Íleo biliar: reporte de casos / Biliary ileus: cases report

Resumen Introducción: El íleo biliar es una causa poco frecuente de obstrucción intestinal mecánica, siendo más frecuente en pacientes mayores de 65 años y sexo femenino. Casos Clínicos: Se exponen cuatro casos clínicos diagnosticados de íleo biliar, intervenidos en nuestro centro. Discusión: El íleo biliar es una enfermedad que se produce a consecuencia del paso de un cálculo al lumen intestinal. Esto se produce por la presencia de una fístula entre la vesícula y el intestino, localizada mayormente a nivel duodenal. Se manifiesta con una clínica muy inespecífica, lo que condiciona un retraso en su diagnóstico. La tomografía computarizada es actualmente el examen de elección. El tratamiento consiste en la enterotomía con extracción del cálculo, realizándose la reparación de la fístula en un primer o segundo tiempo. Tiene un mal pronóstico debido a comorbilidad de los pacientes y la demora diagnóstica y terapéutica.

Introduction: Gallstone ileus is a rare cause of mechanical intestinal obstruction, being more frequent in patients over 65 years and females. Clinical Cases: Four clinical cases diagnosed with gallstone ileus, operated on in our center, are reported. Discussion: Gallstone ileus frequently occurs as a result of a fistula that communicates the digestive tract with the gallbladder. Their clinic is very unspecific, which determines a delay in its diagnosis. Computed tomography is currently the gold standard. The treatment is enterolithotomy and fistula repair in a first or second stage. Prognosis is poor due to patient comorbidities and diagnostic and therapeutic delay.

Obstrucción colónica por cálculo / Colonic obstruction by gallstone

El íleo biliar es una rara complicación de la colelitiasis, que se caracteriza por presentar clínicamente una obstrucción intestinal mecánica intraluminal, secundaria a la impactación de un cálculo biliar en el tubo digestivo, debido a la existencia de una fístula bilio-entérica. El diagnóstico preoperatorio es difícil, ya que presenta síntomas y signos de obstrucción intestinal, los cuales son muy inespecíficos para sospechar un íleo biliar. El tratamiento de elección en el manejo del íleo biliar es el quirúrgico. Habitualmente se realiza una cirugía en dos tiempos, enterolitotomía como único gesto, sin embargo no hay una técnica quirúrgica definitiva estandarizada. Presentamos el caso de una paciente de 70 años que acude al Departamento de Urgencias con el diagnóstico clínico de obstrucción intestinal mecánica baja, de cuatro días de evolución, como consecuencia de un cálculo impactado en colon sigmoides.

Gallstone ileus is a rare complication of cholelithiasis, which is characterized by clinically presenting as an intraluminal mechanical intestinal obstruction secondary to the impaction of a gallstone in the digestive tract, due to the existence of a biliary-enteric fistula. The preoperative diagnosis is difficult, since it presents symptoms and signs of intestinal obstruction, which are very unspecific to suspect a Biliary Ileus. The treatment of choice in the management of gallstone ileus is surgery; usually is performed in two stages, whole lithotomy as the only gesture, however there is no standardized definitive surgical technique. We present the case of a 70-year-old patient, who attended the emergency department with the clinical diagnosis of low mechanical bowel obstruction, four days of evolution, as a result of a stone impacted in the sigmoid colon.

Intususcepción ileocólica en el adulto como presentación de un linfoma no Hodgkin de intestino delgado / Ileocolic Intussusception in Adults due to Small-Bowel Non-Hodgkin's Lymphoma

La intususcepción intestinal, definida como la penetración de un segmento intestinal en otro adyacente, es una causa infrecuente de obstrucción intestinal en el adulto. El objetivo de este trabajo es presentar el caso de un paciente adulto con intususcepción ileocólica como presentación de un linfoma no Hodgkin de intestino delgado. Este paciente presenta una causa poco frecuente de intususcepción intestinal. Dada lo inespecífico de la clínica, el diagnóstico etiológico suele ser intraoperatorio, precisando resección de la lesión causante y, en el caso de nuestro paciente, quimioterapia adyuvante(AU)

Intestinal intussusception, defined as penetration of an intestinal segment into an adjacent, is a rare cause of intestinal obstruction in adults. The aim of this paper is to present the case of an adult patient with ileocolic intussusception as presenting a non-Hodgkin lymphoma of the small intestine. This patient has a rare cause of intestinal intussusception. Because of its non-specific clinical, etiologic diagnosis is usually intraoperative, requiring resection of the culprit lesion and, in the case of our patient, adjuvant chemotherapy(AU)

Intestinal intussusception in adults: tomographic findings and report of two cases / Intestinal intussusception in adults: tomographic findings and report of two cases.

Intestinal intussusception is infrequent in adults. Unlike what happens in kids, it shows a demonstrable etiology in most cases: polyps, lipomas, hamartomas, malignancies, etc. Among diagnostic methods, CT scan is the study that yields the best results for the diagnosis, giving forth pathognomonic signs and favoring therapeutic decision-making. Two cases of intestinal intussusception in adults secondary to benign pathology are analyzed, stressing mainly the tomographic findings and some considerations about therapeutic decision-making based on tomographic results.

Severe Mesenteric Hemorrhagic Infarction by Superior Mesenteric Arterial Occlusion in a Patient with Buerger's Disease / 대한소화기학회지

No abstract available.

Laparoscopy assisted hemi-colectomy for ileo-caecal tuberculosis.

Laparoscopy assisted hemicolectomy for ileo-caecal tuberculosis is being evaluated the world over. Several procedures are performed laparoscopically, including the laparoscopic hemicolectomy, for benign and malignant diseases. Abdominal tuberculosis is one of the commonest causes of intestinal obstruction in India. We have evaluated the role of laparoscopic resection of ileocaecal tuberculosis and successfully performed the procedure in five patients. The clinical profiles of patients and operative procedure are discussed in this article with a brief review of the literature.

Radiologic evaluation of ileo-ceacal tuberculosis

The radiologic findings in 22 patients with ileo-caecal tuberculosis were studied to determine its role in diagnostic evaluation. On barium contrast studies 20 patients showed characteristic radiographic appearances: conical, shrunken, retracted caecum associated with a narrow, ulcerated terminal ileum. Two cases presented with nonspecific intestinal obstruction. In conjunction with clinical correlation, barium studies are helpful in the evaluation of ileo-caecal tuberculosis showing the location and extent of intestinal involvement in most cases. Typical radiographic findings are seen when the inflammatory process is severe