ABSTRACT
BACKGROUND AND AIM: Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) has become the standard treatment for peripancreatic fluid collections. Its use in other intra-abdominal abscesses has been reported, although there is limited evidence. METHODS: We carried out a single-center retrospective cohort study comparing percutaneous drainage (PCD) and EUS-D of upper abdominal abscesses between January 2012 and June 2017. Pancreatic fluid collections and liver transplant recipients were excluded. Primary endpoints were technical and clinical success rates. RESULTS: We included 18 EUS-D (nine hepatic and nine intraperitoneal abscesses) and 62 PCD. There were no differences regarding age, gender and etiology. Size was larger in the PCD group (80 vs 65.5 mm, P = 0.04) and perivesicular location was more frequent in the PCD group (24.2% vs 11.1%, P = 0.003). In the EUS-D group, metal stents were deployed in 16 (88.9%) subjects (eight lumen-apposing metal stents and eight self-expandable metal stents), coaxial double-pigtail plastic stents in six (33.3%) and lavage/debridement was carried out in five (27.8%). There were no significant differences in technical success (EUS-D: 88.9%, PCD: 96.8%, P = 0.22) or clinical success (EUS-D: 88.9%, PCD: 82.3%, P = 0.50), with no relapses in the EUS-D group and 10 (16.1%) in the PCD group (P = 0.11). There were four (22.2%) adverse events in the EUS-D group, none of them severe, and 13 (21%) in the PCD group (P = 0.91). CONCLUSIONS: EUS-D is an alternative to PCD in the treatment of upper abdominal abscesses, reaching similar success, relapse and adverse events rates.
Subject(s)
Abdominal Abscess/surgery , Drainage/methods , Endosonography , Ultrasonography, Interventional , Abdominal Abscess/diagnostic imaging , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Niveles elevados de vitamina B12 pueden ser relacionados con un alto riesgo de desarrollo de cáncer debido a una alteración de la integridad del ADN, como consecuencia del metabolismo anómalo de la cobalamina. Esto es importante para tener en cuenta la vitamina B12 como marcador tumoral inespecífico en el desarrollo de neoplasias sólidas, una vez descartadas otras patologías serias como enfermedades hematológicas, hepáticas y renales. Se presenta el caso de un paciente con hipervitaminosis B12 y cáncer de recto (AU)
High extreme values of B12 vitamin could be linked with high risk cáncer development throughout the DNA integrity distress because a cobalamine disfunctional metabolism. It's vital to understand the role of B12 vitamin as inespecific tumoral marker in the development of solid neoplasm when other many serious diseases as blood, liver and kidney diseases are rejected. We report a patient case about B12 hypervitaminosis and rectum cáncer (AU)
