Portal vein thrombosis (PVT) is a rare condition in the general population that develops serious complications if left untreated for long time. We present a case of a 29-year-old woman who developed PVT due to protein S deficiency versus neonatal funiculitis. Over time, the patient developed upper gastrointestinal bleeding due to esophageal varices and hypersplenism with splenic sequestration that caused minor bleeding episodes. Laparoscopic splenectomy and proximal splenorenal shunt with distal pancreatectomy due to aneurysmal dilatations of the splenic artery were successfully performed to avoid mayor progression of portal hypertension. Patient was discharged with indefinite anticoagulation and after surgery platelets raised 3 3 ectomy and proximal splenorenal shunt for portal hypertension due to portal vein ombosis is an adequate surgery procedure which should be applied in these medical cases.
La injuria hepática inducida por fármacos (IHIF) puede ser desencadenado por varios medicamentos incluyendo fármacos anti tuberculosos. Presentamos el caso de una paciente mujer de 37 años con un frotis positivo para tuberculosis pulmonar quien inició tratamiento de primera línea y 4 semanas después, presentó ictericia, somnolencia y un exantema generalizado de tipo morbiliforme con deterioro neurológico progresivo y un desenlace fatal. Los fármacos anti tuberculosos pueden producir injuria inducida por fármacos en 2 a 28% de pacientes y síndrome de DRESS (reacción de sensibilidad a medicamentos con eosinofilia y síntomas sistémicos) en 1,2%. La falla hepática aguda (FHA) en pacientes con injuria hepática inducida por fármacos, puede presentarse en un 35% con una mortalidad del 9,7%. Si la FHA no responde a tratamiento médico, el trasplante hepático ha mostrado resultados positivos y evita la progresión de complicaciones. La IHIF puede ser una condición médica grave en pacientes que reciben medicamentos antituberculosos. Si se desencadena una FHA y no responde a tratamiento médico, debe considerarse con urgencia la posibilidad de trasplante hepático.
Introduction: Irritable bowel syndrome (IBS) is a chronic functional bowel condition with an average world prevalence of 11.2%. Is associated with multiple factors as female sex, young age, stress, anxiety and depression which can have a negative impact on quality of life. IBS in Peru is not investigated at all specially in the Andean region. The objective of this study is to determine the prevalence and associated factors of IBS in an Andean community from Peru using the Rome IV criteria. Materials and methods: Cross-sectional study in a rural community dedicated to livestock and agriculture in Peru at 3,235 meters above sea level. Questionnaires provided by the Rome Foundation as the Rome IV – Diagnostic questionnaire for adults, Irritable Bowel Syndrome - Symptom Severity Scale and Bristol stool scale were used. Results: 130 residents met the inclusion criteria. 46.9% were males with an average age of 54 years old. 11.54% presented red flags and were not included in the analysis. 13.1% were diagnosed with IBS and 52.9% presented constipation as predominant bowel pattern. 52.9% presented a mild course of the disease. In the chi-square analysis, factors as depression, anxiety, female sex, younger age, liquefied petroleum gas exposure for cooking and education achievement were statistically significant associated to IBS. In the logistic regression analysis, anxiety was the unique independent predictor factor with an OR of 9.6 (95% IC: 1.78-51.82). Conclusion: IBS is a prevalent condition in the Andean region and should be managed as a public health issue to improve quality of life.
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