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1.
Rev. medica electron ; 43(2): 3249-3256, mar.-abr. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251942

ABSTRACT

RESUMEN El Blastocystis sp. es un parásito frecuente en el humano, identificado por el laboratorio en muestras de heces fecales. Se presentó el caso de un paciente de 5 años atendido en consulta de Gastroenterología en el Hospital Pediátrico Docente Provincial Eliseo Noel Caamaño, de Matanzas, por presentar dolor abdominal, heces pastosas, náuseas y vómitos desde hacía un año. Llevó tratamiento con ranitidina, omeprazol y domperidona, sin mejoría clínica. Se realizó estudio coproparasitológico en muestras de heces fecales seriadas, con la presencia del Blastocystis hominis. Se indicó tratamiento con metronidazol, sin mejoría clínica, y posteriormente se indicó como alternativa la nitazoxanida. Se evaluó a los 15 días, sin sintomatología y con negativización de las heces fecales seriadas. Resulta frecuente el desconocimiento y la poca importancia que los profesionales sanitarios muestran ante esta infestación, aunque cada vez más se confirma la participación del parásito en manifestaciones clínicas (AU).


ABSTRACT Blastocystis sp. is a frequent parasite in humans, identified in the laboratory in samples of fecal feces. The case of a 5-year-old patient is presented; he assisted the consultation of Gastroenterology in the Provincial Teaching Pediatric Hospital Eliseo Noel Caamaño in Matanzas, suffering abdominal pain, mash feces, nauseas and vomits for one year, and was treated with ranitidine, omeprazole and domperidone without clinical improvement. A coproparasitological study was carried out in serial fecal feces samples with the presence of Blastocystis hominis. Treatment with metronidazole was indicated without clinical improvement and them, as an alternative, nitazoxanide was indicated. He was evaluated at 15 days without symptoms and with negative serial fecal feces. The ignorance and the little importance that health professionals show towards this infestation are frequent, although more and more frequently it is confirmed the participation of the parasite in clinical manifestations (AU).


Subject(s)
Humans , Male , Child , Abdominal Pain/diagnosis , Child , Blastocystis hominis/pathogenicity , Signs and Symptoms , Specimen Handling/methods , Clinical Diagnosis , Feces/parasitology , Gastroenterology , Intestinal Diseases, Parasitic/complications
3.
In. Machado Rodríguez, Fernando; Liñares, Norberto; Gorrasi, José; Terra Collares, Eduardo Daniel. Manejo del paciente en la emergencia: patología y cirugía de urgencia para emergencistas. Montevideo, Cuadrado, 2020. p.17-30, tab.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1342980
4.
Article in English | LILACS | ID: biblio-1057212

ABSTRACT

ABSTRACT Objective: To report a case of a child with primary immunodeficiency who at eight years developed digestive symptoms, culminating with the diagnosis of a neuroendocrine tumor at ten years of age. Case description: One-year-old boy began to present recurrent pneumonias in different pulmonary lobes. At four years of age, an immunological investigation showed a decrease in IgG and IgA serum levels. After the exclusion of other causes of hypogammaglobinemia, he was diagnosed with a Common Variable Immunodeficiency and started to receive monthly replacement of human immunoglobulin. The patient evolved well, but at 8 years of age began with epigastrium pain and, at 10 years, chronic persistent diarrhea and weight loss. After investigation, a neuroendocrine tumor was diagnosed, which had a rapid progressive evolution to death. Comments: Medical literature has highlighted the presence of gastric tumors in adults with Common Variable Immunodeficiency, emphasizing the importance of early diagnosis and the investigation of digestive neoplasms. Up to now there is no description of neuroendocrine tumor in pediatric patients with Common Variable Immunodeficiency. We believe that the hypothesis of digestive neoplasm is important in children with Common Variable Immunodeficiency and with clinical manifestations similar to the case described here in the attempt to improve the prognosis for pediatric patients.


RESUMO Objetivo: Relatar um caso de criança portadora de imunodeficiência primária que, aos oito anos, desenvolveu sintomas digestivos, culminando com o diagnóstico de tumor neuroendócrino aos dez anos de idade. Descrição do caso: Menino, com um ano de idade, começou a apresentar pneumonias de repetição em diferentes lobos pulmonares. Aos quatro anos, a investigação imunológica mostrou diminuição dos níveis séricos de IgG e IgA. Após exclusão de outras causas de hipogamaglobulinemia, teve diagnóstico de imunodeficiência comum variável, passando a receber reposição mensal de imunoglobulina humana. Evoluiu bem, porém, aos oito anos, começou com epigastralgia e, aos dez anos, diarreia crônica persistente e perda de peso. O quadro culminou com o diagnóstico de tumor neuroendócrino intestinal, de rápida progressão, com óbito do paciente. Comentários: A literatura tem chamado a atenção para tumores gástricos em adultos com imunodeficiência comum variável, alertando para a importância do diagnóstico precoce e da pesquisa de neoplasias digestivas. Até o momento, não há descrição de tumor neuroendócrino em pacientes pediátricos portadores de imunodeficiência comum variável. Acredita-se ser importante a hipótese de neoplasia digestiva diante de crianças com imunodeficiência comum variável e com manifestações clínicas semelhantes ao caso descrito, na tentativa de melhorar o prognóstico para pacientes pediátricos.


Subject(s)
Humans , Male , Child , Pneumonia/diagnosis , Common Variable Immunodeficiency/complications , Neuroendocrine Tumors/diagnosis , Pneumonia/etiology , Recurrence , Weight Loss , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Common Variable Immunodeficiency/immunology , Neuroendocrine Tumors/pathology , Neuroendocrine Tumors/therapy , Fatal Outcome , Diarrhea/diagnosis , Diarrhea/etiology , Intestinal Neoplasms/surgery , Intestinal Neoplasms/pathology , Intestinal Neoplasms/diagnostic imaging , Neoplasm Metastasis/pathology , Antineoplastic Agents/therapeutic use
5.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(3): 318-324, July-Sept. 2019. tab
Article in English | LILACS | ID: biblio-1041334

ABSTRACT

ABSTRACT Objective: To investigate the influence of patient age on the diagnosis and management of appendicitis, as well as to evaluate the rate of complications according to the age group. Methods: We undertook a retrospective analysis of 1,736 children who underwent laparoscopic appendectomy in our center between January 2000 and December 2013. Patients were divided in groups taken into account their age: group A were infants, group B were preschoolers, group C were those ones older than five years old, and group D were those ones younger than five years old. A p value of 0.05 was considered statistically significant. Results: We found higher incidence of misdiagnosis and atypical symptoms in the youngest patients. The rate of perforation was similar between group A and B (p=0.17). However, it was higher in group D than in group C (p<0.0001). The incidence of postoperative complications was higher in the youngest patients too (p=0.0002). Conclusions: The age does make a difference in acute appendicitis. Because of its unusual presentation in children younger than five years old, it is often misdiagnosed, which leads to an increased morbidity. Although clinical presentation varies between infants and preschoolers, no statistically significant differences were observed in the rate of perforated appendix or postoperative complications.


RESUMO Objetivo: Investigar a influência da idade do paciente no diagnóstico e tratamento de apendicite, bem como avaliar a frequência de complicações dependendo da faixa etária. Métodos: Análise retrospectiva dos 1.736 pacientes pediátricos que foram submetidos à apendicectomia laparoscópica em nosso hospital de janeiro de 2000 a dezembro de 2013. Os pacientes foram divididos em grupos de acordo com sua idade: grupo A eram crianças, grupo B eram pré-escolares, grupo C eram maiores de cinco anos de idade e grupo D eram menores de cinco anos de idade. Considerou-se estatisticamente significante p-valor <0,05. Resultados: Encontramos maior incidência de diagnóstico incorreto e sintomas atípicos em pacientes mais novos. A taxa de perfuração foi semelhante entre os grupos A e B (p=0.17); foi maior, porém, no grupo D que no grupo C (p<0.0001). A incidência de complicações no pós-operatório também foi maior em pacientes mais novos (p=0.0002). Conclusões: A idade faz diferença em casos de apendicite aguda. Por causa da sua apresentação rara em crianças menores de cinco anos, é frequentemente diagnosticada incorretamente, o que aumenta a morbidade. Apesar de sua apresentação clínica variar entre lactentes e pré-escolares, não foram observadas diferenças estatisticamente significativas na proporção de apêndices perfurados nem na de complicações pós-operatórias.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Appendectomy/statistics & numerical data , Appendicitis/diagnosis , Abdominal Pain/diagnosis , Appendicitis/surgery , Biomarkers/blood , Abdominal Pain/surgery , Retrospective Studies , Diagnostic Errors/statistics & numerical data , Leukocyte Count
7.
Rev. méd. Chile ; 147(8): 1073-1077, ago. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058645

ABSTRACT

In lupus enteritis, circulating pathological immune complexes and thrombosis of intestinal vessels may occur, resulting in acute abdominal pain. We report a 24-year-old woman without a history of systemic lupus erythematosus (SLE), admitted for abdominal pain. An exploratory laparotomy found an appendicitis along with ascites. An appendectomy was performed, and the patient was discharged from the hospital two days later. Three days after discharge, the patient was admitted to another hospital due to the persistence of abdominal pain. An abdominal computed tomography scan showed diffuse mesenteric congestion, concentric bowel loops (double halo or target sign) and the presence of free fluid in the peritoneal cavity. Suspecting a rheumatic disorder, the diagnosis of SLE was confirmed by immunological studies. The patient was treated with pulses of methylprednisolone with good results.


Subject(s)
Animals , Female , Young Adult , Enteritis/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Appendicitis/diagnosis , Methylprednisolone/therapeutic use , Tomography, X-Ray Computed/methods , Abdominal Pain/diagnosis , Diagnosis, Differential , Enteritis/drug therapy , Lupus Erythematosus, Systemic/drug therapy
8.
Rev. medica electron ; 41(3): 725-732, mayo.-jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1094079

ABSTRACT

RESUMEN Se presentó un caso de una paciente de 78 años de edad, procedente del municipio de Calimete, con antecedentes patológicos personales de infarto agudo miocárdico sin elevación del segmento ST e hipertensión arterial. Llegó a la Unidad de Cuidados Intensivos de Emergencia, de Colón con un estado toxico infeccioso severo. Fue intervenida quirúrgicamente con el diagnóstico presuntivo de una trombosis mesentérica. Se constató dicho diagnóstico complementario a una neoplasia maligna de colon sigmoides. Falleció producto a un shock séptico refractario a aminas. En la necropsia se reportaron hallazgos de interés.


ABSTRACT The authors present the case of a 78-years-old female patient from the municipality of Calimete, with personal pathological antecedents of acute myocardial infarct without ST segment elevation and arterial hypertension. She arrived to the Emergency Intensive Care Unit of Colon with a severe toxic-infectious status. She underwent a surgery with a presumptive mesenteric thrombosis. It was stated that diagnosis, complementary to a sigmoid colon malignant neoplasia. She died as a product of an amine-refractory septic shock. The autopsy showed findings of interest.


Subject(s)
Humans , Female , Aged , Sigmoid Diseases/complications , Sigmoid Diseases/diagnosis , Sigmoid Neoplasms/surgery , Sigmoid Neoplasms/complications , Sigmoid Neoplasms/diagnosis , Sigmoid Neoplasms/mortality , Colorectal Neoplasms/complications , Colorectal Neoplasms/diagnosis , Mesenteric Vascular Occlusion/complications , Mesenteric Vascular Occlusion/diagnosis , Peritonitis , Shock, Septic , Colostomy , Cardiovascular System/physiopathology , Abdominal Pain/diagnosis , Sigmoidoscopy , Glomerular Filtration Rate , Kidney Failure, Chronic , Laparotomy , Neoplasms
10.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(2): 161-165, Apr.-June 2019. tab
Article in English | LILACS | ID: biblio-1013280

ABSTRACT

ABSTRACT Objective: To investigate how symptoms vary according to the appendiceal position in pediatric patients and to demonstrate that the laparoscopic approach is safe and effective in any appendiceal location by comparing each location to another. Methods: The medical records of 1,736 children aged 14 or younger who underwent laparoscopic appendectomy over a period of 14 years were analyzed retrospectively. Patients were divided according to the position of the appendiceal tip into four groups: anterior, pelvic, retrocecal and subhepatic. The Kruskal-Wallis and chi-square tests were used with the Bonferroni correction, with a significant p<0.05. Results: The appendiceal location was anterior in 1,366 cases, retrocecal in 248 cases, pelvic in 66 cases and subhepatic in 56 cases. There were no significant differences between the groups in terms of patient age and gender. Abdominal pain was the only symptom with statistically significant differences between the groups. The rate of perforated appendicitis was higher in the subhepatic and pelvic positions. Intraoperative complications and conversions were not statistically significant. Technical difficulties and operative time were higher in subhepatic position. The rate of postoperative complications was similar between the different locations, except for bowel obstruction, which was higher in pelvic appendicitis. Conclusions: The clinical symptoms of appendicitis hardly ever change with the position of the appendix. The laparoscopic approach is safe and effective, regardless the appendiceal location.


RESUMO Objetivo: Investigar como os sintomas variam de acordo com a posição do apêndice em pacientes pediátricos e demonstrar que a laparoscopia é segura e eficaz em qualquer posição do apêndice, comparando-as. Métodos: Os prontuários de 1.736 pacientes pediátricos com idade ≤14 anos submetidos à apendicectomia laparoscópica em um período de 14 anos foram analisados retrospectivamente. Os pacientes foram divididos de acordo com a posição do apêndice: anterior, pélvica, retrocecal e sub-hepático. Os testes de Kruskal-Wallis e do qui-quadrado foram usados com a correção de Bonferroni, sendo significante p<0,05. Resultados: A posição do apêndice era anterior em 1.366 casos, retrocecal em 248 casos, pélvica em 66 casos e sub-hepática em 56 casos. Não houve diferenças significativas entre os grupos quanto às variáveis idade e sexo. A dor abdominal foi a única variável com diferenças estatisticamente significantes entre os grupos. A taxa de apêndice perfurado foi superior nas posições sub-hepática e pélvica. As complicações intraoperatórias e a taxa de conversão não foram estatisticamente significativas. As dificuldades técnicas e o tempo cirúrgico foram superiores em posição sub-hepática. A taxa de complicações pós-operatórias foi semelhante entre as diferentes posições, exceto a obstrução intestinal, que foi superior em posição pélvica. Conclusões: Os sintomas da apendicite dificilmente variam com a posição do apêndice. A laparoscopia é segura e eficaz, independentemente da posição do apêndice.


Subject(s)
Humans , Male , Female , Child , Adolescent , Appendicitis/surgery , Appendix/pathology , Outcome and Process Assessment, Health Care , Appendectomy/adverse effects , Appendectomy/methods , Appendectomy/statistics & numerical data , Appendicitis/diagnosis , Appendicitis/physiopathology , Appendicitis/epidemiology , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Postoperative Complications/epidemiology , Spain/epidemiology , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Laparoscopy/adverse effects , Laparoscopy/methods , Laparoscopy/statistics & numerical data , Operative Time , Intraoperative Complications/epidemiology
11.
Rev. Col. Bras. Cir ; 46(6): e20192285, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1057186

ABSTRACT

RESUMO Objetivo: estabelecer a correlação entre dados objetivos coletados na avaliação inicial e os desfechos nos casos de dor abdominal aguda. Métodos: estudo retrospectivo, de caso controle, em que foram revisados prontuários de pacientes atendidos em um serviço de urgência e emergência no ano de 2016, diagnosticados com dor abdominal e pélvica. Resultados: de 2.352 prontuários avaliados, 330 foram considerados válidos para o estudo. Destes pacientes, 235 (71,2%) receberam alta e os 95 (28,8%) restantes foram internados, submetidos à cirurgia ou morreram. A análise estatística demonstrou que sexo masculino, idade ≥50 anos, temperatura axilar >37,3ºC, anemia, leucocitose >10.000/mm3, neutrocitose acima de 7.700/mm3, linfopenia <2.000/mm3 e hiperamilasemia são variáveis isoladamente associadas a pior desfecho. Conclusão: a presença de três ou mais das variáveis avaliadas aumenta fortemente a chance de um paciente sofrer os desfechos de cirurgia ou morte, sendo a chance de óbito tanto maior quanto maior o número de variáveis presentes.


ABSTRACT Objective: to establish a correlation between objective data collected at the initial evaluation and the outcomes in cases of acute abdominal pain. Methods: we conducted a retrospective, case-control study in which we reviewed medical records of patients treated at an emergency room in 2016, diagnosed with abdominal and pelvic pain. Results: of the 2,352 medical records evaluated, we considered 330 valid for the study. Of these patients, 235 (71.2%) were discharged and the remaining 95 (28.8%) were hospitalized, submitted to surgery, or died. The statistical analysis demonstrated that male gender, age ≥50, axillary temperature >37.3ºC, anemia, leukocytosis >10,000/mm3, neutrophil count above 7,700/mm3, lymphocyte count less than 2,000/mm3 and hyperamylasemia were variables in independently associated with worse outcome. Conclusion: the presence of three or more of the evaluated variables greatly increases the chances of a patient suffering the outcomes of surgery or death, the chance of death being greater the greater the number of variables present.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Abdominal Pain/diagnosis , Abdomen, Acute/diagnosis , Abdominal Pain/etiology , Abdominal Pain/physiopathology , Case-Control Studies , Sex Factors , Retrospective Studies , Risk Factors , Emergency Service, Hospital , Abdomen, Acute/etiology , Abdomen, Acute/physiopathology , Middle Aged
12.
Gastroenterol. latinoam ; 30(supl.1): S39-S43, 2019. tab
Article in Spanish | LILACS | ID: biblio-1116437

ABSTRACT

Fluctuating abdominal pain and bloating suggest gastrointestinal origin with multiple causes. In adults, patients fulfilling the Rome criteria for irritable bowel syndrome (IBS) have a low probability of neoplasms or intestinal inflammatory diseases. In these patients it is cost effective to request fecal calprotectin and celiac disease serology. Due to the high probability of nocebo effect, the diagnosis of sensitivity to non celiac and food allergies should require a blind rechallenge. It is recommended to evaluate other non ominous diagnostic options in a second stage if there is not good control of symptoms. In adults that do not fulfil the criteria of IBS or in adults older than 50 it is often necessary to request more studies, including endoscopic examinations. In children, abdominal pain and bloating occur frequently in the context of excessive consumption of sugar (including fructose, lactose and sorbitol). In infants it can occur in the context of congenital malformations, infant colics and food allergies. An active search for symptoms and signs of alarm is recommended. In their absence the performance of an endoscopic study is low. The use of celiac disease serology is also recommended, but the use of fecal calprotectin has the limitation that normal values are not present below age 4, so its use is not recommended under that age.


El dolor abdominal y la distensión abdominal fluctuantes sugieren origen gastrointestinal, con múltiples causas. En adultos, los pacientes que cumplen criterios de Roma para Síndrome de Intestino Irritable (SII) tienen una baja probabilidad de neoplasias o enfermedades inflamatorias intestinales (EII). En estos pacientes, es costoefectivo solicitar calprotectina fecal y serología de enfermedad celiaca. Por la alta probabilidad de efecto nocebo, el diagnóstico de sensibilidad al gluten no celiaca (SGNC) y alergias alimentarias debería requerir un rechallenge ciego. Es recomendable evaluar otras opciones diagnósticas no ominosas en una segunda etapa, si no hay buen control sintomático. En adultos que no cumplen criterios de SII o en adultos mayores de 50 años, suele requerirse más cantidad de estudios, incluyendo endoscópicos. En niños, el dolor abdominal y distensión ocurren frecuentemente en el contexto de consumo excesivo de azúcares (incluyendo fructosa, lactosa y sorbitol). En lactantes puede ocurrir también en el contexto de malformaciones congénitas, cólicos del lactante y alergia alimentaria. Se recomienda la búsqueda activa de signos y síntomas de alarma. En su ausencia el rendimiento del estudio endoscópico es bajo. También se recomienda el uso de serología de enfermedad celíaca, pero el uso de calprotectina fecal tiene la limitación de ausencia de valores de normalidad hasta los 4 años, por lo que su uso no se recomienda bajo esa edad.


Subject(s)
Humans , Child , Adult , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/etiology , Abdomen/pathology , Celiac Disease/complications , Irritable Bowel Syndrome/complications , Carbohydrate Metabolism , Food Hypersensitivity , Malabsorption Syndromes/complications
13.
Rev. fac. cienc. méd. (Impr.) ; 15(1): 56-60, 2018. ilus
Article in Spanish | LILACS | ID: biblio-947017

ABSTRACT

Las hernias hiatales, son defectos anatómicos en el hiato diafragmático. Las de tipo "paraesofágicas" son frecuentes, se sabe que atentan contra la vida de una manera potencial, ya que presentan un alto riesgo de complicación de vólvulo y encarcelación lo que incrementa con la edad. Objetivo: establecer una ruta diagnóstica para mejorar el abordaje clínico de esta patología. Caso Clínico: niño de 4 años, con historia de dolor abdominal de 3 meses de evolución en región mesogástrica, que se acompaña de palidez hiporexia y estreñimiento. Laboratorio: hemoglobina 4.3g/dl, hematocrito 13.9%, diagnóstico de anemia, diagnóstico por endoscopía: hernia hiatal tipo III (mixta), mal rotación de estómago. Se trató con funduplicatura Nissen y posteriormente con dilataciones esofágicas. Conclusión: La hernia hiatal es la anormalidad más frecuente del tracto digestivo alto, las de tipo paraesofágico son infrecuentes y debe ser incluida como diagnóstico diferencial en niños con repetidos episodios de infección respiratoria o vómitos a repetición. El estudio diagnóstico de elección es el esofagograma con medio de contraste.


Subject(s)
Humans , Male , Child, Preschool , Abdominal Pain/diagnosis , Hernia, Hiatal/complications , Hernia, Hiatal/diagnosis , Stomach Volvulus/complications
14.
Cir. parag ; 41(2): 30-32, ago. 2017. ilus
Article in Spanish | LILACS, BDNPAR | ID: biblio-972610

ABSTRACT

Se reporta el caso de una joven con esplenomegalia, que consulta por dolor abdominal crónico en hipocondrio izquierdo. Los estudios mostraron un quiste tabicado de gran tamaño, con desplazamiento de órganos. Se realizó una esplenectomía total, confirmándose al estudio histopatológico, un quiste epitelial esplénico


We report the case of a girl with splenomegaly, who consults for chronicabdominal pain in the left hypochondrium. The studies showed a largecyst with organ displacement. A total splenectomy was performed, confirmingto the histopathological study, a splenic epithelial cyst.


Subject(s)
Female , Humans , Adolescent , Abdominal Pain/diagnosis , Abdominal Pain/surgery , Cysts/diagnosis , Cysts/surgery , Splenectomy , Splenomegaly
15.
Autops. Case Rep ; 7(2): 49-54, Apr.-June 2017. ilus
Article in English | LILACS | ID: biblio-905238

ABSTRACT

Primary pelvic hydatid cysts are a rare entity and are often overlooked as a differential diagnosis of a pelvic-space-occupying lesion particularly in non-endemic regions. Unpreparedness and a hasty decision on the surgical approach may end in life-threatening complications and systemic dissemination of the disease. We report the case of a 55-year-old postmenopausal woman with a history of two previous unsuccessful surgeries to remove pelvic cystic lesions due to dense adhesions between the surrounding gut wall, bladder, and the cyst wall. Clinical and imaging findings failed to diagnose the nature of the cysts, and a laparotomy was contemplated. On the third surgical attempt, the clinical suspicion was considered and by meticulous dissection the cysts were removed thoroughly without undue complications. In the postoperative follow-up period there was no sign of disease recurrence or dissemination.


Subject(s)
Humans , Female , Middle Aged , Echinococcosis/surgery , Ovarian Cysts/surgery , Abdominal Pain/diagnosis , Cystectomy , Echinococcosis/therapy , Ovarian Cysts/diagnosis , Parasitic Diseases/diagnosis , Postmenopause , Zoonoses/therapy
16.
EMHJ-Eastern Mediterranean Health Journal. 2016; 22 (10): 756-760
in English | IMEMR | ID: emr-184215

ABSTRACT

This study was carried out to determine the prevalence of intestinal parasites and their seasonal variation in northern Jordan. A total of 21 906 stool samples were collected over a period of 4 years [2009-2013] from 5 government hospitals in 3 cities. Samples were processed and examined microscopically and by concentration methods. Parasitic infection was found in 9611 samples [44%]. Giardia lamblia was the most prevalent parasite [41%] followed by Entamoeba histolytica [31%] and Ent. coli [13%]; the least prevalent parasites were Ascaris lumbricoides [1%], Hymenolepis nana, Taenia sp., and Chilomastix mesnili [all < 1%]. The prevalence of different parasites varied according to season, on average the summer months showed the highest incidence of parasitic infection [62%] compared with the winter months [16%]. Giardia lamblia and Ent. histolytica were most prevalent in the summer months


Subject(s)
Humans , Female , Male , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Seasons , Abdominal Pain/diagnosis , Giardia lamblia/pathogenicity , Entamoeba histolytica , Feces/cytology , Prevalence
17.
Rev. méd. (La Paz) ; 22(1): 47-54, 2016. ilus
Article in Spanish | LILACS | ID: lil-797315

ABSTRACT

El objetivo del presente caso clínico es mostrar los signos y síntomas que puedan determinar diagnósticos presuntivos no claros, cuándo se trata de masas mesentéricas primarias, que pueden simular patologías de origen biliar, compromiso vascular mesentérico, síndromes de FID y patologías ginecológicas dependientes de anexo derecho. La TAC es el patrón diagnóstico, que no cuentan los hospitales de segundo nivel como el nuestro, de manera que las decisiones que se toman en el servicio de emergencias, frente a este tipo de abdomen agudo quirúrgico es una laparotomía exploradora; para evitar complicaciones, no solo en órganos de la cavidad abdominal, sino también de orden legal. Los resultados de la cirugía mostraron la presencia de un masa mesentérica correspondiente a un absceso mesentérico inespecífico compatible con una paniculitis intra-abdominal, patología rara dentro la estadística nacional e internacional. Los síntomas más frecuentes son dolor abdominal, anorexia, plenitud abdominal y pérdida de peso, a veces oclusión intestinal. Otras manifestaciones comprenden: estreñimiento, fiebre, diarrea y a la palpación; masa abdominal. La duración de los síntomas es mayor a dos semanas. El laboratorio a veces es normal con aumento del VES. El contraste baritado muestra la pared del colon de aspecto irregular sin lesiones intraluminales. La ecografía; masa hiperecogenica bien definida en la raíz. La TAC: aumento de la densidad grasa, del mesenterio, bien delimitada con halo graso o pseudocapsula que rodea a los ganglios y vasos (signo del anillo graso fat-ring sign).


The present study aims to display how the patient symptomatology does not help to determine a clear presuntive diagnoses, especially when we deal with primary mesenteric masses that can simulate a biliary pathology, mesenteric vascular disorder, right lower quadrant syndrome and dependent gynecological pathologies of right annex. CT is a diagnostic pattern that second level hospitals do not have, so that decisions are taken into the emergency room. An exploratory laparatomy is the option to face up such acute abdomen in order to avoid complications in organs of abdominal cavity as well as legal problems. This case report, surgery results displayed the presence of a mesenteric mass corresponding to a non-specific mesenteric abscess compatible with a intra-abdominal panniculitis, an unusual pathology according to national and international statistics data. The most frecuent symptoms are abdominal pain, anorexia, abdominal fullness, loss of weight and sometimes intestinal occlusion. Constipation, fever, diarrhea and abdominal tenderness are additional manifestations. Those symptoms last longer than two weeks. Laboratory results display normal but with an increased ESR. Barium test shows a colon wall of irregular appearance without intraluminal injury. Ultrasound shows a hyperechoic mass well defined in the root. CT reflects an increased density of the mesenteric fat, well defined with a pseudocapsule that rounds lymph nodes and vessels (fat-ring sign).


Subject(s)
Humans , Female , Adult , Panniculitis, Peritoneal , Mesentery/abnormalities , Tomography/instrumentation , Abdominal Pain/diagnosis
18.
GED gastroenterol. endosc. dig ; 34(3): 135-142, jul.-set. 2015. ilus
Article in Portuguese | LILACS | ID: lil-779347

ABSTRACT

A dor abdominal é um sintoma relativamente comum que leva centenas de pessoas (adultos e crianças) aos centros de emergência e consultórios médicos no Brasil e no mundo. Eventualmente, a investigação por anormalidades estruturais nos órgãos abdominais não revela alterações indicativas de doença, resultando no diagnóstico de desordem funcional gastrointestinal. As desordens funcionais precisam ser investigadas a fundo para a aquisição do diagnóstico correto e início do tratamento direcionado. Nas últimas cinco décadas, a Discinesia da Vesícula Biliar (DVB) tem sido reconhecida como a principal causa da dor abdominal em pacientes com desordens funcionais gastrointestinais sem alterações aparentes nos órgãos abdominais. A DVB é um distúrbio funcional da vesícula biliar caracterizada pelos sintomas de cólica biliar, pela ausência de patologia da vesícula biliar visível e pela redução da fração de ejeção da vesícula biliar (FEVB) observada na colecintigrafia. Entretanto, o diagnóstico e o tratamento desta doença permanecem controversos. Nesse contexto, o presente trabalho consiste em uma revisão da literatura e tem, como objetivo, apresentar e discutir o estado da arte da DVB, contemplando as mais atuais modalidades de diagnóstico e os principais métodos de tratamento da doença.


The abdominal pain is a relatively common symptom that takes hundreds of people (adults and children) to Emergency Rooms and doctors offices in Brazil and all around the world. Occasionally, the search for structural irregularities in the abdominal organs does not reveal indication of diseases, leading to the diagnosis of gastrointestinal functional disorder. The functional disorders must be deeply investigated in order to achieve the correct diagnosis and begin the specific treatment. Over the last five decades, the Gallbladder Dyskinesia (GD) has been recognized as the main cause for abdominal pain among patients with gastrointestinal functional disorders but no apparent alteration in the abdominal organs. The GD is a gallbladder functional disorder known for symptoms such as biliary colic, absence of any noticeable gallbladder pathology and a reduction of the gallbladders ejection fraction (GEF) noticed through the cholecystography. Nonetheless, the diagnosis and the treatment for this disease remain controversial. In this context, the following study consists in a review of the literature and has, as its main objective, to present and discuss the current situation of the GV, addressing the most advanced diagnosis strategies and the main treatment methods for the disease.


Subject(s)
Humans , Biliary Dyskinesia , Abdominal Pain , Biliary Dyskinesia/diagnosis , Biliary Dyskinesia/etiology , Cholecystectomy , Abdominal Pain/diagnosis , Gallbladder
19.
Gastroenterol. latinoam ; 26(supl.1): S40-S47, 2015. tab, ilus
Article in Spanish | LILACS | ID: biblio-868975

ABSTRACT

Acute abdominal pain is one of the most frequent causes of medical consultation in emergency urgent care centers. ER doctors must be capable of recognizing those cases requiring medical treatment and those requiring emergency surgery. Clinical history and physical examination are still the basis for diagnosis, and will guide decisions regarding lab tests and more safe and specific imaging. There are diagnosis such as abdominal pain of unknown origin, gastritis and constipation proven to be associated to error, therefore a stricter follow-up is recommended for these cases. Appendicitis still poses a challenge for diagnosis and if there is clinical suspicion, particularly in young patients and/or women in reproductive age, the recommended approach is ultrasound followed by CT scan (pelvis and abdomen), in case the former is not conclusive. There are special conditions for pregnant and elderly patients regarding imaging tests. During pregnancy, ultrasound and MRI are preferred, whereas CT scan is preferred in case of the elderly, except when biliary disease is suspected, in this case ultrasound is the preferred approach.


El dolor abdominal agudo es una de las causas más frecuentes de consulta a los servicios de urgencia. Los médicos de urgencia deben tener presente su amplio diagnóstico diferencial, y ser capaces de distinguir aquellos casos que requieren un manejo médico o quirúrgico de urgencia. La historia clínica y examen físico siguen siendo las armas fundamentales para el diagnóstico, que guiarán el estudio de laboratorio y la selección de imágenes más segura y de mejor sensibilidad y especificidad. Existen diagnósticos como el dolor abdominal no precisado, gastritis y constipación, que han demostrado estar asociados a error, por lo que se sugiere un seguimiento más estricto en estos casos. La apendicitis sigue siendo un desafío diagnóstico y frente a sospecha clínica, especialmente en jóvenes y/o mujeres en edad fértil, el enfrentamiento diagnóstico con imágenes recomendado es el ultrasonido, seguido de la tomografía computarizada (TC) de abdomen y pelvis, si el primero es no concluyente o negativo. La embarazada y el adulto mayor tienen condiciones especiales, y en cuanto a imágenes, se prefiere el ultrasonido y la resonancia magnética en la primera y la TC precoz en el adulto mayor, excepto cuando hay sospecha de patología biliar donde siempre es de elección el ultrasonido.


Subject(s)
Humans , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Abdominal Pain/therapy , Acute Disease , Appendicitis/complications , Diagnosis, Differential , Pregnancy Complications , Signs and Symptoms
20.
Rev. int. sci. méd. (Abidj.) ; 16(1): 31-36, 2014.
Article in French | AIM, AIM | ID: biblio-1269142

ABSTRACT

Contexte : Les douleurs abdominales aigues (DAA) posent en urgence un probleme diagnostique et prise en charge therapeutique. Les causes medicales n'ont pas encore ete precisees chez l'enfant a Bouake. Objectif : Identifier les principales etiologies de la DAA de l'enfant Patients et methodes : Il s'agit d'une etude retrospective et descriptive realisee au CHU de Bouake du 1 er janvier au 31 decembre 2012. Elle a inclus 90 enfants ages de 2 a 14 ans hospitalises pour DAA. Les parametres d'etudes etaient epidemiologiques et diagnostiques. Resultats : Les 90 cas de DAA ont ete retenus parmi 3677 admissions soit 2;5 . Le sexe ratio etait de 0;95 et l'age median de 72 mois (24-168 mois). La tranche d'age 60-119 mois representait 46;5. Le delai avant la consultation etait superieur a 48 heures dans 63;1. Les principaux signes fonctionnels associes etaient la fievre 86;7; les vomissements 62;2; l'anorexie 50; l'asthenie 37;7; le trouble de la conscience 20 et les convulsions 15;5. Les principaux signes physiques etaient la fievre 67;7; l'anemie 63;4 ; la splenomegalie 23;6; le coma 19 et le tirage intercostal 11;8 . Le paludisme (62;1); la drepanocytose (6;6); la pneumonie (5;7); la fievre typhoide (5;5) et la gastroenterite (4;4) etaient les principales causes. Conclusion : Les principales causes medicales des DAA de l'enfant sont le paludisme; la drepanocytose et la pneumonie. L'amelioration du pronostic des DAA necessite le controle de ses principales causes


Subject(s)
Abdominal Pain/diagnosis , Abdominal Pain/epidemiology , Abdominal Pain/etiology , Acute Pain , Child , Inpatients , Pain Management
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