RESUMO
INTRODUCTION AND AIM: Normally, the bile ducts are sterile, but up to 4.2% of healthy persons can present with positive cultures. Certain circumstances favor that situation, such as gallstones or biliary tree manipulation. The aim of the present study was to determine the factors that influence the presence of bacteriobilia, as well as its implications for clinical practice. MATERIALS AND METHODS: A prospective study was conducted on bile cultures from patients that underwent cholecystectomy at our hospital center within the time frame of 2013 to 2015. RESULTS: The study included 196 patients (42.3% women and 57.7% men) that underwent either open or laparoscopic cholecystectomy and in whom bile fluid samples were taken. The clinical, epidemiologic, and laboratory test characteristics of the patients were analyzed, as well as the surgical indication (urgent surgery or programmed surgery). With respect to microbiology, 47% of the bile cultures were positive: 56.5% presented with one microorganism, 25% with two, and 18.5% with three or more. CONCLUSION: Microbiologic bile analysis should not be systematically performed, given that its result is relevant only in cases that present with demonstrated risk factors. However, in those cases, said analysis is essential to establish adequate antibiotic treatment, in relation to activity spectrum and duration, to prevent complications and an increase in microbial resistance.
Assuntos
Bile/microbiologia , Colecistectomia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVE: Report our experience in the diagnosis and treatment of Boerhaave syndrome by retrospective study from 1997 to 2013. PATIENTS AND METHODS: A retrospective study was conducted covering the time frame of 1997 to 2013. RESULTS: There were a total of 5 men (71%) and 2 women (29%) and the mean age was 54 years (range: 33-80 years). Diagnosis was made through computed tomography scan in 5 cases (71%) and esophagogram in 2 cases (19%). Six patients (86%) had emergency surgery, whereas one case (14%) was managed conservatively. The surgical technique employed was primary suture and repair in 4 patients (67%) and esophageal resection and subsequent cervical esophagostomy in 2 patients (33%). CONCLUSIONS: Boerhaave's syndrome is a clinically rare entity with an elevated mortality rate. Therefore, a high degree of suspicion is necessary for making the diagnosis and providing early treatment that can result in improved outcome.