Síndrome de Cockett o de May-Thurner o síndrome de compresión de la vena ilíaca / Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome

El síndrome de compresión de la vena ilíaca, de May-Thurner o de Cockett es una entidad clínica rara, en la cual la vena ilíaca común izquierda se encuentra comprimida a su paso entre la arteria ilíaca común derecha y la columna. Como consecuencia de la compresión mantenida y del traumatismo causado por la fuerza pulsátil de la arteria sobre la vena, se produce una lesión de la íntima que provoca la formación de membranas o bandas en la luz vascular que dificultan u obstruyen el flujo venoso, lo que favorecería la formación de un trombo. La estrategia terapéutica actual de elección es el tratamiento endovascular con parche venoso y la colocación de endoprótesis, con el objetivo de mejorar el calibre de la luz y permitir un drenaje venoso normal. Presentamos 2 casos clínicos de Síndrome de May-Thurner y revisamos los hallazgos clínicos y radiológicos en la TC computarizada (AU)

Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings (AU)

[Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome]. / Síndrome de Cockett o de May-Thurner o síndrome de compresión de la vena ilíaca.

Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings.

[Anisakiasis gastrointestinal manifestations: description of 42 cases]. / Manifestaciones digestivas de la anisakiasis: descripción de 42 casos.

BASIS: Anisakiasis is an emerging parasitosis in our environment, although still scarcely known, mainly its gastrointestinal manifestations. PATIENTS AND METHODS: In this paper 42 cases of anisakiasis with gastrointestinal symptoms (with or without cutaneous allergic manifestations) are described; all cases were studied in our hospital between 1995 and May 2004. RESULTS: Thirty seven cases showed a gastric or gastroallergic form (6 confirmed with gastroscopy) and 5 suffered intestinal symptoms. In those in which endoscopy was not carried out, the diagnosis was done after clinical and biological findings. All patients were sensitized in the presence of Anisakis simplex. The 69% (29 cases) described raw anchovies ingestion or anchovies seasoned in vinegar ingestion some hours before the beginning of the clinical picture. The 59% showed allergic symptoms (gastroallergic anisakiasis); no patient with intestinal affectation showed allergic symptoms. Nausea (67%), vomiting (51%), and epigastralgia (50%) were the dominant symptoms in the group with gastric or gastroallergic anisakiasis without endoscopic confirmation; on the other hand, pain in right ileac fossa was the dominant symptom in the intestinal form. Fever was seen in two of the later patients (40%), but in no patient with gastric or gastroallergic anisakiasis. CONCLUSIONS: Gastrointestinal symptomatology after ingestion of fish suspiciously prepared should suggest anisakiasis, regardless if clinical picture includes allergic manifestations. In our study, pain in right ileac fossa, fever, and absence of allergic manifestations were typical of intestinal form.

Manifestaciones digestivas de la anisakiasis: descripción de 42 casos / Anisakiasis gastrointestinal manifestations: description of 42 cases

Fundamento. La anisakiasis es una parasitosis emergente en nuestro medio, aunque todavía escasamente conocida, principalmente en sus manifestaciones digestivas. Pacientes y métodos. Se describen 42 casos de anisakiasis con afectación digestiva (con o sin manifestaciones alérgicas cutáneas) estudiados en nuestro hospital entre 1995 y mayo de 2004. Resultados. Treinta y siete casos mostraban una forma gástrica o gastroalérgica (6 confirmados mediante gastroscopia) y 5 manifestaciones intestinales. En aquellos en que no se realizó endoscopia el diagnóstico se efectuó tras los hallazgos clínicos y biológicos. Todos los pacientes estaban sensibilizados frente a Anisakis simplex. El 69% (29 casos) referían ingesta unas horas antes de anchoas en vinagre o crudas. El 59% presentó clínica alérgica asociada (anisakiasis gastroalérgica), no presentando esta clínica ninguno de los casos con afectación intestinal. Las náuseas (67%), vómitos (51%) y epigastralgia (50%) fueron los síntomas dominantes en el grupo con anisakiasis gástrica o gastroalérgica sin confirmación endoscópica, mientras que el dolor en fosa ilíaca derecha lo fue en la forma intestinal. Dos de estos pacientes (40%) presentaron fiebre, aunque ninguno de los casos con anisakiasis gástrica o gastroalérgica. Conclusiones. La aparición de sintomatología digestiva después de la ingesta de pescado preparado de forma sospechosa debe hacer pensar en una posible anisakiasis, independientemente de que se asocien o no manifestaciones alérgicas. La presencia de dolor en fosa ilíaca derecha, fiebre y la ausencia de manifestaciones alérgicas fueron característicos de las formas intestinales

Basis. Anisakiasis is an emerging parasitosis in our environment, although still scarcely known, mainly its gastrointestinal manifestations. Patients and methods. In this paper 42 cases of anisakiasis with gastrointestinal symptoms (with or without cutaneous allergic manifestations) are described; all cases were studied in our hospital between 1995 and May 2004. Results. Thirty seven cases showed a gastric or gastroallergic form (6 confirmed with gastroscopy) and 5 suffered intestinal symptoms. In those in which endoscopy was not carried out, the diagnosis was done after clinical and biological findings. All patients were sensitized in the presence of Anisakis simplex. The 69% (29 cases) described raw anchovies ingestion or anchovies seasoned in vinegar ingestion some hours before the beginning of the clinical picture. The 59% showed allergic symptoms (gastroallergic anisakiasis); no patient with intestinal affectation showed allergic symptoms. Nausea (67%), vomiting (51%), and epigastralgia (50%) were the dominant symptoms in the group with gastric or gastroallergic anisakiasis without endoscopic confirmation; on the other hand, pain in right ileac fossa was the dominant symptom in the intestinal form. Fever was seen in two of the later patients (40%), but in no patient with gastric or gastroallergic anisakiasis. Conclusions. Gastrointestinal symptomatology after ingestion of fish suspiciously prepared should suggest anisakiasis, regardless if clinical picture includes allergic manifestations. In our study, pain in right ileac fossa, fever, and absence of allergic manifestations were typical of intestinal form