CONSTIPACION EN PEDIATRIA PDF

Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy. See our Privacy Policy and User Agreement for details. Published on Mar 3, SlideShare Explore Search You.

Author:Mezisho Braktilar
Country:Eritrea
Language:English (Spanish)
Genre:Politics
Published (Last):16 February 2007
Pages:452
PDF File Size:20.14 Mb
ePub File Size:9.17 Mb
ISBN:140-5-45753-524-5
Downloads:43723
Price:Free* [*Free Regsitration Required]
Uploader:Kezahn



Servicio de Medicina de Aparato Digestivo. Hospital Universitario 12 de Octubre. Es poco frecuente pero determina una alta morbilidad. La complejidad de estos enfermos aconseja su seguimiento multidisciplinar. Motilidad intestinal. Chronic intestinal pseudo-obstruction CIPO is a syndrome characterized by the presence of recurrent episodes of clinical intestinal obstruction in the absence of obstructive lesions.

Although this syndrome is rare, it causes a high morbidity. It is caused by a disturbance of the intestinal motility, that results in a failure of the progression of the intestinal content. Basically, the failure of the intestinal motility is a consequence of muscular disorder, neurological disorder or both. The use of new manometric tecniques and specific histological procedures have allowed to clarify the pathogenesis of some of these entities including mitochondrial diseases and paraneoplasic syndromes.

Clinical manifestations of CIPO are diverse, depending on the location and extension of the motility disorder. As the diagnosis of this disease is usually not an easy task, patients frecuently undergo unnecesary surgical interventions, are diagnosed of psyquiatric disorders, or the correct diagnosis is delayed several years after the first symptoms arise.

The aims of the treatment are to maintain the nutritional condition and to improve symptoms using nutritional measures, drugs or, eventually, endoscopical or surgical procedures. Key words: Chronic intestinal pseudo-obstruction. Intestinal motility. La prevalencia de la POIC se desconoce. Se estima que en EE. La serotonina es liberada desde los mastocitos de la mucosa y activa las terminaciones nerviosas de las neuronas sensoriales para iniciar la peristalsis.

En otras enfermedades del tejido conectivo se han referido casos de POIC pero con menor frecuencia que en la esclerodermia 4. Algunos casos pueden ser primarios en su origen 8, En las fibras musculares de estos pacientes se puede detectar una deficiencia de citocromo c oxidasa. El dolor puede ser de dos tipos diferentes. Los estudios hormonales tiroideos pueden excluir el hipotiroidismo.

La electroforesis proteica en sangre y orina puede poner de manifiesto la existencia de un mieloma. Por este motivo se debe valorar el hacer las tomas mediante laparoscopia Los casos de naturaleza inflamatoria o autoinmune pueden responder al tratamiento corticoideo.

Los efectos extrapiramidales de la primera hacen que no puedan administrarse dosis altas de la misma. Sin embargo, su eficacia en la POIC es limitada debido al desarrollo de tolerancia si se utiliza de forma prolongada. No existen publicaciones al respecto 5, La historia natural de la POIC secundaria depende de la causa subyacente.

Los pacientes con esclerodermia habitualmente mueren como consecuencia de complicaciones renales, cardiacas o digestivas. Chronic intestinal pseudo-obstruction. Curr Treat Options Gastroenterol ; 8: Patel R, Christensen J. Chronic intestinal pseudo-obstruction: diagnosis and treatment. Gastroenterologist ; 3: Hirano I, Pandolfino J.

Chronic intestinal pseudo-obstruction: pathogenesis, diagnosis and therapy. Z Gastroenterol ; Diagnosis and management of adults patients with chronic intestinal pseudo-obstruction. Nut Clin Prac ; Chronic intestinal pseudo-obstruction: Assessment and management. Gastroenterology ; SS Intestinal pseudo-obstruction. J Royal Coll Surg Edinb ; 3: Chronic idiopathic intestinal pseudo-obstruction.

Am J Med ; Di Lorenzo C. Pseudo-obstruction: Current aproaches. Gastroenterology ; Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study. Clin Gastroenterol Hepatol ; 3: Keller J, Layer P. Cucchiara S. Chronic intestinal pseudo-obstruction: The clinical perspective.

J Pediatr Gastroenterol Nutr ; 32 Supl. I : SS Krishnamurthy S, Schuffler MD. Pathology of neuromuscular disorders of the small intestine and colon. Fundamentals of neurogastroenterology. Gut ; 45 Supl. Role of interstitial cells of Cajal in motility disorders of the bowel.

Am J Gastroenterol ; Advances in our understanding of the pathology of chronic intestinal pseudo-obstruction. Gut ; Levin KH. Paraneoplasic neuromuscular syndromes. Neurol Clin ; Intestinal pseudo-obstruction in patients with amyloidosis: clinicopathologic differences between chemical types of amyloid protein. Intestinal pseudoobstruction secondary to hypothyroidism. Importance of small bowel manometry.

J Clin Gastroenterol ; DNA viruses in the pathogenesis of sporadic chronic idiopatic intestinal pseudo-obstruction. Neuromuscular diseases of the gastrointestinal tract. Specific disorders than often get a nonspecific diagnosis. Postgrad Med ; , , Chronic intestinal pseudo-obstruction: a report of 27 cases and review of the literature.

Medicine ; Radiologic and histologic differentiation of neuromuscular disorders of the gastrointestinal tract: visceral myopathies, visceral neuropathies and progressive systemic sclerosis. Am J Roentgenol ; Lyford G, Foxx-Orenstein A. Chronic intestinal pseudoobstruction. Curr Treat Options Gastroenterol ; 7: Smith VV. Milla PJ. Histological phenotypes of enteric smoth muscle disease causing functional intestinal obstruction in chilhood. Histopathology ; Intestinal pseudo-obstruction with deficient smoth muscle alfa actin.

Rev Esp Enferm Dig ; New insights into human enteric neuropathies. Neurogastroenterol Motil ; De Giorgio R, Camilleri M. Human enteric neuropathies: morphology and molecular pathology. Sutton I, Winer JB. The inmunopathogenesis of paraneoplastic neurological syndromes.

Clin Sci ; Gastrointestinal manifestations of mitochondrial disease. Gastroenterol Clin ; 32 : Digestive smooth muscle mitochondrial myopathy in patients with mitochondrial-neuro-gastro-intestinal encephalomyopathy MNGIE.

KLAFKI NEUE STUDIEN ZUR BILDUNGSTHEORIE UND DIDAKTIK PDF

Síntomas del cáncer infantil

Use of polyethylene glycol in functional constipation and fecal impaction. Universidad de Valencia. Objective: The objective of this study was to evaluate in an analytical and descriptive manner the evidence published so far on the use of polyethylene glycol PEG , with or without electrolytes, in the management of functional constipation and the treatment of fecal impaction. Results: Fifty-eight publications have been chosen for descriptive analysis; of them, 41 are clinical trials, eight are observational studies and nine are systematic reviews or meta-analysis. Twelve clinical trials evaluate PEG efficacy versus placebo, eight versus lactulose, six are dose studies, five compare polyethylene glycol with and without electrolytes, two compare its efficacy with respect to milk of magnesia, and the rest of the trials evaluate polyethylene glycol with enemas two , psyllium one , tegaserod one , prucalopride one , paraffin oil one , fiber combinations one and Descurainia sophia one. Conclusions: Polyethylene glycol with or without electrolytes is more efficacious than placebo for the treatment of functional constipation, either in adults or in pediatric patients, with great safety and tolerability.

DESCARGAR EL PRINCIPE DESTRONADO EN PDF

2018, Número 1

.

Related Articles