ABSTRACT
No disponible
Subject(s)
Humans , Liver Cirrhosis, Alcoholic/complications , Liver Transplantation , Treatment OutcomeABSTRACT
No disponible
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Humans , Male , Adult , Gastrointestinal Stromal Tumors/diagnosis , Lipomatosis/diagnosis , Colonic Diseases/diagnosis , ColonoscopyABSTRACT
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Humans , Fibromatosis, Aggressive/pathology , Fibroma, Desmoplastic/pathology , Abdominal Neoplasms/pathology , BiopsySubject(s)
Abdominal Neoplasms , Fibromatosis, Aggressive , Abdominal Neoplasms/diagnosis , Abdominal Neoplasms/epidemiology , Abdominal Neoplasms/genetics , Abdominal Neoplasms/pathology , Abdominal Neoplasms/therapy , Adenomatous Polyposis Coli/epidemiology , Adenomatous Polyposis Coli/genetics , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/classification , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Diagnosis, Differential , Diagnostic Imaging , Fibromatosis, Aggressive/diagnosis , Fibromatosis, Aggressive/epidemiology , Fibromatosis, Aggressive/genetics , Fibromatosis, Aggressive/pathology , Fibromatosis, Aggressive/therapy , Humans , Laparotomy , Meta-Analysis as Topic , Neoplasm Recurrence, Local/prevention & control , Radiotherapy, Adjuvant , Remission Induction , Risk FactorsSubject(s)
Diet , Dietary Fats , Hepatitis C/therapy , Protease Inhibitors/therapeutic use , Combined Modality Therapy , HumansABSTRACT
Los síntomas que con mayor frecuencia aparecen en el cáncer de páncreas son el dolor abdominal, la pérdida de peso o la ictericia. La hemorragia digestiva alta por rotura de varices gástricas es una entidad mucho menos prevalente en estos pacientes. Este hallazgo requiere descartar siempre la presencia de trombosis de la vena esplénica. Presentamos el caso de un varón joven que acude a urgencias por hematemesis en el que las pruebas diagnósticas acabaron dilucidando un linfoma pancreático primario (LPP) que provocó trombosis de la vena esplénica, circulación colateral y varices gástricas aisladas sangrantes. Hasta hoy no hemos encontrado en la literatura médica ningún LPP que se exprese inicialmente de este modo. Finalmente realizamos una revisión de la literatura médica e incidimos en la importancia de descartar la trombosis de la vena esplénica en pacientes con varices gástricas aisladas y unas nociones acerca del diagnóstico y tratamiento del LPP (AU)
In patients with pancreatic cancer, the most frequent symptoms are abdominal pain, weight loss and jaundice. Upper gastrointestinal bleeding produced by gastric varices is a rare entity in these patients and requires the presence of splenic vein thrombosis (SVT) to be excluded. We describe the case of a young man who presented to the emergency department with hematemesis. Diagnostic tests revealed primary pancreatic lymphoma (PPL), which provoked splenic vein thrombosis, collateral circulation and the formation of isolated bleeding gastric varices. To date, we have found no reports in the literature of PPL with this form of presentation. Finally, we review the literature, with emphasis on the importance of excluding splenic vein thrombosis in patients with isolated gastric varices, and discuss certain features of the diagnosis and treatment of PPL (AU)
Subject(s)
Humans , Male , Adult , Esophageal and Gastric Varices/etiology , Gastrointestinal Hemorrhage/etiology , Lymphoma, Large-Cell, Anaplastic/complications , Pancreatic Neoplasms/complications , Splenic Vein , Venous Thrombosis/etiology , Diabetes Mellitus, Type 1/etiology , Hematemesis/etiology , Lymph Nodes/pathology , Lymphoma, Large-Cell, Anaplastic , Melena/etiology , Neoplasm Invasiveness , Lymphoma, Large-Cell, Anaplastic/diagnosisABSTRACT
In patients with pancreatic cancer, the most frequent symptoms are abdominal pain, weight loss and jaundice. Upper gastrointestinal bleeding produced by gastric varices is a rare entity in these patients and requires the presence of splenic vein thrombosis (SVT) to be excluded. We describe the case of a young man who presented to the emergency department with hematemesis. Diagnostic tests revealed primary pancreatic lymphoma (PPL), which provoked splenic vein thrombosis, collateral circulation and the formation of isolated bleeding gastric varices. To date, we have found no reports in the literature of PPL with this form of presentation. Finally, we review the literature, with emphasis on the importance of excluding splenic vein thrombosis in patients with isolated gastric varices, and discuss certain features of the diagnosis and treatment of PPL.
Subject(s)
Esophageal and Gastric Varices/etiology , Gastrointestinal Hemorrhage/etiology , Lymphoma, Large-Cell, Anaplastic/complications , Pancreatic Neoplasms/complications , Splenic Vein , Venous Thrombosis/etiology , Adult , Diabetes Mellitus, Type 1/etiology , Hematemesis/etiology , Humans , Lymph Nodes/pathology , Lymphoma, Large-Cell, Anaplastic/diagnosis , Lymphoma, Large-Cell, Anaplastic/diagnostic imaging , Lymphoma, Large-Cell, Anaplastic/pathology , Male , Melena/etiology , Neoplasm Invasiveness , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/diagnostic imaging , RadiographyABSTRACT
BACKGROUND AND OBJECTIVE: Patients with Inflammatory Bowel Disease (IBD) may have an increased risk of developing hepatitis B virus (HB) infection. Invasive procedures such as colonoscopies and surgery might be some of the reasons for this. Moreover, the use of immunosuppressors may reactivate a latent infection. We assessed the immune status among IBD patients receiving HB vaccine and the circumstances that predicted its results. AIMS AND METHODS: Serological markers of B and C hepatitis virus in patients with IBD who were referred for consultation were assessed since 2006. The subsequent determination of antibodies against superficial antigen (HBsAb) could differentiate between responders and non responders to the vaccine and an adequate immunity to HB was defined as higher than 10mUI/ml. RESULTS: One hundred and twenty nine patients were included in our study. Fifty-six (43,4%) patients had received immunosuppressive medication before the first vaccine dose. Notably, 85 (65.9%) patients had inadequate levels of HBsAb: 36 had no detectable levels and 49 had less than 10mUI/ml. Younger patients had a better immunity response than older patients (30.91+/-14.8 vs 39.91+/-14.2) (p<0.001). CONCLUSION: More than half of the patients had a suboptimal serologic response after vaccination. Only the younger group showed a better rate of response. It was not demonstrated whether an additional fourth dose of vaccination or a complete revaccination improved the rate of responders.
Subject(s)
Hepatitis B Vaccines/immunology , Inflammatory Bowel Diseases/immunology , Adult , Female , Hepatitis B/prevention & control , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/immunology , Humans , Inflammatory Bowel Diseases/blood , Inflammatory Bowel Diseases/complications , MaleABSTRACT
Fundamento y objetivo: Aunque parece que no hay un aumento en la prevalencia de infección por el virus de la hepatitis B (VHB) en pacientes con enfermedad inflamatoria intestinal (EII), se especula que la necesidad de exploraciones invasivas e intervenciones quirúrgicas sitúa a estos pacientes dentro de un grupo de riesgo para contraer esta infección. Además, el uso cada vez más frecuente de inmunomoduladores puede conducir a una reactivación vírica latente. El objetivo de este trabajo fue evaluar la eficacia de la vacuna contra el VHB en pacientes con EII y las circunstancias que pueden influir en su resultado. Pacientes y métodos: Desde el año 2006, se determinaron los marcadores serológicos de los virus B y C de la hepatitis en los pacientes con EII atendidos en esta consulta médica de forma consecutiva. La posterior determinación de los anticuerpos contra el antígeno de superficie del VHB (anti-HBs) diferenció entre reactivos o no a la vacuna, y se consideró como respuesta valores iguales o superiores a≥10mUI/ml. Resultados: Se incluyó en el estudio a 129 pacientes. Cincuenta y seis pacientes (43,4%) habían recibido algún tratamiento inmunomodulador previo a la vacuna. En 85 pacientes (65,9%) la vacuna no indujo una respuesta adecuada: 36 pacientes no crearon anti-HBs y en 49 pacientes se desarrollaron títulos inferiores a 10mUI/ml. El único factor implicado en la respuesta de la vacuna fue la edad, de forma que en los pacientes más jóvenes la eficacia de la vacuna fue mayor (media de 30,91 [14,8] frente a 39,91 [14,2] años, p<0,001). Conclusiones: En más de la mitad de los pacientes con EII no se desarrolló una respuesta adecuada a la vacuna del VHB. El único factor relacionado con una mejor eficacia fue la edad más joven. Queda por demostrar si una cuarta dosis o si la revacunación completa aumentarían esta tasa de respuesta (AU)
Background and objective: Patients with Inflammatory Bowel Disease (IBD) may have an increased risk of developing hepatitis B virus (HB) infection. Invasive procedures such as colonoscopies and surgery might be some of the reasons for this. Moreover, the use of immunosuppressors may reactivate a latent infection. We assessed the immune status among IBD patients receiving HB vaccine and the circumstances that predicted its results. Aims and methods: Serological markers of B and C hepatitis virus in patients with IBD who were referred for consultation were assessed since 2006. The subsequent determination of antibodies against superficial antigen (HBsAb) could differentiate between responders and non responders to the vaccine and an adequate immunity to HB was defined as higher than 10mUI/ml. Results: One hundred and twenty nine patients were included in our study. Fifty-six (43,4%) patients had received immunosuppressive medication before the first vaccine dose. Notably, 85 (65.9%) patients had inadequate levels of HBsAb: 36 had no detectable levels and 49 had less than 10mUI/ml. Younger patients had a better immunity response than older patients (30.91±14.8 vs 39.91±14.2) (p<0.001). Conclusion: More than half of the patients had a suboptimal serologic response after vaccination. Only the younger group showed a better rate of response. It was not demonstrated whether an additional fourth dose of vaccination or a complete revaccination improved the rate of responders (AU)
