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Id: lil-497164
Autor: Pereira, Gustavo M; Lira, Patricia.
Título: Ictericia obstructiva / Obstructive Jaundice
Fonte: Med. infant;14(4):303-308, dic. 2007. ilus.
Idioma: es.
Descritores: Ultrassonografia
Cirrose Hepática Biliar/diagnóstico
Hepatopatias/diagnóstico
Icterícia Obstrutiva
Neoplasias de Tecido Muscular/diagnóstico
Neoplasias de Tecido Muscular/terapia
Omento
Limites: Criança
Tipo de Publ: Relatos de Casos
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: biblio-1003839
Autor: Gómez, Martín Alonso; Ruiz, Óscar; Estarita, Javier.
Título: Síndrome de Lemmel documentado con ecoendoscopia / Lemmel's Syndrome Documented with Endoscopic Ultrasound
Fonte: Rev. colomb. gastroenterol;34(1):69-72, ene.-mar. 2019. graf.
Idioma: es.
Resumo: Resumen La ictericia obstructiva es una causa frecuente de consulta en los servicios de urgencias. El síndrome de Lemmel se describe como un síndrome biliar obstructivo secundario a un divertículo duodenal perpipapilar en el que se han descartado otras causas de ictericia obstructiva. Se describe un caso de ictericia obstructiva en una paciente de 84 años, en la que se realiza resonancia magnética y endosonografía biliopancreática que descartan litiasis biliar; posteriormente, es llevada a colangiopancreatografía retrógrada endoscópica (CPRE), en la que se evidencia divertículo peripapilar sin coledocolitiasis, y se realiza papilotomía, luego de la cual la paciente presenta una evolución clínica favorable.

Abstract Obstructive jaundice is a frequent for patients to come to emergency services. Lemmel's syndrome is an obstructive biliary syndrome secondary to a papillary duodenal diverticulum for which other causes of obstructive jaundice have been ruled out. We describe a case of obstructive jaundice in an 84-year-old patient who underwent magnetic resonance imaging and biliopancreatic endosonography to rule out biliary lithiasis. Subsequently, the patient underwent ERCP where the papillary diverticulum was evident and without choledocholithiasis. A papillotomy was performed. Afterwards, the patient's clinical evolution was favorable.
Descritores: Síndrome
Colangiopancreatografia Retrógrada Endoscópica
Icterícia Obstrutiva
Limites: Humanos
Feminino
Idoso de 80 Anos ou mais
Tipo de Publ: Relatos de Casos
Responsável: CO354 - Sociedad Colombiana de Gastroenterología


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Id: biblio-1156337
Autor: Polanía-Liscano, Héctor Adolfo; Jiménez-Sánchez, Héctor Conrado; Polanía-Galindo, David José.
Título: Ultrasonografía endoscópica para el diagnóstico de áscaris biliar: reporte de caso y revisión de la literatura / Endoscopic ultrasound for the diagnosis of biliary ascariasis: case report and literature review
Fonte: Rev. colomb. gastroenterol;35(4):537-541, dic. 2020. tab, graf.
Idioma: es.
Resumo: Resumen Se presenta un caso de áscaris de la vía biliar (AB), cuya manifestación clínica fue ictericia obstructiva, acompañada de dolor abdominal causado por un cuadro de pancreatitis aguda. Inicialmente, se sospechó de etiología litiásica, por lo cual se realizaron estudios de imágenes diagnósticas y se evidenció la presencia de AB como hallazgo incidental, diagnosticado por ultrasonografía endoscópica biliopancreática (UEB), que fue confirmado y tratado mediante colangiopancreatografía retrógrada endoscópica (CPRE).

Abstract The following is a case of biliary ascariasis (BA), whose clinical presentation was obstructive jaundice, accompanied by abdominal pain due to acute pancreatitis. At first, clinical suspicion led to consider a stone etiology, for which diagnostic imaging studies were performed, evidencing BA as an incidental finding diagnosed by endoscopic biliopancreatic ultrasonography (EBU), which was confirmed and treated using endoscopic retrograde cholangiopancreatography (ERCP).
Descritores: Ascaris
Ductos Biliares
Ultrassonografia
Colangiopancreatografia Retrógrada Endoscópica
-Pancreatite
Dor Abdominal
Icterícia Obstrutiva
Literatura
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CO354 - Sociedad Colombiana de Gastroenterología


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Id: biblio-1118243
Autor: Venegas, Josefa; Tapia, Alvaro; Salazar, Carolina; Valdivia, Alejandra; Ortiz, Victor.
Título: Coledocolitiasis múltiples y colangitis en paciente con quiste de colédoco: a propósito de un caso / Multiple choledocholithiasis and cholangitis in a patient with choledochal cyst: a case report
Fonte: Rev. ANACEM (Impresa);9(2):87-92, 2015. ilus.
Idioma: es.
Resumo: INTRODUCCIÓN: El quiste de colédoco (QC) es una patología infrecuente, caracterizada por una dilatación de vía biliar intra o extrahepática. Constituye una lesión congénita, representado 1% de las lesiones biliares benignas. Tiene una incidencia de 1 en 100.000 a 150.000 habitantes. Es más frecuente en mujeres, y su etiología es desconocida. En adultos los síntomas son inespecíficos; predominando dolor abdominal e ictericia. PRESENTACIÓN DEL CASO: Mujer de 61 años con cólico abdominal en hipocondrio derecho de tres días, vómitos e ictericia. Al ingreso hospitalario presentaba leucocitosis, hiperbilirrubinemia, aumento de fosfatasa alcalina, transaminasas y amilasa. Se plantearon los diagnósticos de ictericia obstructiva, pancreatitis y quiste hidatídico complicado, por lo que se realiza tomografía computada (TC) de abdomen evidenciando dilatación sacular intra y extrahepática, compatible con QC tipo IV-a. Se realizó colecistectomía y coledocostomía con sonda T de urgencia por evolución a colangitis con resultados favorables. DISCUSIÓN: Los QC son una causa rara de ictericia obstructiva. En Chile existen escasos datos estadísticos al respecto. Se manifiesta con una sintomatología inespecífica, sobretodo en adultos. El diagnóstico se realiza con hallazgos de laboratorio concordantes con ictericia colestásica, donde los estudios imagenológicos como ultrasonido y TC tienen un rol importante, pese a que en algunas ocasiones pueden pasar inadvertido. Es primordial un alto índice de sospecha para el diagnóstico y un tratamiento oportuno debido a su importante riesgo de progresión a colangiocarcinoma

INTRODUCTION: Choledochal cysts (CCs) is a rare disease characterized by dilatation of the intrahepatic or extrahepatic bile duct, which is about 1% of all benign biliary lesions. Its incidence is 1:100,000 to 150,000 habitants. It is more common in females, and its etiology is unknown. In adults the symptoms are nonspecific, predominantly abdominal pain and jaundice. CASE REPORT: 61 year old female patient with three days of severe abdominal colic in the right upper quadrant, whit both vomiting and jaundice. On admission, she presents leukocytosis, hyperbilirubinemia, and increased levels of alkaline phosphatase, transaminases and amylase. Diagnosis of obstructive jaundice, pancreatitis and complicated hydatid cyst arising. The abdominal CT Scan reveals intra and extrahepatic saccular dilatations, compatible with a type IV-a CCs. Both cholecystectomy and T-tube choledochotomy were done by evolution to cholangitis with favorable results and satisfactory postoperative. DISCUSSION: CCs is a rare cause of obstructive jaundice, and in this regard, there are few data described in Chile, Its diagnosis requires a high index of suspicion because of its nonspecific symptoms found mostly in adults. Despite this, the diagnosis is determined with laboratory findings consistent with cholestatic jaundice and support diagnostic imaging such as ultrasound, CT Scan, among others. Although the imaging findings, it may not be detected. A correct diagnosis and appropriate treatment is essential because of its high risk of progression to cholangiocarcinoma. Currently the patient is waiting for resection of extrahepatic bile duct and Roux-en-Y hepatic jejunostomy which is the optimal treatment.
Descritores: Cisto do Colédoco/cirurgia
Cisto do Colédoco/complicações
Cisto do Colédoco/diagnóstico por imagem
-Colecistectomia
Tomografia Computadorizada por Raios X
Colangite
Coledocolitíase
Icterícia Obstrutiva/etiologia
Hiperbilirrubinemia/etiologia
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CL126.2 - Biblioteca Médica Dr. Profesor Hernán Alessandri R.


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Id: biblio-1157422
Autor: López-P Rocóo del Pilar; Forero Jennifer-Deina; Sierra Fernando.
Título: Ictericia colestásica inducida por metimazol en una paciente con hipertiroidismo / [Methimazole-induced cholestatic jaundice in a hyperthyroid patient].
Fonte: Acta gastroenterol. latinoam;44(1):52-8, 2014 Mar.
Idioma: es.
Resumo: Hyperthyroidism is one of the most frequent endocrine disorders and its current treatment is based on drugs, surgery and radioactive iodine. Methimazole is the antithyroid drug of choice because of its potency and infrequent side effects, usuaIly mild. This medication is rarely associated with liver toxicity, usually manifested as cholestatic jaundice. Here we report the case of a 33-year-old woman treated at the University Hospital Fundación Santa Fe de Bogota, with hepatotoxicity induced by a methimazole-based treatment for Graves' disease. The pruritus and jaundice appeared after three weeks of therapy, viral hepatitis markers were negative, hepatobiliary ultrasonography was normal, and an increase of the levels of alkaline phosphatase, total bilirubin and aminotransferases was found The causal diagnosis of methimazole-induced hepatotoxicity was supported by the results of a liver biopsy. According to the CIOMS scale the score was 10, and the causal relationship of the hepatic adverse reaction by methimazole is highly probable. The clinical course was satisfactory when the medication was suspended, with clinical improvement at 5 days, and normalization of liver tests at 5 weeks. We discuss this case from a diagnostic and therapeutic approach.
Descritores: Antitireóideos/efeitos adversos
Icterícia Obstrutiva/induzido quimicamente
Metimazol/efeitos adversos
-Adulto
Feminino
Hipertireoidismo/tratamento farmacológico
Humanos
Icterícia Obstrutiva/diagnóstico
Tipo de Publ: Relatos de Casos
Resumo em Inglês
Artigo de Revista
Responsável: AR5.1 - Centro de Gestión del Conocimiento y las Comunicaciónes


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Id: biblio-1149922
Autor: Villamil Martínez, Ramón; Pi Osoria, Andrés José; Ramírez Guirado, Alejandro; Pérez Duvergel, Anecio; Betancourt Berriz, Daniela; Silverio García, César; Cobas Torres, Yanisleidys.
Título: Guía de práctica clínica en atresia de las vías biliares / Clinical practice guidelines in biliary atresia
Fonte: Rev. cuba. pediatr;92(4):e1168, oct.-dic. 2020.
Idioma: es.
Resumo: Basada en la mejor evidencia científica disponible, se presenta la guía de práctica clínica en atresia de vías biliares, la cual se define como una obstrucción progresiva de las vías biliares intra- o extrahepáticas en recién nacidos y lactantes pequeños y causa ictericia colestásica grave y cirrosis hepática. Es una enfermedad poco frecuente, de etiología desconocida, con mayor incidencia en países asiáticos. Clínicamente se expresa por ictericia obstructiva, acolia, coluria y hepatoesplenomegalia. Los complementarios expresan una hiperbilirrubinemia directa con aumento de las enzimas hepáticas, y el diagnóstico se confirma en nuestro hospital con la colangiografía, generalmente en el curso de una laparoscopía. El tratamiento es quirúrgico y consiste en la portoenterostomía de Kasai, con mejores resultados en cuanto al drenaje biliar si se realiza antes de los 60 días de vida, así como el trasplante hepático. La enfermedad tiene un curso progresivo hacia la cirrosis hepática en etapas tempranas de la vida, sobre todo si no se realiza el diagnóstico y tratamiento quirúrgico precozmente, con implicaciones en la supervivencia y calidad de vida de estos pacientes. Por tanto, referir precozmente al paciente con sospecha de atresia de vías biliares a un centro especializado es la piedra angular de la actitud médica. La presente guía de práctica clínica pretende ofrecer las herramientas técnicas estandarizadas para mejorar los resultados a los pacientes con esta enfermedad, así como contribuir con la docencia y las investigaciones(AU)

Based on the best scientific evidence available, it is presented the clinical practice guidelines on biliary atresia. This disease is defined as a progressive obstruction of the intra and/or extrahepatic bile ducts in newborns and young infants, causing severe cholestatic jaundice and cirrhosis of the liver. It is a rare disease of unknown etiology, with a higher incidence in Asian countries. It is clinically expressed by obstructive jaundice, acholia, choluria and hepatosplenomegaly. Laboratory tests show a direct hyperbilirubin and elevated liver enzymes, and in our hospital, the diagnosis is confirmed by a cholangiography, usually during a laparoscopy procedure. It has surgical treatment and it involves a Kasai portoenterostomy, with better results regarding biliary drainage if it is performed before 60 days of life, as well as liver transplant. This condition has a progressive course towards liver cirrhosis in early stages of life, mainly if the diagnosis and surgical treatment are not made timely, with implications for the survival and quality of life of these patients. Therefore, early referral of the patient with suspected biliary atresia to a specialized center is the cornerstone of the medical attitude. This clinical practice guidelines aims to offer standardized technical tools to improve the outcome for patients with this disease, as well as to contribute to teaching and research(AU)
Descritores: Atresia Biliar/cirurgia
Atresia Biliar/epidemiologia
Icterícia Obstrutiva/complicações
Cirrose Hepática Biliar/complicações
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Tipo de Publ: Guia de Prática Clínica
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-887256
Autor: Manterola, Carlos; Otzen, Tamara.
Título: Cholangiohydatidosis: an Infrequent Cause of Obstructive Jaundice and Acute Cholangitis
Fonte: Ann. hepatol;16(3):436-441, May.-Jun. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background. One of the evolutionary complications of hepatic echinococcosis (HE) is cholangiohydatidosis, a rare cause of obstructive jaundice and cholangitis. The aim of this study was to describe the results of surgical treatment on a group of patients with cholangiohydatidosis and secondary cholangitis in terms of post-operative morbidity (POM). Material and method. Case series of patients operated on for cholangiohydatidosis and cholangitis in the Department at Surgery of the Universidad de La Frontera and the Clínica Mayor in Temuco, Chile between 2004 and 2014. The minimum follow-up time was six months. The principal outcome variable was the development of POM. Other variables of interest were age, sex, cyst diameter, hematocrit, leukocytes, total bilirubin, alkaline phosphatase and transaminases, type of surgery, existence of concomitant evolutionary complications in the cyst, length of hospital stay, need for surgical re-intervention and mortality. Descriptive statistics were calculated. Results. A total of 20 patients were studied characterized by a median age of 53 years, 50.0% female and 20.0% having two or more cysts with a mean diameter of 13.3 ± 6.3 cm. A median hospital stay of six days and follow-up of 34 months was recorded. POM was 30.0%, re-intervention rate was 10.0% and mortality rate was 5.0%. Conclusion. Cholangiohydatidosis is a rare cause of obstructive jaundice and cholangitis associated with significant rates of POM and mortality.(AU)
Descritores: Colangite/etiologia
Adenoma de Ducto Biliar/patologia
Icterícia Obstrutiva/etiologia
-Cuidados Pós-Operatórios/reabilitação
Procedimentos Cirúrgicos Operatórios/métodos
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: lil-522102
Autor: Echezarreta, E. N; Chaves, S; Dávila, M. T. G de.
Título: Suboclusión intestinal e ictericia colestática / Cholestatic jaundice and intestinal suboclusión
Fonte: Med. infant;5(2):140-145, jun. 1998.
Idioma: es.
Descritores: Icterícia Obstrutiva/etiologia
Icterícia Obstrutiva/terapia
Obstrução Intestinal/complicações
Obstrução Intestinal/etiologia
Limites: Lactente
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: biblio-1123238
Autor: Pereira Graterol, Freddy; Salazar Marcano, Francisco; Venales Barrios, Yajaira.
Título: Síndrome de Mirizzi que simulaba una neoplasia biliar maligna / Mirizzi syndrome simulating a biliary malignant neoplasm
Fonte: Rev. colomb. cir;35(3):507-513, 2020. fig, tab.
Idioma: es.
Resumo: El síndrome de Mirizzi puede cursar con manifestaciones clínicas y hallazgos imagenológicos y de laboratorio, similares a los encontrados en las neoplasias biliares malignas. Se describe el caso de un paciente cuyo enfoque clínico inicial y estudios de imágenes aportaron datos sugerentes de neoplasia de las vías biliares. Los marcadores tumorales (CA 19-9, CEA) resultaron elevados. Una nueva evaluación clínica, la laparoscopia exploradora y la exploración endoscópica de las vías biliares, permitieron establecer el diagnóstico de síndrome de Mirizzi. Después de la extracción del cálculo biliar y de la anastomosis entre el conducto hepático y el yeyuno, el paciente permaneció asintomático. En este caso, la reevaluación clínica y el uso del protocolo adecuado de estudio, contribuyeron a orientar y confirmar el diagnóstico de síndrome de Mirizzi, lo cual determinó la conducta terapéutica más acertada

Mirizzi syndrome can occur with clinical manifestations and imaging and laboratory findings, similar to those found in malignant biliary neoplasms. We describe the case of a patient whose initial clinical approach and imaging studies provided data suggestive of bile duct neoplasia. Tumor markers (CA 19-9, CEA) were high. A new clinical evaluation, an explorative laparoscopy and endoscopic bile duct exploration allowed establish the diagnosis of Mirizzi syndrome. After removal the bile duct stone and to perform an hepatico jejunostomy the patient remained asymptomatic. In this case the clinical reevaluation and the use of the appropriate study proto-col contributed to guide and confirm the diagnosis of Mirizzi syndrome, which determined the most successful therapeutic approach
Descritores: Síndrome de Mirizzi
-Colangiopancreatografia Retrógrada Endoscópica
Procedimentos Cirúrgicos Minimamente Invasivos
Icterícia Obstrutiva
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: CO113


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Id: biblio-833545
Autor: Tinoco, Renam Catarina; Tinoco, Augusto Claudio de A; Sueth, Daniela M; Gentil, Pedro Henrique Alvares.
Título: Tumor de colédoco distal vs. coledocolitíase: desafio no diagnóstico pré-operatório / Distal bile duct cancer vs. choledocholithiasis: challenge in preoperative evaluation
Fonte: GED gastroenterol. endosc. dig;36(1):30-33, jan.-mar. 2017. ilus, tab.
Idioma: pt.
Resumo: O diagnóstico do paciente ictérico, por vezes, pode ser uma tarefa árdua. Dentre as causas principais, destacam-se a doença litiásica, como a coledocolitíase. Por outro lado, doenças neoplásicas como neoplasias peri-ampulares e da via biliar principal apresentam grande relevância, com destaque para o tumor de via colédoco. Apresentamos relato de caso de um paciente que apresentou dúvida diagnóstica nos exames pré-operatórios de imagem (US abdominal, TC multislice e Colangiorressonância). Realizada a abordagem através da exploração transcística das vias biliares para a confirmação do diagnóstico e posterior duodenopancreatectomia laparoscópica. Este relato ilustra a dificuldade em realizar o diagnóstico diferencial desta patologia. Mesmo com exames laboratoriais e de imagem, associados à anamnese e ao exame físico detalhado, nem sempre é possível confirmar o diagnóstico no pré-operatório, muitas vezes só confirmado durante o procedimento cirúrgico.

The diagnosis of jaundiced patient can sometimes be difficult task. Among the most important causes are common bile duct and its complications. By the other side, periampullary tumors and the main biliary duct tumor also have great relevance, especially cholangiocarcinoma. In this paper, we present the case report of patient that presented doubt diagnostic in preoperative in ultrasound, multislice CT and magnetic resonance. The patient underwent a laparoscopic trancystic common bile exploration, than decide to perform the laparoscopic pancreaticoduodenectomy. This report show the difficulty to make the diagnosis in pre operative evaluation. Even with laboratory and image, associate detailed case history and physical examination, not always is possible and confirm the diagnosis, many times the diagnostic is confirm during the surgical procedure.
Descritores: Pancreaticoduodenectomia
Colangiocarcinoma
Neoplasias do Ducto Colédoco
Coledocolitíase
Icterícia Obstrutiva
-Diagnóstico Diferencial
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR9.1 - Biblioteca de Ciências da Saúde Profa. Susana Schimidt



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