ABSTRACT
La esofagitis eosinofílica (EE) es una enfermedad infradiagnosticada que hay que sospechar ante todo paciente con disfagia e impactación alimentaria. Aunque estos son los síntomas guía, el espectro clínico y endoscópico es muy variable. Es obligatorio tomar conciencia sobre las posibles complicaciones derivadas de las maniobras diagnósticas y terapéuticas en la EE. Un manejo cuidadoso de los procedimientos endoscópicos conseguirá extremar las precauciones necesarias para evitar iatrogenia. Presentamos el caso de un varón joven con disfagia y estenosis esofágica que en el curso de su diagnóstico sufre como complicación una perforación esofágica (AU)
Eosinophilic esophagitis is an underdiagnosed disease that should be suspected in all patients with dysphagia and food impaction. Although these are the leading symptoms, the clinical and endoscopic spectrum is highly varied. Clinicians should be aware of the risk of endoscopy-related complications in this disorder. Precautions should be maximized in endoscopic examinations to avoid iatrogenic damage. We describe the case of a young patient with esophageal stricture and dysphagia who suffered a perforation following a biopsy (AU)
Subject(s)
Humans , Esophageal Perforation/etiology , Eosinophilic Esophagitis/diagnosis , Biopsy, Fine-Needle/adverse effects , Iatrogenic Disease , Endoscopy, Gastrointestinal/adverse effectsABSTRACT
Eosinophilic esophagitis is an underdiagnosed disease that should be suspected in all patients with dysphagia and food impaction. Although these are the leading symptoms, the clinical and endoscopic spectrum is highly varied. Clinicians should be aware of the risk of endoscopy-related complications in this disorder. Precautions should be maximized in endoscopic examinations to avoid iatrogenic damage. We describe the case of a young patient with esophageal stricture and dysphagia who suffered a perforation following a biopsy.
Subject(s)
Biopsy/adverse effects , Eosinophilic Esophagitis/pathology , Esophageal Perforation/etiology , Esophagoscopy/adverse effects , Deglutition Disorders/etiology , Eosinophilic Esophagitis/complications , Esophageal Perforation/prevention & control , Esophageal Stenosis/etiology , Humans , Male , Mediastinal Emphysema/etiology , Risk Factors , Subcutaneous Emphysema/etiology , Young AdultABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Amyloidosis/etiology , Liver Transplantation , Hepatitis B/surgery , Carcinoma, Hepatocellular/surgery , Liver Cirrhosis/surgery , Postoperative ComplicationsABSTRACT
BACKGROUND/AIMS: To determine the value of systemic cytokines as predictors of relapse in inflammatory bowel disease (IBD). METHODOLOGY: A prospective study with 135 patients in clinical remission for at least 3 months. At enrollment, a venous blood was drawn in order to measure, by an ELISA test, the following cytokines: TNFalpha, TNFalpha-R1 and R2, IL-16, IL-1beta, IL 2, IL-R2, IL-6, IL-10, and IFNgamma. All patients were followed-up for one year. RESULT: Sixty-six patients had Crohn's disease (CD) and 69 had ulcerative colitis (UC). Thirty-nine (30%) had a relapse. Forty-four percent were receiving immunomodulatory therapy. No differences were found regarding detection and baseline concentration of the various cytokines between patients with CD and UC, or between patients with or without ongoing use of immunomodulators. The detection and concentration levels of cytokines were not associated with the risk of relapse of IBD. CONCLUSIONS: Systemic cytokines are of little value to predict IBD relapse.
