VALORACIÓN DEL TIEMPO DE TRÁNSITO COLÓNICO (TTC) EN EL DIAGNÓSTICO DEL ESTREÑIMIENTO CRÓNICO FUNCIONAL (ECF) Y SU RELACIÓN CON LOS DATOS DE UN DIARIO CLÍNICO (30 DÍAS)

Introduccion El estrenimiento es un sintoma relatado por el paciente y el medico verifica que cumple los criterios consensuados para sentar el diagnostico de ECF. Para algunos autores el TTC seria el metodo objetivo para la definicion de estrenimiento. Objetivos Relacionar los datos clinicos recogidos mediante diario de 30 dias con el TTC determinado por marcadores radioopacos en pacientes con ECF. Material y metodos Grupo de estudio constituido por 220 pacientes diagnosticados de ECF (Roma II) de edad media 38,3±15 anos (IC95% 36,3–40,3, mediana 37 anos), integrado por 204 mujeres (38,4±15,2, IC95% 36,3–40,5, mediana 37) y 16 hombres (36,1±12,9, IC95% 29,2–43, mediana 31,5 anos). Se han re…

Treatment of infected pancreatic necrosis: Outcome in a 9-year, single-center, consecutive series (2006-2014)

RELACIÓN DE COMPLICACIONES LOCALES EN PANCREATITIS AGUDA CON LA PERSISTENCIA DE LAS COMPLICACIONES SISTÉMICAS

Antecedentes De acuerdo con la clasificacion de Atlanta, la pancreatitis aguda grave se define por la presencia de complicaciones locales (CL) y/o sistemicas (CS). Recientemente se ha sugerido que aquellos pacientes con complicaciones sistemicas de inicio (CSI) que aparecen en la primera semana, pero duran menos de 48 horas, no deberian considerarse como indicadores de gravedad. Objetivo Analizar la evolucion y aparicion de complicaciones locales en pacientes con Pancreatitis Aguda (PA) en funcion de la presencia o no de CSI transitorias o permanentes. Metodos Se han recogido prospectiva y consecutivamente todos los pacientes con un primer episodio de PA entre enero de 2000 y diciembre de 2…

Recurrence of Acute Gallstone Pancreatitis and Relationship with Cholecystectomy or Endoscopic Sphincterotomy

To determine the prevalence of recurrence of gallstone pancreatitis, its clinical features, and the presence of prognostic factors of recurrence.From January 1, 2000 to August 31, 2003, 233 patients admitted with acute gallstone pancreatitis (AGP) were prospectively studied. Patients were divided into two groups: recurrent and nonrecurrent group. Clinical, analytical, radiological, prognostic parameters, and severity (Atlanta criteria) were assessed, along with the performance of cholecystectomy or endoscopic sphincterotomy (ES). Clinical features of recurrence were analyzed. Univariate (chi(2), Student's t-test) and multivariate tests were performed. Statistical significance was assumed if…

Neoplasias de páncreas y periampulares: morbimortalidad, resultados funcionales y supervivencia a largo plazo

Resumen Objetivos Evaluar la morbimortalidad postoperatoria, el estado funcional y la supervivencia a largo plazo de pacientes con tumores de pancreas o periampulares a los que se intervino quirurgicamente. Pacientes y metodos Cohorte de 160 pacientes a los que se intervino consecutivamente: 80 duodenopancreatectomias cefalicas (DPC), 30 resecciones corporocaudales (RCC), 7 duodenopancreatectomias totales, 4 resecciones centrales y 3 ampulectomias; en 36 pacientes no se realizo reseccion. La funcion pancreatica se evaluo mediante test de sobrecarga oral a la glucosa, grasas en heces y elastasa fecal. Resultados La tasa de resecabilidad fue del 77,5%. En los pacientes resecados (n = 124) la …

Methotrexate induced sprue-like syndrome

A 52 year-old male patient diagnosed of ankylosing spondylitis presented with an iron deficiency anemia after a ten-month treatment of methotrexate. He did not respond to treatment with oral iron not a proton pump inhibitor and an upper endoscopy was performed. The histological study of the duodenal biopsies showed villus atrophy. After removing the methotrexate, administrating intramuscular iron and undertaking a gluten-free diet, the histological and analytical alterations progressively resolved.

A risk score system for identification of patients with upper-GI bleeding suitable for outpatient management.

Abstract Background The aim of this study was to develop a risk score system for identification of patients with upper-GI hemorrhage who are suitable for outpatient management. Methods From a prospective cohort of 983 consecutive patients with upper-GI hemorrhage not associated with portal hypertension, 581 cases that did not meet pre-established criteria for admission were selected, and a logistic regression analysis was performed to identify factors associated with two adverse outcomes: recurrent bleeding and/or the need for emergency surgery. The risk score system was developed by using the beta coefficients of the logistic model, and its performance was evaluated. The results of this mo…

Pancreatic and periampullary tumours: morbidity, mortality, functional results, and long-term survival

Abstract Aims To evaluate postoperative morbidity and mortality, pancreatic function and long-term survival in patients with surgically treated pancreatic or periampullar tumours. Patients and methods Cohort study including 160 patients consecutively operated on: 80 pancreaticoduodenectomies (PD), 30 distal pancreatectomies (DP), 7 total pancreatectomies, 4 central pancreatic resections, and 3 ampullectomies. The tumour was not resected in 36 patients. Pancreatic function was evaluated by oral glucose tolerance test, faecal fat excretion, and elastase. Results Resectability rate was 77.5%. In resected patients (n = 124), 38.7% had complications with a pancreatic fistula rate of 6.4% and a m…

Malondialdehyde in early phase of acute pancreatitis

Aims: to assess oxidative stress in acute pancreatitis, its evolution over time and its relationship with the severity of the disease. Methods: during a two-year period, patients with acute pancreatitis with less than 24 hours of pain were evaluated. Serum was obtained the first, second and fourth day from admittance, if complications were detected, and after recovery. Malondialdehyde was determined by high performance liquid chromatography. Twenty healthy volunteers constituted the control group. Malondialdehyde between groups was compared with Mann-Whitney and Kruskal-Wallis tests; malondialdehyde evolution was studied with Wilcoxon test. Results: one hundred and sixty-nine patients were …

Predictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation

Abstract Background & Aims: The aim of this study was to establish a simple method to exclude the possibility of pelvic floor dyssynergia (PFD) in constipated patients and thus avoid unnecessary expensive physiologic studies. Methods: Patients with suspicion of functional constipation (FC) were studied prospectively between 1994 and 2002, excluding those with severe systemic, psychological, or symptomatic anorectal/colonic disorders or taking medications that might modify symptoms or results of studies. Diagnosis of PFD was established retrospectively by manometric plus defecographic findings according to Rome II criteria. Two groups of patients were identified: FC without PFD (FC group) an…