ABSTRACT
Leiomyoma is the most frequent esophageal benign tumor. It represents 70% of these tumors and 1 to 8% of all esophageal tumors. The majority of cases are asymptomatic and are discovered by chance in endoscopic examinations, and a conservative management is adopted. An endoscopic or surgical treatment can be applied in symptomatic cases, basically depending on the size and the underlying layer. OBJECTIVE: To report the endoscopic resection of an esophageal leiomyoma by using an elastic band ligation. Case report: A 55 year-old man complained of prolonged upper dysphagia with solids during three months. An upper gastrointestinal endoscopy was performed and an elevated lesion of 1 cm in diameter was found in the esophagus, at 25 cm from the upper dental arcade, with smooth surface and adjacent areas of normal mucosa. It was interpreted as a submucosal lesion. A hypoechoic mucosal and submucosal formation with well delimited borders was observed in an endoscopic ultrasonography. The lesion was resected by using an endoscopic band ligation and a subsequent section with a polypectomy snare. The patient evolved uneventfully and was discharged in 24 hours. The endoscopic examinations during the follow-up showed the healing of the resulting scar. Pathologists diagnosis was esophageal leiomyoma. CONCLUSION: The elastic band ligation is a simple, safe, effective and cheap method to be taken into account for the treatment of mucosal and submucosal esophageal lesions.
El leiomioma es el tumor esofágico benigno más frecuente;representa el 70 % de los mismos y el 1 a 8% de todos los tumores del esófago. La mayoría de los casos son asintomáticos y su hallazgo es accidental en estudios endoscópicos, tomándose una conducta conservadora.En los casos sintomáticos se puede decidir un tratamiento quirúrgico o endoscópico, dependiendo fundamentalmente del tamaño y la capa de la pared en la que asienta. Objetivo: Comunicar una resección endoscópicade un leiomioma esofágico mediante el uso de la ligadura con banda elástica. Caso clínico: Se presenta un paciente de 55 años de edad que consultó pordisfagia alta para sólidos, continua y de tres meses de evolución. Se realizó una endoscopía en la que se observóuna lesión elevada de 1 cm de diámetro en esófago, a 25 cm de la arcada dentaria superior, con superficielisa y áreas adyacentes de mucosa sana. Se interpretó la lesión como submucosa. En la ecoendoscopia se apreció una formación hipoecoica de bordes bien delimitados, ubicada en mucosa y submucosa. Se decidió realizar una resección de la lesión utilizando la ligadura endoscópica con banda elástica y posterior sección con asa de polipectomía. El paciente evolucionó favorablemente y fue dado de alta a las 24 horas. Los controles endoscópicos posteriores mostraron una buena cicatrización de la escara resultante. El informe anatomopatológico fue leiomioma esofágico. Conclusión: Laaplicación de la banda elástica es un método simple, seguro, eficaz y de bajo costo para considerar en el manejode las lesiones mucosas y submucosas esofágicas.
Subject(s)
Humans , Male , Middle Aged , Esophagoscopy , Leiomyoma/surgery , Esophageal Neoplasms/surgery , LigationABSTRACT
Leiomyoma is the most frequent esophageal benign tumor. It represents 70% of these tumors and 1 to 8% of all esophageal tumors. The majority of cases are asymptomatic and are discovered by chance in endoscopic examinations, and a conservative management is adopted. An endoscopic or surgical treatment can be applied in symptomatic cases, basically depending on the size and the underlying layer. OBJECTIVE: To report the endoscopic resection of an esophageal leiomyoma by using an elastic band ligation. Case report: A 55 year-old man complained of prolonged upper dysphagia with solids during three months. An upper gastrointestinal endoscopy was performed and an elevated lesion of 1 cm in diameter was found in the esophagus, at 25 cm from the upper dental arcade, with smooth surface and adjacent areas of normal mucosa. It was interpreted as a submucosal lesion. A hypoechoic mucosal and submucosal formation with well delimited borders was observed in an endoscopic ultrasonography. The lesion was resected by using an endoscopic band ligation and a subsequent section with a polypectomy snare. The patient evolved uneventfully and was discharged in 24 hours. The endoscopic examinations during the follow-up showed the healing of the resulting scar. Pathologists diagnosis was esophageal leiomyoma. CONCLUSION: The elastic band ligation is a simple, safe, effective and cheap method to be taken into account for the treatment of mucosal and submucosal esophageal lesions.(AU)
El leiomioma es el tumor esofágico benigno más frecuente;representa el 70 % de los mismos y el 1 a 8% de todos los tumores del esófago. La mayoría de los casos son asintomáticos y su hallazgo es accidental en estudios endoscópicos, tomándose una conducta conservadora.En los casos sintomáticos se puede decidir un tratamiento quirúrgico o endoscópico, dependiendo fundamentalmente del tamaño y la capa de la pared en la que asienta. Objetivo: Comunicar una resección endoscópicade un leiomioma esofágico mediante el uso de la ligadura con banda elástica. Caso clínico: Se presenta un paciente de 55 años de edad que consultó pordisfagia alta para sólidos, continua y de tres meses de evolución. Se realizó una endoscopía en la que se observóuna lesión elevada de 1 cm de diámetro en esófago, a 25 cm de la arcada dentaria superior, con superficielisa y áreas adyacentes de mucosa sana. Se interpretó la lesión como submucosa. En la ecoendoscopia se apreció una formación hipoecoica de bordes bien delimitados, ubicada en mucosa y submucosa. Se decidió realizar una resección de la lesión utilizando la ligadura endoscópica con banda elástica y posterior sección con asa de polipectomía. El paciente evolucionó favorablemente y fue dado de alta a las 24 horas. Los controles endoscópicos posteriores mostraron una buena cicatrización de la escara resultante. El informe anatomopatológico fue leiomioma esofágico. Conclusión: Laaplicación de la banda elástica es un método simple, seguro, eficaz y de bajo costo para considerar en el manejode las lesiones mucosas y submucosas esofágicas.(AU)
Subject(s)
Male , Middle Aged , Humans , Esophageal Neoplasms/surgery , Esophagoscopy , Leiomyoma/surgery , LigationABSTRACT
INTRODUCTION: Precut papillotomy, has been considered a potentially dangerous procedure. In spite of this, numerous national and foreign referral centers have reported good results with the use of this technique that increases the cannulation rate and permits additional therapeutic procedures. OBJECTIVES: We evaluated the procedure in terms of frequency of use, effectiveness, complications and mortality. PATIENT AND METHODS: Between January 1, 1996 and December 31, 1999, 419 ERCP were performed in our centers. We used precut papillotomy in 51 patients. Inclusion criteria for precut papillotomy protocol were: 1 precut papillotomy indication. 1-1 failure to cannulate the papilla, 1-2 appropriate indication, 1-3 Expert endoscopist, 2 complete follow up, 3 informed consent. The experimental design of the study was prospective. When the patients entered into the protocol, they underwent a needle-knife sphincterotomy according to Huibregise's technique. The follow up was done during 30 days, with a clinical examination, laboratory test and ultrasonography all of them weekly, to determine the possible complications according to Cotton's criteria and the mortality. RESULTS: 4-1) Precut frequency: 51 patients (pts.) (12.1%). 4-2) Follow up: 49 pts. (96.1%) fulfilled the weekly controls; 2 pts. (3.9%) did not come for the controls. 4-3) Sex and Age: Women 29 pts. (56.9%). Age 62.5 +/- 1.74 years. Men: 22 pts. (43.1%) Age +/- 3.35 years. 4-4) INDICATIONS: Jaundice, diagnosis and treatment: 44 pts. (86.3%), post-cholecystectomy pain; 4 pts. (7.8%), and idiopathic abdominal pain: 3 pts. (5.9%). 4-5) Effectiveness: First attempt 35 pts. (71.4%), second attempt: 10 pts (20.4%). Definite effectiveness: 45 pts. (98.1%), failure: 4 pts. (8.1%). 4-6) Complementary treatment: in 43 pts. we performed the following procedures: papillotomy and stone extraction: 26 pts. (53%), papillotomy and prosthesis: 9 pts. (18.4%), Prosthesis: 8 pts. (16.3%, only pre-cut papillotomy: 6 pts. (12.2%). 4-7 Final diagnoses: Coledocholithiasis 41 pts. (83.6%); Malignant obstruction of biliary duct: 4 pts. (8.2%), Pancreatic Cancer: 1 pts. (2%); Ampullary Cancer 1 pts. (2%). Oddi sphyncter dysfunction: 1 pts. (2%). 4-8. COMPLICATIONS: Total 9 pts. (18.4%). mild Haemorrhage: 7 pts. (14.4%). Acute pancreatitis: 2 pts. (4%), mild: 1 pts. (2%), severe: 1 pts. (2%) 4-9-Mortality: not recorded. CONCLUSIONS: 5-1 Precut papillotomy is used by us with the same frequency native authors use it, but less than foreign authors. 5-2 Age, sex, indications, complementary treatment and final diagnoses are similar to those repo. 5-3 reported by other authors. 5-3- High rate of follow up. 5-4- High percentage of effectiveness which coincide with consulted studies. Precut papillotomy was the only therapy in 12.2% of the cases. 5-5 Low percentage of complications and, when present, of minor importance coinciding with other authors. 5-6 No mortality. 5-7 In our experience, precut papillotomy was a safe and effective technique to cannulate the papilla.
Subject(s)
Ampulla of Vater/surgery , Common Bile Duct Diseases/surgery , Sphincterotomy, Endoscopic , Argentina , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Sphincterotomy, Endoscopic/adverse effects , Sphincterotomy, Endoscopic/mortality , Sphincterotomy, Endoscopic/statistics & numerical dataABSTRACT
1) INTRODUCTION: Precut papillotomy, has been considered a potentially dangerous procedure. In spite of this, numerous national and foreign referral centers have reported good results with the use of this technique that increases the cannulation rate and permits additional therapeutic procedures. 2) OBJECTIVES: We evaluated the procedure in terms of frequency of use, effectiveness, complications and mortality. 3) PATIENT AND METHODS: Between January 1, 1996 and December 31, 1999, 419 ERCP were performed in our centers. We used precut papillotomy in 51 patients. Inclusion criteria for precut papillotomy protocol were: 1 precut papillotomy indication. 1-1 failure to cannulate the papilla, 1-2 appropriate indication, 1-3 Expert endoscopist, 2 complete follow up, 3 informed consent. The experimental design of the study was prospective. When the patients entered into the protocol, they underwent a needle-knife sphincterotomy according to Huibregise's technique. The follow up was done during 30 days, with a clinical examination, laboratory test and ultrasonography all of them weekly, to determine the possible complications according to Cotton's criteria and the mortality. 4) RESULTS: 4-1) Precut frequency: 51 patients (pts.) (12.1 percent). 4-2) Follow up: 49 pts. (96.1 percent) fulfilled the weekly controls; 2 pts. (3.9 percent) did not come for the controls. 4-3) Sex and Age: Women 29 pts. (56.9 percent). Age 62.5 +/- 1.74 years. Men: 22 pts. (43.1 percent) Age +/- 3.35 years. 4-4) Indications: Jaundice, diagnosis and treatment: 44 pts. (86.3 percent), post-cholecystectomy pain; 4 pts. (7.8 percent), and idiopathic abdominal pain: 3 pts. (5.9 percent). 4-5) Effectiveness: First attempt 35 pts. (71.4 percent), second attempt: 10 pts (20.4 percent). Definite effectiveness: 45 pts. (98.1 percent), failure: 4 pts. (8.1 percent). 4-6) Complementary treatment: in 43 pts. we performed the following procedures: papillotomy and stone extraction: 26 pts. (53 percent), papillotomy and prosthesis: 9 pts. (18.4 percent), Prosthesis: 8 pts. (16.3 percent, only pre-cut papillotomy: 6 pts. (12.2 percent). 4-7 Final diagnoses: Coledocholithiasis 41 pts. (83.6 percent); Malignant obstruction of biliary duct: 4 pts. (8.2 percent), Pancreatic Cancer: 1 pts. (2 percent); Ampullary Cancer 1 pts. (2 percent). Oddi sphyncter dysfunction: 1 pts. (2 percent). 4-8...
Subject(s)
Humans , Male , Female , Middle Aged , Ampulla of Vater , Common Bile Duct Diseases , Follow-Up Studies , Sphincterotomy, Endoscopic , Prospective Studies , Sphincterotomy, EndoscopicABSTRACT
1) INTRODUCTION: Precut papillotomy, has been considered a potentially dangerous procedure. In spite of this, numerous national and foreign referral centers have reported good results with the use of this technique that increases the cannulation rate and permits additional therapeutic procedures. 2) OBJECTIVES: We evaluated the procedure in terms of frequency of use, effectiveness, complications and mortality. 3) PATIENT AND METHODS: Between January 1, 1996 and December 31, 1999, 419 ERCP were performed in our centers. We used precut papillotomy in 51 patients. Inclusion criteria for precut papillotomy protocol were: 1 precut papillotomy indication. 1-1 failure to cannulate the papilla, 1-2 appropriate indication, 1-3 Expert endoscopist, 2 complete follow up, 3 informed consent. The experimental design of the study was prospective. When the patients entered into the protocol, they underwent a needle-knife sphincterotomy according to Huibregises technique. The follow up was done during 30 days, with a clinical examination, laboratory test and ultrasonography all of them weekly, to determine the possible complications according to Cottons criteria and the mortality. 4) RESULTS: 4-1) Precut frequency: 51 patients (pts.) (12.1 percent). 4-2) Follow up: 49 pts. (96.1 percent) fulfilled the weekly controls; 2 pts. (3.9 percent) did not come for the controls. 4-3) Sex and Age: Women 29 pts. (56.9 percent). Age 62.5 +/- 1.74 years. Men: 22 pts. (43.1 percent) Age +/- 3.35 years. 4-4) Indications: Jaundice, diagnosis and treatment: 44 pts. (86.3 percent), post-cholecystectomy pain; 4 pts. (7.8 percent), and idiopathic abdominal pain: 3 pts. (5.9 percent). 4-5) Effectiveness: First attempt 35 pts. (71.4 percent), second attempt: 10 pts (20.4 percent). Definite effectiveness: 45 pts. (98.1 percent), failure: 4 pts. (8.1 percent). 4-6) Complementary treatment: in 43 pts. we performed the following procedures: papillotomy and stone extraction: 26 pts. (53 percent), papillotomy and prosthesis: 9 pts. (18.4 percent), Prosthesis: 8 pts. (16.3 percent, only pre-cut papillotomy: 6 pts. (12.2 percent). 4-7 Final diagnoses: Coledocholithiasis 41 pts. (83.6 percent); Malignant obstruction of biliary duct: 4 pts. (8.2 percent), Pancreatic Cancer: 1 pts. (2 percent); Ampullary Cancer 1 pts. (2 percent). Oddi sphyncter dysfunction: 1 pts. (2 percent). 4-8... (Au)
Subject(s)
Humans , Male , Female , Middle Aged , Common Bile Duct Diseases/surgery , Sphincterotomy, Endoscopic , Ampulla of Vater/surgery , Follow-Up Studies , Sphincterotomy, Endoscopic/adverse effects , Sphincterotomy, Endoscopic/mortality , Sphincterotomy, Endoscopic/statistics & numerical data , Prospective StudiesABSTRACT
1) INTRODUCTION: Precut papillotomy, has been considered a potentially dangerous procedure. In spite of this, numerous national and foreign referral centers have reported good results with the use of this technique that increases the cannulation rate and permits additional therapeutic procedures. 2) OBJECTIVES: We evaluated the procedure in terms of frequency of use, effectiveness, complications and mortality. 3) PATIENT AND METHODS: Between January 1, 1996 and December 31, 1999, 419 ERCP were performed in our centers. We used precut papillotomy in 51 patients. Inclusion criteria for precut papillotomy protocol were: 1 precut papillotomy indication. 1-1 failure to cannulate the papilla, 1-2 appropriate indication, 1-3 Expert endoscopist, 2 complete follow up, 3 informed consent. The experimental design of the study was prospective. When the patients entered into the protocol, they underwent a needle-knife sphincterotomy according to Huibregises technique. The follow up was done during 30 days, with a clinical examination, laboratory test and ultrasonography all of them weekly, to determine the possible complications according to Cottons criteria and the mortality. 4) RESULTS: 4-1) Precut frequency: 51 patients (pts.) (12.1
). 4-2) Follow up: 49 pts. (96.1
) fulfilled the weekly controls; 2 pts. (3.9
) did not come for the controls. 4-3) Sex and Age: Women 29 pts. (56.9
). Age 62.5 +/- 1.74 years. Men: 22 pts. (43.1
) Age +/- 3.35 years. 4-4) Indications: Jaundice, diagnosis and treatment: 44 pts. (86.3
), post-cholecystectomy pain; 4 pts. (7.8
), and idiopathic abdominal pain: 3 pts. (5.9
). 4-5) Effectiveness: First attempt 35 pts. (71.4
), second attempt: 10 pts (20.4
). Definite effectiveness: 45 pts. (98.1
), failure: 4 pts. (8.1
). 4-6) Complementary treatment: in 43 pts. we performed the following procedures: papillotomy and stone extraction: 26 pts. (53
), papillotomy and prosthesis: 9 pts. (18.4
), Prosthesis: 8 pts. (16.3
, only pre-cut papillotomy: 6 pts. (12.2
). 4-7 Final diagnoses: Coledocholithiasis 41 pts. (83.6
); Malignant obstruction of biliary duct: 4 pts. (8.2
), Pancreatic Cancer: 1 pts. (2
); Ampullary Cancer 1 pts. (2
). Oddi sphyncter dysfunction: 1 pts. (2
). 4-8. Complications: Total 9 pts. (18.4
). mild Haemorrhage: 7 pts. (14.4
). Acute pancreatitis: 2 pts. (4
), mild: 1 pts. (2
), severe: 1 pts. (2
) 4-9-Mortality: not recorded. CONCLUSIONS: 5-1 Precut papillotomy is used by us with the same frequency native authors use it, but less than foreign authors. 5-2 Age, sex, indications, complementary treatment and final diagnoses are similar to those repo. 5-3 reported by other authors. 5-3- High rate of follow up. 5-4- High percentage of effectiveness which coincide with consulted studies. Precut papillotomy was the only therapy in 12.2
of the cases. 5-5 Low percentage of complications and, when present, of minor importance coinciding with other authors. 5-6 No mortality. 5-7 In our experience, precut papillotomy was a safe and effective technique to cannulate the papilla.
ABSTRACT
We present a young, female patient with clinical and biochemical manifestations of acute cholestasis who had undergone a 10-day course of 1,500 mg/day amoxicillin 3 weeks before the consultation. Diagnosis was based on the absence of alcohol consumption, negative viral markers and antibodies, normal biliary tract, clinical and biochemical improvement when amoxicillin was withdrawn and liver biopsy with histological changes compatible with amoxicillin-induced acute cholestasis. Because hepatotoxicity induced by amoxicillin alone is rare, we believe it important to communicate this new case and to warn of this possible complication. We also stress that simple cholestasis induced by amoxicillin alone, as presented in this case, has been described in only one report, published 10 years ago.
Subject(s)
Amoxicillin/adverse effects , Cholestasis, Intrahepatic/chemically induced , Penicillins/adverse effects , Acute Disease , Adult , Female , HumansABSTRACT
PURPOSE: To show the experience in rigid prosthesis used as a palliative treatment for malignant++ esophageal stenosis. MATERIAL AND METHOD: From November 1995 to January 1997, 14 patients between 51 and 83 years old, were referred for rigid prosthesis in a prospective way (71.5 = 2.3); 11 of them were men and 3 women. The criteria for including them was: 11 (eleven) patients suffering from esophagus cancer stage IV; 2 (two) patients suffering from stomach cancer with esophageal invasion stage IV and 1 (one) patient with mediastinum metastasis of breast cancer. Wilson-Cook rigid prosthesis was used for all these cases. The insertion technique was "the dilator method". RESULTS: Successful method: 14 (100%). Mortality: Not recorded. Disorders: In 6 (six) patients (42.8%); 3 (three) (21.4%) at an early stage: migrations and 3 (21.4%) at a later stage: 2 (two) tamponade because of food and 1 (one) magration. Time in hospital or clinic: 24 hours (100%). Improvement on Dysphagia: 14 (100%). Following: 13 (92.8%). Survivance: 18-266 days (92 = 83.6). CONCLUSIONS: 1. High percentage of success in prosthesis setting. 2. No mortality. 3. Low percentage of complications and if so, of minor importance. 4. Minimal time in hospital or clinic. 5. Quick and effective dysphagia improvement. 6. Appropriate follow up. 7. Survival similar to other palliative methods, less morbimortality and cost and better life conditions.
Subject(s)
Esophageal Neoplasms/surgery , Esophageal Stenosis/surgery , Esophagus/surgery , Palliative Care , Prostheses and Implants , Aged , Aged, 80 and over , Argentina , Esophageal Neoplasms/complications , Esophageal Stenosis/etiology , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
1. PURPOSE: To show the experience in rigid prosthesis used as a palliative treatment for malignant++ esophageal stenosis. 2. MATERIAL AND METHOD: From November 1995 to January 1997, 14 patients between 51 and 83 years old, were referred for rigid prosthesis in a prospective way (71.5 = 2.3); 11 of them were men and 3 women. The criteria for including them was: 11 (eleven) patients suffering from esophagus cancer stage IV; 2 (two) patients suffering from stomach cancer with esophageal invasion stage IV and 1 (one) patient with mediastinum metastasis of breast cancer. Wilson-Cook rigid prosthesis was used for all these cases. The insertion technique was [quot ]the dilator method[quot ]. 3. RESULTS: Successful method: 14 (100
). Mortality: Not recorded. Disorders: In 6 (six) patients (42.8
); 3 (three) (21.4
) at an early stage: migrations and 3 (21.4
) at a later stage: 2 (two) tamponade because of food and 1 (one) magration. Time in hospital or clinic: 24 hours (100
). Improvement on Dysphagia: 14 (100
). Following: 13 (92.8
). Survivance: 18-266 days (92 = 83.6). 4. CONCLUSIONS: 1. High percentage of success in prosthesis setting. 2. No mortality. 3. Low percentage of complications and if so, of minor importance. 4. Minimal time in hospital or clinic. 5. Quick and effective dysphagia improvement. 6. Appropriate follow up. 7. Survival similar to other palliative methods, less morbimortality and cost and better life conditions.
ABSTRACT
Objetivo: Mostrar la experiencia en prótesis rígidas para el tratamiento paliativo de las estenosis malignas esofágicas. Material y Método: Desde noviembre de 1995 hasta enero de 1997 ingresaron al protocolo de prótesis rígidas en forma prospectiva no randomizada 14 pacientes, cuya edad fue de 51 a 83 años (71.5 + 2.3); 11 de sexo masculino y 3 de sexo feminino. Los criterios de inclusión fueron 11 pacientes con cáncer de esófago en estadio IV, 2 pacientes con cáncer de estómago con invasión a esófago y estadio IV y 1 paciente con metástasis en mediastino de cáncer de mama. Se utilizó prótesis rígida modelo Wilson-Cook. La técnica de inserción fue "el método sobre el dilatador". Resultados: Procedimiento exitoso: 14 (100 por ciento), Mortalidad: no se registró, Complicaciones: en 6 pacientes (42.8 por ciento), 2 (14.3 por ciento) tempranas: migraciones y 4 (28.5 por ciento) tardías: 3 taponamiento por alimentos y una migración, Tiempo de Internación: 24 horas (100 por ciento), Mejoría de la Disfagia: 14 (100 por ciento), Seguimento: 13 (92.8 por ciento), Sobrevida: 18 a 266 días (92 + 83.6). Conclusiones: En nuestra casuística hemos observado: 1º Alto porcentaje de éxitos en la colocación; 2º Ausencia de mortalidad; 3º Bajo porcentaje de complicaciones y dentro de ellas menores; 4º Mínimo tiempo de internación; 5º Rápida y efectiva mejoría de la disfagia; 6º Adecuado seguimiento; 7º Tiempo de sobrevida similar a otros métodos paliativos, pero con menor morbimortalidad y costo, y mejor calidad de vida.
Subject(s)
Humans , Male , Female , Middle Aged , Esophageal Neoplasms/surgery , Esophageal Stenosis/surgery , Esophagus/surgery , Palliative Care , Prostheses and Implants , Aged, 80 and over , Argentina , Prospective StudiesABSTRACT
Objetivo: Mostrar la experiencia en prótesis rígidas para el tratamiento paliativo de las estenosis malignas esofágicas. Material y Método: Desde noviembre de 1995 hasta enero de 1997 ingresaron al protocolo de prótesis rígidas en forma prospectiva no randomizada 14 pacientes, cuya edad fue de 51 a 83 años (71.5 + 2.3); 11 de sexo masculino y 3 de sexo feminino. Los criterios de inclusión fueron 11 pacientes con cáncer de esófago en estadio IV, 2 pacientes con cáncer de estómago con invasión a esófago y estadio IV y 1 paciente con metástasis en mediastino de cáncer de mama. Se utilizó prótesis rígida modelo Wilson-Cook. La técnica de inserción fue "el método sobre el dilatador". Resultados: Procedimiento exitoso: 14 (100 por ciento), Mortalidad: no se registró, Complicaciones: en 6 pacientes (42.8 por ciento), 2 (14.3 por ciento) tempranas: migraciones y 4 (28.5 por ciento) tardías: 3 taponamiento por alimentos y una migración, Tiempo de Internación: 24 horas (100 por ciento), Mejoría de la Disfagia: 14 (100 por ciento), Seguimento: 13 (92.8 por ciento), Sobrevida: 18 a 266 días (92 + 83.6). Conclusiones: En nuestra casuística hemos observado: 1º Alto porcentaje de éxitos en la colocación; 2º Ausencia de mortalidad; 3º Bajo porcentaje de complicaciones y dentro de ellas menores; 4º Mínimo tiempo de internación; 5º Rápida y efectiva mejoría de la disfagia; 6º Adecuado seguimiento; 7º Tiempo de sob
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Esophagus/surgery , Prostheses and Implants , Palliative Care , Esophageal Stenosis/surgery , Esophageal Neoplasms/surgery , Argentina , Prospective Studies , Aged, 80 and overABSTRACT
Se comunica un nuevo caso de S.I.C. ocasionado por un divertículo yeyunal, y revisión de la literatura referente a etiopatogenia, clínica, diagnóstico y tratamiento del mismo.
Subject(s)
Humans , Male , Adult , Diverticulum/complications , Intestinal Pseudo-Obstruction/etiology , Jejunal Diseases/complications , Chronic DiseaseABSTRACT
Se comunica un nuevo caso de S.I.C. ocasionado por un divertículo yeyunal, y revisión de la literatura referente a etiopatogenia, clínica, diagnóstico y tratamiento del mismo. (AU)
Subject(s)
Humans , Male , Adult , Intestinal Pseudo-Obstruction/etiology , Diverticulum/complications , Jejunal Diseases/complications , Chronic DiseaseABSTRACT
Se comunica una complicación no descripta de la sonda nasoyeyunal, un nudo en la misma. Se analiza la frecuencia, tipos, motivos de esta complicación y sugerencias para evitarla.
Subject(s)
Humans , Male , Aged , Equipment Failure , Intubation, Gastrointestinal/adverse effects , Enteral Nutrition/adverse effects , Intubation, Gastrointestinal/instrumentation , Jejunum , Enteral Nutrition/instrumentationABSTRACT
Se comunica una complicación no descripta de la sonda nasoyeyunal, un nudo en la misma. Se analiza la frecuencia, tipos, motivos de esta complicación y sugerencias para evitarla. (AU)
Subject(s)
Humans , Male , Aged , Equipment Failure , Enteral Nutrition/adverse effects , Intubation, Gastrointestinal/adverse effects , Jejunum , Intubation, Gastrointestinal/instrumentation , Enteral Nutrition/instrumentationABSTRACT
We report a problem not yet described with nasojejunal tube. It got knotted frequency, types and causes are reported as well frequency, types and causes are reported as well as suggestions to prevent it.
Subject(s)
Enteral Nutrition/adverse effects , Equipment Failure , Intubation, Gastrointestinal/adverse effects , Aged , Enteral Nutrition/instrumentation , Humans , Intubation, Gastrointestinal/instrumentation , Jejunum , MaleABSTRACT
En un estudio anterior observamos una elevada prevalencia de infección por el VHB en enfermeras y mucamas del asilo para ancianos del Hospital Municipal de Lincoln, Provincia de Buenos Aires. El objetivo de este trabajo fue conocer la prevalencia de infección por el VHB y analizar el patrón serológico hallado en la población geriátrica de dicho asilo. Se estudiaron 38 personas de ambos sexos, de más de 60 años de edad que viven en el asilo. El grupo control lo constituyeron 91 personas con características similares a las del grupo de estudio, provenientes de consultorio externo. Se investigaron en ambos grupos Anti-HBc, Anti-HBs y AgHBs por el método de ELISA. Resultaron con marcadores repetidamente reactivos 3 participantes (7.9//) del grupo estudiado y 6 (6.5//) del grupo tomado como control. No hubo diferencias estadísticamente signficativas entre ambos grupos (P 0.05). La población geriátrica del asilo de nuestro medio, no corresponde a población de alto riesgo para infección por el VHB. Se relaciona la alta prevalencia hallada en enfermeras y mucamas con factores de índole laboral y extralaboral y no con su tarea específica en el asilo para ancianos
Subject(s)
Humans , Male , Female , Middle Aged , Hepatitis B/epidemiology , Homes for the Aged , Aged, 80 and over , Argentina/epidemiology , Case-Control Studies , Prevalence , Risk Factors , Sampling Studies , Seroepidemiologic StudiesABSTRACT
En un estudio anterior observamos una elevada prevalencia de infección por el VHB en enfermeras y mucamas del asilo para ancianos del Hospital Municipal de Lincoln, Provincia de Buenos Aires. El objetivo de este trabajo fue conocer la prevalencia de infección por el VHB y analizar el patrón serológico hallado en la población geriátrica de dicho asilo. Se estudiaron 38 personas de ambos sexos, de más de 60 años de edad que viven en el asilo. El grupo control lo constituyeron 91 personas con características similares a las del grupo de estudio, provenientes de consultorio externo. Se investigaron en ambos grupos Anti-HBc, Anti-HBs y AgHBs por el método de ELISA. Resultaron con marcadores repetidamente reactivos 3 participantes (7.9//) del grupo estudiado y 6 (6.5//) del grupo tomado como control. No hubo diferencias estadísticamente signficativas entre ambos grupos (P 0.05). La población geriátrica del asilo de nuestro medio, no corresponde a población de alto riesgo para infección por el VHB. Se relaciona la alta prevalencia hallada en enfermeras y mucamas con factores de índole laboral y extralaboral y no con su tarea específica en el asilo para ancianos (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hepatitis B/epidemiology , Homes for the Aged , Aged, 80 and over , Argentina/epidemiology , Prevalence , Seroepidemiologic Studies , Risk Factors , Sampling Studies , Case-Control StudiesABSTRACT
In a previous study we observed a high prevalence of infection with hepatitis B virus (HBV) among nurses and maids of the elder's home at the Lincoln Town Hospital, Lincoln, province of Buenos Aires, Argentine Republic. The purpose of this study was to know the prevalence of infection with HBV and analyze the serologic pattern found in old people of the home. We studied 38 people of both sexes, older than 60 years, who live at the home. The control group was formed with 91 people with the same characteristics but from the ambulatory clinic. In both groups anti-HBc, anti-HBs and AgHBs were detected by ELISA method. Results were: 3 subjects (7.9%) in the studied group and 6 (6.5%) in the control group presented markers repeatedly. The was no significant statistic difference between both groups (P 0.05). The old people from the elder home of this city, are not in great danger of HBV infection. We relate the high prevalence among nurses and maids with labor and extra labor factors and not with their specific work in this elder home.
