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Ileocolic Intussusception Prolapsing from the Rectum in von Recklinghausen's Disease

Surgical Science 2012年第8期3卷 421-423页

作者： Marlén Alvite Canosa Leticia Alonso Fernández Lucía Dorado Castro Rocío González López Ana álvarez Gutiérrez inmaculada monjero ares José Conde Vales Félix Arija Val General surgery department of Hospital Universitario Lucus Augusti Lugo Spain

Intussusception is a paediatric condition that rarely presents in adults. We report an exceptional case of ileocolic intussusception prolapsing from the rectum in an adult with Von Recklinghausen′s disease. A 31-year-old man with von Recklinghausen′s disease presented to emergency department with a history of severe abdominal pain, vomits and rectal bleeding. Abdominal computed tomography showed intestinal obstruction probably due to a sigmoidorectal intussusception. Ileum, appendix, cecum and ascending colon were found to be intussuscepting through transverse, descending and sigmoid colon and prolapsing from the rectum during an emergent laparotomy. A right hemicolectomy was performed. An anatomical pathology examination revealed a neurofibroma of the appendix as lead point for intussusception. Intussusception in adults requires early surgical resection regardless of the nature of the initial case. Neurofibroma of the appendix is very rare;although it is benign, prompt resection is recommended because of a high risk of appendicitis and malignant transformation.

关键词： Adult Intussusceptions Neurofibromatosis Von Recklinghausen′s Disease Appendiceal Neurofibroma

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Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients

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World Journal of Gastroenterology 2009年第38期15卷 4781-4787页

作者： Antonio Diaz-Sanchez Oscar Nuez-Martinez Cecilia Gonzalez-Asanza Ana Matilla Beatriz Merino Diego Rincon inmaculada Beceiro Maria Vega Catalina Magdalena Salcedo Rafael Baares Gerardo Clemente Liver Unit-CIBEREHD.Hospital General Universitario Gregorio Maraón Madrid 28007Spain Gastroenterology Unit Hospital Infanta Leonor Gastroenterology Unit Hospital Infanta Sofia Department of Gastroenterology Hospital Universitario Príncipe de Asturias

AIM： To assess the prevalence of portal hypertension （PH） related colorectal lesions in liver transplant candidates, and to evaluate its association with the severity of PH. METHODS： Between October 2004 and December 2005, colonoscopy was performed in 92 cirrhotic liver transplant candidates. We described the lesions resulting from colorectal PH and their association with the grade of PH in 77 patients who underwent measurement of hepatic venous pressure gradient （HVPG）. RESULTS： Mean age was 55 years and 80.7% of patients were men. The main etiology of cirrhosis wasalcoholism （45.5%）. Portal hypertensive colopathy （PHC） was found in 23.9%, colonic varices in 7.6% and polyps in 38% of patients （adenomatous type 65.2%）. One asymptomatic patient had a well-differentiated adenocarcinoma. The manifestations of colorectal PH were not associated with the etiology of liver disease or with the Child-Pugh grade. Ninety percent of patients with colopathy presented with gastroesophageal varices （GEV）, and 27.5% of patients with GEV presented with colopathy （P = 0.12）. A relationship between higher values of HVPG and presence of colopathy was observed （19.9：1：6.2 mmHg vs 16.8 ± 5.4 mmHg, P = 0.045）, but not with the grade of colopathy （P = 0.13）. Preneoplastic polyps and neoplasm （P = 0.02） and spontaneous bacterial peritonitis （P = 0.006） were more prevalent in patients with colopathy. We did not observe any association between previous β-blocker therapy and the presence of colorectal portal hypertensive vasculopathy. CONCLUSION： PHC is common in cirrhotic liver transplant candidates and is associated with higher portal pressure.

关键词： Liver cirrhosis Portal hypertension Polyps Colopathy Liver transplantation

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Community‑based screening of Chagas disease among Latin American migrants in a non‑endemic country: an observational study

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Infectious Diseases of Poverty 2021年第5期10卷 14-27页

作者： Violeta Ramos‑Sesma Miriam Navarro Jara Llenas‑García Concepción Gil‑Anguita Diego Torrus‑Tendero Philip Wikman‑Jorgensen María García‑López Concepción Amador‑Prous María‑Paz Ventero‑Martín Pedro Guevara‑Hernández Ana Garijo‑Saiz ares Sanchez‑Sanchez Cristina Bernal‑Alcaraz Ana‑Isabel Pujades‑Tarraga Roser Muñoz‑Perez María Flores‑Chávez José‑Manuel Ramos‑Rincón Internal Medicine Service HLA Inmaculada HospitalGranadaSpain Public Health Science History and Gynecology DepartmentUniversidad Miguel Hernández de ElcheAlicanteSpain Epidemiology Unit Public Health Center of Elche AlicanteSpain Internal Medicine Department Hospital Vega Baja de Orihuela(AlicanteSpain)-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region(FISABIO)AlicanteSpain Clinical Medicine Department University Miguel Hernández of ElcheSant Joan d’AlacantSpain Internal Medicine Department Hospital Marina BaixaLa Vila Joiosa(AlicanteSpain)-FISABIOAlicanteSpain Internal Medicine Department General University Hospital of Alicante–Biomedical and Health Research Institute of Alicante(ISABIAL)AlicanteSpain Parasitology Area University Miguel Hernández of ElcheSant Joan d’AlacantSpain Internal Medicine Department University Hospital of Sant Joan(Sant Joan d’AlacantSpain)–FISABIOAlicanteSpain Microbiology Service General University Hospital of Alicante–ISABIALAlicanteSpain Pediatric Department General University Hospital of Alicante–ISABIALAlicanteSpain Digestive Service General University Hospital of Alicante–ISABIALAlicanteSpain Reference and Research Laboratory in Parasitology National Center of Microbiology/Mundo Sano FoundationMadridSpain

Background:Chagas disease is a parasitic disease endemic to Latin America,but it has become a disease of global concern due to migration *** carriers may host the parasite for years,without knowing they are *** aim of this study is to assess prevalence of Chagas disease and evaluate the participants’level of knowl‑edge between Latin American migrants attending a community-based screening ***:Three community-based campaigns were performed in Alicante(Spain)in 2016,2017 and 2018,including educational chats and blood tests for Trypanosoma cruzi *** completed a questionnaire assessing knowledge about the mechanisms of transmission,disease presentation,diagnosis,and *** seroposi‑tive for *** underwent diagnostic confrmation by two diferent *** were analyzed by multivariable logistic regression and expressed as adjusted odds ratios(aORs),adjusting for age,sex,and time in ***:A total of 596 participants were included in the study;17%were aged under 18 *** in adults was 11%[54/496;95%confdence interval(CI):8.3–14.5%]versus 0%among *** but one case were in *** was independently associated with having been born in Bolivia(aOR:102,95%CI:13–781)and a primary school-level education(aOR:2.40,95%CI:1.14–5.06).Of 54 people diagnosed with Chagas disease(most of whom were asymptomatic),42(77.7%)returned to the clinic at least once,and 24(44.4%)received *** analysis showed that coming from Argentina(aOR:13,95%CI:1.61–1188)or Bolivia(aOR:1.90,95%CI:1.19–3.39)and having received information about Chagas disease in Spain(aOR:4.63,95%CI:2.54–8.97)were associ‑ated with a good level of knowledge on the *** primary level studies(aOR:0.59,95%CI:0.34–0.98)and coming from Ecuador(aOR:4.63,95%CI:2.52–847)were independently associated with a lower level of ***:Community-based interventions are a good strategy for diagnosi

关键词： Chagas disease Trypanosoma cruzi Knowledge Community-based intervention Migrant Early diagnosis Screening

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