Introducción: La escala de Glasgow-Blatchford (GBS) nos permite clasificar al paciente como riesgo alto o bajo de presentarcomplicaciones. En los pacientes identificados como “bajo riesgo”, la realización de una endoscopia temprana, podría disminuirlos días intrahospitalarios y en el coste global. En nuestro medio, desconocemos la utilidad de la escala de GBS. Objetivo: Describirla utilidad de la escala de Glasgow-Blatchford (GBS) en la estratificación del riesgo en los pacientes con hemorragia digestiva alta(HDA) no variceal atendidos en el servicio de urgencias en un hospital de tercer nivel. Materiales y métodos: Se incluyeronprospectivamente 218 pacientes, y se les realizó en las primeras 24-48 h endoscopia urgente. Éstos se estratificaron, según la escalade GBS, en bajo riesgo (GBS ≤ 2), y alto riesgo (GBS ≥ 3). Se calculó la sensibilidad, especificidad, valor pred...

El pioderma gangrenoso (PG), es una dermatosis neutrofílica, cutáneo-ulcerativa, no infecciosa, que ocurre hasta en un 2% delos pacientes con enfermedad de Crohn (EC). Su aparición suele ser independiente del curso clínico de la EC. Las terapias másutilizadas han sido los corticoides sistémicos, la ciclosporina y la terapia biológica, los cuales han mostrado buenos resultados.El Metotrexate (MTX) es un fármaco antimetabolito con actividad antiinflamatoriaque se caracteriza por una dosificaciónsemanal, un inicio de acción más rápida, con buen perfil de seguridad relacionado con neoplasias malignas y sobretodoun menor costo. Posee eficacia en la inducción de la remisión en pacientes con EC, sin embargo su eficacia en el manejode manifestaciones extraintestinales como el PG es incierta. Presentamos el caso de un varón joven que acude a urgenciaspor diarrea crónica, pérdid...

Introduction: Helycobacter pylori (HP) infection is a public health problem in Latin America with a prevalence of infection of up to 70%. There are endoscopic findings associated with the presence of infection, however we do not know the current prevalence in Panama and if the endoscopic findings are related to HP infection. Objective: To assess the frequency of HP infection in patients who underwent upper gastrointestinal endoscopy and its association with HP infection. Materials and methods: An observational, cross-sectional and analytical study was carried out from January 1, 2019 to December 31, 2019 in the Gastroenterology service of Hospital Santo Tomás, Panama city. The frequency of HP infection in patients who underwent upper gastrointestinal endoscopy and the association of endoscopic findings with HP infection was evaluated. Results: In total, 1,281 digestive endoscopie...

The wireless capsule to measure gastroesophageal reflux, also known as pH monitoring capsule, is a technique used in ambulatory reflux monitoring. This capsule is introduced through a guide into the esophagus and is placed using a suction system and anchored to the esophageal mucosa. From there, it communicates with an external device using radio signals to record the activity of gastric acid in the esophagus over a specified period of time. Unlike the conventional technique, which involves inserting a tube through the nose into the esophagus, the wireless capsule may be a more comfortable and tolerable alternative for patients, potentially improving adherence to the procedure. In some cases, patients may present chest pain after placement of the pH monitoring capsule, however there is little evidence about the etiology and management. We present the case of a woman with a clinical pictu...

Introduction: Colonoscopy is the standard method for colorectal cancer diagnosis. Despite the use of multiple devices, polyp and adenoma detection results have been inconsistent. Objectives: The main aim of this research is to determine if there have been differences between conventional colonoscopy (CC) and cap-assisted colonoscopy (CAC) in the diagnosis performance to detect adenomas. Materials and methods: This is a prospective randomized clinical trial that compares the diagnostic performance of CC and CAC in detecting adenomas in a public reference hospital. Results: We randomly assigned 131 patients to either CC (n=64) or CAC (n=67). Cap-assisted colonoscopy was associated with shorter cecal intubation times (6 min vs. 7,5 min, p=0.005) and a higher chance of intubating the ileum (RR = 1.62; 1.21-2.17). There was no statistical difference in the adenoma detection rates (RR: 1.62; 1...

Endoscopic ultrasound (EUS)-guided sampling is a safe and reliable method for obtaining pathological results of gastrointestinal and adjacent gastrointestinal lesions. Some colon lesions are located in the muscular layer or even in the serosa beneath the mucosa, so conventional colonoscopy with forceps biopsy is often negative. In patients with colon cancer, forceps biopsy during colonoscopy is the current standard diagnostic modality. However, there are cases that are difficult to confirm with forceps biopsy, such as stenosing tumors, or those originating from deep layers. Endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) is a useful alternative for diagnosis in these cases. We present the successful case of a 62-year-old male with a history of progressive weight loss and a colonic mass at the splenic flexure, whose colonoscopy was unsuccessful, therefore a FNB puncture by EUS...