Surgical complications of Chagas' disease: Megaesophagus, achalasia of the pylorus, and cholelithiasis

Pinotti, H W; Felix, Valter Nilton; Zilberstein, Bruno; Cecconello, Ivan

doi:10.1007/bf01659053

Cited by 44 publications

(25 citation statements)

References 8 publications

(6 reference statements)

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“…Nevertheless, it is of major interest because of the range of diseases associated with alterations in its microbiota. 44,45 Shiner 46 developed a stainless steel capsule that only opens at collection time to aspirate the contents of the jejunum; this avoids contamination during its passage, but it is very complex to use. Kalser et al 6 developed a double lumen polyvinyl catheter with a mercury weight on the distal end for taking samples starting 75 cm from Treitz's ligament to near the distal ileum and cecal valve.…”

Section: Discussionmentioning

confidence: 99%

Digestive Tract Microbiota in Healthy Volunteers

Zilberstein

Quintanilha

Santos

et al. 2007

Clinics

Self Cite

136

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PURPOSE:The aim of this study was to standardize the methods of sample collection of mucus from the digestive tract and to determine the microbiota in healthy volunteers from Brazil, collecting samples from the mouth, esophagus, stomach, duodenum, jejunum, ileum, colon, and rectum. METHODS: Microbiota of selected healthy volunteers from the oral cavity (n=10), the esophagus (n=10), the upper digestive tract (n=20), and the lower digestive tract (n=24) were evaluated through distinct collection methods. Collection methods took into account the different sites, using basic scraping and swabbing techniques, stimulated saliva from the oral cavity, irrigationaspiration with sterile catheters especially designed for the esophagus, a probe especially designed for upper digestive tract, and a special catheter for the lower digestive tract. RESULTS: (i) Mixed microbiota were identified in the oral cavity, predominantly Gram-positive aerobic and anaerobic cocci; (ii) transitional flora mainly in the esophagus; (iii) Veillonella sp, Lactobacillus sp, and Clostridium sp in the stomach and duodenum; (iv) in the jejunum and upper ileum, we observed Bacteroides sp, Proteus sp, and Staphylococcus sp, in addition to Veillonella sp; (v) in the colon, the presence of "nonpathogenic" anaerobic bacteria Veillonella sp (average 10 5 UFC) indicates the existence of a low oxidation-reduction potential environment, which suggests the possibility of adoption of these bacteria as biological markers of total digestive tract health. CONCLUSIONS: The collection methods were efficient in obtaining adequate samples from each segment of the total digestive tract to reveal the normal microbiota. These procedures are safe and easily reproducible for microbiological studies.

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Section: Discussionmentioning

confidence: 99%

Digestive Tract Microbiota in Healthy Volunteers

Zilberstein

Quintanilha

Santos

et al. 2007

Clinics

Self Cite

136

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“…However, studies investigating accessory organs and glands of the digestive tract in Chagas disease, particularly the gallbladder, are scarce [2][3][4] . The incidence of cholelithiasis is high in the presence of parasympathetic nerve damage of the biliary tract either due to surgery (vagotomy) 5,6 or neuronal destruction 1 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of cholelithiasis in patients with chagasic megaesophagus

Crema

Silva

Franciscon

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction:The prevalence of cholelithiasis in the general population ranges from 9 to 18%. This prevalence is known to be higher in the presence of parasympathetic nerve damage of the biliary tract either due to surgery (vagotomy) or neuronal destruction (Chagas disease). The objective of this study was to evaluate the association of cholelithiasis and chagasic or idiopathic megaesophagus. Methods: The ultrasound scans of 152 patients with megaesophagus submitted to cardiomyotomy and subtotal esophagectomy surgery were evaluated. The presence of cholelithiasis was compared between chagasic and idiopathic esophagopathy and ultrasound and clinical findings were correlated with age, sex and race. Results: A total of 152 cases of megaesophagus, including 137 with chagasic megaesophagus and 15 with idiopathic megaesophagus, were analyzed. The mean age was 56.7 years (45-67) in the 137 patients with chagasic megaesophagus and 35.6 years (27-44) in the 15 cases of idiopathic megaesophagus, with a significant difference between the two groups (p < 0.0001). The group with chagasic megaesophagus consisted of 59 (43%) women and 78 (56.9%) men, while the group with idiopathic megaesophagus consisted of 8 (53.3%) women and 7 (46.6%) men, showing no significant difference between the groups. Of the 137 patients with confirmed chagasic megaesophagus, 39 (28.4%) presented cholelithiasis versus one case (6.6%) in the 15 patients with idiopathic megaesophagus. Conclusions: The prevalence of cholelithiasis is high in patients with chagasic megaesophagus and preoperative ultrasound should be performed routinely in these patients in order to treat both conditions during the same surgical procedure.

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“…26 The maximal antral areas obtained after administration of the test meal, and those obtained under initial fasting conditions, were similar in controls and Chagasic patients. These findings suggest that, in agreement with the literature, megastria is uncommon, and that the elasticity of the stomach is preserved, even in patients with denervation secondary to trypanosomiasis.…”

Section: 25mentioning

confidence: 65%

Delayed Gastric Emptying for Semi-Solid Diets in Patients With Chagasic Megaesophagus

Chinzon¹,

Navarro–Rodriguez²,

Dal-Paz³

et al. 2011

Gastroenterology

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OBJECTIVE:To measure the time to gastric emptying of a semi-solid diet in individuals with Chagasic megaesophagus, in comparison with a non-Chagasic control group. METHOD: The time to gastric emptying of a semi-solid diet was assessed via ultrasonography in 28 patients with Chagasic megaesophagus (grades I, II, and III) and compared to that of a control group (n ¼ 15). After measurement of antral diameter under fasting conditions, 400 mL of a semi-solid diet were administered and consecutive measurements were performed every 30 min. RESULTS: The duration of dysphagia was significantly lower in patients with megaesophagus grade I than in those with grades II or III. The time to gastric emptying was significantly increased in the megaesophagus group compared to the control group. The means of antral areas measured under fasting conditions and after maximal antral distension did not differ between the megaesophagus and control groups. CONCLUSION: The time to gastric emptying of a semi-solid diet was significantly greater in patients with Chagasic megaesophagus than in controls. The delay did not depend on the extent of dilatation of the megaesophagus or the duration of dysphagia.

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Surgical complications of Chagas' disease: Megaesophagus, achalasia of the pylorus, and cholelithiasis

Cited by 44 publications

References 8 publications

Digestive Tract Microbiota in Healthy Volunteers

Digestive Tract Microbiota in Healthy Volunteers

Prevalence of cholelithiasis in patients with chagasic megaesophagus

Delayed Gastric Emptying for Semi-Solid Diets in Patients With Chagasic Megaesophagus

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