RESUMO
Sporadic lymphangiectasias are commonly found throughout the small bowel and are considered to be normal. Not uncommonly, lymphangiectasias are pathologic and can lead to mid-gastrointestinal bleeding, abdominal pain and protein-losing enteropathy. Pathologic lymphangiectasias of the small bowel include primary lymphangiectasia, secondary lymphangiectasia and lymphaticovenous malformations. In this report we present three different cases of small bowel lymphangiectasia detected by double balloon enteroscopy. The patients were diagnosed with South American blastomycosis, tuberculosis and primary small bowel lymphangioma.
Assuntos
Cateterismo/métodos , Endoscopia Gastrointestinal/métodos , Linfangiectasia/diagnóstico , Linfangiectasia/terapia , Adulto , Idoso , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/patologia , Humanos , Neoplasias Intestinais/patologia , Intestino Delgado/patologia , Linfangiectasia/complicações , Linfangioma/complicações , Linfangioma/patologia , MasculinoRESUMO
Se presenta el caso de un recién nacido de término, sexo femenino, de 3.380 g de peso al nacer, producto de un embarazo fisiológico de madre sana, que evolucionó desde el primer minuto de vida con insuficiencia respiratoria y respuesta parcial a ventilación con presión positiva y oxígeno. Una radiografía de tórax mostró sombras pulmonares difusas sin cardiomegalia, sospechándose un drenaje venoso pulmonar anómalo total obstructivo, siendo descartado por ecocardiografía. Los gases arteriales demostraron hipoxemia y acidosis metabólica; las radiografías posteriores mostraron hiperinsuflación pulmonar con sombras reticulonodulares difusas. Se planteó el diagnóstico de linfangiectasia pulmonar congénita y se mantuvo el tratamiento para hipertensión pulmonar con ventilación mecánica, drogas vasoactivas y bicarbonato endovenoso, pese a lo cual presentó deterioro hemodinámico progresivo, falleciendo a las 13 horas de vida. La autopsia confirmó el diagnóstico de linfangiectasia pulmonar congénita. Se presenta el caso clínico con sus hallazgos radiológicos, anatomopatológicos y una breve revisión del tema
Assuntos
Humanos , Feminino , Recém-Nascido , Linfangiectasia/congênito , Pneumopatias/congênito , Linfangiectasia/complicações , Linfangiectasia/diagnóstico , Linfangiectasia/terapia , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologiaRESUMO
These are osteolytic type bone lesions conditioned to congenital malformations of the lymphatic system. Most cases become evident during adolescence. At the clinical study, extraosseous lymphatic changes may be found and frequently there is chylous pleural effusion caused by trauma, wounds, surgery or congenital anomalies of the thoracic duct. Pathologic fractures may show the anomaly. Lymphangiectatic lesions studied at the X-rays, especially if they are multiple and affect long bones, flat bones and skull, may show the lesion. Lymphography is used as a clue diagnostic procedure and shows dilated engorged lymph vessels with stagnation of the contrast medium at the cistern of Pecquet. The diagnosis must be clinical and radiological. The prognosis varies according to the extension of the process. Diets rich in proteins are given in the treatment and fractures are managed by orthopedic means.