RESUMO
Malabsorption is a well-known complication of infection with Giardia lamblia. However, selective protein-losing enteropathy is rare. We report a child with anasarca due to hypoalbuminemia as a result of gastrointestinal protein loss. Investigations established giardiasis as the etiology. The child returned to normal health after treatment with metronidazole.
Assuntos
Anti-Infecciosos/uso terapêutico , Criança , Giardíase/complicações , Humanos , Hipoproteinemia/etiologia , Masculino , Metronidazol/uso terapêuticoRESUMO
BACKGROUND: Early decompression is needed in the Budd-Chiari syndrome (BCS) to prevent liver dysfunction and death. AIMS: To study the technical difficulties during surgery and the results of surgery for BCS. METHODS: Retrospective review of nine patients operated on between 1994 and January 1998 for BCS--1 for uncontrolled fundal variceal bleed and 8 for chronic BCS. Isolated hepatic vein block was found in 5, inferior vena cava (IVC) block in 1 and a combination in 3 patients. Preoperative liver biopsies did not reveal cirrhosis in any patient. Portacaval shunt (3), portorenal shunt (2), mesocaval shunt (1), mesoatrial shunt (2) and devascularisation (1) were the operations performed. RESULTS: In 3 patients, side-to-side portacaval shunt was not possible because of caudate lobe hypertrophy (1), aberrant right hepatic artery (1) and presence of IVC stent (1); they required portorenal (2) or interposition mesocaval (1) shunts. Both mesoatrial shunts were unsuccessful. Devascularisation was effective in controlling the acute bleed. There was no intraoperative death. Postoperatively there were 3 deaths. Of the 6 survivors, 5 are asymptomatic over a mean follow up of 19.7 months. CONCLUSIONS: Side-to-side portacaval shunt is effective in the management of BCS; results with the mesoatrial shunt are disappointing.
Assuntos
Adulto , Síndrome de Budd-Chiari/cirurgia , Feminino , Humanos , Hipertensão Portal/cirurgia , Masculino , Derivação Portossistêmica Cirúrgica , Estudos Retrospectivos , Resultado do TratamentoRESUMO
HIV infection is known to be associated with endothelial dysfunction leading to thrombosis. We report a patient with multiple abdominal venous thrombosis and splenic hematoma who was seropositive for HIV-1. No cause for the hypercoagulable state was detected; prothrombin time, activated partial thromboplastin time, and levels of protein S, protein C and antithrombin III were normal. He tested negative for VDRL and anticardiolipin antibodies.