RESUMO

BACKGROUND: To explore the median effective dose (ED50) and 95% effective dose (ED95) of remimazolam besylate combined with alfentanil for adult gastroscopy. METHODS: This prospective studyenrolled 31 patients scheduled to painless gastroscopy at Anhui No. 2 Provincial People's Hospital between April and May, 2022. 5 µg.kg-1 of alfentanil hydrochloride was used for pre-analgesia. The initial single loading dose of remimazolam besylate was 0.12 mg.kg-1, increased or reduced by 0.01 mg.kg-1 for the next patient with modified Dixon sequential method. The modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) was used to assess sedation. RESULTS: Combined with alfentanil, the ED50 of remimazolam besylate was 0.147 mg.kg-1 (95% CI: 0.138-0.160 mg.kg-1) and ED95 0.171 mg.kg-1 (95% CI: 0.159-0.245 mg.kg-1). The induction time after injection of remimazolam besylate was 70 ± 25 s, with the anesthesia recovery time and the observation time in resuscitation room 5.13 ± 2.13 min and 2.32 ± 1.6 min, respectively. Twenty nine patients' vital signs were within acceptable limits during gastroscopy. CONCLUSIONS: The ED50 of remimazolam besylate combined with alfentanil for painless gastroscopy was 0.147 mg.kg-1, and the ED95 was 0.171 mg.kg-1.

Assuntos

Alfentanil , Benzodiazepinas , Relação Dose-Resposta a Droga , Gastroscopia , Humanos , Alfentanil/administração & dosagem , Estudos Prospectivos , Feminino , Masculino , Gastroscopia/métodos , Adulto , Pessoa de Meia-Idade , Benzodiazepinas/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem , Idoso , Analgésicos Opioides/administração & dosagem , Adulto Jovem

RESUMO

BACKGROUND: The existing literature does not contain information about the prevalence of gastric ulcers in mules, and on the potential associations between the presence of ulcers and work load, work type, diet, sex, age and body condition score (BCS). OBJECTIVE: To estimate the prevalence and factors associated with mule gastric ulcer syndrome (MGUS) and evaluate its distribution in both mule squamous gastric disease (MSGD) and mule glandular gastric disease (MGGD) mucosa in a population of mules in Colombia. STUDY DESIGN: Observational, cross-sectional. METHODS: A total of 97 clinically healthy mules of different ages and locations in the province of Antioquia (Colombia) were included in this study. The mules were involved in agricultural activities (i.e., riding, pack and ranch mules) at the time of the study. The animals underwent gastroscopic evaluation, and ulcer scores from 0 to 4 were assigned based on severity, with scores ≥2 indicating clinical relevance. The presence or absence of ulcer in the squamous and/or glandular region of the stomach was recorded. Data related to work type, work load and diet, as well as sex, age and BCS were recorded for each mule. Pearson's chi-square test was used to determine the association between the outcomes and explanatory variables of the study (p ≤ 0.05). The results of the risk estimations were presented as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: The frequency of MGUS in the study population was 42%. Most of the lesions were located in the squamous region of the stomach (27%), mainly in the margo plicatus, and 20% were located in the glandular region, mainly in the fundus and pyloric antrum. Six animals showed lesions in both squamous and glandular regions. Work load was the only variable associated with the presence of MGUS (OR: 1.98; 95% CI: 0.49-0.96) and MSGD (OR: 1.78; 95% CI: 0.36-0.67). Nevertheless, the findings did not provide any significant risk assessment result, nor did they reveal any significant interactions among the other variables. MAIN LIMITATIONS: This study used convenience sampling from a limited geographic region, and multivariate analysis was not performed, one of the exclusion criteria was the use of nonsteroidal anti-inflammatory drugs, which means that the effect of these drugs can no longer be evaluated. CONCLUSIONS: MGUS occurs in mules subjected to agricultural work, the risk factors associated with EGUS do not appear to be significant in mules and other equids subjected to the same conditions, in this region. Further research is needed to define the differential dynamics of MGUS in comparison with the findings in horses.

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HISTORIAL: La literatura existente no contiene información sobre la prevalencia de úlceras gástricas en mulas, y sobre las potenciales asociaciones entre la presencia de ulceras y carga de trabajo, tipo de trabajo, dieta, sexo, edad y score de condición corporal (BCS). OBJETIVO: Estimar la prevalencia y factores asociados con síndrome de ulceración gástrica en mulas (MGUS) y evaluar su distribución tanto en la mucosa escamosa (MSGD) como glandular (MGGD) en una población de mulas en Colombia. DISEÑO DE ESTUDIO: Este estudio descriptivo observacional, seccional fue llevado a cabo por muestreo de conveniencia basado en estimación mínima de muestreo y una definición a priori con criterios de inclusión y exclusión. MÉTODOS: un total de 97 mulas clínicamente sanas de diferentes edades y localidades en la provincia de Antoquia (Colombia) fueron incluidas en este estudio. Las mulas estaban involucradas en actividades agrícolas (ie. monta, carga o rancho) en el momento de este estudio. Se les hizo una evaluación gastroscópica, se les dio un score de 0 a 4 basado en la severidad, con un score ≥2 indicando relevancia clínica. La presencia o ausencia de ulceras en la región escamosa y/o glandular del estomago fue anotada. Información relacionada con el tipo de trabajo, carga de trabajo y dieta, además del sexo, edad (joven, adulto, geriátrico), y el score de condición corporal fueron anotadas para cada mula. La prueba de Chi­cuadrado de Pearson fue usada para determinar la asociación entre los resultados y las variables explicativas del estudio (p ≤ 0.05). Los resultados de las estimaciones de riesgo fueron presentado como odds­ratios (ORs) con 95% de intervalo de confianza (CI). RESULTADOS: La frecuencia de MGUS en la población del estudio fue de 42%. Las mayoría de las lesiones fueron localizadas en la porción escamosa del estómago (27%), principalmente en el margo plicatus, y 20% fueron halladas en le región glandular, principalmente en el fondo y el antro pilórico. Seis animales presentaron lesiones en ambas regiones escamosa y glandular. La carga de trabajo estuvo variablemente asociada a la presencia de MGUS (OR: 1.98; 95% CI: 0.49­0.96) y MSGD (OR: 1.78; 95% CI: 0.36­0.67). Sin embargo, los hallazgos no proporcionaron resultados significativos de análisis de riesgo, y no revelaron ningunas interacciones entre las otras variables. LIMITACIONES PRINCIPALES: Este estudio utilizó muestreo de conveniencia de una región geográfica limitada, y no se llevaron a cabo análisis multivariados, un criterio de exclusión fue el uso de anti inflamatorios no esteroidales, lo que quiere decir que el efecto de estos fármacos ya no puede ser evaluado. CONCLUSIONES: MGUS ocurren en mulas haciendo trabajo agrícola, los factores de riesgo asociados a EGUS no parecen ser significativos en mulas y otros equinos sujetos a las mismas condiciones en esta región. Mas investigación es necesaria para definir la dinámica que diferencia a MGUS en comparación a los hallazgos en caballos.

Assuntos

Carcinoma de Células Escamosas , Doenças dos Cavalos , Úlcera Gástrica , Humanos , Cavalos , Animais , Úlcera Gástrica/epidemiologia , Úlcera Gástrica/veterinária , Equidae , Úlcera/veterinária , Prevalência , Colômbia/epidemiologia , Estudos Transversais , Doenças dos Cavalos/epidemiologia , Carcinoma de Células Escamosas/veterinária

RESUMO

Introduction: Tuberculosis remains a public health concern in developing countries, as well as in developed countries as a result of immigration from endemic areas. Gastroduodenal and colorectal tuberculosis are rare manifestations of gastrointestinal infection. Case Presentation: We present 2 cases of gastric, duodenal, and colorectal tuberculosis. The first case, a 17-year-old male with no medical record, presented with chronic diarrhea and abdominal pain. At endoscopy, he had multiple ulcers in the stomach, colon, and rectum, which were positive to Mycobacterium tuberculosis. The second case was a 43-year-old HIV-positive male, with a history of intermittent fever, nausea, and vomiting. Upper gastrointestinal endoscopy revealed a deep ulcer on gastric fundus that tested positive to M. tuberculosis in the acid-fast bacilli staining. Discussion/Conclusion: Gastroduodenal and colorectal tuberculosis, although rare, should be considered in the differential diagnosis in both immunosuppressed and immunocompetent patients. An adequate tissue sample and appropriate diagnostic tests are essential for the diagnosis and prompt start of first-line antituberculosis agents.

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Introdução: A tuberculose continua sendo um problema de saúde pública nos países em desenvolvimento, bem como nos países desenvolvidos, em decorrência da imigração. A tuberculose gastroduodenal e colorretalsão manifestações raras de infecção gastrointestinal. Apresentação do Caso: Apresentamos dois casos de tuberculose gástrica, duodenal ecolorretal. O primeiro caso, um jovem de 17 anos, apresentou diarreia crônica e dor abdominal. Na endoscopia, tinha múltiplas úlceras no estômago, cólon e reto que foram positivas para Mycobacterium Tuberculosis. O segundo caso foi um homem de 43 anos, HIV positivo, com relato de febre intermitente, náuseas e vômitos. A endoscopia digestiva alta revelou úlcera profunda do fundo gástrico positivo para Mycobacterium tuberculosis na coloração de bacilos álcool-ácido resistentes. Discussão/Conclusão: Tuberculosegastroduodenal e colorretal, embora raras, deve ser considerada como diagnóstico em pacientes imunossuprimidos e imunocompetentes. Uma amostra de tecido adequada e testes diagnósticos apropriados são essenciais para o diagnósticoe início imediato dos tuberculostáticos de primeira linha.

RESUMO

Firocoxib is a non-steroidal anti-inflammatory drug specifically formulated for veterinary medicine and selectively acts on inhibiting the cyclooxygenase 2 enzyme (COX-2). This study evaluated the possible adverse effects of administering oral therapeutic firocoxib on gastric mucosa, hematological parameters, coagulation cascade, and hepatic and renal biochemistry in healthy horses. Nine clinically healthy Arabian horses, approximately 9 years old, received 0.1 mg/kg of oral firocoxib for 14 days. The gastroscopic examination was conducted 1 day before starting treatment (D0) and two days after the last blood collection (D23). Venous blood samples were obtained for laboratory tests on day 1, immediately prior to the initiation of treatment (D1), after 7 and 14 days of treatment (D7 and D14), and 7 days after the conclusion of treatment (D21. No changes were found in the gastroscopic and hematological tests. Coagulation and serum biochemistry levels remain between these species' average values. However, the increased activated partial thromboplastin time (aPTT) and prothrombin time (PT) indicate reduced blood coagulation capacity, which contradicts the expected effect of treatment with selective COX-2 inhibitors, as these drugs theoretically promote coagulation. Administering firocoxib to horses is safe as it does not cause significant adverse reactions. Therefore, it is a suitable option for managing inflammatory conditions in these animals with attention to an unexpected adverse anti-coagulopathy effect, and further study is warranted.

RESUMO

Presentamos el caso de un varón de 64 años quien, tras un primer episodio de pancreatitis aguda necrotizante, reingresa a los 20 días por cuadro de dolor epigástrico intenso y posteriormente episodio de hemorragia digestiva alta en forma de hematemesis y melenas con inestabilización hemodinámica. Se realiza en ese momento gastroscopia urgente objetivándose probable fistula gastrointestinal en bulbo duodenal con coágulo adherido sin sangrado activo en ese momento por lo que se realiza angio-TC urgente que revela colección peripancreática necrótica con presencia de sangrado activo en su interior, procedente de la arteria pancreatoduodenal. La arteriografía urgente identificó imagen compatible con pseudoaneurisma arterial dependiente de la rama de arteria pancreatoduodenal, que fue embolizada con éxito. Desgraciadamente el paciente falleció en las horas posteriores, como consecuencia de un shock séptico secundario a colección pancreática infectada.

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We present the case of a 64-year-old man who, after a first episode of acute pancreatitis, was readmitted 20 days later due to severe epigastric pain and later an episode of upper gastrointestinal bleeding in the form of hematemesis and melena with hemodynamic instability. An urgent gastroscopy was performed at that time, revealing a probable gastrointestinal fistula in the duodenal bulb with an adherent clot without active bleeding at that time, so an urgent CT angiography was performed that revealed a necrotic peripancreatic collection with the presence of active bleeding inside from the pancreatoduodenal artery. Urgent arteriography identified an image compatible with arterial pseudoaneurysm dependent on the pancreaticoduodenal artery branch, which was successfully embolized. Unfortunately, the patient died a few hours later as a result of septic shock secondary to an infected pancreatic collection.

RESUMO

Introducción : La disposición regular de vénulas colectoras tiene alto valor para predecir la ausencia de infección gástrica por Helicobacter pylori, los estudios que validaron este hallazgo se realizaron con imágenes de magnificación y cromoendoscopia digital, es común realizar endoscopias con equipos convencionales de luz blanca sin magnificación. Objetivo : Este estudio pretende validar este hallazgo como predictor de ausencia de infección por H. pylori utilizando equipos de endoscopia con luz blanca convencional sin magnificación. Materiales y métodos : Se realizó un estudio observacional identificando la presencia de RAC con endoscopio convencional, la determinación de Helicobacter pylori se estableció por histopatología. Se calculó sensibilidad, especificidad, valor predictivo positivo (VPP) y valores predictivos negativos (VPN) en relación con la presencia de RAC y el estado de infección por H. pylori. Resultados : 241 pacientes fueron incluidos encontrando una sensibilidad de 5%, con especificidad de 89%. La prevalencia de H. pylori disminuyo con la edad. Conclusión : Este estudio reporta una baja sensibilidad con elevada especificidad de la distribución regular de vénulas colectoras para establecer el estado de infección por H. pylori. El desempeño diagnóstico fue inferior al reportado en estudios llevados a cabo con cromo endoscopia con magnificación.

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Introduction : The regular arrangement of collecting venules has high value to predict the absence of gastric infection by Helicobacter Pylori, the studies that have validated this finding were carried out with magnification images and digital chromoendoscopy, it is common to perform endoscopies with conventional white light equipment without magnification. Objective : This study aims to validate this finding as a predictor of the absence of H. Pylori infection using endoscopy equipment with conventional white light without magnification. Material and methods : An observational study was carried out identifying the presence of RAC with a conventional endoscope, the determination of Helicobacter pylori was established by histopathology. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated in relation to the presence of RAC and the H. pylori infection status. Results : 241 patients were included, finding a sensitivity of 5%, with a specificity of 89%. The prevalence of H. Pylori decreased with age. Conclusion : This study reports a low sensitivity with a high specificity of the regular distribution of collecting venules to establish the state of infection by H. Pylori. The diagnostic performance was lower than that reported in studies carried out with chromium endoscopy with magnification.

RESUMO

We evaluated 28 horses from a squad applied in public safety in Paraná (Brazil), in order to check the incidence of gastric ulcers and its correlation with mounted policing activity, considering the initial and maintenance training to which such animals are submitted. Horses were divided in two groups, one named control with 14 individuals, used in policing community activities, and the 14 others named as target group, these were used in restoration and maintenance of public order. Both groups have differentiated maintenance training protocols, and all had been evaluated for fecal occult blood, clinical evaluation, gastroscopy and histopathological. There were no significant changes that proved the development of gastric ulcers in horses used in public safety due to initial and maintenance training, and the main factor for prevention was the diversified diet with emphasis in hayed alfalfa.

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Foram avaliados 28 equinos do plantel de animais aplicados na segurança pública do estado do Paraná, com o objetivo de verificar as incidências de úlceras gástricas e a correlação da manifestação de tal doença com a atividade de policiamento montado, considerando o treinamento inicial e o de manutenção aos quais tais animais são submetidos. Os equinos foram divididos em dois grupos: controle, com 14 indivíduos, aplicados na atividade de policiamento montado comunitário, e grupo-alvo, com os outros 14 animais, utilizados em ações de restabelecimento e manutenção da ordem pública, ambos os grupos com protocolos de treinamentos de manutenção diferenciados. Todos os animais foram submetidos à avaliação de sangue oculto em fezes, à avaliação clínica, à gastroscopia, à avaliação odontológica e comportamental, ao escore corporal e à histopatológica de mucosa gástrica. Não foram encontradas alterações significativas que comprovam o desenvolvimento de úlceras gástricas, em consequência do treinamento inicial e o de manutenção, nos equinos utilizados na segurança pública, cujo fator primordial preventivo foi a matriz alimentar diversificada com ênfase na alfafa fenada.

Assuntos

Animais , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/epidemiologia , Doenças dos Cavalos , Úlcera Gástrica/veterinária , Bem-Estar do Animal , Medicago sativa

RESUMO

Abstract The ingestion or aspiration of dental material or instruments is one of the most feared complications in clinical dental practice, it can occur in both children and adults. The mouth is a moist, dark, small area; where the involuntary movements of the patient during the procedures and the small dimensions of the materials and instruments turn dental care into a challenge. A swallowed or aspirated foreign body during dental treatment can result in serious complications and even death, these depend largely on the shape, size and anatomical pathway through which it passes. This article describes an uncommon complication of which there is only one report in the literature worldwide, the ingestion of the tip of a triple syringe during a routine dental procedure that was recovered by esophagogastroduodenoscopy. It also highlights the importance of knowing the protocols for handling aspirated or swallowed foreign bodies where a fast and adequate approach during the first minutes can make the difference between life and death.

Assuntos

Humanos , Feminino , Adolescente , Seringas , Acidentes , Costa Rica , Odontologia

RESUMO

Resumen La ingesta de cuerpos extraños es una entidad clínica común en el servicio de gastroenterología; la mayoría de veces estos pasan a través del tracto digestivo de manera espontánea y, en algunos casos, pueden presentar complicaciones como obstrucción o perforación. Es importante realizar un diagnóstico temprano con el fin de definir una terapia conservadora o quirúrgica inmediata. Se presenta el caso de una paciente de 67 años de edad que ingresó al servicio de urgencias por dolor abdominal de 16 días de evolución; como había sospecha de tumor gástrico sobreinfectado, se solicitó una endoscopia digestiva alta para la toma de biopsias, pero de forma sorpresiva se extrajo una espina de pescado de 3,5 cm sin complicaciones; posteriormente, se realizó el manejo del absceso gástrico con antibióticos por 14 días, con un buen desenlace clínico.

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Abstract Foreign body ingestion is a common reason for consultation to the Gastroenterology Service. Most of these bodies pass through the digestive tract spontaneously and, in some cases, may cause complications such as obstruction or perforation. Early diagnosis is crucial to establish immediate conservative or surgical therapy. The following is the case of a 67-year-old patient admitted to the Emergency Department due to abdominal pain of 16 days of evolution. Since an over-infected gastric tumor was suspected, an upper gastrointestinal endoscopy was requested for biopsy. Strikingly, a 3.5cm fish bone was removed without complications. Gastric abscess was treated subsequently with antibiotics for 14 days, obtaining a good clinical outcome.

Assuntos

Humanos , Feminino , Idoso , Trato Gastrointestinal , Corpos Estranhos , Endoscopia Gastrointestinal , Ingestão de Alimentos , Relatório de Pesquisa , Literatura

RESUMO

The occurrence of gastrointestinal myiasis caused by Gasterophilus spp. larvae (Diptera: Oestridae) in adult horses has been widely characterized, however data on natural infestation in young foals have been lacking. This observation may be related to the absence of conclusive diagnosis in these individuals, most likely due to logistical or financial constraints. Gastric ulceration is a problem and a significant cause of morbidity in foals, particularly during the weaning stage; therefore, gasterophilosis should be included in the differential diagnosis. The primary purpose of this study was to determine the prevalence of gasterophilosis in 4- to 6-month-old weanling foals. Seventy-one healthy weanling foals were enrolled in the study. Physical assessment blood sampling and was completed in all foals before the commencement of the experiment. Gastroscopy examinations were performed under sedation (Detomidine 0.01 - 0.02 mg/kg) with a flexible endoscope inserted through nasogastric via. The lumen of the stomach was examined in order to search for botflies' larvae. Following gastroscopy, foals were classified into 2 groups based on the presence of Gasterophilus spp. larvae in their stomachs: 1) Infected and 2) Not Infected. Infected foals received a single dose of commercial trichlorfon and albendazole equine oral gel and were stalled for 24 h. The passed feces were thoroughly examined, searching for elimination of larvae. A total of 64% of the foals (n = 45/71) harbored Gasterophilus spp. larvae in the stomach. Mild hyperemia in the gastric mucosa was observed in the attachment sites of the parasites. Physical assessment and hematological parameters' data were analyzed with Shapiro-Wilk normality test. Comparison between groups for clinical signs, hematological parameters and Gasterophilus spp. infection rates were evaluated using the Kruskal-Wallis test or Student's t-test. Statistical significance was set at P < 0.05. There were no statistically significant variations in physical and hematological parameters between foals that were affected and those that were not infected. The larvae found in the feces were subjected to morphological examination, which confirmed the diagnosis of Gasterophilus intestinalis. No systemic clinical indications compatible with Gasterophilus spp. infestation were seen, as described in previous studies of horses infected with the parasite. No botfly eggs were observed in the hair of evaluated foals. During gastroscopy, mild hyperemic lesions in the gastric mucosa were observed in the larvae fixation sites. Although no changes in clinical or hematological parameters were noted, the confirmation of parasite presence is a cause for concern due to horses' tolerance for low infestation levels and poor diagnosis. Additionally, the presence of this myiasis in foals may be a significant stressor during the weaning period and should be included in the differential diagnosis of recurring abdominal pain. Furthermore, infected foals might be a reservoir for the parasite and, contribute to the elimination and spread of the larvae in the environment. Thus, inclusion of young horses in deworming protocols targeted to botfly larvae is needed. This is the first report of Gasterophilus intestinalis myiasis in foals in Brazil. Further research is necessary to fully understand the epidemiology and prevalence of this condition in young horses in Brazil, based on the findings of this study.(AU)

Assuntos

Animais , Úlcera Gástrica/veterinária , Fezes/parasitologia , Doenças dos Cavalos/parasitologia , Doenças dos Cavalos/sangue , Miíase/veterinária , Miíase/epidemiologia , Contagem de Ovos de Parasitas/veterinária , Prevalência , Cavalos

RESUMO

RESUMEN Las enfermedades gastrointestinales equinas tienen una alta incidencia con un pronóstico variable en la práctica clínica. La mayoría de los estudios se limitan a describir lesiones ulcerativas y lesiones inflamatorias. El objetivo de este estudio fue evaluar el potencial diagnóstico complementario de la cromoendoscopia convencional en la mucosa gas-troesofágica y duodenal proximal del equino. El estudio incluyó 20 caballos criollos colombianos de ambos sexos (12 hembras y 8 machos), con edades entre 5 y 20 años, peso entre 250 y 350 kilogramos, condición corporal 4-5/9 y con historial de alteraciones digestivas en los últimos 3 meses; quienes previo a la evaluación por gastroscopia y cromoendoscopia se sometieron a ayuno (sólidos 12h y líquidos 4h) y sedación (xilacina 0,5 mg/kg/iv). Se utilizaron tinciones como rojo fenol, lugol, índigo carmín, azul de metileno y ácido acético y se tomaron biopsias de los segmentos que mostraron reacción. El azul de metileno reveló 52% de las lesiones, el lugol 19%; por su parte, el rojo fenol, el índigo carmín y el ácido acético revelaron el 9,5% restante. El epitelio escamoso fue el más afectado (66,6%), el glandular (19%), antro pilórico (9,5%) y duodeno proximal (4,7%). Los hallazgos histopatológicos fueron hiperplasia, hipertrofia, hiperqueratosis, congestión, degeneración vacuolar, infiltrados celulares, fibrosis, necrosis y atrofia en diferentes grados de severidad. La cromoendoscopia reveló lesiones prematuras, que pasaron desapercibidas con las técnicas convencionales de endoscopia del tracto digestivo. Este es el primer estudio que emplea la cromoendoscopia en equinos; a pesar de que la técnica mejoró la visualización y facilitó la ubicación y descripción de lesiones ulcerativas prematuras a través de la histopatología, se recomiendan mayores estudios controlados y con un número más amplio de muestras.

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ABSTRACT Equine gastrointestinal diseases have a high occurrence with a variable prognostic in clinic practice. Most of the studies limits to describe ulcerative and inflammatory lesions. The objective of this study was to evaluate the potential complementary diagnostic of conventional chromoendoscopy on the gastroesophageal and proximal duodenal mucosa of the equine. 20 Colombian creole horses, of both sexes (12 females and 8 males), with ages between 5 and 20 years old, weight between 250 and 350 kilograms, body condition 4-5/9, that had presented digestive alterations in the last 3 months, were subjected to fasting (solids 12h and liquids 4h) and sedated (xylazine 0,5 mg/kg/iv) to be evaluated by gastroscopy and chromoendoscopy, using for stains phenol red, lugol, indigo carmine, methylene blue and acetic acid, taking biopsy samples of the segments that showed reaction. The methylene blue revealed 52%, lugol 19%, and phenol red, indigo carmine and acetic acid revealed only 9,5% of the lesions, being the squamous epithelium the most affected (66,6%), glandular epithelium (19%), pyloric antrum (9,5%) and proximal duodenum (4,7%), where histopathological findings were hyperplasia, hypertrophy, hyperkeratosis, congestion, vacuolar degeneration, cellular infiltrates, fibrosis, necrosis and atrophy in different degrees of severity. Chromoendoscopy revealed lesions premature, which go unnoticed with conventional light endoscopy techniques. This is the first study using chromoscopy in horses to show that the reagents used allow a better visualization of injuries than the conventional technique, helping histopathological studies and molecular biology to understand ulcerative premature injuries and possible pathophysiological pathways. However, larger controlled studies and a larger number of samples are needed.

Assuntos

Animais , Ferimentos e Lesões , Gastroscopia , Corantes , Endoscopia , Cavalos , Atrofia , Vacúolos , Biópsia , Células , Carmim , Jejum , Ácido Acético , Fenol , Duodeno , Epitélio , Distribuição por Idade e Sexo , Junção Esofagogástrica , Hiperplasia , Hipertrofia , Azul de Metileno , Mucosa , Necrose

RESUMO

RESUMEN Las úlceras gástricas se definen como la pérdida de continuidad de la mucosa gástrica. Se originan principalmente por desequilibrio entre factores injuriantes y de protección del estómago. Generalmente se manifiestan con signos como pérdida de peso, cólico, bruxismo e inapetencia, conllevando al bajo rendimiento del animal y pérdidas económicas. El objetivo del presente estudio fue determinar la prevalencia y factores de riesgo para la presentación de SUGE en CCC del Valle de Aburra. Se realizó gastroscopia a 100 animales de diferentes pesebreras, entre dos y 25 años de edad; cada estómago se caracterizó macro y microscópicamente. Las lesiones macroscópicas se valoraron de acuerdo con el grado de lesión según el Equine Gastric Ulcer Council, y la clasificación microscopica se basó en una adaptación hecha por patrones de descripción de lesiones más utilizados como: The sidney system y Equine gastritis grading system (EGGS). Para el análisis de los resultados, se tuvieron en cuenta variables como la intensidad del ejercicio, alojamiento, tipo y frecuencia de alimentación, transporte y frecuencia del mismo. El 65% de los equinos evaluados presentaron lesiones compatibles con SUGE. Macroscópicamente el grado 2 de severidad fue el más común (38%), con mayor presentación en la región aglandular. Microscópicamente el edema en la región fundica y pilórica fue la lesión más frecuente (35,2% y 30,7%, respectivamente). Los principales factores de riesgo asociados a la presentación de las lesiones fueron el transporte de los animales y la intensidad del ejercicio.

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ABSTRACT Gastric ulcers are defined as the loss of continuity of the gastric mucosal. They are mainly caused by an imbalance between harmful and protective factors of the stomach. It generally manifests itself with signs such as weight loss, colic, bruxism and inappetence, which can lead to low performance and economic losses. The objective of the present study was to determine the prevalence and risk factors for the presentation of SUGE in CCC of the Valle del Aburra. Gastroscopy was made to 100 animals from different stables, between two and 25 years of age; each stomach characterized, macro and microscopically. Lesions are evaluate depending on the degree of injury to the "Equine Gastric Ulcer Council". Microscopic lesions classification was based on an adaptation by patterns most commonly used description of injuries such as: the Sidney System and the equine gastritis grading system (EGGS). For the analysis of the results, variables such as exercise intensity, accommodation, type and frequency of feeding, transportation and its frequency were taken into account. 65% of the equines evaluated presented SUGE-compatible lesions, of which the most common degree of severity macroscopically was grade 2 (38%), with grater presentation in the non-glandular region. Microscopically, edema in the fundic and pyloric region was the most frequent (35.2% and 30.7%, respectively). The main risk factors associated with the presentation of the lesions were the transport of the animals and the intensity of the exercise.

Assuntos

Úlcera Gástrica , Ferimentos e Lesões , Redução de Peso , Cólica/veterinária , Fatores de Risco , Gastroscopia , Mucosa Gástrica , Estômago , Meios de Transporte , Bruxismo/veterinária , Exercício Físico , Anorexia/veterinária , Alojamento , Dieta , Edema

RESUMO

A síndrome de úlcera gástrica equina (SUGE) é uma patologia com grande incidência na espécie equina. Causa danos à saúde e bem-estar animal, gerando queda de desempenho atlético ocasionando, também, perdas econômicas aos proprietários. Apresenta sinais clínicos inespecíficos, o que pode gerar interpretações errôneas, visto que o diagnóstico definitivo somente é possível com o uso de gastroscopia. Com isso, o objetivo foi relatar um caso clínico de equino com SUGE, bem como a importância da gastroscopia para um diagnóstico correto. Um equino macho, seis anos de idade, com 440kg, foi recebido no HDM Horse Service com encaminhamento cirúrgico de outro veterinário. Após anamnese e exame clínico, essa indicação foi descartada e a suspeita clínica de SUGE foi proposta. A confirmação de diagnóstico foi através do exame de gastroscopia, no qual foi possível observar ulcerações na mucosa gástrica. O tratamento foi instituído com fluidoterapia, flunixin meglumine para controle da dor, uma bisnaga de omeprazol por via oral durante 28 dias e protetores de mucosa como sucralfato, uma bisnaga, via oral por 15 dias. O animal obteve melhora considerável no quadro clínico inicial, seguido por recuperação total e retorno gradativo a suas atividades atléticas. Pode-se concluir que, a gastroscopia desempenhou papel fundamental para o esclarecimento do quadro clínico do paciente, apresentando um diagnóstico adequado e definitivo, e proporcionado um tratamento correto para a patologia.

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Equine gastric ulcer syndrome (SUGE) is a pathology with great incidence in the equine species. It causes damages to the health and animal welfare, generating a fall of athletic performance, causing, also, economic losses to the owners. It presents nonspecific clinical signs, which can generate erroneous interpretations, since the definitive diagnosis is only possible with the use of gastroscopy. With this, the objective was to report a clinical case of equine with SUGE, as well as the importance of gastroscopy for a correct diagnosis. A 4-kg, 6-year-old male horse was received at the HDM Horse Service with surgical referral from another veterinarian. After anamnesis and clinical examination, this indication was discarded and the clinical suspicion of SUGE was proposed. The diagnosis was confirmed by gastroscopy, in which it was possible to observe ulcerations in the gastric mucosa. The treatment was instituted with fluid therapy, flunixin meglumine for pain control, an oral omeprazole tube for 28 days and mucosal protectors such as sucralfate, a tube, orally for 15 days. The animal obtained a considerable improvement in the initial clinical picture, followed by total recovery and gradual return to its athletic activities. It can be concluded that gastroscopy played a fundamental role in clarifying the patient's clinical condition, presented an adequate and definitive diagnosis, and provided the correct treatment for a pathology.

Assuntos

Masculino , Animais , Cavalos , Úlcera Gástrica/diagnóstico por imagem , Úlcera Gástrica/tratamento farmacológico , Úlcera Gástrica/veterinária , Gastroscopia/veterinária

RESUMO

A síndrome de úlcera gástrica equina (SUGE) é uma patologia com grande incidência na espécie equina. Causa danos à saúde e bem-estar animal, gerando queda de desempenho atlético ocasionando, também, perdas econômicas aos proprietários. Apresenta sinais clínicos inespecíficos, o que pode gerar interpretações errôneas, visto que o diagnóstico definitivo somente é possível com o uso de gastroscopia. Com isso, o objetivo foi relatar um caso clínico de equino com SUGE, bem como a importância da gastroscopia para um diagnóstico correto. Um equino macho, seis anos de idade, com 440kg, foi recebido no HDM Horse Service com encaminhamento cirúrgico de outro veterinário. Após anamnese e exame clínico, essa indicação foi descartada e a suspeita clínica de SUGE foi proposta. A confirmação de diagnóstico foi através do exame de gastroscopia, no qual foi possível observar ulcerações na mucosa gástrica. O tratamento foi instituído com fluidoterapia, flunixin meglumine para controle da dor, uma bisnaga de omeprazol por via oral durante 28 dias e protetores de mucosa como sucralfato, uma bisnaga, via oral por 15 dias. O animal obteve melhora considerável no quadro clínico inicial, seguido por recuperação total e retorno gradativo a suas atividades atléticas. Pode-se concluir que, a gastroscopia desempenhou papel fundamental para o esclarecimento do quadro clínico do paciente, apresentando um diagnóstico adequado e definitivo, e proporcionado um tratamento correto para a patologia.(AU)

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Equine gastric ulcer syndrome (SUGE) is a pathology with great incidence in the equine species. It causes damages to the health and animal welfare, generating a fall of athletic performance, causing, also, economic losses to the owners. It presents nonspecific clinical signs, which can generate erroneous interpretations, since the definitive diagnosis is only possible with the use of gastroscopy. With this, the objective was to report a clinical case of equine with SUGE, as well as the importance of gastroscopy for a correct diagnosis. A 4-kg, 6-year-old male horse was received at the HDM Horse Service with surgical referral from another veterinarian. After anamnesis and clinical examination, this indication was discarded and the clinical suspicion of SUGE was proposed. The diagnosis was confirmed by gastroscopy, in which it was possible to observe ulcerations in the gastric mucosa. The treatment was instituted with fluid therapy, flunixin meglumine for pain control, an oral omeprazole tube for 28 days and mucosal protectors such as sucralfate, a tube, orally for 15 days. The animal obtained a considerable improvement in the initial clinical picture, followed by total recovery and gradual return to its athletic activities. It can be concluded that gastroscopy played a fundamental role in clarifying the patient's clinical condition, presented an adequate and definitive diagnosis, and provided the correct treatment for a pathology.(AU)

Assuntos

Animais , Masculino , Cavalos , Úlcera Gástrica/diagnóstico por imagem , Úlcera Gástrica/tratamento farmacológico , Úlcera Gástrica/veterinária , Gastroscopia/veterinária

RESUMO

We report the case of a female Shih-Tzu dog with chronic vomiting and hematemesis not responsive to symptomatic treatment. Due to the non-specific clinical signs, the patient underwent endoscopy and biopsy of the gastric mucosa. Histopathological analysis revealed atrophic gastritis, a disease rarely reported in dogs and characterized by the destruction of parietal cells of the mucosa and their replacement by fibrosis. This analysis allowed an adequate treatment based on the administration of corticosteroids by the anti-inflammatory effects and action in the regeneration of parietal cells, associated with a soft, hypoallergenic diet formulated with a low fat content, low digestible fibers, and high contents of complex carbohydrates, which resulted in the resolution of the clinical condition in a few weeks. In a second endoscopy, performed after eight months of treatment, the gastric mucosa presented a pink color, regardless of the degree of distension, no lesions or discontinuity points. Fragments were collected for histopathological analysis, which confirmed the recovery of gastric lesions and restoration of the macroscopically healthy mucosa. Most gastric diseases require histological analysis for a definitive diagnosis. In this context, endoscopy has brought unquestioned benefits to the patient since it allowed an accurate diagnosis with a quick and safe collection of gastric mucosa samples.(AU)

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Relata-se o caso de uma cadela da raça Shih-Tzu com vômito crônico e hematêmese não responsivos ao tratamento sintomático. Devido aos sinais clínicos inespecíficos, a paciente foi submetida à endoscopia e biópsia da mucosa gástrica. A análise histopatológica revelou gastrite atrófica, doença raramente reportada em cães e caracterizada pela destruição das células parietais da mucosa e sua substituição por fibrose. Esta análise possibilitou o tratamento adequado, embasado na administração de corticosteróides, pelos efeitos antiinflamatórios e pela atuação na regeneração das células parietais, associada a uma dieta leve, hipoalergênica, formulada com baixos teores de gordura, pobre em fibras digeríveis e altos teores de carboidratos complexos, que resultou na resolução do quadro clínico em poucas semanas. Em uma segunda endoscopia, realizada após oito meses de tratamento, a mucosa gástrica se apresentava de coloração rósea, independentemente do grau de distensão, sem lesões ou pontos de descontinuidade. Foram colhidos fragmentos para análise histopatológica, que confirmou a recuperação das lesões gástricas e restabelecimento de mucosa macroscopicamente saudável. A maioria das doenças gástricas necessita de análise histológica para o diagnóstico definitivo. Neste contexto, a endoscopia trouxe benefícios incontestes à paciente, pois possibilitou o diagnóstico preciso com colheita de amostras de mucosa gástrica de forma rápida e segura.(AU)

Assuntos

Animais , Cães , Gastrite Atrófica/diagnóstico , Gastrite Atrófica/veterinária , Gastroscopia/veterinária , Biópsia/veterinária , Endoscopia/veterinária

RESUMO

SUMMARY OBJECTIVE: This study retrospectively reviewed 46 cases of gastric gastrointestinal stromal tumors treated by endoluminal endoscopic full-thickness resection (EFR) microsurgery in our gastrointestinal endoscopy center. We aimed to evaluate the EFR for the treatment of gastric gastrointestinal stromal tumors originating from the muscularis propria. METHODS: A total of 46 patients with gastric gastrointestinal stromal tumors originated from the muscularis propria layer from January 2012 to June 2015 were treated with EFR. The patients were followed up with gastroscope and computed tomography (CT) for evaluation of therapeutic effect and safety. RESULTS: EFR was successfully accomplished to remove all tumors in 46 patients. The mean procedure time was 82.5±39.8min (56-188min). Except in 3 leiomyomas, pathological examination confirmed gastrointestinal stromal tumor (GIST) in 43 cases. None of the patients had occurred bleeding, peritonitis and other complications after EFR. Thereafter, all patients were followed up with gastro-scope after 1, 6,12 months. CONCLUSIONS: EFR is effective and safe for patients with gastric gastrointestinal stromal tumors originated from muscularis propria layer and has the advantage of less invasive treatment and higher tumor resection rate. It should be considered for further application.

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RESUMO OBJETIVO: Este estudo revisou retrospectivamente 46 casos de tumores gástricos estromáticos gastrointestinais tratados por microcirurgia endoluminal endoscópica de ressecção completa (EFR) em nosso centro de endoscopia gastrointestinal. Pretendemos avaliar a EFR para o tratamento de tumores gastrointestinais estromáticos originários da muscularis própria. MÉTODOS: Um total de 46 pacientes com tumores gástricos estromáticos gastrointestinais originários da camada muscular própria, de janeiro de 2012 a junho de 2015, foi tratado com EFR. Os pacientes foram acompanhados com gastroscópio e tomografia computadorizada (TC) para avaliação de efeitos terapêuticos e segurança. RESULTADOS: A EFR foi realizada com sucesso para remover todos os tumores em 46 pacientes. O tempo médio de procedimento foi de 82,5±39,8 min (56-188 min). Exceto em três leiomiomas, exame patológico confirmou tumor estromal gastrointestinal (Gist) em 43 casos. Em nenhum paciente ocorreu sangramento, peritonite e outras complicações após EFR. Posteriormente, todos os pacientes foram acompanhados com gastroscópio após um, seis e 12 meses. CONCLUSÕES: A EFR é eficaz e segura para pacientes com tumores gastrointestinais originários da camada muscular própria e tem a vantagem de ser um tratamento menos invasivo e com maior taxa de ressecção tumoral. Deve ser considerada para posterior aplicação.

Assuntos

Humanos , Masculino , Feminino , Adulto , Idoso , Adulto Jovem , Neoplasias Gástricas/cirurgia , Tumores do Estroma Gastrointestinal/cirurgia , Ressecção Endoscópica de Mucosa/métodos , Gastrectomia/métodos , Mucosa Gástrica/cirurgia , Leiomioma/cirurgia , Neoplasias Gástricas/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Mucosa Gástrica/patologia , Leiomioma/patologia , Pessoa de Meia-Idade

RESUMO

ABSTRACT BACKGROUND: Endoscopic submucosal dissection (ESD) is a complex endoscopic procedure, with high rates of adverse events and technical difficulties. To overcome that problem, many training centers published the importance of animal models for skill acquirement in ESD. However, no study has used the submucosal dissection depth (DSUB) as a parameter to evaluate the learning curve in ESD, which might be a relevant factor since an optimal resection plane is important to achieve a curative resection and avoid intraoperative complications. OBJECTIVE: This study aimed to assess ESD skill acquirement after short-term training sessions by evaluating the submucosal dissection depth (DSUB) and the association with adverse events. METHODS: This experimental study included 25 experienced endoscopists in therapeuthic procedures (>5years) and 75 specimens resected by ESD (three resections / endoscopist). Learning parameters (resection time, size, en bloc resection rate, bleeding, perforation and submucosal dissection depth) were prospectively evaluated. The percentages of DSUB of all specimens resected were calculated. RESULTS: All specimens were resected from the gastric body (n=75). The mean size of the resected specimens was 23.97±7.2 mm. The number of adverse events, including bleeding, perforation, and death, were 17 (22.67%), 3 (4%), and 0 cases, respectively. The average mean time by the third dissection decreased from 28.44±9.73 to 18.72±8.81 min (P<0.001). The proportion of DSUB in the bleeding and non-bleeding group were respectively 37.97%±21.13% and 68.66%±23.99%, indicating a significant association between DSUB and bleeding incidence (P<0.001). The ROC curve analysis indicated a cut-off point of 61% (sensitivity, 64%; specificity, 94%) of submucosal dissection depth associated with bleeding. Therefore, when ESD was performed at a depth of >61% of the submucosal layer, the risk for bleeding during the procedure decreased (PPV, 0.97; 95% CI, 0.85-0.99). CONCLUSION: Improvement in the learning curve in ESD and a better cognitive ability were seen by the third dissection in these short term training courses. And a significant association between DSUB and the risk of bleeding.

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RESUMO CONTEXTO: A técnica de ESD (Endoscopic Submucosal Dissection) é um procedimento endoscópico de grande complexidade, com alto índice de complicações e dificuldades técnicas. Para superar este problema, muitos centros de treinamento em endoscopia vêm publicando a aplicabilidade dos modelos animais para a aquisição de competência em ESD. Entretanto, a profundidade de ressecção nunca foi utilizada como parâmetro de aprendizagem, o que pode ser um fator relevante a ser ensinado, dado que atingir o plano de dissecção ideal é de suma importância para uma ressecção curativa e na prevenção de complicações intraoperatórias. OBJETIVO: Analisar o aprendizado em ESD em treinamentos de curta duração através da avaliação da profundidade de submucosa ressecada; e sua associação com complicações. MÉTODOS: Estudo experimental; incluídos 25 endoscopistas com experiência em procedimentos terapêuticos (> 5anos) e 75 peças ressecadas por ESD sendo uma média de três resseções por endoscopista. Os parâmetros de aprendizagem (tempo de ressecção, tamanho, taxa de ressecção em bloco, sangramento, perfuração e análise histológica da camada submucosa) foram prospectivamente avaliados. A percentagem de profundidade de submucosa ressecada foi calculada. RESULTADOS: Todas as ressecções foram realizadas no corpo gástrico (n=75). O tamanho médio das peças ressecadas foi de 23,97±7,2 mm. O número de complicações como sangramento, perfuração e morte foram respectivamente, 17 (22,67%), 3 (4%) e 0 casos. Na terceira dissecção, tempo médio do procedimento diminuiu de 28,44±9,73 para 18,72±8,81 minutos (P<0,001). O grupo que teve sangramento durante o procedimento ressecou 37,97%±21,13% da camada submucosa e o grupo sem sangramento ressecou 68,66%±23,99%, demonstrando uma associação significante entre a profundidade de dissecção submucosa e a incidência de sangramento (P<0,001). De acordo com a análise de curva ROC, o valor de corte da profundidade de submucosa ressecada para a ocorrência de sangramento é de 61% (64% sensibilidade, 94% especificidade), logo quando o ESD é realizado em uma profundidade maior do que 61% da camada submucosa o risco de sangramento durante o procedimento diminui (VPP=0,97; IC95%:0,85-0,99). CONCLUSÃO: O modelo de treinamento de curta duração possibilitou um aprendizado da técnica de ESD mostrando uma melhora cognitiva dos alunos já na terceira dissecção. Existe uma associação significativa entre a profundidade de ressecção da submucosa com o risco de sangramento.

Assuntos

Animais , Masculino , Feminino , Modelos Animais , Ressecção Endoscópica de Mucosa/educação , Ressecção Endoscópica de Mucosa/efeitos adversos , Mucosa Gástrica/cirurgia , Valores de Referência , Suínos , Inquéritos e Questionários , Reprodutibilidade dos Testes , Fatores de Risco , Curva ROC , Perda Sanguínea Cirúrgica , Competência Clínica , Estatísticas não Paramétricas , Curva de Aprendizado , Ressecção Endoscópica de Mucosa/métodos , Complicações Intraoperatórias

RESUMO

We report the case of a female Shih-Tzu dog with chronic vomiting and hematemesis not responsive to symptomatic treatment. Due to the non-specific clinical signs, the patient underwent endoscopy and biopsy of the gastric mucosa. Histopathological analysis revealed atrophic gastritis, a disease rarely reported in dogs and characterized by the destruction of parietal cells of the mucosa and their replacement by fibrosis. This analysis allowed an adequate treatment based on the administration of corticosteroids by the anti-inflammatory effects and action in the regeneration of parietal cells, associated with a soft, hypoallergenic diet formulated with a low fat content, low digestible fibers, and high contents of complex carbohydrates, which resulted in the resolution of the clinical condition in a few weeks. In a second endoscopy, performed after eight months of treatment, the gastric mucosa presented a pink color, regardless of the degree of distension, no lesions or discontinuity points. Fragments were collected for histopathological analysis, which confirmed the recovery of gastric lesions and restoration of the macroscopically healthy mucosa. Most gastric diseases require histological analysis for a definitive diagnosis. In this context, endoscopy has brought unquestioned benefits to the patient since it allowed an accurate diagnosis with a quick and safe collection of gastri

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Relata-se o caso de uma cadela da raça Shih-Tzu com vômito crônico e hematêmese não responsivos ao tratamento sintomático. Devido aos sinais clínicos inespecíficos, a paciente foi submetida à endoscopia e biópsia da mucosa gástrica. A análise histopatológica revelou gastrite atrófica, doença raramente reportada em cães e caracterizada pela destruição das células parietais da mucosa e sua substituição por fibrose. Esta análise possibilitou o tratamento adequado, embasado na administração de corticosteróides, pelos efeitos antiinflamatórios e pela atuação na regeneração das células parietais, associada a uma dieta leve, hipoalergênica, formulada com baixos teores de gordura, pobre em fibras digeríveis e altos teores de carboidratos complexos, que resultou na resolução do quadro clínico em poucas semanas. Em uma segunda endoscopia, realizada após oito meses de tratamento, a mucosa gástrica se apresentava de coloração rósea, independentemente do grau de distensão, sem lesões ou pontos de descontinuidade. Foram colhidos fragmentos para análise histopatológica, que confirmou a recuperação das lesões gástricas e restabelecimento de mucosa macroscopicamente saudável. A maioria das doenças gástricas necessita de análise histológica para o diagnóstico definitivo. Neste contexto, a endoscopia trouxe benefícios incontestes à paciente

RESUMO

We report the case of a female Shih-Tzu dog with chronic vomiting and hematemesis not responsive to symptomatic treatment. Due to the non-specific clinical signs, the patient underwent endoscopy and biopsy of the gastric mucosa. Histopathological analysis revealed atrophic gastritis, a disease rarely reported in dogs and characterized by the destruction of parietal cells of the mucosa and their replacement by fibrosis. This analysis allowed an adequate treatment based on the administration of corticosteroids by the anti-inflammatory effects and action in the regeneration of parietal cells, associated with a soft, hypoallergenic diet formulated with a low fat content, low digestible fibers, and high contents of complex carbohydrates, which resulted in the resolution of the clinical condition in a few weeks. In a second endoscopy, performed after eight months of treatment, the gastric mucosa presented a pink color, regardless of the degree of distension, no lesions or discontinuity points. Fragments were collected for histopathological analysis, which confirmed the recovery of gastric lesions and restoration of the macroscopically healthy mucosa. Most gastric diseases require histological analysis for a definitive diagnosis. In this context, endoscopy has brought unquestioned benefits to the patient since it allowed an accurate diagnosis with a quick and safe collection of gastri

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Relata-se o caso de uma cadela da raça Shih-Tzu com vômito crônico e hematêmese não responsivos ao tratamento sintomático. Devido aos sinais clínicos inespecíficos, a paciente foi submetida à endoscopia e biópsia da mucosa gástrica. A análise histopatológica revelou gastrite atrófica, doença raramente reportada em cães e caracterizada pela destruição das células parietais da mucosa e sua substituição por fibrose. Esta análise possibilitou o tratamento adequado, embasado na administração de corticosteróides, pelos efeitos antiinflamatórios e pela atuação na regeneração das células parietais, associada a uma dieta leve, hipoalergênica, formulada com baixos teores de gordura, pobre em fibras digeríveis e altos teores de carboidratos complexos, que resultou na resolução do quadro clínico em poucas semanas. Em uma segunda endoscopia, realizada após oito meses de tratamento, a mucosa gástrica se apresentava de coloração rósea, independentemente do grau de distensão, sem lesões ou pontos de descontinuidade. Foram colhidos fragmentos para análise histopatológica, que confirmou a recuperação das lesões gástricas e restabelecimento de mucosa macroscopicamente saudável. A maioria das doenças gástricas necessita de análise histológica para o diagnóstico definitivo. Neste contexto, a endoscopia trouxe benefícios incontestes à paciente

RESUMO

We report the case of a female Shih-Tzu dog with chronic vomiting and hematemesis not responsive to symptomatic treatment. Due to the non-specific clinical signs, the patient underwent endoscopy and biopsy of the gastric mucosa. Histopathological analysis revealed atrophic gastritis, a disease rarely reported in dogs and characterized by the destruction of parietal cells of the mucosa and their replacement by fibrosis. This analysis allowed an adequate treatment based on the administration of corticosteroids by the anti-inflammatory effects and action in the regeneration of parietal cells, associated with a soft, hypoallergenic diet formulated with a low fat content, low digestible fibers, and high contents of complex carbohydrates, which resulted in the resolution of the clinical condition in a few weeks. In a second endoscopy, performed after eight months of treatment, the gastric mucosa presented a pink color, regardless of the degree of distension, no lesions or discontinuity points. Fragments were collected for histopathological analysis, which confirmed the recovery of gastric lesions and restoration of the macroscopically healthy mucosa. Most gastric diseases require histological analysis for a definitive diagnosis. In this context, endoscopy has brought unquestioned benefits to the patient since it allowed an accurate diagnosis with a quick and safe collection of gastri

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Relata-se o caso de uma cadela da raça Shih-Tzu com vômito crônico e hematêmese não responsivos ao tratamento sintomático. Devido aos sinais clínicos inespecíficos, a paciente foi submetida à endoscopia e biópsia da mucosa gástrica. A análise histopatológica revelou gastrite atrófica, doença raramente reportada em cães e caracterizada pela destruição das células parietais da mucosa e sua substituição por fibrose. Esta análise possibilitou o tratamento adequado, embasado na administração de corticosteróides, pelos efeitos antiinflamatórios e pela atuação na regeneração das células parietais, associada a uma dieta leve, hipoalergênica, formulada com baixos teores de gordura, pobre em fibras digeríveis e altos teores de carboidratos complexos, que resultou na resolução do quadro clínico em poucas semanas. Em uma segunda endoscopia, realizada após oito meses de tratamento, a mucosa gástrica se apresentava de coloração rósea, independentemente do grau de distensão, sem lesões ou pontos de descontinuidade. Foram colhidos fragmentos para análise histopatológica, que confirmou a recuperação das lesões gástricas e restabelecimento de mucosa macroscopicamente saudável. A maioria das doenças gástricas necessita de análise histológica para o diagnóstico definitivo. Neste contexto, a endoscopia trouxe benefícios incontestes à paciente, pois possibilitou o diagnóstico preciso com colheita de