ABSTRACT
Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspe-cific, so diagnostic suspicion must be high in order to make an early diagnosis and prevent iatrogenia. Pharmacotherapy is often effective, with an excellent clinical and endoscopic evolution. Surgical treatment is reserved for complications. We present the case of cecal tuberculosis diagnosed endoscopically; this is the second case diagnosed in a few months in our center. In this case there were no risk factors, such as recent travel, risk of contacts or inmunosupression.
Subject(s)
Cecal Diseases/microbiology , Cecal Diseases/pathology , Colonoscopy , Tuberculosis, Gastrointestinal/pathology , Aged , Humans , MaleABSTRACT
We present the case of a middle-aged woman with antecedents of cholecystectomy and several episodes of resi-dual coledocolitiasis resolved endoscopically. She attended Emergency Services due to a new clinical picture of abdo-minal pain and alteration of hepatic enzymes. Image tests showed lesions that suggested hepatic abscesses without ruling out a malign origin. Given this doubt it was decided to carry out a thick needle biopsy obtaining a diagnosis of an inflammatory pseudotumour of the liver related to IgG4-related disease. This is an infrequent entity but must be taken into consideration because - unlike malign pathology, which is the main differential diagnosis - its behaviour is benign, with a good evolution with medical treatment. That is why a suitable diagnosis is vital to avoid aggressive, diagnostic-therapeutic procedures.
Subject(s)
Granuloma, Plasma Cell/pathology , Liver Diseases/pathology , Female , Humans , Middle AgedABSTRACT
La tuberculosis intestinal es mucho menos frecuente que la pulmonar. Además, tanto su presentación como el aspecto endoscópico son muy variados, de modo que la sospecha diagnóstica debe ser elevada para un diagnóstico precoz y para evitar la posible yatrogenia. Con el tratamiento antituberculoso convencional la evolución, tanto clínica como endoscópica, suele ser excelente, quedando la cirugía relegada como tratamiento para las complicaciones. Presentamos un caso de tuberculosis cecal diagnosticada endoscópicamente, la segunda diagnosticada en unos meses en nuestro centro. En este caso no había factores de riesgo como viajes recientes, contactos con infectados ni toma de fármacos inmunosupresores (AU)
Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspecific, so diagnostic suspicion must be high in order to make an early diagnosis and prevent iatrogenia. Pharmacotherapy is often effective, with an excellent clinical and endoscopic evolution. Surgical treatment is reserved for complications. We present the case of cecal tuberculosis diagnosed endoscopically; this is the second case diagnosed in a few months in our center. In this case there were no risk factors, such as recent travel, risk of contacts or inmunosupression (AU)
Subject(s)
Humans , Male , Aged , Tuberculosis, Gastrointestinal/diagnosis , Cecal Diseases/diagnosis , Colonic Diseases/diagnosis , Tuberculosis, Gastrointestinal/epidemiology , Early Diagnosis , Risk FactorsABSTRACT
Presentamos el caso de una mujer de mediana edad con antecedentes de colecistectomía y varios episodios de coledocolitiasis residual resueltos endoscópicamente. Acude al servicio de Urgencias por un nuevo cuadro de dolor abdominal y alteración de enzimas hepáticas, apreciándose en las pruebas de imagen lesiones sugestivas de abscesos hepáticos sin poder descartarse un origen maligno. Dada esta duda se decide realizar una biopsia con aguja gruesa llegando al diagnóstico de pseudotumor inflamatorio hepático relacionada con la enfermedad por IgG4. Ésta es una entidad infrecuente pero que debe ser tenida en cuenta debido a que, a diferencia de la patología maligna, que es el principal diagnóstico diferencial, su comportamiento es benigno, con buena evolución con tratamiento médico. Por ello es vital un adecuado diagnóstico para evitar procedimientos diagnóstico-terapéuticos agresivos (AU)
We present the case of a middle-aged woman with antecedents of cholecystectomy and several episodes of residual coledocolitiasis resolved endoscopically. She attended Emergency Services due to a new clinical picture of abdominal pain and alteration of hepatic enzymes. Image tests showed lesions that suggested hepatic abscesses without ruling out a malign origin. Given this doubt it was decided to carry out a thick needle biopsy obtaining a diagnosis of an inflammatory pseudotumour of the liver related to IgG4-related disease. This is an infrequent entity but must be taken into consideration because - unlike malign pathology, which is the main differential diagnosis - its behaviour is benign, with a good evolution with medical treatment. That is why a suitable diagnosis is vital to avoid aggressive, diagnostic-therapeutic procedures (AU)
Subject(s)
Humans , Female , Middle Aged , Waldenstrom Macroglobulinemia/diagnosis , Liver Neoplasms/diagnosis , Granuloma, Plasma Cell/diagnosis , Diagnosis, Differential , Biopsy, Large-Core Needle , Adrenal Cortex Hormones/therapeutic useABSTRACT
Autoimmune pancreatitis (AIP) is an infrequent pathology, although there is a growing incidence in Eastern countries, which might be due to a greater rate of detection. It can be associated with other auto immune pathologies and its association with IgG4-related systemic disease has been described.Its clinical presentation is varied and the normal treatment is medical, using corticoids.A diagnosed clinical case is described.
Subject(s)
Autoimmune Diseases , Pancreatitis , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Humans , Immunoglobulin G , Incidence , Pancreatitis/diagnosis , Pancreatitis/therapyABSTRACT
La pancreatitis autoinmune (PAI) es una patología poco frecuente, aunque con una creciente incidencia en países orientales, si bien esto podría deberse a una mayor tasa de detección. Puede asociarse a otras patologías autoinmunes, y se ha descrito su asociación con la enfermedad sistémica por IgG4. La clínica es variada y el tratamiento habitualmente es médico, mediante corticoides. Se describe un caso clínico diagnosticado (AU)
Autoimmune pancreatitis (AIP) is an infrequent pathology, although there is a growing incidence in Eastern countries, which might be due to a greater rate of detection. It can be associated with other autoimmune pathologies and its association with IgG4-related systemic disease has been described. Its clinical presentation is varied and the normal treatment is medical, using corticoids. A diagnosed clinical case is described (AU)
Subject(s)
Humans , Male , Adult , Pancreatitis/complications , Pancreatitis/diagnosis , Pancreatitis/immunology , Autoimmunity , Autoimmunity/immunology , Immunoglobulin G/analysis , CD4 Immunoadhesins/analysis , Adrenal Cortex Hormones/therapeutic use , Pancreatitis , Cholangiopancreatography, Endoscopic Retrograde/instrumentation , Cholangiopancreatography, Endoscopic Retrograde/methods , Cholangiopancreatography, Endoscopic RetrogradeABSTRACT
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