Assuntos
Úlcera Péptica/diagnóstico , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Úlcera Duodenal/diagnóstico , Endoscopia , Feminino , Gastrite/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/diagnóstico por imagem , Estudos Prospectivos , Radiografia , Neoplasias Gástricas/diagnóstico , Úlcera Gástrica/diagnósticoRESUMO
Se presenta un estudio de 100 pacientes adultos con sintomatologia ulcerosa cronica, en donde se compara en forma prospectiva, la eficacia del diagnostico endoscopico con la del diagnostico radiologico.La metodologia fue disenada de tal manera que ningun metodo tuviese ventaja sobre el otro. Participaron en el estudio especialistas de las siguientes disciplinas: gastroenterologia, radiologia, patologia y cirugia. Sirvieron como diagnostico definitivo la biopsia, la fotografia endoscopica y la biopsia quirurgica cuando fue posible realizarla. Los resultados muestran que la endoscopia tuvo un 98% de eficacia para aclarar la etiologia del sindrome y que la radiologia lo logro en el 61% de los casos. La radiologia presento falsas negativas y falsas positivas ademas de hallazgos indefinidos; la endoscopia presento una falsa negativa y una falsa positiva. Como informacion adicional util para el manejo del paciente, la radiologia aporto datos en el 8% de los casos y la endoscopia en el 19% de los casos. Los diagnosticos finales correspondieron a: ulcera duodenal 31 casos, ulcera gastrica 25 casos, gastritis 13, carcinoma gastrico 10, esofagitis 6, ulcera pilorica 5, duodenitis 5 y 5 casos normales. Concluimos que la endoscopia es el metodo mas confiable en el paciente con sindrome ulceroso y se propone como el estudio de eleccion, aun cuando no exista informacion radiologica para el endoscopista
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Úlcera Duodenal , Úlcera GástricaRESUMO
In our Service of Gastroenterology (Hospital Colonia) there were 16 patients in whom surgical plastic repair of the biliary tract was done. Out of these, the files of 11 were reviewed; national and international related medical literature is reviewed. In all cases the lesion was related to previous surgery. The main symptoms were: jaundice, acolia, coluria and pain. Laboratory tests were of help in preoperelative diagnosis and postoperative follow up. Operative findings were section and or ligature of the hepatic duct or the common bile duct. In 6 patients and end to end anastomosis was made, in 4 cases a biliary-digestive tract anastomosis and in one case an internal fistula was closed and common bile dilatation performed. In 8 patients results were considered good, in 2 they were bad, and one case was lost. There were complications in 6 patients, these consisted in wound infections and pneumonia. Four patients were reoperated, one because of a residual common bile duct stone one because of stenosis and two because of insuficient treatment at the first operation. Patients were followed from 6 months to 15 years. The tube was left for more than 11 months in 70% of the cases. There was no immediate mortality. One patient died after 4 years of secundary biliary cirrhosis.