Giant hiatal hernia is a condition in which more than 30 % of the stomach is displaced upward toward the thorax, thusproducing an abnormal protrusion above the diaphragmatic clamp. This can occur by various mechanisms such as alterationsat the gastroesophageal junction or diaphragmatic atrophy that can take place due to a number of reasons, includinginvolutional changes, extensive trauma or damage to the phrenic nerve.Most cases are usually asymptomatic; however, when clinical manifestations occur, they vary depending on the size of theherniation and range from chest pain (also epigastric pain), nausea, vomiting to abdominal distension. In case of presentingcomplications such as gastric volvulus or Cameron lesions, the symptoms include Borchardt’s triad, which consists ofabdominal pain and distension, violent vomiting and difficulty passing a nasogastric tube.We present the case of an ...

Objective: To compare the levels of sedation, pain and satisfaction among patients who received oral vs. intravenous midazolam for gastroscopy. Materials and methods: A quantitative, correlational, observational, analytical and cross-sectional study was conducted. The population consisted of patients from Cusco (3,400 m a.s.l.) treated at Hospital Regional del Cusco. The study analyzed the type of sedation (oral vs. intravenous) and midazolam dosage, as well as the level of sedation using the Ramsay Sedation Scale, perceived pain and patient satisfaction. Student’s t test and Mann-Whitney U test were used to assess differences according to the route of administration. Results: A total of 150 patients participated in the study, 71 % of whom were male, with a mean age 55.5 years. Midazolam was administered orally (55 %) and intravenously (45 %), with a mean dose of 5.47 mg. Forty-four pe...

Fasciolosis (liver fluke disease) is a zoonosis of significant public health relevance, caused by parasites of the genus Fasciola, specifically of the species Fasciola hepatica, a helminth of the class Trematoda, which exhibits a lanceolate morphology and is involved in the zoonotic cycle through contamination of bodies of water and aquatic vegetation, including watercress, by means of metacercariae, its infective form. Their biological cycle includes a migration phase from the host’s intestine to the liver, where they mature and settle in the bile ducts, causing pathological changes such as direct hepatic lesions, bile duct obstruction and a systemic inflammatory response. Clinically, these events manifest through predominantly hepatic and gastrointestinal symptoms secondary to hepatic involvement, which can escalate to severe complications such as cirrhosis and hepatic abscesses in t...