RESUMO
La enteritis eosinofílica, es una patología rara, caracterizada por infiltración de eosinófilos en una o más capas histológicas en diferentes niveles del tracto gastrointestinal, siendo el estómago e intestino delgado los más afectados; su cuadro clínico, inespecífico, caracterizado por dolor abdominal, náusea, vómito, diarrea o estreñimiento, pérdida de peso y ascitis, con presencia o ausencia de eosinofilia en la biometría. Reporte de caso Paciente masculino de 51 años de edad, acudió a emergencia por distensión abdominal y náusea, al examen físico en la palpación intenso dolor y distención abdominal, percusión timpánico y abolición de ruidos hidroaéreos. La analítica reportó leucocitosis con neutrofilia, radiografía de abdomen íleo adinámico, en la ecografía abdominal presencia de imágenes tubulares con aspecto de diana, asociado a líquido libre purulento en fosa ilíaca derecha y fondo de saco vésico rectal. Un cuadro clínico compatible con abdomen agudo de resolución quirúrgica, se realizó laparotomía exploratoria (AU);
The eosinophilic enteritis is a rare pathology, characterized by infiltration of eosinophils in one or more histological layers at different levels of the gastrointestinal tract, the stomach and small intestine being the most affected; its nonspecific clinical picture, characterized by abdominal pain, nausea, vomiting, diarrhea or constipation, weight loss and ascites, with the presence or absence of eosinophilia in the biometry. Enteritis eosinofílica, una causa extraña de abdomen agudo. reporte de caso clínico Eosinophilic enteritis, a strange cause of acute abdomen year-old male patient came to the emergency room due to abdominal distention and nausea, to physical examination on palpation, intense abdominal pain and distention, tympanic percussion and abolition of air-fluid sounds. Laboratory analysis reported leukocytosis with neutrophilia, abdominal ileus adynamic radiography, abdominal ultrasound presence of tubular images with a target appearance, associated with free purulent fluid in the right iliac fossa and rectal vesicum fundus. A clinical picture compatible with an acute abdomen with surgical resolution, an exploratory laparotomy was performed (AU);
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Enterite/complicações , Eosinofilia/complicações , Abdome Agudo/etiologia , Enterite/cirurgia , Enterite/diagnóstico por imagem , Eosinofilia/cirurgia , Eosinofilia/sangue , Abdome Agudo/cirurgia , Abdome Agudo/diagnóstico por imagemRESUMO
RESUMEN Se expone el caso de un paciente de 40 años con diagnóstico de granulomatosis eosinofílica con poliangeítis subyacente a una rinosinusitis crónica recalcitrante. Se describe el caso y se discuten aspectos relevantes de la literatura al respecto.
ABSTRACT We report the case of a 40-year-old man with diagnosis of chronic recalcitrant rhino-sinusitis secondary to eosinophilic granulomatosis with polyangiitis. We described the case and discuss relevant aspects of the literature about it.
Assuntos
Sinusite/cirurgia , Sinusite/terapia , Rinite/cirurgia , Rinite/terapia , Granulomatose com Poliangiite/cirurgia , Granulomatose com Poliangiite/terapia , Eosinofilia/cirurgia , Eosinofilia/terapia , Sinusite/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Rinite/diagnóstico por imagem , Granulomatose com Poliangiite/diagnóstico por imagem , Eosinofilia/diagnóstico por imagemRESUMO
BACKGROUND: Eosinophilic enteritis is a rather rare condition characterized by infiltration of the gastrointestinal tract by eosinophils; as a casue of acute abdomen it is really exceptional. The etiology is unclear and its description in the literature is sparse, but associations have been made with collagen vascular disease, inflammatory bowel disease, food allergy and parasitic infections as it was confirmed in one of our pathologic studies. CLINICAL CASES: From 1997 to 2011 six cases of eosinophilic enteritis that involved a small bowel segment were diagnosed. A partial resection by an irreversible necrosis was necessary in three of them; in the other three only a biopsy was necessary due to the inflammatory aspect of the affected loop causing the acute abdomen. CONCLUSIONS: Eosinophilic enteritis can originate acute abdomen processes where an urgent surgical treatment is necessary. The intraoperative aspect can be from a segment of small bowel with inflammatory signs up to a completely irrecoverable loop, where removing of the affected segment is the correct treatment, which can be done laparoscopically.
Antecedentes: la enteritis eosinofílica es un padecimiento raro y los casos de abdomen agudo que origina suponen un mínimo porcentaje. Su etiología aún no está aclarada pero se asocia con enfermedades del colágeno, intolerancias alimentarias e infestaciones por parásitos, como anisakis, descubierto en una de las histologías de nuestros casos. Casos clínicos: de 1997 a 2011 se diagnosticaron seis casos de abdomen agudo; en tres de ellos la enteritis eosinofílica causó necrosis irreversible de un segmento intestinal y hubo que practicar una resección intestinal segmentaria. En dos de ellos había un segmento intestinal con aspecto inflamatorio, que fue el único hallazgo causante del cuadro agudo y en los que sólo se practicó biopsia y otro caso donde fue un hallazgo sin relación con el proceso agudo. Conclusiones: la enteritis eosinofílica puede ocasionar cuadros de abdomen agudo que requieren intervención quirúrgica urgente. El aspecto intraoperatorio es el de un segmento con aspecto inflamatorio que puede llegar a ser macroscópicamente irreversible y donde sólo la resección parcial es el tratamiento correcto, que puede hacerse por vía laparoscópica.
Assuntos
Abdome Agudo/etiologia , Enterite/complicações , Eosinofilia/complicações , Gastrite/complicações , Adulto , Anastomose Cirúrgica , Anisaquíase/complicações , Anisaquíase/diagnóstico , Anisaquíase/parasitologia , Anisaquíase/cirurgia , Apendicite/diagnóstico , Biópsia , Diagnóstico Diferencial , Emergências , Enterite/diagnóstico , Enterite/patologia , Enterite/cirurgia , Eosinofilia/diagnóstico , Eosinofilia/patologia , Eosinofilia/cirurgia , Feminino , Gastrite/diagnóstico , Gastrite/patologia , Gastrite/cirurgia , Humanos , Íleo/irrigação sanguínea , Íleo/cirurgia , Pseudo-Obstrução Intestinal/etiologia , Isquemia/etiologia , Isquemia/cirurgia , Masculino , Pessoa de Meia-Idade , Necrose , Peritonite/complicações , Complicações Pós-Operatórias/etiologia , Estudos RetrospectivosRESUMO
Eosinophilic cholecystitis is a rare disease with clinical presentation similar to acute cholecystitis. The diagnosis is based on typical symptoms of acute cholecystitis with presence of more than 90% eosinophilic infiltration within the gallbladder wall. The case of a 27-year-old woman with periodic epigastric pain during ten years is presented. Routine and Boyden s technique biliary ultrasounds were normal. Hepatobiliary scintigraphy showed delayed gallbladder empty and patient underwent endoscopic sphinterotomy. Laparoscopic cholecystectomy was performed with uneventful postoperative course. Histopathologic examination of the gallblader demonstrated infiltration with eosinophils, consistent with acute eosinophilic cholecystitis.
Assuntos
Colecistite , Eosinofilia , Adulto , Colecistite/diagnóstico , Colecistite/cirurgia , Eosinofilia/diagnóstico , Eosinofilia/cirurgia , Feminino , HumanosRESUMO
Eosinophilic ulcer of the oral mucosa is a benign, rare, self-limiting, and generally asymptomatic lesion that shows spontaneous regression. Its etiopathogenesis is still uncertain, but trauma seems to play a fundamental role in the occurrence of this tumor. Clinically, this lesion manifests as an isolated ulcer preferentially located on the tongue, showing a raised and indurated border in addition to a white or yellowish bed. Microscopically, eosinophilic ulcer is characterized by an inflammatory infiltrate rich in leukocytes. Since these lesions show spontaneous cure, treatment becomes unnecessary, but in certain cases, cure is obtained by excision of the ulcer during biopsy. In these cases, the differential diagnosis with squamous cell carcinoma is made. A case of very small eosinophilic ulcer of the oral mucosa located on the lateral border of the tongue is presented.
Assuntos
Carcinoma de Células Escamosas/patologia , Eosinofilia/patologia , Neoplasias Bucais/patologia , Úlceras Orais/patologia , Doenças da Língua/patologia , Diagnóstico Diferencial , Eosinofilia/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Úlceras Orais/cirurgia , Doenças da Língua/cirurgiaRESUMO
Ulceration is a complication that may occur after an ileocolonic anastomosis. Most of the etiologies remain speculative. The case of a 33-year-old woman with eosinophilic colitis is reported, in whom a colectomy with an ileocolonic anastomosis was performed. After four months, the patient presented with a stenosis in the ileocolonic anastomosis, necessitating surgical restoration. Four weeks later, the patient presented with rectal bleeding, and a colonoscopy showed an ulcer in the anastomosis. Collagen-polyvinylpyrrolidone was applied into and on the surface of the ulcer, and five days later the procedure was repeated. Follow-up endoscopies at seven days and three months showed complete healing of the ulcer and the patient remained without bleeding throughout a further four weeks of follow-up tests. It was concluded that this biological product could be an excellent treatment for these lesions.