[Eosinophilic esophagitis in the adult--clinical, endoscopic, pH-metric, and manometric findings]. / Esofagitis eosinofílica en el adulto: aspectos clínicos, endoscópicos, pH-métricos y manométricos.

OBJECTIVES: Eosinophilic esophagitis (EE) is a condition characterized by dysphagia and frequent food impaction in young adults. The aim of our study was to evaluate the clinical aspects, endoscopic features, pH-metric and motility disorders in EE. PATIENTS AND METHODS: Adult patients with EE were prospectivity included. Endoscopy with biopsy, stationary esophageal manometry, and 24-hour pH-metry were performed. We analyzed the duration of disease, allergies, blood peripheral eosinophilia, prevalence of dysphagia, number of food impaction episodes, and complications during the endoscopic procedure. RESULTS: Eleven male patients with a mean age of 35 years were followed. Endoscopy showed esophageal disorders in all cases: 5 esophageal felinizations, mucosal abnormalities in 4 cases, distal rings in 3 cases, and 2 esophageal stenoses. In two cases mucosal tearing during the endoscopic procedure was described. In 6 patients the manometric study showed motor disorders affecting the esophageal body, 5 of them displaying hypomotility. Two patients showed pathological gastroesophageal reflux during pH-monitoring. Blood peripheral eosinophilia was detected in 3 patients. CONCLUSION: Although endoscopic abnormalities are frequently found, they do not usually explain dysphagia and food impaction episodes in EE. Ineffective esophageal peristalsis is the most prevalent manometric disorder associated with this entity, although it is not clearly related to symptom worsening either.

Impactación alimentaria esofágica recidivante y esofagitis eosinofílica / No disponible

No disponible

Esofagitis eosinofílica en el adulto: aspectos clínicos, endoscópicos, pH-métricos y manométricos / No disponible

Objetivos: la esofagitis eosinofílica (EE) es una entidad de interéscreciente caracterizada en el adulto por disfagia y episodiosde impactación alimentaria recurrentes. Nuestro objetivo fue estudiarlas características clínicas, endoscópicas, manométricas y pHmétricasen los pacientes con EE, así como la relación que pudieraexistir entre ellas.Pacientes y métodos: se estudiaron de forma prospectivadurante un año los pacientes adultos diagnosticados de EE. En todosse realizó endoscopia digestiva alta con toma de biopsias, manometríaesofágica estacionaria y pH-metría ambulatoria. Se documentóademás el tiempo de evolución clínica, los antecedentesde atopia, la presencia de eosinofilia periférica, la frecuencia de ladisfagia y el número de desimpactaciones y complicaciones endoscópicas.Resultados: se estudiaron 11 pacientes (edad media 35años). Todas las endoscopias presentaron hallazgos patológicos:traquealización en 5, alteraciones mucosas en 4, en 3 anillos esofágicosdistales y en 2 estenosis esofágicas. Precisaron desimpactacionesendoscópicas 7 pacientes. Se produjeron desgarros de lamucosa esofágica durante la endoscopia en 2 pacientes. La manometríaesofágica fue patológica en 6 pacientes, de estos, 5 fuerontrastornos de hipomotilidad. La pH-metría fue patológica en2 casos. Presentaron eosinofilia periférica 3 pacientes.Conclusión: aunque los hallazgos patológicos en la endoscopiason frecuentes, no siempre justifican los episodios de impactaciónalimentaria característicos de la EE. Los trastornos de motilidad enforma de peristalsis esofágica ineficaz son el hallazgo manométricomás frecuente, aunque tampoco se han podido relacionar con unmayor número de episodios de disfagia o de impactaciones

Objectives: eosinophilic esophagitis (EE) is a condition characterizedby dysphagia and frequent food impaction in youngadults. The aim of our study was to evaluate the clinical aspects,endoscopic features, pH-metric and motility disorders in EE.Patients and methods: adult patients with EE were prospectivityincluded. Endoscopy with biopsy, stationary esophagealmanometry, and 24-hour pH-metry were performed. We analyzedthe duration of disease, allergies, blood peripheraleosinophilia, prevalence of dysphagia, number of food impactionepisodes, and complications during the endoscopic procedure.Results: eleven male patients with a mean age of 35 yearswere followed. Endoscopy showed esophageal disorders in allcases: 5 esophageal felinizations, mucosal abnormalities in 4cases, distal rings in 3 cases, and 2 esophageal stenoses. In twocases mucosal tearing during the endoscopic procedure was described.In 6 patients the manometric study showed motor disordersaffecting the esophageal body, 5 of them displayinghypomotility. Two patients showed pathological gastroesophagealreflux during pH-monitoring. Blood peripheraleosinophilia was detected in 3 patients.Conclusion: although endoscopic abnormalities are frequentlyfound, they do not usually explain dysphagia and food impactionepisodes in EE. Ineffective esophageal peristalsis is themost prevalent manometric disorder associated with this entity, althoughit is not clearly related to symptom worsening either

[Multichannel intraluminal esophageal impedance: a new frontier in motility]. / Impedancia esofágica intraluminal de canal múltiple: una nueva frontera en motilidad.

Multichannel intraluminal impedance is a new technique for evaluating esophageal function and gastroesophageal reflux disease (GERD). This technique relies on the monitoring of electric conductivity in the esophagus though electrodes, and on changes developing in this variable as a result of bolus passage. The proximal distribution and duration of non-acid reflux events can now be quantified, and combined manometry defines the effectiveness of esophageal body function, until now only indirectly evaluated with pH changes. We discuss the case of a woman with persistent cough in whom intraesophageal multichannel impedance demostrates a minor acid reflux that could not be demonstrated with other diagnostic methods previously, and how this technique excludes any association between cough and non-acid reflux.

Impedancia esofágica intraluminal de canal múltiple: una nueva frontera en motilidad / No disponible

La impedancia esofágica multicanal constituye una de las másrecientes herramientas diagnósticas aplicadas a la evaluación de laenfermedad por reflujo gastroesofágico. Esta técnica se basa en lamonitorización continua de la conductividad eléctrica en un medio,en este caso el esófago, a través de electrodos situados en lalongitud de una sonda, y en los cambios que un elemento como elbolo alimentario puede producir en dicha variable. De esta técnicase derivan nuevas perspectivas en la exploración de la funciónesofágica y de la enfermedad por reflujo gastroesofágico, hastaahora sólo cuantificable de forma indirecta por las fluctuacionesgeneradas por los cambios en el pH del reflujo ácido. Presentamosel caso de una paciente con tos persistente evaluada con esteprocedimiento, en quien se demostró la presencia de reflujo gastroesofágicodébilmente ácido que no pudo ser demostrado previamentecon otras exploraciones, y de cómo la impedancia descartóla asociación entre este síntoma y el reflujo no ácido

Multichannel intraluminal impedance is a new technique for evaluatingesophageal function and gastroesophageal reflux disease(GERD). This technique relies on the monitoring of electric conductivityin the esophagus though electrodes, and on changes developingin this variable as a result of bolus passage. The proximal distributionand duration of non-acid reflux events can now be quantified,and combined manometry defines the effectiveness of esophagealbody function, until now only indirectly evaluated with pH changes.We discuss the case of a woman with persistent cough in whom intraesophagealmultichannel impedance demostrates a minor acidreflux that could not be demonstrated with other diagnostic methodspreviously, and how this technique excludes any association betweencough and non-acid reflux

Presentación tardía de la enfermedad de Wilson / Late presentation of Wilson's disease

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[Mesenteric fibromatosis as the cause of a single abdominal mass]. / Fibromatosis mesentérica como causa de masa abdominal única.

We present a mesenteric desmoid tumor in a man without associated diseases. Characteristics of this tumor are reviewed and the need to perform total exeresis of the mass for diagnosis is emphasized. Although surgery is the treatment of choice, alternative treatments are recommended when surgery cannot be performed, has been incomplete, or in cases of repeated recurrence.