Irritable bowel syndrome in medical students from Lima, Peru, during the COVID-19 pandemic, using virtual questionnaires according to the Rome IV criteria: prevalence and associated factors.

Unlabelled: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, characterized by changes of the intestinal habit associated with abdominal pain. This study analyzed factors associated with this pathology during the COVID-19 pandemic, and it was seen that the impact of IBS was higher in young women who had ongoing studies in the medical field.

Objectives: Determine the prevalence of IBS in medical students and explore the associated factors with the increase of its symptoms, through the use of digital tools.

[Approach to refractory gastroesophageal reflux disease].

An adequate approach to refractory gastroesophageal reflux disease (rGERD) is essential for achieving therapeutic success. From the precise definition of rGERD to the detailed characterization of its phenotypes, it will pave the way for the customization of optimal therapy for each patient. In this narrative literature review, the aim is to provide an updated synthesis of the utility of various diagnostic tools and explore the wide range of therapeutic options, both medical and invasive, available for this condition.

Frequency of functional esophageal disorders in patients with refractory reflux symptoms in Lima, Peru.

Gastroesophageal reflux disease (GERD) is a clinical condition in which gastric reflux causes symptoms or damage to the esophageal mucosa. It is managed with proton pump inhibitors, however, up to 45% of patients with suspected GERD are refractory to treatment. It is necessary to establish a true GERD diagnosis by means of a digestive endoscopy, which does not show lesions in approximately 70% of patients.

[Generation of a predictive test for the diagnosis of the etiology of variceal upper gastrointestinal bleeding].

Our objective was to develop a diagnostic test to predict the etiology of Variceal Upper Gastrointestinal Bleeding (VUGIB). We conducted a retrospective cohort study. Medical records of patients over 18 years of age with Upper Gastrointestinal Bleeding (UGIB) who attended the emergency service of Hospital Cayetano Heredia (HCH) in Lima-Peru between 2019 and 2022 were reviewed; demographic, laboratory and clinical data were collected.

[Antibiotic resistance of Helicobacter pylori in the Peruvian population: a systematic review and meta-analysis of its prevalence in the general population].

Helicobacter pylori infection is quite common worldwide and is associated with gastric adenocarcinoma. The high rates of resistance found in Latin American countries justify the investigation of local resistance rates, which could improve the therapeutic approach and eradication rates. The objective is to evaluate the prevalence of resistance in Peru of Helicobacter pylori to commonly used antibiotics.

Endoscopic removal of a toothbrush in a young adult with psychiatricdisorder.

Ingestion of foreign bodies is a relative common situation in the emergency department; however, ingestion of toothbrush is rarely reported in the literature. We present the case of a 27-year-old man with a previous diagnosis of obsessive-compulsive disorder, who presented to the emergency department 17 hours after an ingestion of a toothbrush. We performed an endoscopic removal using a polypectomy snare in the Gastroenterology Department under moderate sedation.

Hepatitis A and hepatitis E virus co-infection with right pleural effusion, ascites and acute acalculous cholecystitis. A case report.

Hepatitis A and hepatitis E are the leading causes of acute viral hepatitis in developing countries due to our poor sanitary conditions, both spread by fecal-oral route or through contaminated water and food. Being both self-limiting diseases, they are usually benign but may present with atypical clinical findings. A 32 year-old female with right pleural effusion, ascites and acalculous cholecystitis during the course of HAV and HEV co-infection is reported.

[Colonic balantidiasis: report of a fatal case and review of the literature].

Balantidiasis is a zoonosis produced by Balantidium coli, which inhabits the large intestine of the pig and man. Infection is uncommon in humans and mainly affects the colon. It occurs more frequently in developing countries, tropical and subtropical regions.

[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.

Hypoxic hepatitis in an extensive aortic disecction: case report.

Hypoxic hepatitis is an uncommon cause of hepatic damage characterized by a centrolobular necrosis. Its pathophysiology remains unclear. Aortic dissection is a rare but frequently catastrophic event.

[Prevalence of histological types of gastric polyps in adult patients from a public hospital in Lima-Peru (2007 - 2016)].

Objectives: Establish the prevalence of gastric polyps detected by upper gastrointestinal endoscopy in patients older than 18 years old during the period from 2007 - 2016 in Cayetano Heredia Hospital.

Materials And Methods: Retrospective cross-sectional study, performed with data from the gastric biopsies reports of patients that have undergone upper gastrointestinal endoscopy between January 2007 and July 2016. Demographic data, endoscopic characteristics of the polyps and associated histological changes of the surrounding gastric mucosa were evaluated, which were subjected to statistical analysis using STATA v14.

[Fulminating ischemic hepatitis induced by severe cardiac dysfunction: case report].

Ischemic Hepatitis is an uncommon entity in daily clinical practice with a prevalence of 0.16 to 0.5% among patients admitted to a critical care unit, associated with an approximate 60% mortality rate.

Histoplasmosis-induced ileal perforation in a patient with acquired immune deficiency syndrome: Case report.

Intestinal involvement with disseminated histoplasmosis is common in some populations infected with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), especially in those who come from tropical zones. We report the case of a 29-year-old male patient, from a tropical zone, with HIV infection and a CD value less than 50 cells/mm, with a history of abdominal pain, fever, diarrhea, and weight loss. On presentation, he was pale, sweaty, and had abdominal rebound tenderness.

[Safety of gastroenterologist-directed propofol administration for endoscopic procedures: 10-year experience in a private clinic in Lima, Peru].

Objective: To evaluate safety of propofol combined with Meperidine and Midazolam in colonoscopies, upper endoscopies (EGD) and Endoscopic Ultrasound (EUS) administered by a nurse supervised by a trained gastroenterologist. To compare the required doses of propofol among older and younger than 75 years old.

Materials And Methods: Retrospective descriptive study including patients 18 years of age and older who received propofol for EGD, colonoscopy (or EGD + colonoscopy) and EUS.

[Accuracy of ASGE predictors in diagnosis of coledocolithiasis in a public hospital of Lima, Peru].

Background: The predictors proposed by the American Society of Gastrointestinal Endoscopy (ASGE) are commonly used topredict the presence and management of choledocholithiasis.

Objective: To evaluate the performance and precision of thepredictors of choledocholithiasis proposed by ASGE.

Materials And Methods: Prospective and longitudinal study performed ata third level hospital during January 2015 to June 2017.

[Porphyria cutanea tarda as extrahepatic manifestation of chronic hepatitis C: a case report].

The present case is a 56 year old male who present hyperpigmented and hypopigmented scars in both hands, associated with the presence of milia cysts. It was studied the metabolism of porphyrins and skin biopsy of the lesions which were compatible with porphyria cutanea tarda. In the initial laboratory, elevated transaminases values were found and subsequently identified chronic infection of hepatitis C virus.

[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.

[Autoimmune pancreatitis type 1: a case report].

Autoimmune pancreatitis type 1 (AIP) is the pancreatic manifestation of IgG4-related disease. The most frequent presentation of AIP is with obstructive jaundice. For definite diagnosis of type 1 Autoimmune pancreatitis international consensus diagnosis criteria (ICDC) for AIP are used.

[Duodenal Linphoma asociated to Strongyloides stercoralis infection. Two types of HTLV-1 infection].

Infection by the Human T- Lymphotropic virus I (HTLV-1) causes Adult T cell Leukemia-lymphoma (ATLL), being the duodenal involvement rare. Commonly, patients co-infected with HTLV-1 and Strongyloides stercoralis are seen due to the lack of TH2 response found on these patients. We describe a 48-year- old woman, from the jungle of Peru, with a family history of HTLV-1 infection, who presented with a History of chronic diarrhea and weight loss.

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.

[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).