a more conservative approach to prophylactic surgery in patients with recurrent disease or chronic symptoms. Finally, new pathophysiological knowledge suggests that other treatments may be useful (mesalamine, rifaximin and probiotics). However, more research is necessary to validate the safety, effectiveness and cost-effectiveness of these strategies.


Subject(s)
Humans , Diverticulitis/classification , Diverticulitis/diagnosis , Diverticulitis/etiology , Diverticulitis/therapy
20.
Rev. méd. Chile ; 144(12): 1612-1616, dic. 2016. ilus
Article in Spanish | LILACS | ID: biblio-845493

ABSTRACT

Benign multicystic peritoneal mesothelioma is an uncommon lesion arising from the peritoneal mesothelium. It is asymptomatic or presents with unspecific symptoms. Imaging techniques may reveal it, however the final diagnosis can only be made by histopathology. Surgery is the only effective treatment considering its high recurrence rate. We report a 19 years old male with Crohn’s disease. Due to persistent abdominal pain, an abdominal magnetic resonance imaging was performed, showing a complex cystic mass in the lower abdomen. The patient underwent surgery and the lesion was completely resected. The pathological study reported a benign multicystic peritoneal mesothelioma.


Subject(s)
Humans , Male , Young Adult , Peritoneal Neoplasms/complications , Crohn Disease/complications , Mesothelioma, Cystic/complications , Peritoneal Neoplasms/surgery , Peritoneal Neoplasms/pathology , Mesothelioma, Cystic/surgery , Mesothelioma, Cystic/pathology
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