ABSTRACT
No disponible
Subject(s)
Humans , Endosonography/instrumentation , Carcinoid Tumor/therapy , Duodenum/injuriesABSTRACT
The present study was carried out to evaluate the diagnostic usefulness of stationary esophageal manometry in 263 patients divided into three groups: 150 patients with reflux symptoms, 68 with dysphagia, and 45 with non-cardiac chest pain. Patients with endoscopic abnormalities were excluded. Standard manometry was performed following the station pull-through technique. In the group of patients with reflux symptoms 40.7% had a normal manometry and 57.3% had abnormalities, being the most frequent (43%) hypotensive lower esophageal sphincter. In the dysphagia group, 20.6% of manometries were normal and 79.4% were abnormal, of which achalasia was the most frequent disorder (53.7%). In the case of non-cardiac chest pain, 42.2% of patients had a normal manometry and 57.8% an abnormal one, of which hypotensive lower esophageal sphincter was the most frequent abnormality. A significant higher proportion of manometric alterations were found in the dysphagia group compared to reflux symptoms and non-cardiac chest pain (p < 0.05). No statistical differences were found between the reflux and the non-cardiac chest pain groups. Manometry yields a higher diagnostic value in patients with dysphagia, and therefore manometry should be performed routinely after the exclusion of any organic esophageal disease. Manometry is not a first-choice functional diagnostic test in the study of patirnts with gastroesophageal reflux or non-cardiac chest pain.
Subject(s)
Chest Pain/diagnosis , Chest Pain/etiology , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/diagnosis , Adolescent , Adult , Aged , Chest Pain/therapy , Diagnosis, Differential , Esophagus/physiopathology , Female , Gastroesophageal Reflux/therapy , Humans , Male , Manometry/instrumentation , Manometry/methods , Middle Aged , Sensitivity and SpecificityABSTRACT
El presente estudio ha sido realizado para evaluar la utilidad diagnóstica de la manometría esofágica estacionaria en 263 pacientes divididos en 3 grupos: 150 pacientes con síntomas de reflujo gastroesofágico, 68 con disfagia y 45 con dolor torácico no cardiaco. Se excluyeron los pacientes con alteraciones endoscópicas. La manometría se realizó según la técnica de retirada estacionaria. Entre los pacientes con síntomas de reflujo gastroesofágico, el 40,7 por ciento tuvieron una manometría normal y el 57,3 por ciento presentaron alteraciones, siendo la presencia de un esfínter esofágico inferior hipotenso la alteración más frecuente (43 por ciento). En el grupo de disfagia, el 20,6 por ciento de las manometrías fueron normales y el 79,4 por ciento anormales, siendo la achalasia el trastorno motor más frecuente (53,7 por ciento). En el grupo con dolor torácico no cardiaco, el 42,2 por ciento de los pacientes tuvieron manometría normal y el 57,8 por ciento anormal, siendo esfínter esofágico inferior hipotenso la alteración más frecuente. Se encontró mayor proporción de alteraciones manométricas en el grupo de disfagia comparado con el de reflujo y con el de dolor torácico no cardiaco (p < 0,05). No se encontraron diferencias estadísticamente significativas entre el grupo con reflujo y dolor torácico no cardiaco. La manometría tiene un mayor valor diagnóstico en el grupo de pacientes con disfagia y, por lo tanto, debería de realizarse de forma rutinaria tras excluir una enfermedad orgánica esofágica. La manometría no es la primera opción diagnóstica funcional para estudiar reflujo gastroesofágico o dolor torácico no cardiaco (AU)
Subject(s)
Aged , Adult , Female , Humans , Male , Middle Aged , Adolescent , Manometry , Sensitivity and Specificity , Chest Pain , Diagnosis, Differential , Esophagus , Gastroesophageal Reflux , Gastroesophageal RefluxABSTRACT
The chest pain is one of the most common reasons for consultation of the patients seen in the emergency services of hospitals. Still being the acute coronary syndrome one of the first causes to confirmed by its important repercussions, we do not have to forget other reasons. We report a case of acute anginalike chest pain due to gastric anisakiasis. The larvae of Anisakis in the gastric mucosa were found and extracted endoscopically. Gastric anisakiasis should be included in the differential diagnosis of acute chest pain.
Subject(s)
Anisakiasis/complications , Chest Pain/etiology , Gastric Mucosa/parasitology , Stomach Diseases/complications , Aged , Animals , Anisakiasis/therapy , Anisakis/isolation & purification , Chest Pain/diagnosis , Chest Pain/therapy , Female , Fishes/parasitology , Food Parasitology , Gastric Mucosa/pathology , Gastroscopy , Humans , Stomach Diseases/parasitology , Stomach Diseases/therapy , Treatment OutcomeABSTRACT
El dolor torácico es una de las patologías que con mayor frecuencia se atienden en los servicios de urgencia hospitalarios. Aún siendo el síndrome coronario agudo una de las primeras causas a descartar por sus importantes repercusiones, no debemos descuidar otras etiologías. Presentamos un caso de un dolor torácico de características anginosas secundario a anisakiasis gástrica. La larva del anisakis en la mucosa gástrica fue encontrada y extraída endoscópicamente. La anisakiasis gástrica debería ser incluido en el diagnóstico diferencial de un dolor torácico (AU)
Subject(s)
Animals , Aged , Female , Humans , Gastric Mucosa , Treatment Outcome , Stomach Diseases , Gastroscopy , Food Parasitology , Fishes , Chest Pain , Anisakis , AnisakiasisABSTRACT
Peritoneal mesothelioma is an uncommon neoplasm often related to previous asbestos exposure. It is necessary to exclude other secondary peritoneal neoplasm. The application of immunohistochemical analysis in the biopsy sample is important for establishing an accurate diagnosis. We report the case of a peritoneal mesothelioma that started as a haemorrhagic ascites. After laparotomy, the initial diagnosis was peritoneal carcinomatosis from adenocarcinoma of unknown origin. The diagnosis was obtained by using immunohistochemical analysis: vimentin and keratine antibodies were positive and leu M1, antibodies were negative. The interest of our case resides in the difficulty for obtaining the diagnosis and the complicate management of refractory ascites. Our patient required intraperitoneal 5-fluorouracil for controlling the ascites.
Subject(s)
Ascites/diagnosis , Mesothelioma/diagnosis , Peritoneal Neoplasms/diagnosis , Adenocarcinoma/diagnosis , Ascites/etiology , Ascites/therapy , Combined Modality Therapy , Diagnosis, Differential , Humans , Male , Mesothelioma/complications , Mesothelioma/therapy , Middle Aged , Neoplasms, Unknown Primary/diagnosis , Peritoneal Neoplasms/complications , Peritoneal Neoplasms/therapy , RecurrenceABSTRACT
We present the case of a 79-years-old male with episodes of digestive bleeding in the form of melenas in which two pathological findings were observed as potential causes: ectopic pancreas in subpyloric position and diffuse colon angiodysplasia. The difficult management of the digestive bleeding when two lesions are associated as potential causes is stressed.
