RESUMO
Introducción: La Strongyloidiasis es una parasitosis intestinal producida por un nematodo de distribución mundial, es endémica en zonas tropicales. Los métodos convencionales de diagnósticos suelen no ser lo suficientemente sensibles ni específicos. La endoscopia ha aumentado la sensibilidad de realizar mejores diagnósticos. Así es como la biopsia gástrica y/o duodenal juegan un rol importantísimo y se considera que los hallazgos endoscópicos son útiles como marcadores de severidad de la infección y obtención del agente etiológico. Objetivos: Realizar una revisión bibliográfica sobre la fisiopatogénesis y signo sintomatología del Strongyloides Stercoralis. Demostrar la utilidad de la endoscopía para evaluar inmenidad o daño de la mucosa duodenal como signo directo de organicidad y como método de obtención de muestras con el fin de realizar la observación directa del agente patógeno causal. Material y Método: Estudio observacional. Transversal. Retrospectivo. Se tuvieron en cuenta las endoscopías realizadas en el Servicio de Endoscopía del Hospital Español de Buenos Aires desde junio de 2016 a junio 2018. Resultados: Se realizaron 5286 estudios endoscópicos que constituyeron el 100% de la muestra. El 0,0189% (1 una endoscopía) de las endoscopías realizadas correspondieron a duodenitis inespecífica asociada a estudio anatomopatológico que confirma parasitosis intestinal por Strongiloidesis stercolaris. Discusión: Los principales síntomas clínicos de presentación de este nematodosis son náuseas, vómitos, anorexia, diarrea, pérdida de peso, y dolor abdominal, que frecuentemente confunden la etiología e imitan los síntomas de otras enfermedades, como en el caso de nuestro paciente. Tener en cuenta signosintomatologia atípica como refiere la World Gastroenterology Organization en su Practice Guidelines aumenta la sospecha diagnóstica Conclusión: La endoscopia digestiva alta es una herramienta diagnostica muy útil cuando la signo sintomatología no es muy clara. Una de las principales claves para hacer el diagnostico es tener un indicio de sospecha.
ntroduction: Strongyloidiasis is an intestinal parasitosis produced by a nematode of worldwide distribution, endemic in tropical areas., The conventional methods of diagnosis are usually not sensitive or specific enough. Endoscopy has increased the sensibility of making better diagnoses, as well as gastric and / or duodenal biopsy; plays a very important role and it is considered that the endoscopic findings are useful as markers of infection severity and in obtaining the etiological agent. Objectives: Carrying out a bibliographic review on the pathogenesis and signosyntomathology of Strongyloides Stercorali symptomatology. To demonstrate the usefulness of endoscopy to evaluate indemnity or damage of the duodenal mucosa as a direct sign of organicity and as a simple obtaining method in order to perform direct observation of the causative pathogen. Materials and Methods: Observational study. Cross. Retrospective. Endoscopies performed at the Endoscopy Service of the Hospital Español de Buenos Aires from June 2016 to June 2018 were taken into account. Results: There were 5286 endoscopic studies that constituted 100% of the sample. The 0.0189% (1 endoscopy) of the endoscopies performed corresponded to nonspecific duodenitis associated with an anatomopathological study that confirmed intestinal parasites by Strongiloidesis stercolaris. Discussion: The main clinical symptoms of this nematode are nausea, vomiting, anorexia, diarrhea, weight loss, and abdominal pain that frequently confuse the etiology and mimic the symptoms of other diseases, as in the case of our patient. Taking into account atypical signs and symptoms as the World Gastroenterology Organization refers in its Practice Guidelines increases diagnostic suspicion Conclusion: Upper digestive endoscopy is a very useful diagnostic tool when the signs and symptoms are not very clear. One of the main keys to make the diagnosis is to have an indication of diagnostic suspicion
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Endoscopia , Enteropatias Parasitárias/diagnóstico por imagem , Enteropatias Parasitárias/diagnósticoAssuntos
Enteropatias Parasitárias/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Estrongiloidíase/diagnóstico por imagem , Humanos , Enteropatias Parasitárias/parasitologia , Intestino Delgado/parasitologia , Masculino , Radiografia , Índice de Gravidade de Doença , Adulto JovemRESUMO
The aim of this study was to compare portal and splenic blood flows and the liver morphology in hepatosplenic (HS) and hepatointestinal (HI) schistosomiasis. Doppler ultrasound measurements were performed in 48 adult patients with schistosomiasis, according to the criteria of the World Health Organization, and compared with those performed in 20 healthy controls. Portal flow was significantly higher (P < 0.0001) in both HS and HI (2481 +/- 1467 and 2159 +/- 1446 ml/min, respectively) than in normal individuals (842 +/- 322 ml/min). There was no difference in splenic blood flow (822 +/- 685 and 458 +/- 292 ml/min, respectively) between HS and HI, but these values were significantly higher than those of normal controls (243 +/- 94 ml/min). Portal and splenic overflow are found in both the HS and the HI forms of schistosomiasis.
Assuntos
Hipertensão Portal/fisiopatologia , Enteropatias Parasitárias/fisiopatologia , Circulação Hepática/fisiologia , Hepatopatias Parasitárias/fisiopatologia , Esquistossomose mansoni/fisiopatologia , Esplenopatias/fisiopatologia , Ultrassonografia Doppler , Adulto , Animais , Velocidade do Fluxo Sanguíneo/fisiologia , Fezes/parasitologia , Feminino , Humanos , Hipertensão Portal/diagnóstico por imagem , Hipertensão Portal/etiologia , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/diagnóstico por imagem , Hepatopatias Parasitárias/complicações , Hepatopatias Parasitárias/diagnóstico por imagem , Masculino , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/complicações , Esquistossomose mansoni/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Esplenopatias/parasitologiaRESUMO
OBJECTIVES: This study presents seven cases of severe hepatobiliary and pancreatic complications of ascariasis in children. The authors describe the clinical, laboratory, and imaging findings, as well as the patients' clinical evolution. METHODS: These cases were studied within a period of approximately 1 year and included children younger than 11 years (mean age, 4.4 years). The authors reviewed their medical history and evaluated the results of their main diagnostic examinations. RESULTS: All of the patients had vomiting, abdominal pain, pallor, and abdominal distension at presentation. Passage of Ascaris lumbricoides in stool occurred in five cases, emesis with worms in three, fever in three, and hepatomegaly in two. Five patients had pancreatitis, of which two were necrohemorrhagic and one had pseudocyst of the pancreas. In three patients, A. lumbricoides was present in the pancreatic duct. Two patients had hepatic abscess (28.6%), and one of them also had cholangitis. One of the patients with pancreatitis also had signs of cholecystitis at presentation. CONCLUSIONS: Ultrasonography was the imaging diagnostic method of choice and demonstrated the presence of A. lumbricoides in the biliary and the pancreatic ducts, as well as signs of pancreatitis, cholecystitis, and hepatic abscess. Endoscopic retrograde cholangiopancreatography, used to confirm the diagnosis, was a fundamental procedure in the treatment, allowing the removal of worms from the biliary duct in four of seven patients.
Assuntos
Ascaríase/complicações , Ascaris lumbricoides/isolamento & purificação , Doenças Biliares/diagnóstico , Fígado/parasitologia , Pâncreas/parasitologia , Pancreatopatias/diagnóstico , Dor Abdominal/etiologia , Animais , Ascaríase/diagnóstico , Doenças Biliares/parasitologia , Criança , Pré-Escolar , Fezes/parasitologia , Feminino , Humanos , Lactente , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/diagnóstico por imagem , Fígado/diagnóstico por imagem , Fígado/patologia , Masculino , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , Pancreatopatias/parasitologia , Ultrassonografia , Vômito/etiologiaRESUMO
The author presents a clinical and anatomopathologic study of six cases of abdominal angiostrongyloidiasis seen in the southeast part of the state of Paraná and western part of the state of Santa Catarina--Brazil. The importance of the disease, in our region is such that it should be considered in the differential diagnosis of acute abdominal conditions in children and adults. The number of cases in the last two years have increased probably related to the extensive use of pesticides on corps.
Assuntos
Enteropatias Parasitárias/diagnóstico , Infecções por Nematoides/diagnóstico , Abdome Agudo/etiologia , Adulto , Idoso , Angiostrongylus/isolamento & purificação , Animais , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Enteropatias Parasitárias/diagnóstico por imagem , Enteropatias Parasitárias/patologia , Masculino , Pessoa de Meia-Idade , Infecções por Nematoides/diagnóstico por imagem , Infecções por Nematoides/patologia , RadiografiaRESUMO
Chagas' disease is caused by Trypanosoma cruzi, a protozoan parasite that infects an estimated 10 to 12 million Latin Americans. Because infection is often lifelong, individuals from endemic areas may develop symptomatic chronic Chagas' disease years after emigrating to the United States. We report three immigrant patients from Latin America who illustrate the indeterminate phase and the symptomatic cardiac and gastrointestinal syndromes of this illness.