ABSTRACT
Objetivou-se caracterizar as EDA realizadas na Comunidade de Saúde de Mossoró, RN, no período de 2008 a 2013, definindo a taxa de exames normais e a prevalência dos principais achados sugestivos de patologias digestivas. Trata-se de um estudo transversal e retrospectivo, no qual se analisou 10311 laudos de EDA. As análises estatísticas foram realizadas pelo SPSS (Statistical Package for the Social Sciences, versão 20.0), com nível de confiança95% e um p < 0,05, utilizando-se testes Qui-quadrado. Pelos dados levantados, constatamos que a EDA é um exame prático e seguro, com raríssimas complicações, sendo a agitação e a presença de alimento no estômago as limitações mais comuns. Na análise descritiva geral observou-se que a maioria dos exames foi realizada no gênero feminino, formando mais de 70% da amostra total. A faixa etária predominante, independente do gênero, foi 41 a 60 anos. As patologias frequentes no segmento esofágico foram as Esofagites. No segmento gástrico, a maior frequência de achados foram as Gastrites, que são mais frequentes com o avançar da idade. Na Transição Gastroduodenal, as úlceras de Canal Pilórico são os achados mais descritos, mas observamos também modestos achados de duodenites. No duodeno, os principais achados foram úlceras duodenais, seguidas pelas duodenites e sinais de atrofia. Portanto, as EDA são mais realizadas no gênero feminino, mas apresentam maior percentual de exames normais, sendo a maior frequência de achados encontrada no gênero masculino. Assim, após analisar as 10.311 EDA, é possível prever os achados mais comuns encontrados a EDA.
This study aimed to characterize the EDA held in Mossoro Health Community, RN, from 2008 to 2013, setting the rate of normal examinations and the prevalence of the main findings suggestive of digestive pathologies. It is a cross-sectional retrospective study, which analyzed 10,311 reports of EDA. Statistical analyzes were performed using SPSS (Statistical Package for Social Sciences, version 20.0), with a confidence level 95% and p <0.05, using chi-square tests. Raised by the data, we found that EDA is a practical and safe exam, with very few complications, agitation and presence of food in the stomach the most common limitations. In general descriptive analysis it was observed that most of the exams was held in females, forming more than 70% of the total sample. The predominant age group, regardless of gender, was 41-60 years. The frequent pathologies in esophageal segment were Esophagitis. Gastric segment, the highest frequency of findings were Gastritis, which are more common with advancing age. Gastroduodenal in Transition, the Channel Pyloric ulcers are the most described findings, but also observed modest findings of duodenitis. In the duodenum, the main findings were duodenal ulcers, followed by duodenitis and signs of atrophy. Therefore, the EDA are more performed in females, but have a higher percentage of normal results, with the highest frequency of findings found in males. So after analyzing 10,311 EDA, it is possible to predict the most common findings EDA.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Endoscopy, Digestive System , Duodenal Diseases/diagnosis , Cross-Sectional Studies , Retrospective Studies , Endoscopy, Digestive System/adverse effects , Duodenitis/diagnosis , Esophagitis/diagnosis , Gastritis/diagnosis , Gastrointestinal Neoplasms/diagnosisABSTRACT
El objetivo de este estudio fue evaluar a los pacientes con fiebre mediterránea familiar (familial Mediterranean fever, FMF) y dolor abdominal crónico resistentes al tratamiento con colchicina. Se incluyó a 48 pacientes diagnosticados en nuestro consultorio de reumatología pediátrica que tenían dolor abdominal a pesar del tratamiento con colchicina. A todos los pacientes se los derivó a un gastroenterólogo pediátrico. Se registraron las características del dolor, tales como aparición, duración y frecuencia; se planificó una endoscopía digestiva para obtener un diagnóstico diferencial. Se determinó la presencia de una mutación del gen MEFV en 46 pacientes. La mediana de la duración del tratamiento fue de 2,8 años. Aproximadamente el 60% de los pacientes tenían dolor abdominal todos los días o de dos a tres veces a la semana; en el 73% de los casos, duró menos de tres horas. A 41 pacientes se les realizó una endoscopía digestiva alta. La gastroduodenitis es un hallazgo frecuente en los pacientes con FMF y dolor abdominal persistente a pesar del tratamiento. Los pacientes con los puntajes más altos de severidad de la enfermedad tenían inflamación digestiva grave.
The aim of the study to evaluate familial mediterranean fever (FMF) patients with chronic abdominal pain unresponsive to colchicine treatment. Forty-eight patients who diagnosed in our Pediatric Rheumatology clinics and suffering from abdominal pain despite colchicine treatment were include. All patients were referred to a pediatric gastroenterologist. The pain characteristics such as onset, duration and frequency were recorded; gastrointestinal (GI) endoscopy was planned for differential diagnosis. MEFV mutation was determined in 46 patients. The median duration of treatment was 2.8 years. Approximately 60% of the patients suffered from abdominal pain every day or 2-3 times a week, in 73% of the cases it lasted less than three hours. Forty-one patients underwent upper GI endoscopy. Gastroduodenitis is a common finding in persisting abdominal pain despite therapy of FMF patients. The patients with the highest disease severity scores had severe inflammation within the entire GI system.
Subject(s)
Humans , Child , Adolescent , Familial Mediterranean Fever/complications , Abdominal Pain/epidemiology , Colchicine/administration & dosage , Chronic Pain/etiology , Familial Mediterranean Fever/drug therapy , Abdominal Pain/etiology , Endoscopy, Gastrointestinal/methods , Duodenitis/diagnosis , Duodenitis/etiology , Chronic Pain/epidemiology , Gastritis/diagnosis , Gastritis/etiologyABSTRACT
There are various etiologies of duodenojejunitis such as Henoch-Schonlein purpura (H-S purpura), vasculitis, Crohn's disease, celiac sprue, ischemia, lymphoma, Zollinger-Ellison syndrome, bacteria or parasite infection, radiation, drug induced jejunitis, eosinophilic jejunitis, and toxins. A 31-year-old man presented with left upper quadrant pain. He did not have febrile sense, hematochezia, melena, diarrhea, arthralgia and hematuria. He had neither drug history nor traveling history. Esophagogastroduodenoscopy showed diffuse mucosal erythema and segmental hemorrhagic erosions on the distal area to the descending portion of the duodenum and proximal jejunum, which were commonly observed in the gastrointestinal involvement of H-S purpura. However, he showed no skin lesions, joint and urologic problems until the discharge. Autoimmune markers such as antinuclear antibody and antineutrophil cytoplasmic antibody were negative. Celiac and mesenteric angiogram showed no vascular abnormality. After the administration of oral prednisolone 40 mg daily for therapeutic trial, abdominal pain and endoscopic lesions were improved. He experienced relapses of same episode without skin lesions 16 times during follow-up of 8 years, which were also treated with prednisolone. The abdominal computed tomography during the follow-up also showed no significant finding. We report a case of primary recurrent duodenojejunitis similar to the gastrointestinal involvement of H-S purpura without purpura.
Subject(s)
Adult , Humans , Male , Angiography , Anti-Inflammatory Agents/therapeutic use , Duodenitis/diagnosis , Endoscopy, Gastrointestinal , Enteritis/diagnosis , Jejunal Diseases/diagnosis , Prednisolone/therapeutic use , IgA Vasculitis/diagnosis , RecurrenceABSTRACT
La Strongyloidiasis es una parasitosis intestinal producida por un nematodo de distribución mundial, es endémica en zonas tropicales, el parasito penetra a través de los pies en forma de larva filariforme presente en suelos infectados. Puede presentar manifestaciones Dermatológicas, Respiratorias y Gastrointestinales, siendo estas ultimas de variado espectro, que van desde síntomas vagos e inespecíficos hasta Enteritis Invasiva. Los métodos convencionales de examen de heces seriados o radiología no son lo suficientemente sensibles ni específicos. La endoscopia ha aumentado la posibilidad de hacer mejores diagnósticos, así como la biopsia gástrica y duodenal; de hecho se considera a los hallazgos endoscópicos como marcadores de severidad de la infección. Presentamos el caso de un paciente con síntomas dispépticos y hallazgos endoscópicos e histológicos de Duodenitis por Strongyloides Stercoralis. El paciente recibió tratamiento con Ivermectina.
The intestinal strongyloidiasis is a parasitic disease caused by a global distribution nematode endemic in tropical areas, penetrates through the feet in the form of larvae present in infested soil filariform. May present with dermatological, respiratory and gastrointestinal tracts, the latter being varied spectrum of symptoms ranging from vague to invasive enteritis. Conventional methods of serial stool examination, radiology are not sensitive enough nor specific. Endoscopy has increased the possibility of better diagnosis, as well as gastric and duodenal biopsy, in fact considered the endoscopic findings as markers of severity of infection. We report the case of a patient with dyspeptic symptoms with endoscopic and histological findings of Duodenitis for Strongyloides Stercoralis. He was treated with Ivermectin.
Subject(s)
Humans , Male , Adult , Duodenitis/diagnosis , Duodenitis/parasitology , Histological Techniques , Strongyloides , Peptic Ulcer/microbiology , Gastric Acidity Determination , Gastrointestinal Diseases , Intestinal Diseases, ParasiticABSTRACT
Helicobacter pylori [H. pylori] infection in characterized by marked changes in cytokine production, resulting from the immune response to infection. The H. pylori-associated diseases present with manifestations varying from mild non-ulcer dyspepsia or peptic ulcer disease [PUD] to gastric cancer. Study the effect of H. pylori infection on circulating serum levels of IL-1beta in some gastroduodenal disorders. According to upper gastrointestinal [GI] tract symptoms, upper GI endoscopy [including gastric pH measurement, ultra-rapid urease test-for the diagnosis of H-pylori infection, and biopsy], and histo-pathological examination, 80 patient with gastroduodenal disorders [20 gastric ulcer, 20 duodenal ulcer, 10 gastritis, 10 duodenitis and 20 gastric cancer] were studied. In addition, 10 apparently healthy subjects served as a control group. Circulating serum IL-1beta levels were determined for all subjects, by ELISA. The majority of gastroduodenal disorders studied had evidence of H. pylori infection and significantly higher serum IL-1beta than control subjects, being more in gastric disorders [gastritis, cancer and ulcer]. Gastric pH was significantly higher in patients with gastric disorders [gastric cancer, gastric ulcer and gastritis]. IL-1beta correlates positively with H. pylori infection in patients with duodenal ulcer and gastric ulcer. Meanwhile, it correlates negatively with gastric pH, in patients with gastric ulcer. Gastric pH and serum IL-1beta are significantly higher in cancer patients than in non-cancer patients. On other hand, H. pylori infection is detected more significantly in non-cancer patients. The mean serum IL-1beta was found to be significantly higher in patients with positive H. pylori infection than in those negative for H. pylori infection. IL-1beta is in an important pro-inflammatory cytokine with profound effects. Its acid inhibitory properties uniquely qualify it as a major player in the host's response to H. pylori infection and the diseases associated with it
Subject(s)
Humans , Male , Female , Stomach Ulcer/diagnosis , Duodenitis/diagnosis , Endoscopy, Gastrointestinal , Interleukin-1/blood , Helicobacter Infections , Helicobacter pylori , CytokinesABSTRACT
OBJETIVO: Avaliar as características clínicas e histológicas de crianças e adolescentes com úlcera duodenal. MÉTODOS: Foram avaliadas prospectiva e consecutivamente 43 pacientes com úlcera duodenal ao longo de 6 anos (7,2 pacientes por ano). A avaliação consistiu de questionário clínico de sintomas dispépticos, exame físico e endoscopia digestiva com biópsias gástricas para exame histológico e detecção do Helicobacter pylori. RESULTADOS: A idade no diagnóstico variou de 4 anos e 8 meses a 17 anos e 4 meses (mediana = 12 anos e 4 meses). O sintoma mais freqüente foi dor abdominal (39/43, 90,7 por cento): no epigástrio em 31/39, periumbilical em 7/39 e noturna em 27/39. Outros sintomas freqüentes foram: diminuição do apetite (32/43, 74,4 por cento), vômitos (30/43, 69,8 por cento), plenitude pós-prandial (23/43, 53,5 por cento), perda de peso (22/43, 51,2 por cento) e sensibilidade abdominal (19/43, 44,2 por cento). Hemorragia digestiva alta ocorreu em 19/43 pacientes (44,2 por cento), e anemia em 21/43 (48,8 por cento). H. pylori foi detectado em 41/43 (95,3 por cento), e todos esses pacientes apresentaram gastrite crônica ativa de antro, 92 por cento deles com predomínio do infiltrado linfomononuclear. A erradicação da bactéria ocorreu em 68,3 por cento dos pacientes infectados, mas houve cicatrização da lesão em 100 por cento dos pacientes erradicados e em 89 por cento dos não-erradicados. CONCLUSAO: Ulcera duodenal foi associada à gastrite crônica por H. pylori na grande maioria dos pacientes. Houve grande freqüência de complicações, especialmente hemorragia digestiva alta.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Duodenal Ulcer/diagnosis , Gastritis/diagnosis , Helicobacter Infections/diagnosis , Chronic Disease , Duodenal Ulcer/microbiology , Duodenal Ulcer/pathology , Duodenitis/diagnosis , Duodenitis/microbiology , Duodenitis/pathology , Gastritis/microbiology , Gastritis/pathology , Helicobacter Infections/microbiology , Helicobacter Infections/pathology , Helicobacter pylori/isolation & purification , Prospective StudiesABSTRACT
La frecuencia de lesiones gastroduodenales fue investigada en ochenta pacientes con cirrosis hepática de diversos grados de severidad de acuerdo a la clasificación de Child-Pugh. La población estudiada fue subdividida en tres grupos con base en su etiología: alcoholismo, viral y criptogénica. La gastritis fue la alteración más frecuente en 52 casos (65 por ciento), cuyo porcentaje fue similar en los tres grupos, sin embargo, fue el agente causal de hemorragia digestiva en casi la mitad de los pacientes que presentaron dicho evento (47.7 por ciento). La lesión ulcerosa fue el segundo hallazgo más frecuente con veinticuatro casos (30 por ciento); predominó en la cirrosis alcohólica y como causa de hemorragia se identificó en doce casos (27.2 por ciento). No obstante que todos los pacientes tenían várices esofágicas, únicamente en once casos (25 por ciento), éstas fueron la causa de la hemorragia digestiva. Dicho porcentaje pudo deberse al grado de severidad de la hepatopatía fue catalogada de leve a moderada en 71 casos (88.7 por ciento)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Liver Cirrhosis/diagnosis , Liver Cirrhosis/etiology , Digestive System/injuries , Endoscopy, Digestive System , Hypertension, Portal/complications , Duodenitis/diagnosis , Esophagitis, Peptic/diagnosis , Esophageal and Gastric Varices/diagnosisABSTRACT
Cytomegalovirus(CMV) disease is a major cause of morbidity and mortality in immunocompromised patients. CMV enteritis should be considered when nausea and vomiting continue 3 to 4 weeks after bone marrow transplantation(BMT). The treatment of CMV enteritis is not well established. We report a CMV duodenitis patient following allogenic bone marrow transplantation. The patient had prolonged nausea and vomiting for 5 weeks after bone marrow transplantation and CMV duodenitis was diagnosed by the gastroduodenoscopic mucosal biopsy which showed cytomegalic cells. Ganciclovir treatment for 3 weeks resulted in the resolution of symptoms and promoted healing of the lesion. The patient was free of CMV infection until 288 days after allogenic BMT without maintenance ganciclovir treatment.
Subject(s)
Adult , Humans , Male , Antiviral Agents/therapeutic use , Bone Marrow Transplantation/adverse effects , Cytomegalovirus Infections/etiology , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/diagnosis , Duodenitis/etiology , Duodenitis/drug therapy , Duodenitis/diagnosis , Ganciclovir/therapeutic use , Transplantation, HomologousABSTRACT
20 children with suspected Helicobacter pylori (H. pylori) infection are presented. The mean age of the children was 9.4 years (range 4-13 years). The mean H. pylori IgG and IgA antibodies were 677 units and 760.7 units respectively. Antral biopsy cultures were positive in five children. Histopathology of the gastric antral and duodenal biopsies showed H. pylori gastritis in 11 children, duodenitis and gastritis in five, normal histology in three and one child had normal histology with H. pylori like organism on the surface of the antral mucosa. From this study, we conclude that serology is a good diagnostic test for H. pylori infection in Saudi Arabia.
Subject(s)
Adolescent , Biopsy , Child , Child, Preschool , Duodenitis/diagnosis , Endoscopy, Gastrointestinal , Enzyme-Linked Immunosorbent Assay , Female , Gastritis/diagnosis , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Humans , Immunoglobulin A/blood , Immunoglobulin G/blood , Male , Prospective Studies , Saudi ArabiaABSTRACT
Ciento diecinueve niños de uno a 14 años que consultaron por síntomas sugestivos de enfermedad ácido péptica (EAP) fueron estudiados con endoscopia y biopsia. Presentaron gastritis antral 73.1 por ciento, duodenitis 10.08 por ciento, úlcera duodenal 4.2 por ciento, úlcera gástrica 1.6 por ciento y esofagitis 0.8 por ciento. Cincuenta y un pacientes fueron positivos para H.pylori. Tanto el grupo positivo como el negativo tuvieron sintomatología similar, pero la úlcera duodenal se asoció significativamente a H.pylori. Veintinueve (87.8 por ciento) de 33 niños positivos mejoraron clínicamente con diferentes combinaciones de amoxacilina, metronidazol, bismuto y antiácidos y antagonistas H2. Veinticinco (95 por ciento) de 26 negativos mejoraron con antiácidos y antagonistas H2
Subject(s)
Humans , Child , Duodenitis/classification , Duodenitis/diagnosis , Duodenitis/drug therapy , Duodenitis/etiology , Esophagitis/classification , Esophagitis/diagnosis , Esophagitis/drug therapy , Esophagitis/etiology , Gastritis/diagnosis , Gastritis/drug therapy , Gastritis/etiology , Gastritis/nursing , Stomach Ulcer/classification , Stomach Ulcer/diagnosis , Stomach Ulcer/etiology , Stomach Ulcer/drug therapy , Helicobacter pylori/classification , Helicobacter pylori/growth & development , Helicobacter pylori/isolation & purification , Helicobacter pylori/pathogenicityABSTRACT
La giardiasis constituye una de las enteroparasitosis más frecuentes en nuestro país presentando sintomatología digestiva variada. El presente es un estudio prospectivo, transversal, realizado con el objetivo de establecer la frecuencia es que está presente G. lamblia en pacientes sintomáticos digestivos que son sometidos a gastroduodenoscopía, relacionando su aislamiento con los resultados del examen endoscópico. se estudiaron 50 pacientes, realizándoles a todos examen endoscópico alto. Durante el procedimiento se aspiró contenido duodenal y se tomaron 6 biopsias de duodeno. De 8 a 14 horas previas a la endoscopía se les hizó tragar la cuerda encapsulada (Enterotest). Se determinó la presencia de G. lamblia mediante coloraciones (azul de metileno, Loefler, ioduro de potasio, Giemsa) para los métodos diagnósticos empleados (Enterotest, aspirado duodenal e impronta). El día del examen endoscópico resolvieron un cuestionario de síntomas digestivos que habían presentado en las últimas 4 semanas. La endoscopía fue normal en 15 pacientes (30 por ciento). Se detectó duodenitis endoscópica en 9 pacientes (18 por ciento), no demostrándose en ninguno de éstos la presencia de G. lamblia, no detectándose duodenitis endoscópica en ninguno de ellos, siendo el puntaje de dispepsia no significativo respecto a pacientes sintomáticos sin G. lamblia demostrable. Se concluye que los tres métodos usados en el diagnóstico de G. lamblia fueron igualmente sensibles, no existiendo preponderancia de síntomas digestivos en pacientes con G. lamblia respecto a pacientes en que no se aisló el parásito, debiéndose considerar el aspirado duodenal rutinariamente durante el procedimiento endoscópico para descartar giardiasis debido al importante porcentaje que hemos obtenido en nuestra serie (10 por ciento)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Endoscopy, Gastrointestinal/statistics & numerical data , Giardiasis/prevention & control , Duodenitis/diagnosis , Signs and Symptoms/classificationABSTRACT
The records of 15 patients [10 females and five males] with peptic disease, i.e., peptic ulcer and/or chronic gastroduodenitis who were endoscoped at Asir Central Hospital between 1989G and 1991G were reviewed. The patients' ages ranged between two and 12 years. All the patients were studied radiologically by barium meal [except for two], followed by endoscopy. Histopathology and culture for Helicobacter pylori were done in six patients. Thirty-three percent [five patients] had positive family history of peptic ulcer. Radiological examination was abnormal in only 38% of the patients [five out of 13]. Four out of six patients [67%] were positive for H. pylori. Patients confirmed to have peptic disease were treated using H[2] blockers [ranitidine] and antacid and one was referred for surgery. The response to treatment was quite favorable in 87%. Endoscopy was uneventful in all the patients. It is concluded that peptic disease in childhood in Saudi Arabia is not uncommon and should be kept in mind. A significant number of the patients have a family history of peptic disease in the first degree relatives. Upper gastrointestinal endoscopy in the pediatric age group in expert hands is a safe procedure with minimal complications. H[2] blockers and antacids are effective in the treatment of peptic disease in childhood
Subject(s)
Duodenitis/diagnosis , Gastritis/diagnosis , Helicobacter pylori/pathogenicity , ChildABSTRACT
Com o objetivo de analisar endoscopicamente a associaçäo entre lesöes de mucosa gastroduodenal e varizes como causa de hemorragia digestiva alta em portadores de síndrome de hipertensäo portal, foram avaliados no Gastrocentro da Universidade Estadual de C - UNICAMP, 11 pacientes com hemorragia digestiva no período de 1§ de agosto de 1990 a 15 de julho de 1992, submetidos à endoscopia até 24 horas após admissäo no Pronto-Socorro. Considerando a faixa etária, o sexo e clínica foi encontrada prevalência de 83,7//da terceiras e sextas décadas, sendo 70,08 por cento do sexo masculino e 29,92 por cento do feminino. A hematêmese esteve presente em 94,02 por cento dos casos. Foram causas de hemorragia digestiva alta: varizes esofágicas (47,87 por cento), varizes gástricas (9,40 por cento), lesöes agudas da mucosa gastroduodenal (34,19 por cento) úlcera gástrica (5,98 por cento) e úlcera duodenal (2,56 por cento). Concluíram os autores existir associaçäo importante entre lesöes de mucosa gastroduodenal e varizes como causa da hemorragia digestiva alta na hipertensäo portal, e que é imprescindível a avaliaçäo endoscópica precoce rotineira e detalhada naqueles pacientes com sangramento digestivo alto. É aconselhável um exame endoscópico semestral quando os sintomas dispépticos forem constantes, com antecedentes de tratamento de lesöes de mucosa gastroduodenal ou úlcera péptica, e anual nos demais
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Gastrointestinal Hemorrhage/etiology , Hypertension, Portal/complications , Age Factors , Duodenitis/complications , Duodenitis/diagnosis , Gastritis/complications , Gastritis/diagnosis , Gastrointestinal Hemorrhage/diagnosis , Hypertension, Portal/etiology , Sex Factors , Duodenal Ulcer/complications , Duodenal Ulcer/diagnosis , Stomach Ulcer/complications , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/diagnosisABSTRACT
Un total de 60 pacientes entre 19 y 73 años de edad (32 mujeres y 28 hombres), fueron selecccionados al azar para un estudio prospectivo sobre la confirmación de las lesiones endoscópicas reportadas como características de la duodenitis giardiásica; a saber: un punteado nodular y blanquecino de la mucosa distribuido en forma localizada o difusa. Se correlacionaron los hallazgos endoscópicos con los microscópicos y exámenes de heces seriados. Se practicó duodenoscopia hasta la 2a porción con un gastroscopio Olympus GIF-Q. Las biopsias fueron tomadas 2 en el bulbo y 2 en la segunda porción, las cuales fueron procesadas por un mismo patólogo, que desconocía los hallazgos endoscópicos. 45 pacientes presentaron el aspecto típico antes señalado siendo confirmado a través de la biopsia en 35 de ellos (77.78 por ciento ). Los exámenes de heces fueron positiivos para 22 de estos pacientes (48.88 por ciento ) y negativos para 23 (53.12 por ciento ). 15 pacientes presentaron un aspecto duodenoscópico normal, 13 de ellos obtuvieron biopsia negativa (86.67 por ciento ) y sólo en dos casos (13.33 por ciento ) la biopsia fue positiva para giardias. Los resultados de heces fueron negativos en un 93.34 por ciento en este grupo. Los principales síntomas del grupo en estudio fueron: dolor en epigastrio (67.50 por ciento ), ácidez (62.50 por ciento ), pirosis (25 por ciento ), diarrea (10 por ciento ) y constipación (10 por ciento ). Los resultados obtenidos en nuestro estudio confirman que un punteado nodular y blanquecino de la mucosa duodenal distribuido ya sea en forma localizada o difusa es, en nuestro medio compatible con el diagnóstico endoscópico de duodenitis por Giardia Lamblia. Esto puede ser confirmado en alto porcentaje por anatomía patológica y en aproximadamente 50 por ciento de los casos por exámenes de heces debido a que la eliminación en forma de trofozoito o quistes no es constante ni periódica
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Duodenitis/diagnosis , Endoscopy, Gastrointestinal/trends , Endoscopy, Gastrointestinal/statistics & numerical data , Giardiasis/complicationsABSTRACT
Se investigaron los hallazgos radiológicos para el diagnóstico de Gastritis, Duodenitis y Ulcera gástrica y/o duodenal confirmada endoscópicamente en 25 pacientes. Para el diagnóstico de Gastritis y Duodenitis se valuaron 5 signos radiológicos de la Serie Gastrointestinal: erosiones, nodulaciones, deformidad de la mucosa gástrica o del duodeno, hipersecresión (gastritis), engrosamiento de pliegues mucosas (gastritis) espasmo duodenal y la presencia de un nicho ulceroso (depósito baritado extraluminal, haloperilesional y confluencia de pliegues) en la Ulcera gástrica y/o duodenal. La correlación diagnóstica en la Gastritis grado I fue de 72% con 2 signos radiológicos y en los grados II y III de 80% y 66% respectivamente con 3 signos radiológicos, de los cuales la hipersecresión, engrosamiento de pliegues y nodularidad fueron los más sensibles. En la Duodenítis grado I la correlación diagnóstica fue de 60% con 2 signos radiológicos y de 71 y 73% en los grados II y III con signos radiológicos. La irregularidad de pliegues, deformidad y espasmo duodenal fueron los signos más sensibles. En los pacientes con Ulcera gástrica y/o duodenal hubo una correlación diagnóstica de 66.6% en general
Subject(s)
Child, Preschool , Child , Adolescent , Humans , History, 20th Century , Duodenitis/diagnosis , Duodenoscopy , Gastritis , Gastritis/diagnosis , Gastroscopy , Duodenal Ulcer/diagnosis , Peptic Ulcer/diagnosis , Duodenitis , Duodenal Ulcer , Peptic UlcerABSTRACT
Fifty patients who presented with symptoms suggestive of disease related to peptic acidity having endoscopic evidence of duodenitis were analysed. Endoscopic duodenal biopsy was done in all these patients. Histologically duodenitis was labelled if there was infiltration of epithelial layer. Male to female ratio was found to be 3:2. Duration of symptoms in the patients ranged from less than one month to more than 5 years. Possible aetiological factors like drugs, alcohol and smoking were established in 26 patients (52%), drugs being the commonest (26%). Stool examination showed cyst or ova of parasites in 8 patients (16%). Endoscopically multiple hyperaemic patches were seen in 15 (30%), erosions in 19 (38%), coarse mucosal folds in 5 (10%), nodules in 2 (4%) and multiple lesions in 9 (18%) patients. Histological and endoscopical correlationship was established in 40 (80%) cases.