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PubMed | Clinica de Enfermedades Digestivas y Obesidad
Type: Case Reports | Journal: Cirugia y cirujanos | Year: 2014

Portal hypertensive biliopathy is an underdiagnosed condition because only some patients have symptoms. The major clinical manifestations include cholestasis and cholangitis. The aim of this study is to present a series of cases evaluated, treated and followed at a tertiary-care public institution.Four patients with portal hypertensive biliopathy were exposed to different therapeutic approaches focused on the management of portal hypertension and biliary decompression. They were followed for ~5 years. Three cases achieved a favorable outcome with symptom remission, but one patient died while attempting dilatation of the bile duct. Finally, we carried out a literature review about actual portal hypertensive biliopathy therapeutics.There is currently no consensus on the optimal treatment for this condition. The goal is to decompress the biliary tree. Each case should be individually evaluated to choose the best treatment option.


Aguilar-Olivos N.E.,Clinica de Enfermedades Digestivas Y Obesidad | De Leon-Monterroso J.L.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | Avila-Escobedo L.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | Lopez-Mendez E.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran
Cirugia y Cirujanos | Year: 2014

Background: Portal hypertensive biliopathy is an underdiagnosed condition because only some patients have symptoms. The major clinical manifestations include cholestasis and cholangitis. The aim of this study is to present a series of cases evaluated, treated and followed at a tertiary-care public institution.Clinical case: Four patients with portal hypertensive biliopathy were exposed to different therapeutic approaches focused on the management of portal hypertension and biliary decompression. They were followed for ~5 years. Three cases achieved a favorable outcome with symptom remission, but one patient died while attempting dilatation of the bile duct. Finally, we carried out a literature review about actual portal hypertensive biliopathy therapeutics.Conclusions: There is currently no consensus on the optimal treatment for this condition. The goal is to decompress the biliary tree. Each case should be individually evaluated to choose the best treatment option.


Aguilar-Olivos N.,Clinica de Enfermedades Digestivas y Obesidad | Manzano-Robleda M.C.,Clinica de Enfermedades Digestivas y Obesidad | Gutierrez-Grobe Y.,Clinica de Enfermedades Digestivas y Obesidad | Chable-Montero F.,Fundacion Clinica Medica Sur | And 2 more authors.
Annals of Hepatology | Year: 2013

The differential diagnosis of fever of unknown origin (FUO) includes infectious, neoplastic, rheumaticinflammatory and miscellaneous diseases. We report the case of a 35-year-old man with FUO caused by Q fever. A liver biopsy showed the characteristic fibrin-ring lipogranulomas compatible with Q fever. The serologic tests confirmed the diagnosis of acute infection by Coxiella burnetii. The therapeutic response was excellent. In conclusion, we described a patient with acute Q fever and granulomatous hepatitis.


Lee-Cervantes D.E.,Clinica de Enfermedades Digestivas y Obesidad | Sanchez-Jimenez B.A.,Clinica de Enfermedades Digestivas y Obesidad | Gutierrez-Grobe Y.,Clinica de Enfermedades Digestivas y Obesidad | Yeverino-Suarez P.,Fundacion Clinica Medica Sur | And 2 more authors.
Medicina Interna de Mexico | Year: 2014

Background: Obesity represents the main cause of morbidity and mortality worldwide. At the emergency room, the obese patient acquires significance due to the possibility of having different clinical presentation, requiring an increased number of complementary tests and displaying unequal evolution. Objective: To assess the difference in clinical presentation, evaluation and evolution of acute abdominal pain between in obese patients. Material and method: A retrospective, analytic and comparative study was done with patients who presented with acute abdominal pain, from February 2009 to January 2011. Differences on clinical presentation, radiologic complementary studies, and different outcomes as surgery, admission to ICU and death were evaluated. Consistency between initial and final diagnosis was also analyzed. Results: There were included 594 patients (68% female), 81 were obese. There was a difference on hemoglobin (14.7 ± 1.6 vs 14.3 ± 1.8 mg/dL) and GGT (101 ± 145 vs 55.9 ± 104 U/L, p=0.05), no differences were found on diagnostic imaging tests; CT 49% vs 44% (p=0.32), abdominal ultrasound 47% vs 42% (p=0.42), and abdominal radiography 28% on both groups (p=0.42). There was surgical resolution in 28% of both groups (p=0.99), with no difference found on UCI admission (1.2% vs 1.6%, p=0.82) or death (0% vs 0.8%, p=0.43). There was poor correlation between initial and final diagnosis on obese patients (Kappa 0.319 vs -0.02). Conclusion: At the emergency service, obese patients with acute abdominal pain exhibit poor correlation between initial and final diagnosis. However, clinical presentation and evaluation was the same in obese and non-obese patients.


Santiago-Hernandez J.J.,Clinica de Enfermedades Digestivas y Obesidad | Villegas-Lopez F.A.,Clinica de Enfermedades Digestivas y Obesidad | Uribe M.,Clinica de Enfermedades Digestivas y Obesidad | Chavez-Tapia N.C.,Clinica de Enfermedades Digestivas y Obesidad
Medicina Interna de Mexico | Year: 2012

Introduction: The histopathological examination of liver obtained by percutaneous biopsy is traditionally considered the gold standard for assessing the degree of fibrosis. However, this is an invasive, painful and has a small risk of complications. The elastography transition (Fibroscan®) was recently introduced, a new noninvasive method to assess the degree of fibrosis, which has been reported in several studies that can be used to replace the liver biopsy to diagnose (detect or assess) hepatic fibrosis. Elastography has been evaluated in a number of chronic liver disease other than hepatitis C to identify the prevalence of fibrosis, including: Hepatitis B, HIV-HCV coinfection, cholestatic diseases and nonalcoholic fatty liver disease with a diagnostic accuracy ranging from 75% to 93%. This article presents the most relevant information on using the Fibroscan® for the detection of hepatic fibrosis.

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