ABSTRACT
BACKGROUND: The volume of the postoperative gastric remnant is a key factor in excess weight loss (EWL) after sleeve gastrectomy (SG). Traditional methods to estimate gastric volume (GV) after bariatric procedures are often inaccurate; usually conventional biplanar contrast studies are used. METHODS: Thirty patients who underwent SG were followed prospectively and evaluated at 6 months after the surgical procedure, performing 3D CT reconstruction and gastric volumetry, to establish its relationship with EWL. The gastric remnant was distended with effervescent sodium bicarbonate given orally. Helical CT images were acquired and reconstructed; GV was estimated with the software of the CT device. The relationship between GV and EWL was analyzed. RESULTS: The study allowed estimating the GV in all patients. A dispersion diagram showed an inverse relationship between GV and %EWL. 55.5% of patients with GV ≤ 100 ml had %EWL 25-75% and 38.8% had an %EWL above 75% and patients with GV ≥ 100 ml had an %EWL under 25% (50% of patients) or between 25 and 75% (50% of this group). The Pearson's correlation coefficient was R = 6.62, with bilateral significance (p ≤ .01). The Chi-square result correlating GV and EWL showed a significance of .005 (p ≤ .01). The 3D reconstructions showed accurately the shape and anatomic details of the gastric remnant. CONCLUSIONS: 3D volumetry CT scans accurately estimate GV after SG. A significant relationship between GV and EWL 6 months after SG was established, seeming that GV ≥ 100 ml at 6 months of SG is associated with poor EWL.
Subject(s)
Gastrectomy/adverse effects , Gastric Stump/pathology , Obesity, Morbid/diagnosis , Obesity, Morbid/surgery , Stomach/diagnostic imaging , Stomach/pathology , Weight Loss/physiology , Adult , Female , Follow-Up Studies , Gastrectomy/methods , Gastric Stump/diagnostic imaging , Humans , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional , Male , Middle Aged , Obesity, Morbid/pathology , Organ Size , Postoperative Period , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
La enfermedad de Addison es una entidad nosológica caracterizada por una deficiencia parcial de glucocorticoides ocasionalmente asociada a déficit de mineralcorticoides, consecuencia ésta derivada de una disfunción de las glándulas suprarenales debida a destrucción autoinmune, infecciosa o metastásica, aunque también se describen otras causas menos importantes como la interferencia en su funcionamiento mediante diversas drogas. La sintomatología de la enfermedad es sumamente variada e inespecífica, requiriéndose en ocasiones de un alto grado de sospecha para plantear su investigación. Se presenta el caso de un hombre en la séptima década de su vida quien luego del diagnóstico correspondiente inició terapia de sustitución hormonal con Prednisona (Meticorten) obteniendo una mejoría dramática