Síncope por calor y taquicardia ventricular sostenida / Tittle

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[The acute pseudobstruction of the colon, or Ogilvie's syndrome: a rare cause of acute abdomen, high mortality and associated pathologies in an internal medicine department]. / Síndrome de Ogilvie o pseudobstrucción aguda del colon: una causa rara de abdomen agudo, de elevada mortalidad y asociada a patologías frecuentes en un Servicio de Medicina Interna.

The acute pseudobstruction of the colon or Ogilvie's syndrome is a infrequent pathology of acute or subacute evolution, that is associated to different clinical or surgical pathologies, and whose pathophysiology continues to be unknown. The treatment begins with general measures and if these are not effective, with the surgical decompression of colon to avoid the most serious complication, and frequently that is perforation of the cecum. We present a case of an acute and idiopathic dilatation of colon in an adult man who entered by an episode of acute respiratory insufficiency, and that was solved with preservative medical treatment.

Síndrome de Ogilvie o pseudobstrucción aguda del colon: una causa rara de abdomen agudo, de elevada mortalidad y asociada a patologías frecuentes en un Servicio de Medicina Interna / The acute pseudobstruction of the colon or Ogilvie´s syndrome

La pseudobstrucción aguda del colon o síndrome de Ogilvie es una entidad clínica rara de curso agudo o subagudo que se asocia a diferentes patologías clínicas o quirúrgicas, y cuya etiopatogenia sigue siendo desconocida. El tratamiento se inicia con medidas generales y si estas no son efectivas, con la descompresión quirúrgica del colón para evitar la complicación más grave y frecuente que es la perforación cecal. Presentamos el caso de una dilatación aguda e idiopática del colón en un varón adulto que ingresó por un episodio de insuficiencia respiratoria aguda, y que se resolvió con tratamiento médico conservador

The acute pseudobstruction of the colon or Ogilvie’s syndrome is a infrecuent pathology of acute or subacute evolution, that is associated to different clinical or surgical pathologies, and whose pathophysilogy continues being not known. The treatment begins with general measures and if these are not effective, with the surgical decompression of colon to avoid the most serious complication and it frequents that it is the perforation of the ceacum. We present a case of an acute and idiopathic dilatation of colon in an adult man who entered by an episode of acute respiratory insufficiency, and that was solved with preservative medical treatment

[Hepatic granulomatosis caused by Q fever: a cause of erroneous tuberculosis diagnosis]. / Granulomatosis hepática por fiebre Q: una causa de falso diagnóstico de tuberculosis.

We present the case of a 31-year-old man hospitalized for the study of a fever syndrome. The patient developed acute respiratory failure, with anemia and hepatic affection. In the histological examination of the liver and bone marrow, the presence of granulomas suggesting a tuberculous etiology was demonstrated. Antibodies IgG anti-Coxiella burnetti were detected, using indirect immunofluorescence, at the level of 1/200, with latter seroconversion to 1/800. Therapy with doxycycline was administered (200 mg/day during 14 days). Fever subsided in 24 hours and the other clinico-biochemical disorders disappeared in the following days. After the literature review, we conclude that Q fever must be taken into account for the differential diagnosis of any granulomatous disease observed in the liver and/or bone marrow. We can confirm that any granuloma is specific of just one pathological entity. The diagnosis must be always supported by other clinical, supplementary and serological data.