[Use of cyanoacrylate as a treatment of gastric varices in a public hospital in Lima - Peru].

Objective: To evaluate the therapeutic success of endoscopic therapy with N-butyl-2-cyanoacrylate and to determine the re- bleeding and mortality rates.

Materials And Methods: Prospective analytical observational study of 47 cases of patients with gastric varices who were treated with N-butyl-2-cyanoacrylate, using a 1: 1 mixture with lipiodol between 2013 and 2017 in a level III public hospital in Lima - Peru. The therapeutic indication was active hemorrhage, primary or secondary prophylaxis.

[Independent risk factors for severity and mortality in lower gastrointestinal bleeding].

Unlabelled: In lower gastrointestinal bleeding (LGIB), it is very important to stratify the risk of LGIB for a proper management.

Objective: Identity the independent risk factors to mortality and severity (require critical care, prolonged hospitalization, reebleding, re hospitalization, politrasfusion, surgery for bleeding control) in LGIB.

Materials And Methods: It is an analytic prospective cohort study, performed between June 2016 and April 2018 in a tertiary care hospital.

[Familiar adenomatous polyposis: report of 2 cases].

Familial Adenomatous polyposis (FAP) it is based on an autosomal dominant mutation which results in loss of function of theAPC tumor suppressor gene. On the other hand, Gardner syndrome is a type of FAP and is characterized for multiple colonic adenomatous polyps and extracolonic abnormalities as desmoid tumors, osteomas, lipomas, dental abnormalities, dermoid cysts and duodenal adenomas. This report aims to present two patients with FAP: The first one is a patient who presented with osteomas and hematochezia, being diagnosed with Gardner Syndrome after the colonoscopy.

[Duodenal melanoma: a case report and review of the literature].

We report the case of a male patient of 75 years old who presents with abdominal pain, hyporexia, early satiety, general malaise and watery stools, admitted in emergency for an episode of syncope. On physical examination, hepatomegaly of 6cm below the right costal margin was detected. CT scan showed multiple liver metastases.

[Gastric hemangioma as a cause of upper gastrointestinal bleeding].

Gastric hemangioma as a cause of upper gastrointestinal bleeding (UGIB) is a rare event. We present the case of an 83 years old male with a history of abdominal pain, vomiting and melena, along with an 8 Kg weight loss. The upper gastrointestinal endoscopy showed an elevated, ulcerated lesion in the gastric antrum with a visible vessel, for which he receives endoscopic therapy.

[Rapunzel syndrome as a cause of obstruction and intestinal perforation].

The following is a case report involving a 16 year old female with trichotillomania as an antecedent. This patient presented to the Emergency Room with a chief complaint of early satiety and persistent abdominal pain for the past 3 months. However, recently her abdominal pain has worsened and it is now complicated by nausea and vomiting.

Penetrating gastric ulcer as a manifestation of multisystemic tuberculosis.

We present the case of a 30-year old female with a history of abdominal pain, fever, poor oral tolerance and weight loss for 6 months. An abdominal CT scan showed marked gastric dilatation due to extrinsic compression from lymphadenopathies around the second portion of the duodenum. The upper endoscopy revealed the presence of a penetrating gastric ulcer in the greater curvature.

[Venous tromboembolism in a patient with Crohn disease with ileal stenosis].

Inflammatory bowel disease is associated with extraintestinal manifestations. Among these manifestations is the venous tromboembolism which presents a risk three times more than that presented in general population. We report the case of a 61-year-old male with a history of abdominal pain, chronic diarrhea and fever, with leukocytosis, and fecal samples containing leukocytes, partial ileal stenosis with multiple ulcers in the enteroscopy, with histologic findings compatible with Crohn's disease.

[Sphincterotomy followed by papillary large balloon in the management of cholecolithiasis. Therapeutic success and safety in a Lima-Peru hospital].

Objective: We present a descriptive analysis of our cases of sphincterotomy followed by papillary large balloon dilation in a single session (ES-LBD) in the management of difficult to extract calculi, with the objective of assessing rates of therapeutic success and complications in local experience.

Material And Methods: ERCP procedures with ES-LBD performed for choledocholithiasis between January 2009 and December 2014 in patients older than 18 years and without preexistent sphincterotomy were selected from records of the Gastroenterology Service at Cayetano Heredia National Hospital. A descriptive analysis of therapeutic success and complications was performed.

[Association between ulcerative colitis and primary esclerosing cholangitis].

Ulcerative Colitis (UC) is associated to Primary Sclerosing Cholangitis (PSC) in 80% of cases, and this association is more common than the one with Crohn’s disease. Nevertheless, the prevalence of PSC in patients with UC is only 2.9% in Latin America.

[Comparison between Glascow-Blatchford, Rockall and AIMS65 scores in patients with upper gastrointestinal bleeding in a hospital in Lima, Peru].

Objective: Identify the best score that predicts each variable outcome (mortality, rebleeding and need for transfusion for more than 2 red blood cells pack) in patients with upper gastrointestinal bleeding until 30 days of the event. Material y methods: Patients included were those over 18 years, who had upper gastrointestinal bleeding between January 2014 to June 2015 in a general hospital of third level. The data was analyzed by the area under the curve ROC (Receiver Operating Characteristic).

[AIMS65 score validation for upper gastrointestinal bleeding in the National Hospital Cayetano Heredia].

Objective: To validate the score AIMS65 in patients with upper gastrointestinal bleeding, in terms of mortality and rebleeding a 30-day event.

Material And Methods: Patients included were those with higher age to 18 years attending the Hospital Nacional Cayetano Heredia during the period May 2013 to December 2014, by upper gastrointestinal bleeding. Data were analyzed using ROC curve (Receiver Operating Characteristic) and the area was obtained under the curve (AUC) to properly qualify the score AIMS65.

[Clinical-radiological characteristics and explore the association between therapeutic success in patients undergoing ERCP and age in Cayetano Heredia Hospital, Lima, Peru].

Objective: To compare the clinical-radiological characteristics and explore the association between therapeutic success in patients undergoing ERCP and age in Cayetano Heredia Hospital, Lima, Peru.

Materials And Methods: Retrospective, descriptive study based on the review of records of patients undergoing ERCP between the years 2008 to 2014. These were divided into two groups: greater than or equal to 60 years (group 1) and less than 60 years (group 2).

[Validation of the Rockall score in elderly patients with non variceal upper gastrointestinal bleeding in a third level general hospital].

Objective: To validate the Rockall score in elderly patients with non variceal upper gastrointestinal bleeding, in terms of mortality and recurrent bleeding at 30 days follow-up.

Material And Methods: Patients older than 60 year-old, with non variceal upper gastrointestinal bleeding demonstrated by endoscopy, who were attended in a third level general hospital from June 2009 to June 2013, were included. Data was analyzed with the ROC (Receiver Operating Characteristic) curve.

[BISAP-O y APACHE-O: utility in predicting severity in acute pancreatitis in modified Atlanta classification].

Objective: To assess the BISAP and APACHE II scores in predicting severity according to the 2012 Atlanta classification and whether the obesity factor added to these scores improves prediction.

Material And Methods: A prospective study between January 2013 and April 2014 including all patients with acute pancreatitis was performed according to the new Atlanta 2012 classification. ROC curves were fabricated for BISAP, BISAP-O, APACHE-II scores and Apache O and appropriate cutoffs were selected to the sensitivity, specificity, PPV, NPV, RPP and RPN.

[The usefulness of the Baylor score in patients with upper gastrointestinal bleeding in a hospital in Lima, Peru].

Objective: To demonstrate the usefulness of the Baylor score in patients with upper gastrointestinal bleeding (UGB) due to peptic ulcer, in terms of mortality and recurrent bleeding at 30 days follow-up.

Material And Methods: This study has collected information prospectively into a registration form from medical histories. Patients included were those who came to the "Hospital Nacional Cayetano Heredia", Lima, Peru, in the period between June 2009 and May 2011, with UGB due to peptic ulcer demonstrated by endoscopy.

[Frequency and mortality by rebleeding in cirrhotic patients treated for bleeding esophagic varices in two hospitals in Lima Peru during years 2009 to 2011].

Unlabelled: During the first 6 weeks after a variceal hemorrhage there is a 30-40% of probability of recurrence and those who rebleed 20- 30% die. Passed this period, the risk of rebleeding is of 60% and reaches a mortality of 60-70% in two years without treatment.

Objective: Describe the frequency of rebleeding and mortality due to rebleeding in cirrhotic patients treated for variceal hemorrhage at Endoscopic Centers of Hospital Nacional Cayetano Heredia, Lima, Peru and Hospital Nacional Arzobispo Loayza, Lima, Peru during the years 2009-2011.

[Risk factors associated to mortality by upper GI bleeding in patients from a public hospital. A case control study].

Objective: Identify and establish risk factors associated with mortality secondary to upper gastrointestinal bleeding up to 30 days after the episode, at the Hospital Nacional Cayetano Heredia.

Material And Methods: A retrospective analytic observational case-control study was made with a case: control proportion of 1:3, analyzing 180 patient from which 135 were the controls and 45 the cases. It was determined by biological plausibility as potential risk factors to 14 variables, with which were performed bivariate and multivariate logistic analyses.

[Validation of a modified version of SODA questionnaire (severity of dyspepsia assessment) adapted to Peru for evaluating evolution of symptoms severity in patients with dyspepsia].

Objectives: To validate SODA (severity of dyspepsia assessment) questionnaire in our population for evaluating symptoms severity in patients with dyspepsia.

Materials And Methods: Content and appearance validity were measured, and then a modified questionnaire was developed. A pilot test was made and reliability, construct validity and responsiveness were measured.

["Pilot study: sequential therapy in erradicating Helicobacter pylori in the Cayetano Heredia Hospital"].

Background: Sequential therapy is used as an alternative to growing antibiotic resistance of Helicobacter pylori to the standard triple therapy. Despite the success it had in Europe, we have no information regarding this therapy in our region.

Objectives: To evaluate the eradication rate of Helicobacter pylori using sequential therapy and show its adverse effects.

[Utility of urease rapid test for detection of Helicobacter pylori in patients with upper gastrointestinal bleeding from peptic ulcer].

Background: Peptic ulcer disease is the main cause of upper gastrointestinal bleeding and Helicobacter pylori is its principal etiology. The sensitivity of the diagnostics tests is low for the detection of H. pylori en the setting of bleeding peptic ulcer.