Proposta de classificação do megacólon chagásico através de enema opaco

Abstract

OBJETIVO: Avaliação de exames radiográficos de portadores de megacólon chagásico, estabelecendo parâmetros que possibilitem uma classificação prática da evolução da doença. MÉTODO: Foram analisados 76 enemas opacos de pacientes com megacólon chagásico e 59 de pacientes normais de acordo com a sorologia. Nestas radiografias foi medido o diâmetro transverso do sigmóide à altura de uma linha imaginária que passa pelas espinhas ilíacas ântero-superiores. Estas medidas foram submetidas à análise de distribuição de freqüência, a partir da qual se construíram tabelas e se estabeleceu uma classificação de 1 a 3. RESULTADOS: Cinquenta e dois pacientes, todos normais, apresentaram diâmetros transversos de sigmóide entre 2 e 5 cm; 29 entre 5 e 9 cm (22 chagásicos e sete normais); 38, todos chagásicos, entre 9 e 13 cm e 16, todos também chagásicos, acima de 13 cm CONCLUSÕES: Propomos uma divisão do megacólon chagásico em Graus, com as seguintes características: no Grau 1, o eixo transversal mede entre 5 cm e 9 cm (inclusive); no Grau 2, o eixo transversal mede entre 9 cm e 13 cm (inclusive) e no Grau 3, agruparam-se todos os eixos transversais com medidas superiores a 13 cm.

Epidemiological and clinical profile of patients with Chagas disease in the Central-North area of Paraná, Southern Brazil

“…Other causes of cardiomegaly were evaluated and excluded, such as hypertensive dilated cardiomyopathy. Esophagus and colon contrast-enhanced radiography were carried out to classify the digestive form of the disease 8,9 .…”

Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

“…Contrast radiography of the esophagus was performed to classify the esophagus into four groups (17) ,and contrast radiography of the colon was performed as previously described (18) . The diameter of the rectum was measured in the right lateral decubitus position, and the sigmoid colon was measured in the dorsal decubitus position, or in the ventral decubitus position if necessary (19) .The sigmoid colon was classifi ed into four grades (0-3) (20) , with some modifi cations.…”

Innate immune receptors over expression correlate with chronic chagasic cardiomyopathy and digestive damage in patients

“…Contrasted colon radiographs were performed in the supine, ventral and right lateral position [ 45 ] using barium sulfate solution (Bariogel ®, Cristália Laboratory, Brazil) via the rectum without prior bowel preparation or double contrast use. The sigmoid was classified into four grades (zero to three) according to Silva et al [ 46 ] modified by Andrade and coworkers [ 3 ]. Radiographic examinations were performed using radiology equipment with X-ray penetration to deep parts (VMI®, Brazil).…”