RESUMO
Liver abscesses are rare entities for which percutaneous drainage is traditionally employed. The technique is simple, but associated with a significant rate of side effects and patient discomfort. We herein report a case of fungal left liver lobe abscess that was successfully treated by using EUS-guided drainage, with insertion of a large caliber lumen-apposing metal stent. The literature review we performed on the topic seems to favor, at least for abscess in the left and/or caudate liver lobes, EUS as compared to percutaneous drainage.
Assuntos
Candidíase/cirurgia , Drenagem/métodos , Abscesso Hepático/microbiologia , Abscesso Hepático/cirurgia , Stents , Ultrassonografia de Intervenção/métodos , Idoso de 80 Anos ou mais , Candida albicans , Feminino , HumanosRESUMO
BACKGROUND: Colon capsule endoscopy (CCE) represents a new diagnostic, endoscopic technology for colonic exploration. Current protocols of preparation led to discordant rates of adequate cleansing level or CCE excretion. AIM: To evaluate the effect of a new regimen of bowel preparation for CCE on colon cleansing levels and on rate of capsule excretion. STUDY: 60 patients were prospectively enrolled. The new regimen of preparation consisted of a split regimen of PEG administration and of a 45 mL dose of sodium phosphate (NaP). Four senna tablets and a low-residue diet were also included. CCE excretion rate, colon cleansing, and accuracy were assessed. RESULTS: Forty-six patients were included in the final analysis, 13 patients (22%) being excluded because of preparation protocol deviations and one due to CCE technical failure (2%). At CCE, bowel preparation was rated as good in 78% of patients, fair in 20% and poor in 2%. CCE excretion rate occurred in 83% of patients. CCE sensitivity and specificity for significant findings was 100% and 95%, respectively. CONCLUSIONS: The combination of a split-dose of PEG solution with a low dose of NaP boosters resulted in high rates of adequate cleansing level and CCE excretion.
Assuntos
Endoscopia por Cápsula/métodos , Catárticos/administração & dosagem , Fosfatos/administração & dosagem , Polietilenoglicóis/administração & dosagem , Extrato de Senna/administração & dosagem , Adulto , Idoso , Cápsulas Endoscópicas , Pólipos do Colo/diagnóstico , Fibras na Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos ProspectivosRESUMO
The study of small bowel disease is hampered by the organ length and shape. Malabsorption syndromes, small bowel bleeding, intestinal obstruction are analyzed with reference to the clinical characteristics and present laboratory and instrumental tests used in diagnosis. The introduction of sophisticated diagnostic imaging procedures, both endoscopic and radiologic have contributed to a better understanding of the symptomatic patterns.
