Diverticulitis aguda de intestino delgado en un paciente con enfermedad de Crohn: Report of one case / Acute small bowel diverticulitis in a patient with crohn’s disease

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

Mesotelioma benigno como causa de dolor abdominal inespecífico en un paciente con Enfermedad de Crohn / Benign multicystic peritoneal mesothelioma in a patient with Crohn disease

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

Invaginación intestinal en adultos como manifestación de enfermedad celíaca: Caso clínico / Celiac disease presenting as an intestinal intussusception: Report of one case

Acute abdominal pain caused by perforation, intestinal lymphoma or intussusception is an uncommon manifestation in adult celiac disease. We report a 49 year-old female with history of irritable bowel syndrome and osteoporosis consulting for acute abdominal pain and severe abdominal distention. Abdominal CT scan and magnetic resonance imaging showed a jejunal intussusception and other radiological alterations that suggested the possibility of celiac disease. Serological antibodies (endomysial and transglutaminase antibodies), endoscopy and the pathological study of duodenal biopsies confirmed the diagnosis. With a gluten free diet, the patient remains asymptomatic.

Enteroclisis por tomografía computarizada en niños: experiencia inicial, técnica y utilidad / Computed tomography enteroclysis in children: initial experience, technical and profit

Objetivo: Evaluar la técnica de enteroclisis por tomografía computarizada (ETC ) y revisar sus indicaciones y hallazgos en niños. Materiales y métodos: Revisión retrospectiva de todas las ETC realizadas por los autores en pacientes menores de 18 años de edad entre enero de 2005 y marzo de 2009. Además, se relacionan los resultados con otros métodos de imagen, cirugía o patología. Resultados: Se revisaron 30 ETC (edad media 14,6 años, rango 8-18 años). Las indicaciones más comunes fueron: enfermedad inflamatoria intestinal (55%), dolor abdominal (25%), posquirúrgico (7%), hemorragia digestiva (5%), síndrome de Peutz-Jeghers (4%) y emésis (4%). No hubo complicaciones. El 10% de los estudios fue normal. El hallazgo más común fue enfermedad de Crohn (37%) y obstrucción parcial del intestino delgado (26%). Conclusión: La ETC es fácil y certera en la pesquisa de la patología de intestino delgado en niños. Esta técnica es de gran utilidad en pacientes con enfermedad de Crohn con afectación del intestino delgado.

Objective: To evaluate CT enteroclysis technique (CT E) and to review their indications and findings in children. Materials and Methods: We retrospectively reviewed all CT enteroclysis studies in younger than 18 years performed between January 2005 and March 2009. We correlated the results with other abdominal imaging studies and surgical and pathological findings. Results: Thereview revealed 30 CTE studies performed (mean age 14.6 years, range 8–18 years). CTE study wasperformed most commonly for evaluation of suspicious intestinal inflammatory disease (55%), abdominal pain (25%), post-operative (7%) digestive hemorrhage (5%) Peutz Jeghers syndrome (4%) and vomiting (4%). No complications of CTE were reported. The findings were normal in 10% of the CT E studies. The most common small bowel diagnoses were Crohn’s disease (37%) andpartial small bowel obstruction (26%). Conclusion: CTE is safe, feasible, and accurate in depicting small-bowel pathology in children. This technique can be particularly useful in children with Crohn’s disease involving the small bowel.

Neoplasia mucinosa intraductal del páncreas: [revisión] / Intraductal papillary mucinous neoplasm of the pancreas: [review]

Intraductal papillary mucinous neoplasm of the pancreas is characterized by a dilatation of the main pancreatic duct and/or secondary ducts, mucin production and the absence of ovarian ¡ike struma. The symptoms are non-specific and often the diagnosis is incidental. The treatment of choice is surgery, since these tumors may become malignant. The prognosis depends on the type of lesion, whether the excision is complete and lymph node involvement. The aim of this review is to analyze the clinical, diganostic, therapeutic and pathological characteristics of this disease.

Enfermedad injerto versus huesped: manifestación-enterocólica y diagnóstico diferencial / Graft versus host disease: gastrointestinal manifestation and differential diagnosis

La enfermedad de injerto contra huésped es un síndrome que ocurre en pacientes inmuno-deprimidos generalmente post-trasplante de médula ósea, caracterizado en su etapa aguda por manifestaciones dermatológicas, hepáticas y gastrointestinales. El diagnóstico oportuno es fundamental, ya que puede disminuir significativamente la morbimortalidad. Dentro del diagnóstico diferencial de las manifestaciones gastrointestinales se incluye enterocolitis neutropénica y colitis pseudomembranosa. Mediante tomografía computada, hay signos que apuntan a su diagnóstico, como dilatación focal de asas, y refuerzo significativo de la mucosa enterocólica.