RESUMO
The case of a 22-year-old male who bled from a Meckel's diverticulum is described. The diagnosis was achieved after 99mTechnetium pertechnetate scintigraphy. With the administration of somatostatin very clear images were obtained. The histological examination confirmed the presence of ectopic gastric mucosa. The literature, over the last 10 years, has been reviewed to identify factors associated with bleeding in adults. Ectopic gastric mucosa is the most important factor predicting bleeding. The diagnostic approach to bleeding Meckel's diverticulum and the improvement in the quality of 99mTechnetium pertechnetate scintigraphy, following administration of somatostatin, is discussed.
Assuntos
Hemorragia Gastrointestinal/etiologia , Divertículo Ileal/complicações , Adulto , Biópsia , Diagnóstico Diferencial , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/patologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Masculino , Divertículo Ileal/diagnóstico por imagem , Divertículo Ileal/patologia , Divertículo Ileal/cirurgia , Cintilografia , Compostos Radiofarmacêuticos , Recidiva , Pertecnetato Tc 99m de SódioRESUMO
BACKGROUND AND METHODS: Four hundred and eighty-four patients with inflammatory bowel disease underwent clinical examination, ultrasonography, and biochemical liver function tests, to estimate the prevalence of hepatobiliary alterations. The patient group included patients without a history of liver disease. Controls were recruited from patients with functional symptoms. RESULTS: More patients with ulcerative colitis than controls had liver steatosis and increased alkaline phosphatase levels. Factors increasing the probability of liver damage were long-standing disease, the presence of moderate/severe disease activity, and treatment with steroids and mesalazine. A significant association was found between biliary disease and long-standing colitis and also therapy with steroids and mesalazine. Alkaline phosphatase and aminotransferase levels were significantly higher in Crohn's disease patients than in controls. Hepatic and biliary damage was found more commonly in the 1st year after diagnosis. CONCLUSIONS: The monitoring of hepatobiliary function is suggested for patients with inflammatory bowel disease, even in the absence of symptoms and history.
Assuntos
Doenças Biliares/etiologia , Colite Ulcerativa/complicações , Doença de Crohn/complicações , Hepatopatias/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Biliares/patologia , Doenças Biliares/fisiopatologia , Criança , Colite Ulcerativa/patologia , Colite Ulcerativa/fisiopatologia , Doença de Crohn/patologia , Doença de Crohn/fisiopatologia , Feminino , Humanos , Hepatopatias/patologia , Hepatopatias/fisiopatologia , Masculino , Pessoa de Meia-IdadeRESUMO
355 patients suffering from dyspepsia with an endoscopic pathological picture were examined. Campylobacter pylori was sought histologically and by culture. Histological and cultural results were compared. There were no bacteria on the gastric mucosa of 46 patients who had no histopathological evidence of lesions. Cultural studies were performed in 40 cases on endoscopic instruments used during the examination, before and after standard sterilization. Campylobacter pylori was found on the gastric mucosa of 224 patients (63.09%); 91.93% with duodenal ulcer; 71.87% with gastric ulcer; 54.23% with erosive duodenitis; 56.71% with erosive gastritis and 54.81% with chronic gastropathy. The agreement between the two techniques was 75.39%, with a male prevalence (p = 0.05). Campylobacter pylori was present on the gastric mucosa of 10.86% of patients without histopathological evidence of lesions. Standard sterilization with alkyl-dimethyl-benzyl ammonium eliminated the campylobacter in 100% of cases.
Assuntos
Infecções por Campylobacter/complicações , Campylobacter/isolamento & purificação , Duodenopatias/etiologia , Mucosa Gástrica/microbiologia , Gastropatias/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Duodenopatias/diagnóstico , Úlcera Duodenal/etiologia , Duodenite/etiologia , Endoscopia , Feminino , Gastrite/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Gastropatias/diagnóstico , Úlcera Gástrica/etiologiaAssuntos
Arritmias Cardíacas/induzido quimicamente , Varizes Esofágicas e Gástricas/tratamento farmacológico , Álcoois Graxos/uso terapêutico , Cirrose Hepática/complicações , Tetradecilsulfato de Sódio/uso terapêutico , Adolescente , Adulto , Idoso , Eletrocardiografia , Varizes Esofágicas e Gástricas/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tetradecilsulfato de Sódio/efeitos adversosAssuntos
Infecções por Campylobacter , Dispepsia/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Campylobacter/classificação , Campylobacter/isolamento & purificação , Úlcera Duodenal/microbiologia , Duodenite/microbiologia , Feminino , Gastrite/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Gástrica/microbiologiaRESUMO
Despite the extensive use of endoscopic diagnostic procedures, the proper standards aimed at preventing electrical hazards are generally little known and inadequately observed. Cases of electrical injury ensuing from endoscopic manoeuvres may have gone unreported either to avoid legal consequences, or owing to incorrect identification of the true cause of the injury. The authors describe the most important safety standards dealing with the risks connected with the use of both endoscopic devices and electrosurgical units, and recommend that in the future more attention be paid to identifying and preventing these risks.
