RESUMEN
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Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hemorragia Gastrointestinal/terapia , Ciego/lesiones , Citomegalovirus/aislamiento & purificación , Biopsia , Válvula Ileocecal/diagnóstico por imagen , Válvula Ileocecal/lesiones , Minerales/uso terapéutico , Ciego/microbiología , Hemorragia Gastrointestinal/diagnóstico , Ciego/cirugía , Cistoscopía/métodos , Citomegalovirus/patogenicidad , Vejiga Urinaria/cirugía , Ganciclovir/uso terapéutico , Colonoscopía/instrumentación , Válvula IleocecalAsunto(s)
Infecciones por Citomegalovirus/complicaciones , Hemorragia Gastrointestinal/tratamiento farmacológico , Hemostáticos/uso terapéutico , Enfermedades del Íleon/complicaciones , Válvula Ileocecal/patología , Minerales/uso terapéutico , Úlcera/complicaciones , Antituberculosos/uso terapéutico , Antivirales/uso terapéutico , Cistitis/complicaciones , Cistitis/tratamiento farmacológico , Cistitis/cirugía , Transfusión de Eritrocitos , Resultado Fatal , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Humanos , Enfermedades del Íleon/terapia , Enfermedades del Íleon/virología , Válvula Ileocecal/virología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/tratamiento farmacológico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/virología , Soluciones Esclerosantes/uso terapéutico , Tuberculosis Urogenital/complicaciones , Tuberculosis Urogenital/tratamiento farmacológico , Tuberculosis Urogenital/cirugía , Úlcera/terapia , Úlcera/virología , Derivación UrinariaRESUMEN
INTRODUCCIÓN: El índice de masa corporal se ha relacionado con la presencia de patología digestiva. El objetivo del estudio fue analizar los hallazgos endoscópicos y la histología gástrica de pacientes con obesidad mórbida candidatos a cirugía bariátrica en nuestro medio. MÉTODOS: Se incluyeron de manera retrospectiva los pacientes intervenidos de cirugía bariátrica en el Hospital de León desde marzo 2005 hasta abril 2013. Se recogieron los hallazgos de la endoscopia digestiva alta y la histología antral. Se estudió si el índice de masa corporal (IMC) estaba relacionado con los hallazgos de la gastroscopia o la presencia de Helicobacter pylori. RESULTADOS: Se incluyeron 194 pacientes. El 48,7 y el 78,9% de los pacientes presentaron alguna alteración en la endoscopia o en la biopsia antral, respectivamente. Tres pacientes presentaron úlcera gástrica péptica, demorándose la intervención hasta la curación. El 63,9% de los pacientes presentaron infección por H. pylori. La presencia de H. pylori y los hallazgos endoscópicos no se relacionaron con el IMC. CONCLUSIÓN: La patología gastroesofágica es frecuente en obesos mórbidos, y aproximadamente la mitad de los pacientes tenían algún tipo de alteración en la endoscopia. La realización de una gastroscopia e investigar la infección por H. pylori previa a la cirugía es necesario con el fin de descartar patología potencialmente susceptible de contraindicar o demorar la intervención
INTRODUCTION: Body mass index has been associated with the presence and severity of various gastrointestinal symptoms. The aim of the study was to analyze the endoscopic findings and gastric histology of morbidly obese candidates for bariatric surgery. METHODS: We retrospectively included patients undergoing bariatric surgery at the Hospital de León from March 2005 to April 2013. The findings of upper gastrointestinal endoscopy and antral histology were collected. The relationship of body mass index (BMI) with gastroscopy findings and the presence ofHelicobacter pylori were assessed. RESULTS: A total of 194 patients were included. An abnormality on endoscopy or antral biopsy was found in 48.7% and 78.9% of the patients, respectively. Three patients had gastric peptic ulcer, and consequently the intervention was postponed until healing. H. pylori infection was found in 63.9% of the patients. The presence of H. pylori and endoscopic findings were not related to BMI. CONCLUSION: Gastroesophageal disease is common in morbidly obese patients and approximately half of the patients had some kind of alteration on endoscopy. Gastroscopy and H. pylori testing prior to surgery is required to rule out disease that could delay or contraindicate surgery
Asunto(s)
Humanos , Obesidad Mórbida/fisiopatología , Endoscopía del Sistema Digestivo , Enfermedades Gastrointestinales/epidemiología , Cirugía Bariátrica , Biopsia , Úlcera Péptica/epidemiología , Helicobacter pylori/aislamiento & purificación , Infecciones por Helicobacter/epidemiología , Índice de Masa Corporal , Cuidados Preoperatorios/métodos , Estudios RetrospectivosRESUMEN
INTRODUCTION: The Boston scale is useful to standardize colon cleansing at colonoscopy. The aim of this study was to analyze the degree of preparation before colonoscopy and the factors associated with cleansing in routine clinical practice. MATERIAL AND METHODS: We included colonoscopies performed from January to June 2013. Exclusion criteria were age <15 years, a history of colon surgery, inflammatory bowel disease, and active gastrointestinal bleeding. The standard preparation was CitraFleet. The parameters related to the degree of bowel cleansing (using the Boston scale) were age, sex, indication, colonoscopy shift (morning or afternoon), patient origin (outpatient or hospitalized), and colonoscopy findings. RESULTS: We analyzed 947 colonoscopies, with exclusion of 297. A total of 5.8% (38/650) of the colonoscopies were incomplete, 50% due to lack of preparation. The mean age of the patients was 61.27 years (SD: 16.1), and 51.8% were women. The distribution of the Boston scale was 0-3 in 6.3%, 4-5 in 12.6%, 6-7 in 30.6%, and 8-9 in 50.4%, with a mean 7.04 (SD: 2.03). On multivariate analysis, the factors statistically associated with better preparation were younger age, afternoon colonoscopy and the outpatient setting. The percentage of polyps in patients with a Boston scale score ≤5 was 10% compared with 27.8% in patients with a score > 5 (P=.014). CONCLUSION: In clinical practice, 80% of patients had an acceptable level of preparation. Older patients, those undergoing colonoscopy in the morning and hospitalized patients would be candidates for measures to improve the degree of colonic preparation.
Asunto(s)
Catárticos/farmacología , Colonoscopía/métodos , Adenoma/diagnóstico , Administración Oral , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Catárticos/administración & dosificación , Citratos/administración & dosificación , Citratos/farmacología , Ácido Cítrico/administración & dosificación , Ácido Cítrico/farmacología , Neoplasias del Colon/diagnóstico , Pólipos del Colon/diagnóstico , Divertículo/diagnóstico , Femenino , Humanos , Óxido de Magnesio/administración & dosificación , Óxido de Magnesio/farmacología , Masculino , Persona de Mediana Edad , Compuestos Organometálicos/administración & dosificación , Compuestos Organometálicos/farmacología , Picolinas/administración & dosificación , Picolinas/farmacología , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
INTRODUCTION: Body mass index has been associated with the presence and severity of various gastrointestinal symptoms. The aim of the study was to analyze the endoscopic findings and gastric histology of morbidly obese candidates for bariatric surgery. METHODS: We retrospectively included patients undergoing bariatric surgery at the Hospital de León from March 2005 to April 2013. The findings of upper gastrointestinal endoscopy and antral histology were collected. The relationship of body mass index (BMI) with gastroscopy findings and the presence of Helicobacter pylori were assessed. RESULTS: A total of 194 patients were included. An abnormality on endoscopy or antral biopsy was found in 48.7% and 78.9% of the patients, respectively. Three patients had gastric peptic ulcer, and consequently the intervention was postponed until healing. H.pylori infection was found in 63.9% of the patients. The presence of H.pylori and endoscopic findings were not related to BMI. CONCLUSION: Gastroesophageal disease is common in morbidly obese patients and approximately half of the patients had some kind of alteration on endoscopy. Gastroscopy and H.pylori testing prior to surgery is required to rule out disease that could delay or contraindicate surgery.