Hallazgos endoscópicos en pacientes con hemorragia digestiva inferior en el Hospital General del Oeste durante los años 2003-2008 / Endoscopic findings in patients with lower gastrointestinal bleeding in the Hospital General del Oeste during the years 2003-2008

La hemorragia digestiva inferior ocupa aproximadamente el 0.5% de todas las admisiones de corta estancia en los hospitales de lo estados Unidos. La incidencia de sangrado digestivo inferior es estimada en 20 a 27 casos por cada 100 mil adultos en la población de riesgos. Es más común en hombres que en mujeres. La mortalidad global oscila al 5 % según la causa. El objetivo de nuestro trabajo fue determinar los hallazgos endoscópicos más frecuentes en pacientes con hemorragia digestiva inferior en el servicio de gastroenterología del hospital General del Oeste. Se realizo una revisión retrospectiva de los hallazgos endoscópicos en pacientes mayores de 18 años que acudieron al servicio de Gastroenterología del Hospital General del Oeste entre diciembre del 2003 y diciembre del 2008 con el diagnostico de hemorragia digestiva inferior. Un total de 389 pacientes. De los cuales el55.7 %fueron del sexo femenino y 44.3 % del sexo masculino. Con una edad promedio de 53.2 años. El principal hallazgo endoscópico fue enfermedad diverticular con un 26. 9%, seguido de hemorroides internas y externas con un 26.4% y 12.8 % respectivamente. El 15.4 % de las endoscopias digestivas inferiores fueron normales. La hemorragia digestiva inferior en nuestro centro es más frecuente en mujeres, siendo el hallazgo endoscópico más común la enfermedad diverticular y la enfermedad hemorroidal en ambos sexo...

Lower gastrointestinal bleeding represents approximately 0.5% of all short-stay admissions in United States hospitals. The incidence of lower gastrointestinal bleeding is estimated at 20-27 cases per 100.000 adults in the risk population. It is more common in men than in women. The overall mortality ranges at 5% depending on the cause. The aim of our study was to determine the endoscopic findings in patients with lower gastrointestinal bleeding in Hospital General del Oeste. Methods: We conducted a retrospective review of endoscopic findings in patients older than 18 years-old who attended the Gastroenterology Service of Hospital General del Oeste between December 2003 and December 2008, with lower gastrointestinal bleeding diagnosis. A total of 389 patients. Of which, 55.7% were female and 44.3% male; with an average age of 53.2 years-old. Diverticulitis was the main endoscopic finding with 26.9%, followed by internal and external hemorrhoids with 26.4% and 12.8% respectively. 15.4% of lower gastrointestinal endoscopies were normal. The lower gastrointestinal bleeding in our hospital is more common in women, being diverticulitis and hemorrhoids the most common endoscopic finding, in either sex...

Gastrocystoplasty using the linear cutter stapler to harvest the segment without opening the stomach

Objectives: We evaluate a modification of gastrocystoplasty using the Linear Cutter stapler to harvest the segment for augmentation without opening the stomach

Patients and Methods: Ten patients [6 children and 4 adults] underwent gastrocystoplasty. Indications for surgery included urinary incontinence and upper tract deterioration. The use of intestinal segments was precluded because of either young age or impaired renal function. Preoperative renal function, radionuclide renal scan and urodynamic evaluations were done in all patients

Results: There were no complaints of early satiety or weight loss. Mean time to feeding was 5 days postoperatively. None of the patients had clinical evidence of gastric leakage. Of the 10 patients, 8 void spontaneously and 2 require intermittent catheterization. Bladder capacity and compliance and urinary flow rates were significantly improved in all patients. At a mean follow-up period of 9.4 months clinically significant hypochloremic, hypokalemic metabolic alkalosis was not noted in any patient

Conclusion: This simplification reduces operative time and blood loss without introducing complications, and has been successfully used in our first 10 patients