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1.
Prensa méd. argent ; 108(3): 151-156, 20220000. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1373112

ABSTRACT

El íleo biliar se define como una obstrucción intestinal mecánica secundaria a la presencia de un cálculo biliar. Menos del 1% de los casos de obstrucción intestinal se derivan de esta etiología. La causa más frecuente es la impactación del cálculo en el íleon, tras su paso por una fístula bilioentérica. Es una complicación rara y potencialmente grave de la colelitiasis. Esta patología se presenta más en adultos mayores, la edad promedio en la que se presenta es entre los 60 y 84 años, afectando principalmente al sexo femenino, atribuido a la mayor frecuencia de patología biliar en dicho sexo. Presenta una alta morbimortalidad, principalmente por la dificultad y la demora diagnóstica.


Gallstone ileus is defined as a mechanical intestinal obstruction secondary to the presence of a gallstone. Less than 1% of cases of intestinal obstruction are derived from this etiology. Te most frequent cause is the impaction of the stone in the ileum, after passing through a bilioenteric fistula. It is a rare and potentially serious complication of cholelithiasis. Tis pathology occurs more in the elderly, the average age at which it occurs is between 60 and 84 years, mainly affecting the female sex, attributed to the higher frequency of biliary pathology in said sex. It presents a high morbidity and mortality, mainly due to the difficulty and the diagnostic delay


Subject(s)
Humans , Aged , Biliary Tract/pathology , Cholelithiasis/surgery , Indicators of Morbidity and Mortality , Diagnosis, Differential , Ileum/pathology , Intestinal Obstruction/surgery , Laparotomy
2.
Article in Portuguese | LILACS | ID: biblio-1369019

ABSTRACT

RESUMO: Obstrução intestinal é a manifestação clínica mais frequente de tumores de cólon sendo esses, em sua maioria, localizados no cólon descendente e reto-sigmoide. A cirurgia de emergência para obstrução intestinal é associada a altos riscos de mortalidade e de morbidade e a abordagem ideal permanece controversa. Procedimentos em vários estágios e o uso de stents como ponte para cirurgia são opções promissoras. É apresentado um caso de paciente de 61 anos, com abdome agudo obstrutivo secundário à neoplasia colorretal, com ênfase em seu diagnóstico e tratamento. (AU)


ABSTRACT: Intestinal obstruction is the most frequent clinical manifestation of colon tumors, most of which are located in the descending and recto-sigmoid colon. Emergency bowel obstruction surgery is associated with high mortality and morbidity risks and the ideal approach remains controversial. Multi-stage procedures and the use of stents as bridges for surgery are promising options. A case of a 61-year-old patient with an acute obstructive abdomen secondary to colorectal neoplasm is presented, with emphasis on its diagnosis and treatment. (AU)


Subject(s)
Humans , Female , Middle Aged , Colorectal Neoplasms , Colectomy , Abdomen, Acute , Intestinal Obstruction/surgery , Megacolon/diagnosis
3.
Rev. Assoc. Med. Bras. (1992) ; 68(1): 67-72, Jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360704

ABSTRACT

SUMMARY OBJECTIVES: This study aimed to investigate the ability of the biomarkers to predict the surgery treatment and mortality in patients above 18 years of age who were hospitalized with the diagnosis of bowel obstruction from the emergency department. METHODS: This is a 2-year retrospective study. The patients' demographic data, laboratory parameters on admission to emergency department, treatment modalities, and the length of hospital stay were recorded. Patients were divided into two groups: conservative and surgical treatment. Statistical analysis was performed to investigate the value of biomarkers in predicting mortality and the need for surgery. Data were analyzed using IBM SPSS version 22. RESULTS: A total of 179 patients were included in this study. Of these, 105 (58.7%) patients were treated conservative and 74 (41.3%) were treated operatively. The elevated procalcitonin (PCT) level, C-reactive protein, blood urea nitrogen-to-albumin ratio, and lactate-to-albumin ratio were significantly correlated with surgical treatment, length of hospital stay, and mortality. procalcitonin threshold value of 0.13 ng/mL was able to predict the need for surgical treatment, with a sensitivity of 79% and a specificity of 70.3%. Procalcitonin threshold value of 0.65 ng/mL was able to predict the mortality rate of the patients, with a sensitivity of 92.9% and a specificity of 78.1%. CONCLUSIONS: Biomarkers, especially procalcitonin, may be useful in bowel obstruction treatment management and may predict mortality.


Subject(s)
Humans , C-Reactive Protein/analysis , Procalcitonin , Intestinal Obstruction/diagnosis , Prognosis , Biomarkers , Predictive Value of Tests , Retrospective Studies
4.
Rev. colomb. cir ; 37(1): 83-89, 20211217. tab
Article in Spanish | LILACS | ID: biblio-1355312

ABSTRACT

Introducción. Las adherencias postoperatorias son la causa más frecuente de obstrucción de intestino delgado. La clínica sugiere el diagnóstico, pero de manera poco precisa la causa y el sitio de la obstrucción. La tomografía computarizada contrastada es el estudio óptimo y permite identificar de manera oportuna a los pacientes que requieren intervención quirúrgica. El objetivo de este estudio fue analizar la correlación entre la clínica y el sitio de obstrucción detectado en la tomografía computarizada contrastada de abdomen, en pacientes con sospecha diagnóstica de obstrucción de intestino delgado por adherencias. Métodos. Estudio prospectivo, transversal y analítico de pacientes con sospecha clínica de obstrucción de intestino delgado por adherencias y antecedentes quirúrgicos y su correlación con el sitio de obstrucción detectado en la tomografía computarizada de abdomen contrastada, de pacientes atendidos entre marzo de 2016 y febrero de 2019 en un hospital de segundo nivel. Resultados. Se incluyeron 41 pacientes, la media de edad fue de 59 años y el género masculino el más comprometido (68,3 %, n=28); la ausencia de evacuaciones estuvo presente en 97,5 % (p=0,026). La tomografía computarizada contrastada mostró el sitio de obstrucción en 73 % de los pacientes y la localización de la obstrucción más prevalente fue en íleon distal (31,7 %, n=13). Se asoció a leucocitosis (p=0,041) y a dolor más intenso (p=0,049), sin presentar irritación peritoneal. Conclusión. La obstrucción localizada en el íleon distal se caracterizó por presentar más dolor y mayor recuento leucocitario, sin correlación como factor de riesgo para requerir tratamiento quirúrgico.


Introduction. Postoperative adhesions are the most common cause of small bowel obstruction. The clinical presentation suggests the diagnosis, but imprecisely the cause and the site of the obstruction. Contrast computed tomography is the optimal study and allows the timely identification of patients requiring surgical intervention. The objective of this study was to analyze the correlation between the symptoms and the obstruction site detected in the abdominal contrasted computed tomography in patients with suspected diagnosis of small bowel obstruction due to adhesions. Methods. Prospective, cross-sectional and analytical study of patients with clinical suspicion of small bowel obstruction due to adhesions and surgical history, and its correlation with the obstruction site detected in the abdominal contrasted computed tomography, during March 2016 to February 2019 in a secondary level hospital. Results. Forty-one patients were included, the mean age was 59 years and the male gender was the most frequent (68.3%, n=28); the absence of evacuations was present in 97.5% (p=0.026). Contrast computed tomography showed the obstruction site in 73% of the patients. The most prevalent location of the obstruction was in the distal ileum (31.7%, n=13). It was associated with leukocytosis (p=0.041) and more intense pain (p=0.049), without presenting peritoneal irritation. Conclusion. The obstruction located in the distal ileum was characterized by more pain and a higher white blood cell count, without correlation as a risk factor for requiring surgical treatment


Subject(s)
Humans , Intestinal Obstruction , Tissue Adhesions , Diagnosis , Intestine, Small
5.
Rev. colomb. cir ; 37(1): 122-128, 20211217. fig
Article in Spanish | LILACS | ID: biblio-1357596

ABSTRACT

Introducción. La hernia de Garengeot se caracteriza por contener el apéndice cecal dentro del saco femoral, y forma parte de una variedad de hernias que reciben el epónimo de acuerdo con su localización anatómica. Entre ellas se encuentra la hernia de Richter, la hernia de Amyand, la hernia de Littré y la hernia de Spiegel. Se presenta una revisión de los abordajes laparoscópicos para estas diversas variantes. Caso clínico. Paciente femenina de 82 años de edad quien consultó al servicio de urgencias por dolor inguinal derecho de ocho días de evolución, asociado a clínica de obstrucción intestinal. Se hizo diagnóstico de hernia inguinal encarcelada y se llevó a cirugía encontrando una hernia de Garengeot. Discusión. Además de los tipos de hernia tradicionalmente conocidos, existen variantes inusuales de hernias de la pared abdominal, que deben ser sospechadas y tenidas en cuenta como diagnóstico diferencial, lo que permitirá realizar su tratamiento de forma oportuna disminuyendo el riesgo de que ocurra una perforación intestinal. Conclusiones. Las variantes de hernia inguinal o de localización inusual, son susceptibles de tratamiento quirúrgico mediante abordajes laparoscópicos con adecuados resultados.


Introduction. Garengeot's hernia is characterized by containing the cecal appendix within the femoral sac, and is part of a variety of hernias that receive their eponymous according to their anatomical location. These include Richter's hernia, Amyand's hernia, Littré's hernia, and Spiegel's hernia. We present a review of the laparoscopic approaches for these variants. Clinical case. An 82-year-old female patient consulted to the emergency department for right groin pain of eight days of evolution, associated with symptoms of intestinal obstruction. With a diagnosis of incarcerated inguinal hernia, she underwent surgery finding a Garengeot ́s hernia. Discussion. In addition to the traditionally known types of hernia, there are unusual variants of hernias of the abdominal wall, which must be suspected and taken into account as a differential diagnosis, which will allow treatment to be carried out in a timely manner, reducing the risk of intestinal perforation. Conclusions. Variants of inguinal hernia or unusual location are susceptible to surgical treatment by laparoscopic approaches with adequate results.


Subject(s)
Humans , Hernia , Appendicitis , Laparoscopy , Intestinal Obstruction
6.
Rev. colomb. cir ; 37(1): 142-145, 20211217. fig
Article in Spanish | LILACS | ID: biblio-1357601

ABSTRACT

Introducción. El divertículo duodenal intraluminal, también conocido como windsock diverticulum, es una causa rara de dolor abdominal intermitente y plenitud postpandrial, que puede complicarse con obstrucción, sangrado, pancreatitis o colangitis. Suele cursar de forma asintomática y ante la aparición de síntomas el tratamiento de elección es quirúrgico. Caso clínico. Presentamos el caso de una mujer de 24 años, sin antecedentes de interés, que es estudiada por dolor abdominal y plenitud postpandrial, que resulta finalmente en una obstrucción intestinal alta. Tras estudio exhaustivo y necesidad de una cirugía previa, es diagnosticada de un divertículo duodenal intraluminal. Conclusión. La paciente se trató mediante cirugía con resolución exitosa del cuadro de obstrucción intestinal.


Introduction: Intraluminal duodenal diverticulum, also known as a windsock diverticulum, is a rare cause of intermittent abdominal pain and postprandial fullness, which can be complicated by obstruction, bleeding, pancreatitis, or cholangitis. It is usually asymptomatic and when symptoms appear, the treatment of choice is surgical. Clinical case: We present the case of a 24-year-old woman with no relevant history who is studied for abdominal pain and postprandial fullness, presented with an upper intestinal obstruction. After an exhaustive study and the need for a previous surgery, she was diagnosed with an intraluminal duodenal diverticulum.Conclusion: The patient was treated by surgery with successful resolution of the intestinal obstruction


Subject(s)
Humans , General Surgery , Duodenal Diseases , Diverticulum , Duodenal Obstruction , Duodenum , Intestinal Obstruction
7.
Medicentro (Villa Clara) ; 25(3): 529-541, 2021. graf
Article in Spanish | LILACS | ID: biblio-1340201

ABSTRACT

RESUMEN El síndrome de Wilkie representa una rara causa de obstrucción intestinal por compresión externa de la tercera porción duodenal por la arteria mesentérica superior. Se presenta una mujer de 68 años que fue a consulta por presentar vómitos biliosos frecuentes, con distensión abdominal, y marcada pérdida de peso. Mediante estudios radiográficos baritados con control fluoroscópico y tomografía axial computarizada con contraste vía oral y endovenosa, se evidenció compresión duodenal extrínseca en la tercera porción; se diagnosticó un síndrome de Wilkie y se instauró un tratamiento conservador, el cual cursó favorablemente. El síndrome de Wilkie, a pesar de su baja incidencia, debe considerarse como diagnóstico diferencial en cuadros de obstrucción intestinal alta.


ABSTRACT Wilkie syndrome represents a rare cause of intestinal obstruction due to external compression of the third duodenal portion by the superior mesenteric artery. We present a 68-year-old woman who came to the consultation for frequent bilious vomiting, abdominal distension and marked weight loss. Extrinsic duodenal compression was evidenced in its third portion by means of barium radiographic studies with fluoroscopic control and computerized axial tomography with oral and intravenous contrast; Wilkie syndrome was diagnosed and conservative treatment was instituted, which progressed favorably. Wilkie syndrome, despite its low incidence, should be considered as a differential diagnosis in cases of upper intestinal obstruction.


Subject(s)
Mesenteric Artery, Superior , Intestinal Obstruction
8.
Dolor ; 31(74): 26-34, sept. 2021. tab
Article in Spanish | LILACS | ID: biblio-1362804

ABSTRACT

El paciente oncológico de cuidados paliativos puede presentar una variedad importante de condiciones clínicas que producen sufrimiento y disminución en la calidad de vida; esto se presenta como un reto para el clínico en la identificación y correcto abordaje de los pacientes. El dolor se ha considerado por años como el síntoma cardinal a tratar en el paciente oncológico, donde se deben considerar sus condicionantes fisiopatológicos, la farmacología de las intervenciones, los posibles efectos secundarios y los condicionantes familiares, sociales y personales del dolor, pero a pesar de su relevancia, no es el único síntoma, estando acompañado de un abanico de patologías, como las afectaciones gastrointestinales, pulmonares, vasculares, hematológicas y neurológicas, que favorecen la pérdida de capacidad del paciente y, en muchas ocasiones, la muerte. Se realizó una revisión actualizada en bases de datos como EMBASE, PUBMED, SCIELO, además de la revisión de guías de asociaciones internacionales con el objetivo de acercar a todos los médicos, sin distinguir su especialidad o área de trabajo, al abordaje y manejo del paciente oncológico en cuidado paliativo, favoreciendo la sensibilización con estas patologías y la importancia en el curso de vida de los pacientes.


The palliative care cancer patient can present a significant variety of clinical conditions that produce suffering and a decrease in the quality of life. This is a challenge for the clinician in the identification and correct approach of patients. Pain has been considered for years as the cardinal symptom to be treated in cancer patients, where its pathophysiological factors, the pharmacology of the interventions, possible side effects and the family, social and personal conditions of pain must be considered, but despite its relevance is not the onset of symptoms and is accompanied by a range of pathologies such as gastrointestinal, pulmonary, vascular, hematological and neurological affectations that favor the loss of capacity of the patient and in many cases death. An updated review was carried out in databases such as EMBASE, PUBMED, SCIELO in addition to the revision of guides from international associations with the aim of bringing all doctors without distinguishing their specialty or area of work to the approach and management of cancer patients in palliative care favoring awareness of these pathologies and their importance in the life course of patients.


Subject(s)
Humans , Palliative Care/methods , Cancer Pain/drug therapy , Analgesics, Opioid/therapeutic use , Superior Vena Cava Syndrome/diagnosis , Tumor Lysis Syndrome/diagnosis , Emergencies , Venous Thromboembolism/diagnosis , Intestinal Obstruction/diagnosis , Morphine/therapeutic use , Neoplasms/complications
9.
Rev. bras. ortop ; 56(4): 523-527, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1341167

ABSTRACT

Abstract Vascular compression of the third part of the duodenum by the superior mesenteric artery results in an unusual occlusion of the duodenal transit known as superior mesenteric artery syndrome. This syndrome can occur after surgeries to correct spinal deformities in a rate ranging from 0.5% to 4.7%. It results from a positional alteration of the artery emergency point due to a change in trunk length after surgery. It is associated with risk factors such as low body mass index and weight loss. Patients usually present with intestinal occlusion, abdominal pain, nausea, bilious vomiting, and early satiety. Superior mesenteric artery syndrome must be recognized early to institute an adequate treatment, which can be clinical (with gastric tube for decompression and nutritional support) or require a surgical procedure. Secondary complications related to superior mesenteric artery syndrome include delayed surgical and nutritional recovery, healing problems, and prolonged hospitalization. The present study aims to report a case of superior mesenteric artery syndrome in a patient with neuromuscular scoliosis secondary to a transverse myelitis who underwent surgical treatment for spinal deformity correction.


Resumo A compressão vascular da terceira parte do duodeno pela artéria mesentérica superior resulta no desenvolvimento de uma condição incomum de oclusão do trânsito duodenal conhecida como síndrome da artéria mesentérica superior. Este fenômeno pode acontecer após cirurgias de correção de deformidades da coluna, e sua taxa de ocorrência é de 0,5 a 4,7% dos casos. Isso ocorre em virtude da alteração do posicionamento do ponto de emergência da artéria, decorrente da mudança do comprimento do tronco após a cirurgia, e está associado a fatores de risco, como baixo índice de massa corpórea e perda ponderal. Os pacientes costumam se apresentar com um quadro de oclusão intestinal, com dor abdominal, náusea, vômito bilioso e saciedade precoce. O reconhecimento desta condição é importante para instituir o tratamento adequado, que varia do tratamento clínico, com sondagem e descompressão gástrica associados a suporte nutricional; à necessidade de abordagem cirúrgica. Complicações secundárias relacionadas à síndrome da artéria mesentérica superior incluem: recuperação cirúrgica e nutricional retardadas, problemas com a cicatrização e hospitalização prolongada. O objetivo do presente estudo é relatar um caso de síndrome da artéria mesentérica superior, ocorrido em um paciente com escoliose neuromuscular secundária a sequela de mielite transversa, submetido ao tratamento cirúrgico da deformidade da coluna.


Subject(s)
Humans , Male , Child , Scoliosis/surgery , Spinal Fusion , Superior Mesenteric Artery Syndrome/complications , Intestinal Obstruction
10.
Biomédica (Bogotá) ; 41(2): 201-207, abr.-jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1339258

ABSTRACT

Resumen. La atresia pilórica es una malformación digestiva poco frecuente y representa alrededor del 1% de las atresias intestinales. En el 55% de los casos, se asocia con alguna otra alteración genética o anatómica, especialmente la epidermólisis ampollosa, que se presenta en el 20% de ellos, en una asociación que se describe como un síndrome de mal pronóstico. Se presentan dos casos de hermanos consecutivos con esta condición, ambos con un desenlace fatal. Se hizo, además, una revisión de la literatura y se expusieron los puntos más importantes.


Abstract. Pyloric atresia is a rare digestive malformation. It represents about 1% of intestinal atresias and is associated with some other genetic or anatomical alteration in 55% of the cases. In 20% of them, it is associated with epidermolysis bullosa, which is described as an established syndrome with a bad prognosis. We present two cases of consecutive siblings with this condition and fatal outcomes in both of them. We made a review of the literature and discussed the main topics.


Subject(s)
Infant, Newborn , Epidermolysis Bullosa , Intestinal Obstruction
11.
Rev. cuba. cir ; 60(2): e1060, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280224

ABSTRACT

Introducción: La hidatidosis es una zoonosis de distribución mundial con alta incidencia en Argentina, Uruguay, Australia, Grecia y Portugal. Dada la escasa sintomatología que habitualmente produce la enfermedad hidatídica, su diagnóstico se realiza de manera casual por estudios radiológicos fortuitos o durante una laparotomía por otras causas. Por otra parte, la volvulación del colon transverso es un evento raro en la población mundial. Objetivo: Analizar, basados en la literatura relacionada, un caso portador de ambas entidades simultáneamente. Caso clínico: Paciente de sexo masculino de 64 años con condiciones de vida deficientes, que acude a consulta por presentar cuadro clínico de oclusión intestinal mecánica. Los estudios preoperatorios muestran un quiste hidatídico en pulmón derecho. En el acto operatorio se encuentra otro quiste hidatídico en el lóbulo izquierdo del hígado y el colon transverso volvulado como causa de la oclusión. Conclusiones: Pocas veces coinciden 2 condiciones médicas infrecuentes en un mismo paciente. Ambas entidades suponen un reto terapéutico cuando se abordan en situaciones de urgencia como en el reporte. En zonas endémicas debe tenerse una alta sospecha clínica con el fin de obtener un diagnóstico adecuado y poder ofrecer un manejo oportuno. La cirugía, en la mayor proporción de pacientes, es prioritaria(AU)


Introduction: Hydatidosis is a worldwide distribution zoonosis with high incidence in Argentina, Uruguay, Australia, Greece and Portugal. Given the scarce symptoms usually produced by hydatid disease, its diagnosis is made inadvertently by fortuitous radiological studies or during laparotomy for other causes. On the other hand, transverse colon volvulus is a rare event in the world population. Objective: To analyze, based on the related literature, the case of a patient with both entities simultaneously. Clinical case: A 64-year-old male patient with poor living conditions came to the medical office due to a clinical picture of mechanical intestinal obstruction. Preoperative studies show a hydatid cyst in the right lung. During the operative act, another hydatid cyst is found in the left lobe of the liver, apart from the transverse colon volvulus due to the occlusion. Conclusions: Rarely do two infrequent medical conditions coincide in the same patient. Both entities pose a therapeutic challenge when they are approached in emergency situations, as they have been reported here. In endemic areas, a high clinical suspicion must be considered, in order to obtain an adequate diagnosis and be able to offer timely management. Surgery, in the largest proportion of patients, is a priority(AU)


Subject(s)
Humans , Male , Middle Aged , Colon, Transverse/surgery , Echinococcosis/epidemiology , Echinococcosis/diagnostic imaging , Intestinal Obstruction/surgery , Laparotomy/methods , Review Literature as Topic
12.
Rev. cuba. cir ; 60(2): e1049, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280215

ABSTRACT

Introducción: El cáncer de colon mantiene un importante impacto social y una alta morbilidad a pesar de programas de detección precoz existentes. Ocupa el cuarto lugar entre los tumores malignos y un número importante de pacientes son operados de urgencia por las complicaciones de esta enfermedad, muchas veces desconocida hasta el momento de la cirugía. Objetivo: Caracterizar la cirugía de urgencia realizada a los pacientes con diagnóstico de cáncer de colon complicado. Método: Se realizó un estudio observacional, descriptivo, de corte transversal entre enero de 2014 y diciembre de 2016, en el Servicio de Cirugía General. La muestra fue de 96 pacientes portadores de esta entidad en el Hospital Universitario "General Calixto García". Resultados: Se analizó la incidencia según sexo, relación sexo/localización, relación localización/complicación, estadificación y mortalidad. Prevalecieron los tumores de colon en el sexo femenino y por ende fueron más frecuente las pacientes con complicaciones quirúrgicas por esta entidad en nuestro centro. Predominó la localización derecha globalmente, con predominio femenino. La oclusión intestinal fue la complicación más frecuente. Sobresalió el estadio II según TNM con un 37,5 por ciento y una mortalidad postoperatoria del 31 por ciento. Conclusiones: Nuestros datos coinciden con la tendencia nacional sobre la mayor incidencia del cáncer de colon en pacientes femeninas, son estas las que mayor tasa de morbilidad y mortalidad reportan. Seguir perfeccionando el programa de prevención y detección temprana de la entidad y su tratamiento oportuno causará la reducción de los índices que hoy se exhiben(AU)


Introduction: Colon cancer still has an important social impact and high morbidity despite existing early detection programs. It ranks fourth among malignant tumors, while a significant number of patients undergo emergency surgery for complications of this disease, many times unknown until the time of surgery. Objective: To characterize the emergency surgery performed to patients with a diagnosis of complicated colon cancer. Method: An observational, descriptive, cross-sectional study was carried out, between January 2014 and December 2016, in the general surgery service. The sample consisted of 96 patients with this entity and from General Calixto García University Hospital. Results: The incidence was analyzed according to sex, sex/location relationship, location/complication relationship, staging and mortality. Colon tumors prevailed in the female sex and, therefore, patients with surgical complications from this entity were more frequent in our center. There right location predominated globally, with a predominance in the female sex. Intestinal obstruction was the most frequent complication. Stage two, according to the TNM classification, stood out, accounting for 37.5 percent, together with a postoperative mortality of 31 percent. Conclusions: Our data coincide with the national trend on the highest incidence of colon cancer in female patients, who account for the highest morbidity and mortality rates. Continuing to improve the entity's prevention and early detection program, as well as its timely treatment, will bring about a reduction in the rates nowadays reported(AU)


Subject(s)
Humans , Male , Female , Colonic Neoplasms/diagnosis , Emergencies , Intestinal Obstruction/complications , Neoplasm Staging/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Colonic Neoplasms/epidemiology , Observational Studies as Topic
13.
Rev. colomb. cir ; 36(3): 514-519, 20210000.
Article in Spanish | LILACS | ID: biblio-1254383

ABSTRACT

Introducción. El linfoma puede afectar el tracto gastrointestinal de manera primaria o secundaria, y representa hasta el 2 % de todas las neoplasias malignas del intestino delgado y colon. El tracto gastrointestinal es la ubicación extraganglionar primaria más común en el linfoma no Hodgkin. Métodos. Se realizó una búsqueda de la literatura en las principales bases de datos académicas, con revisión de textos publicados sobre el tema en los últimos 5 años. Discusión. La presentación clínica del linfoma con compromiso gastrointestinal es inespecífica y, hasta en la mitad de los pacientes, se puede presentar de manera inicial con complicaciones que requieran manejo quirúrgico. Entre las principales se encuentran la perforación intestinal, el sangrado digestivo y la obstrucción intestinal


Introduction. Lymphoma can affect the gastrointestinal tract, primarily or secondarily, and accounts for up to 2% of all malignant neoplasms of the small intestine and colon. The gastrointestinal tract is the most common primary extranodal location in non-Hodgkin lymphoma. Methods. A literature search performed in the main academic databases, with a review of texts published on the subject in the last 5 years.Discussion. The clinical presentation of lymphoma with gastrointestinal involvement is nonspecific and, in up to half of the patients, it can present initially with complications that require surgical management. Among the main ones are intestinal perforation, digestive bleeding and intestinal obstruction.


Subject(s)
Humans , Gastrointestinal Neoplasms , Lymphoma , Gastrointestinal Tract , Intestinal Obstruction , Intestinal Perforation , Intussusception
14.
Rev. colomb. gastroenterol ; 36(supl.1): 67-71, abr. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251550

ABSTRACT

Resumen Objetivos: Presentar el manejo laparoscópico en un caso de bezoar atípico y una revisión de la literatura. Materiales y métodos: Se presenta el caso de un paciente de sexo masculino de 67 años con síndrome pilórico debido a una obstrucción intestinal por cuerpo extraño. Resultados: Se encuentra como hallazgo endoscópico un bezoar atípico (bezoar de dinero) impactado en la región prepilórica sin posibilidad de resolución por este medio, por lo cual se considera el manejo laparoscópico. Discusión: Los bezoares se definen como cualquier objeto el cual tuvo una ingesta voluntaria o involuntaria, que se aloja en alguna parte del tracto gastrointestinal superior, con mayor frecuencia a nivel gástrico, y no se puede digerir por los mecanismos fisiológicos del cuerpo; además, se clasifican según su composición. Conclusiones: En pacientes con obstrucción intestinal alta debido a cuerpos extraños en los cuales el manejo endoscópico falla, el manejo quirúrgico mínimamente invasivo con cirugía laparoscópica es viable y eficaz.


Abstract Objectives: To describe the laparoscopic management of an atypical bezoar case and present a literature review. Materials and methods: This is the case of a 67-year-old male patient with pyloric stenosis due to intestinal obstruction by a foreign body. Results: The endoscopic finding was an atypical bezoar (Money bezoar) in the prepyloric region with no possible resolution by this route, so laparoscopic treatment was considered. Discussion: Bezoars are defined as any object that was voluntarily or involuntarily swollen and is obstructing some part of the upper gastrointestinal tract, usually the stomach, and cannot be digested using the physiological mechanisms of the body. They are categorized based on their composition. Conclusions: When endoscopic treatment fails to relieve upper gastrointestinal tract obstruction caused by foreign bodies, minimally invasive surgical treatment with laparoscopic surgery is a viable and efficient option.


Subject(s)
Humans , Male , Aged , Bezoars , Laparoscopy , Foreign Bodies , Intestinal Obstruction , Literature
15.
Arch. argent. pediatr ; 119(2): e158-e162, abril 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1152049

ABSTRACT

La dilatación segmentaria intestinal es una entidad congénita extremadamente rara, caracterizada por la dilatación local del intestino que no se debe a la obstrucción distal ni a la ausencia de células ganglionares. Se presenta el caso clínico de una paciente en el período neonatal con la presentación típicamente descrita en esta enfermedad en ausencia de comorbilidades, forma clínica poco descrita en la bibliografía. Se desarrolla también la resolución quirúrgica con resección segmentaria y los hallazgos anatomopatológicos.


Segmental dilatation of the intestine is an extremely rare congenital entity characterized by a local dilation of the intestine without distal obstruction or the absence of ganglion cells. We present the case of a patient in the neonatal period with typical clinical features in absence of other comorbidities, shortly published in the bibliography. We also describe the surgical resolution and the pathological results.


Subject(s)
Humans , Female , Infant, Newborn , Intestinal Obstruction/diagnostic imaging , Colectomy , Dilatation
16.
Rev. colomb. cir ; 36(2): 338-343, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1247568

ABSTRACT

Introducción. El objetivo de este artículo es dar a conocer el caso de un paciente con diagnóstico de mesenteritis esclerosante quien cursó con cuadro de obstrucción intestinal. Descripción del caso. Paciente masculino de 28 años de edad, quien se presenta con cuadro clínico sugestivo de obstrucción intestinal, por lo que se decide resolución quirúrgica. Durante la cirugía se observa una zona fibrótica y adherente del intestino delgado, asociada a un mesenterio engrosado. El examen histopatológico de la pieza quirúrgica confirmó el diagnóstico de mesenteritis esclerosante. Discusión. La mesenteritis esclerosante es una patología de baja incidencia, y su forma de presentación es inespecífica, por lo que el diagnóstico definitivo es histopatológico. La tomografía es útil para el diagnóstico cuando se tiene la sospecha clínica. Puede optarse por el tratamiento quirúrgico para los casos que se presenten con clínica de obstrucción intestinal, o en caso contrario, el tratamiento médico a base de fármacos inmunosupresores e inmunomoduladores ha demostrado ser efectivo. De acuerdo con los diferentes estudios publicados hasta el momento, se observa una adecuada respuesta, independientemente del tratamiento empleado


Introduction. The objective of this article is to present the case of a patient diagnosed with sclerosing mesenteritis who presented with intestinal obstruction.Case description. A 28-year-old male patient, who presented with a clinical picture suggestive of intestinal obstruction, for which a surgical resolution was decided. During surgery, a fibrotic and adherent area of the small intestine is observed, associated with a thickened mesentery. The histopathological examination of the surgical specimen confirmed the diagnosis of sclerosing mesenteritis. Discussion. Sclerosing mesenteritis is a low incidence pathology, and its presentation is nonspecific, so the definitive diagnosis is histopathological. Tomography is useful for diagnosis when there is clinical suspicion. Surgical treatment can be chosen for cases that present with symptoms of intestinal obstruction, or otherwise medical treatment based on immunosuppressive and immunomodulatory drugs has proven to be effective. According to the different studies published so far, an adequate response is observed, regardless of the treatment used


Subject(s)
Humans , Panniculitis, Peritoneal , Intestinal Diseases , Intestinal Obstruction , Lipodystrophy
18.
Rev. colomb. cir ; 36(2): 352-357, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1247572

ABSTRACT

Las anomalías del uraco representan un bajo porcentaje de las patologías abdominales, no obstante, forman parte del diagnóstico diferencial del abdomen agudo por las complicaciones que puede tener. Aunque son de difícil diagnóstico debido a los síntomas inespecíficos, las imágenes diagnósticas son de gran utilidad para su identificación y caracterización. En pacientes con obesidad mórbida, la presentación del cuadro aumenta el riesgo de morbimortalidad. Por ende, en estos pacientes es necesario un control postoperatorio estricto para evaluar complicaciones secundarias a la resección del uraco. Dado los casos limitados en la literatura, se requieren estudios clínicos adicionales, para brindar un seguimiento adecuado, en aras de identificar complicaciones y el tratamiento precoz de estas


Urachal abnormalities represent a low percentage of abdominal pathologies; however, they are part of the differential diagnosis of acute abdomen due to the complications it may have. Although they are difficult to diagnose due to nonspecific symptoms, diagnostic images are especially useful for their identification and characterization. In patients with morbid obesity, the presentation of the picture increases the risk of morbidity and mortality. Therefore, in these patients, strict postoperative control is necessary to evaluate complications secondary to urachal resection. Given the limited cases in the literature, additional clinical studies are required to provide adequate diagnosis and follow-up in order to identify complications and their early treatment


Subject(s)
Humans , Obesity, Morbid , Intestinal Obstruction , Urachal Cyst , Urachus
19.
Medisan ; 25(1)ene.-feb. 2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1154855

ABSTRACT

Se describe el caso clínico de un paciente de 37 años de edad, que acudió al Servicio de Emergencia del Hospital General Docente de Riobamba, en Ecuador, con manifestaciones clínicas e imagenológicas que permitieron diagnosticarle un abdomen agudo obstructivo por hernia diafragmática crónica postraumática, por lo que el tratamiento fue quirúrgico. Teniendo en cuenta la evolución satisfactoria del paciente se le dio el alta hospitalaria 10 días después de la operación. Se mantuvo con seguimiento durante 3 meses sin presentar complicaciones.


The case report of a 37 years patient that went to the Emergency Service of the Teaching General Hospital of Riobamba, in Ecuador, is described. He presented clinical and imaging signs that led to the diagnosis of an obstructive acute abdomen due to postraumatic chronic diaphragmatic hernia, reason why the treatment was surgical. Taking into account the patient's favorable clinical course he was discharged from the hospital 10 days after the surgery and received follow-up care during 3 months without presenting complications.


Subject(s)
Thoracotomy , Hernia, Diaphragmatic, Traumatic/diagnostic imaging , Abdomen, Acute/diagnostic imaging , Hernia, Diaphragmatic, Traumatic/surgery , Intestinal Obstruction/diagnostic imaging
20.
Article in English | WPRIM | ID: wpr-922591

ABSTRACT

OBJECTIVES@#At present, there are many studies on Crohn's disease of terminal ileum and colon, but few studies on Crohn's disease of small intestine alone. This study aims to analyze the clinical features and therapeutic effect of small bowel in adult patients with Crohn's disease so as to strengthen the diagnosis and treatment for this disease.@*METHODS@#From July 1, 2015 to October 31, 2018, patients with small bowel Crohn's disease at Department of Gastroenterology, Third Xiangya Hospital of Central South University, were enrolled. At the same time, patients' demographics and clinical data were collected.@*RESULTS@#A total of 44 patients were small bowel Crohn's disease. Among them, 40 patients were male. The age at diagnosis was (35.8±10.3) years old and disease duration was (35.2±59.5) months. The subtypes included 29(65.9%) of ileum, 7(15.9%) of jejunum, 8(18.2%) of ileum with jejunum. There were 27(61.4%) of stricture behavior, 4(9.1%) of penetrating behavior, and 13(29.5%) of non-stricture and non-penetrating behavior. Endoscopic visible stricture (29/85, 34.1%) was common, followed by longitudinal ulcers (27/85, 31.8%). Non-caseate granulomatous were found in 2 cases (4.5%). The score of Crohn's disease activity index was correlated to hemoglobin, hematocrit, and erythrocyte sedimentation rate (all @*CONCLUSIONS@#Patients with ileum account for a large proportion in patients with small bowel Crohn's disease. Stricture is more common in small bowel Crohn's disease. Stricture and longitudinal ulcer are more common under enteroscopy. Crohn's disease activity index is correlated to hemoglobin, red blood cell specific volume, and erythrocyte sedimentation rate. The most common complication is intestinal obstruction. Mesalazine is less effective on small bowel Crohn's disease.


Subject(s)
Adult , Crohn Disease/drug therapy , Endoscopy, Gastrointestinal , Humans , Ileum , Intestinal Obstruction/etiology , Intestine, Small , Male , Middle Aged
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