RESUMEN

BACKGROUND AND STUDY AIMS: Invagination, which can occur in any part of the intestine, usually affects children and is the second most common cause of intestinal obstruction after pyloric stenosis. The cause of these intussusceptions in children is usually unknown and they typically occur within the ileocolic region. Management of pediatric patients with the condition often consists of surgical intervention. However, this retrospective study from the University Hospital of the University of São Paulo, Brazil, reports a series of cases of intussusception in children in whom a colonoscopy was used to reverse the intussusception. PATIENTS AND METHODS: From April 2010 to January 2015, 30 pediatric patients underwent a colonoscopy as an noninvasive method for treatment of children's intestinal intussusception. RESULTS: Overall, treatment with colonoscopy was successful in reversing invagination in 66.7 % of the patients. However, 33.3 % of patients required surgery to resolve the intussusception. CONCLUSION: Noninvasive colonoscopy is a potential treatment for intussusception in children.

RESUMEN

Acute upper gastrointestinal bleeding is a potentially life-threatening emergency, especially in the elderly. This condition accounts for approximately 1% of all emergency room admissions. Among the causes of such bleeding is aortoesophageal fistula, a dreaded but apparently rare condition, first recognized in 1818. The great majority of cases are of primary aortoesophageal fistula, caused by atheromatous aortic aneurysms or, less frequently, by penetrating aortic ulcer. The clinical presentation of aortoesophageal fistula is typically characterized by the so-called Chiari's triad, consisting of thoracic pain followed by herald bleeding, a variable, short symptom-free interval, and fatal exsanguinating hemorrhage. The prognosis is poor, the in-hospital mortality rate being 60%. Conservative treatment does not prolong survival, and the in-hospital mortality rate is 40% for patients submitted to conventional surgical treatment. Here, we report the case of a 93-year-old woman who presented to the emergency room with a history of hematemesis. The patient was first submitted to upper gastrointestinal endoscopy, the findings of which were suggestive of aortoesophageal fistula. The diagnosis was confirmed by multidetector computed tomography of the chest. Surgery was indicated. However, on the way to the operating room, the patient presented with massive bleeding and went into cardiac arrest, which resulted in her death.

RESUMEN

O câncer colorretal (CCR) é uma das maiores causas de óbito no mundo industrializado, com uma incidência anual de 800.000 casos novos, o que significa 8,5% de todos os novos e 12% das mortes relacionadas a essa doença. No Brasil, excluindo-se os cânceres de pele não melanoma, o CCR é o quarto mais freqüente entre os homens e o terceiro entre as mulheres. O risco de desenvolver CCR é de aproximadamente 5% a 6% na população ocidental. Existem evidências epidemiológicas de redução do CCR em 60% -90% quando a colonoscopia com polipectomia é usada preventivamente A colonoscopia ainda é o melhor método para o diagnóstico precoce do CCR e das lesões precursoras. Contudo existem falhas de detecção não desprezíveis. O objetivo deste estudo foi comparar o resultado do exame detalhado da mucosa do cólon e do reto através da colonoscopia convencional, da cromoendoscopia e do NBI, na detecção de lesões elevadas, deprimidas e planas em pacientes submetidos ao exame sem antecedentes pessoais e ou familiares. Entre janeiro de 2007 e outubro de 2009 foram selecionados 181 pacientes divididos aleatoriamente em três grupos: A: 48 pacientes, controle; B: 29 pacientes, NBI; C: 104 pacientes, cromoscopia difusa. Pode-se observar que dos 181 pacientes examinados 38 (21%) não apresentavam lesões. Os 143 pacientes com lesão, apresentaram um número médio de 2,65 lesões, com mínimo de 1 e máximo de 7 lesões. Nos total dos 181 pacientes e no conjunto dos 143 pacientes com lesões não foi observada diferença estatisticamente significante entre os três grupos A, B e C para a idade, o tempo reto-ceco e o tempo ceco-reto, enquanto que para a altura, peso e conseqüente IMC houve variação estatística. O tamanho médio das 379 lesões encontradas nos 143 pacientes, avaliado pelo seu diâmetro foi de 5,45 ± 2,84 mm, sem variação estatística entre os grupos, entre os hemicólons e entre os hemicólons nos grupos. Os tamanhos das lesões foram reunidos em três intervalos distintos: até 5 mm (76,30%)...

Colorectal cancer (CRC) is one of the largest causes of death on the industrialized world. Its annual incidence of 800.000 new cases means 8,5% of all the new ones and 12% of deaths related to this disease. In Brazil, excluding the non-melanoma skin-cancers, CRC is the fourth more frequent among men and the third one among women. The risk for developping CRC is approximately of 5 to 6% on the Western population. There are epidemiological evidences for reducing CRC on 60-90% when colonoscopy with polypectomy is used preventively. Colonoscopy is still the best method both for the early dyagnosis of CRC and precursor lesions. However, there are non-contemptible failures on the detection. This paper purpose was comparing the result of colon and rectum mucous membrane detailed test through conventional colonoscopy, chromoendoscopy and NBI, on the detection of augmented, depressed and flat lesions in patients submitted to it without any personal or familiar antecedents. Between January 2007 and October 2009 181 patients were selected randomically and divided into 3 groups: A: 48 control patients; B: 29 patients, NBI; C: 104 patients, diffuse chromoscopy. It is observed that, from the 181 examined patients, 38 (21%) didnt present lesions. The 143 patients with lesion, presented an average number of 2,65 lesions, with a minimum of 1 and a maximum of 7 lesions. On the total of the 181 patients and on the whole of the 143 patients with lesions it was not observed any statistically significant difference among the three groups A, B and C as for Age, the Rectum-Cecum Time and the Cecum-Rectum Time, while there was a statistical variation for Height, Weight and consequent bmi. The average size of the 379 lesions found on the 143 patients, assessed by its diameter was of 5,45 mm (2.14 in.) + 2,84 mm (1,11 in), without any statistical variation among the groups, among the hemicolons and among the hemicolons in the groups. The size of the lesions were gathered into three...

Asunto(s)

RESUMEN

A hemorragia digestiva é responsável por 2 por cento das internaçöes hospitalares de adultos. As ectasias vasculares estäo entre as causas mais freqüentes de enterorragia. Em cerca de 80 por cento dos casos de ectasias vasculares hemorrágicas há a parada do sangramento espontaneamente, mas com freqüência ocorre a recidiva. Muitos tratamentos säo propostos tais como infusäo de substâncias vasoconstrictoras através de cateterizaçäo superseletiva por arteriografia. O uso da fotocoagulaçäo com laser, heater proable, eletrocoagulaçäo bipolar, uso de pinça tipo hot biopsy, tem sido propostos através de utilizaçäo da via colonoscópica, mas alguns com efeito fugaz e outros com elevado custo e resultado pouco efetivo. Os autores apresentam um caso de ectasia vascular do cólon na vigência de sangramento tratada com injeçäo de adrenalina 1:10.000 seguida pela eletrocauterizaçäo monopolar através de colonoscopia. Trata-se de um novo método, alternativo, seguro e eficaz na abordagem dos doentes portadores de ectasia vascular do cólon na vigência de sangramento

Asunto(s)

RESUMEN

Este trabalho tem por objetivo a apresentacao de dois casos de fistula traqueoesofageana congenita sem atresia de esofago (fistula tipo H ou N) ocorridos no Hospital Infantil Joana de Gusmao , Florianopolis-SC nos ultimos tres anos. Ambos foram submetidos ao tratamento cirurgico com bons resultados. Os autores aproveitam para, baseados numa revisao bibliografica, realizar uma discussao sobre a embriologia, incidencia, localizacao mais comum, aspectos clinicos mais importantes, diagnostico, diagnostico diferencial, tratamento, complicacoes e outras anomalias associadas a esta entidade.

Asunto(s)