RESUMEN
BACKGROUND: Churg-Strauss is a rare, idiopathic, hypereosinophilic disease characterized by blood, tissue, and systemic vasculitis in patients with a history of asthma or allergic rhinitis. Gastrointestinal manifestations of Churg Strauss appear in a 31-45% of the patients according to some series of studies, abdominal pain being the most frequent symptom followed by diarrhea and bleeding. CLINICAL CASE: Male patient with a history of asthma who presents abdominal pain apparently due to acute appendicitis. During the hospital stay the study protocol is complemented, confirmating the diagnosis of Churg Strauss syndrome with intestinal manifestations. CONCLUSION: Churg Strauss syndrome is a rare vasculitis that may present with intestinal manifestations so it is important to take into consideration the differential diagnosis. There are few cases in the literature associated with this syndrome and acute abdomen, all of them on the poor prognosis of this association.
Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.
Asunto(s)
Abdomen Agudo/etiología , Síndrome de Churg-Strauss/complicaciones , Adulto , Apendicitis/diagnóstico , Asma/complicaciones , Síndrome de Churg-Strauss/diagnóstico , Colitis Isquémica/etiología , Diagnóstico Diferencial , Diarrea/etiología , Humanos , Masculino , Complicaciones Posoperatorias/etiología , Choque/etiología , Vómitos/etiologíaRESUMEN
BACKGROUND: Stump appendicitis is a rare disease characterized by inflammation of the appendiceal remnant. Although normally this is an early complication, it can present up to 50 years after surgery. CLINICAL CASE: Male patient of 66 years old with antecedent of laparoscopic appendectomy, presented with abdominal pain, leucocytosis and peritoneal irritation. It was decided he should have surgical management upon finding stump appendicitis, that is, doing stump appendectomy. His evolution was satisfactory. CONCLUSIONS: The diagnosis is a challenge for the surgeon, because imaging studies have not proved very helpful for diagnosis. Resection of the cecal appendix by laparoscopic techniques is now more common, providing the possibility of leaving a long stump, perhaps due to technical difficulties. A history of appendectomy may delay diagnosis thus increasing the morbidity and mortality. The resolution of appendiceal stump appendicitis by surgery is performed either by laparoscopic or open resection of the appendiceal remnant.