Asunto(s)
Canal Anal/diagnóstico por imagen , Cirugía Colorrectal/instrumentación , Recto/diagnóstico por imagen , Ultrasonografía/métodos , Humanos , Dolor/diagnóstico , Dolor/diagnóstico por imagen , Examen Físico , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/diagnóstico por imagenAsunto(s)
Hiperparatiroidismo/cirugía , Glándulas Paratiroides/fisiología , Glándulas Paratiroides/trasplante , Paratiroidectomía/métodos , Calcio/metabolismo , Humanos , Hiperparatiroidismo/fisiopatología , Paratiroidectomía/efectos adversos , Complicaciones Posoperatorias , Trasplante Autólogo , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Incontinencia Fecal/fisiopatología , Incontinencia Fecal/terapia , Canal Anal/fisiopatología , Ensayos Clínicos como AsuntoRESUMEN
No disponible
Asunto(s)
Humanos , Guías de Práctica Clínica como Asunto , Incontinencia Fecal , Canal AnalAsunto(s)
Canal Anal/fisiología , Enfermedades del Ano/diagnóstico , Enfermedades del Recto/diagnóstico , Recto/fisiología , Enfermedades del Ano/fisiopatología , Defecación/fisiología , Incontinencia Fecal/diagnóstico , Incontinencia Fecal/fisiopatología , Fisura Anal/diagnóstico , Fisura Anal/fisiopatología , Enfermedad de Hirschsprung/diagnóstico , Enfermedad de Hirschsprung/fisiopatología , Humanos , Manometría , Perineo/fisiología , Enfermedades del Recto/fisiopatología , Reflejo/fisiología , Maniobra de ValsalvaAsunto(s)
Reflujo Gastroesofágico/diagnóstico , Concentración de Iones de Hidrógeno , Monitoreo Fisiológico , Biopsia , Esófago/patología , Esófago/fisiopatología , Femenino , Reflujo Gastroesofágico/patología , Reflujo Gastroesofágico/fisiopatología , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Factores de TiempoRESUMEN
We report a case of a woman who showed hepatic and renal AA amyloidosis with a liver adenoma associated with the use of oral contraceptives. A nephrotic syndrome secondary to the renal amyloidosis underwent complete remission 7 years after the withdrawal of oral contraceptive therapy. Twenty-nine months after the initial presentation, the patient was admitted with acute upper abdominal pain and abdominal tenderness. The abdominal ultrasound revealed a subphrenic fluid collection, and a presumptive diagnosis of a ruptured hepatic adenoma was made. The liver adenoma diminished from 8 cm to 1 cm over a 13-year follow up after the discontinuance of oral contraceptive therapy.
Asunto(s)
Adenoma de Células Hepáticas/complicaciones , Amiloidosis/inducido químicamente , Anticonceptivos Orales/efectos adversos , Neoplasias Hepáticas/complicaciones , Adenoma de Células Hepáticas/diagnóstico , Adulto , Amiloidosis/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/diagnósticoRESUMEN
Erythromycin has recently been shown to exert a great effect on gastroduodenal motor activity. This prokinetic action may be clinically useful in patients with gastrointestinal hypomotility such as diabetic or postsurgical gastroparesis. The case of a diabetic patient who underwent antrectomy Billroth II for gastric cancer is presented. Severe gastroparesis appeared after surgery and nasogastric aspiration could not be removed, although the patient was treated with metoclopramide, and glucose levels, hydroelectrolytic balance and nutritional status were corrected. Forty-one days after the first operation, a second gastrectomy with Bilroth II reconstruction was performed because of supposed anastomotic narrowing, which was not confirmed at surgery. Fourteen days later, i.v. erythromycin (200 mg/4h) was started owing to gastroparesis persistence. Six days after treatment the patient tolerated oral ingestion. Prokinetic drugs constitute the specific therapy for gastroparesis. Metoclopramide is the most used, although its efficacy is limited. In the last few years, erythromycin has proved to have a powerful effect on gastroduodenal motility. This effect is mediated, at least in part, by its motilin stimulating activity accelerating gastric emptying. Our patient completely recovered from gastroparesis after erythromycin treatment. Recent results of erythromycin therapy in these patients have been promising, despite the difficult management involved.
Asunto(s)
Eritromicina/uso terapéutico , Parálisis/tratamiento farmacológico , Complicaciones Posoperatorias/tratamiento farmacológico , Gastropatías/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Femenino , Gastrectomía , Humanos , Índice de Severidad de la EnfermedadRESUMEN
Three episodes of acute renal failure, all of them requiring hemodialysis, were observed in two patients. The renal biopsy specimens showed a massive periglomerular granulomatosis with crescentic glomerulonephritis. With cyclophosphamide therapy, a dramatic improvement in renal function was observed in both patients. Although the histologic findings and the response to cyclophosphamide therapy were characteristic of Wegener's granulomatosis, there was no evidence of respiratory involvement or extrarenal manifestations throughout the patients' clinical course. We think that these cases could represent limited forms of Wegener's granulomatosis with exclusive renal involvement.