ABSTRACT
La enfermedad fistulosa perianal (EFPA) en la enfermedad de Crohn (EC) constituye una complicación que afecta a la calidad de vida de los pacientes y muchas veces precisa una atención urgente. El tratamiento debe ser individualizado y combinar procedimientos médicos y quirúrgicos. Los aspectos clave para un adecuado manejo de la EFPA son determinar la existencia o no de afectación rectal, las características anatómicas y tipo de fístulas, y descartar la existencia de abscesos perianales. Para lograrlo es necesaria una aproximación diagnóstica que incluya inspección y tacto rectal, endoscopia y exploración bajo anestesia combinado con resonancia magnética pélvica o ecoendoscopia recto-anal (AU)
The treatment of perineal fistulas in Crohn disease should be defined according to the each patient. A combined medical and surgical approach is the optimal treatment. The management of perianal fistula disease is based on the presence or absence of active proctitis, the anatomic location and type fistula, and identify perianal abscess. This evaluation includes digital rectal examination, endoscopy, and examination under anesthesia combined with pelvic magnetic resonance imaging or anorectal endoscopy ultrasonography findings (AU)
Subject(s)
Humans , Crohn Disease/complications , Rectal Fistula/etiology , Magnetic Resonance Imaging , Crohn Disease/therapy , Crohn Disease/diagnosis , Rectal Fistula/therapy , Rectal Fistula/diagnosis , EndosonographyABSTRACT
We present two case of a spontaneous perforation of the esophagus (Boerhaave's syndrome), they were associated with different symptoms. Both of them the diagnosis was make on the second admission to the emergency service. The Boerhaave's syndrome is potentially lethal, relatively rare and the difficult diagnosis in the initial phases. It's a life threatening condition demanding early diagnosis and rapid aggressive management to prevent fulminant death.
Subject(s)
Esophageal Perforation/diagnosis , Aged , Aged, 80 and over , Emergency Service, Hospital , Esophageal Perforation/therapy , Fatal Outcome , Humans , Male , Tomography, X-Ray ComputedABSTRACT
Presentamos dos casos de rotura espontánea de esófago (síndrome de Boerhaave) que acudieron a urgencias por distintos síntomas, en ambos casos el diagnóstico se realizó en una segunda visita tras varias horas de evolución del cuadro. El síndrome de Boerhaave es una entidad grave, infrecuente y de difícil diagnóstico debido a su presentación inespecífica, y en el que es fundamental lograr un diagnóstico y tratamiento precoz por su alta morbimortalidad (AU)
Subject(s)
Aged, 80 and over , Aged , Male , Humans , Tomography, X-Ray Computed , Fatal Outcome , Emergency Service, Hospital , Esophageal PerforationABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Deglutition Disorders , Esophageal Achalasia , Deglutition DisordersSubject(s)
Esophageal Diseases/etiology , Pneumothorax/complications , Aged , Aged, 80 and over , Esophageal Diseases/diagnosis , Humans , Male , Mediastinal Emphysema/complications , Mediastinal Emphysema/diagnosis , Pleural Effusion/complications , Pleural Effusion/diagnosis , Pneumothorax/diagnosis , Rupture, Spontaneous , Subcutaneous Emphysema/complications , Subcutaneous Emphysema/diagnosisABSTRACT
No disponible