Subject(s)
Crohn Disease/surgery , Ileostomy , Postoperative Complications , Follow-Up Studies , Humans , Recurrence , Retrospective Studies , Time FactorsABSTRACT
La hipertensión portal (HTP) es una complicación que puede acontecer en el curso de la enfermedad inflamatoria intestinal (EII). En los pacientes con EII, la HTP a menudo puede obedecer a etiologías distintas a la cirrosis alcohólica o vírica (causante de más del 90% de los casos de HTP en la población general). Por este motivo, el estudio etiológico de la HTP en estos pacientes debe contemplar siempre un amplio abanico de posibilidades. Asimismo, la aparición de HTP en la EII implica un manejo terapéutico diferente (tanto médico como quirúrgico), al constituir por sí misma una contraindicación para ciertos fármacos y un factor de mayor morbimortalidad posquirúrgica. En el presente artículo, se presentan dos casos de pacientes con EII que desarrollaron HTP y se revisan las causas más probables, las consecuencias en la evolución de la EII y las connotaciones preventivas y terapéuticas de la HTP en la EII (AU)
Portal hypertension (PH) is a complication that may occur in patients with inflammatory bowel disease (IBD). In these patients, the etiology of PH may not be alcoholic or viral cirrhosis (which cause 90% of cases in the general population). Consequently, etiologic study of PH in patients with IBD should always include a wide spectrum of possibilities. Moreover, the development of PH in IBD patients often requires a distinct therapeutic approach to IBD (both medical and surgical) as PH may be a contraindication for some drugs and is a risk factor for surgical morbidity and mortality. We present the cases of two patients with IBD who developed PH and review the most likely causes of PH in IBD, as well as preventive and therapeutic strategies (AU)
Subject(s)
Humans , Female , Adult , Crohn Disease/complications , Hypertension, Portal/etiology , Crohn Disease/drug therapy , Crohn Disease/physiopathology , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/drug therapy , Liver Cirrhosis/chemically induced , Mesalamine/therapeutic use , Methotrexate/adverse effects , Methotrexate/therapeutic use , Hypertension, Portal/physiopathologyABSTRACT
Portal hypertension (PH) is a complication that may occur in patients with inflammatory bowel disease (IBD). In these patients, the etiology of PH may not be alcoholic or viral cirrhosis (which cause 90% of cases in the general population). Consequently, etiologic study of PH in patients with IBD should always include a wide spectrum of possibilities. Moreover, the development of PH in IBD patients often requires a distinct therapeutic approach to IBD (both medical and surgical) as PH may be a contraindication for some drugs and is a risk factor for surgical morbidity and mortality. We present the cases of two patients with IBD who developed PH and review the most likely causes of PH in IBD, as well as preventive and therapeutic strategies.
