Scientific letter
Abscess secondary to complicated peptic ulcer managed by endoscopic ultrasound-guided drainage with a lumen-apposing metal stent
Absceso secundario a úlcera péptica complicada resuelto mediante drenaje guiado por ecoendoscopia con prótesis de aposición luminal
Read
1068
Timeswas read the article
89
Total PDF
979
Total HTML
Share statistics
array:24 [ "pii" => "S2444382421000304" "issn" => "24443824" "doi" => "10.1016/j.gastre.2020.04.008" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1599" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Gastroenterol Hepatol. 2021;44:128-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210570520302594" "issn" => "02105705" "doi" => "10.1016/j.gastrohep.2020.04.019" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1599" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Gastroenterol Hepatol. 2021;44:128-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENTÍFICA</span>" "titulo" => "Absceso secundario a úlcera péptica complicada resuelto mediante drenaje guiado por ecoendoscopia con prótesis de aposición luminal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "128" "paginaFinal" => "130" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Abscess secondary to complicated peptic ulcer managed by endoscopic ultrasound-guided drainage with a lumen-apposing metal stent" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 899 "Ancho" => 1733 "Tamanyo" => 237018 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A-B) Imágenes de TC abdominal que manifiestan una colección hipodensa de gran tamaño con nivel hidroaéreo compatible con absceso, que muestra contacto con el lóbulo hepático izquierdo y con el antro gástrico. C) Primera gastroscopia. Úlcera en bulbo duodenal con un orificio en su interior sugestivo de perforación. D) Imagen de ecoendoscopia de la colección abdominal desde el antro gástrico. E) Momento de implantación de la prótesis de aposición luminal Hot-Axios® con drenaje de material purulento. F) Revisión a la semana, prótesis abierta que permite acceso a una cavidad ya sin material purulento.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gonzalo Hijos, Daniel Abad, Viviana Laredo, Enrique Alfaro, Pablo Cañamares, Sandra García, Raúl Velamazán, María Hernández, Nuria Saura, Carlos Sostres" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Gonzalo" "apellidos" => "Hijos" ] 1 => array:2 [ "nombre" => "Daniel" "apellidos" => "Abad" ] 2 => array:2 [ "nombre" => "Viviana" "apellidos" => "Laredo" ] 3 => array:2 [ "nombre" => "Enrique" "apellidos" => "Alfaro" ] 4 => array:2 [ "nombre" => "Pablo" "apellidos" => "Cañamares" ] 5 => array:2 [ "nombre" => "Sandra" "apellidos" => "García" ] 6 => array:2 [ "nombre" => "Raúl" "apellidos" => "Velamazán" ] 7 => array:2 [ "nombre" => "María" "apellidos" => "Hernández" ] 8 => array:2 [ "nombre" => "Nuria" "apellidos" => "Saura" ] 9 => array:2 [ "nombre" => "Carlos" "apellidos" => "Sostres" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2444382421000304" "doi" => "10.1016/j.gastre.2020.04.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421000304?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520302594?idApp=UINPBA00004N" "url" => "/02105705/0000004400000002/v2_202109150625/S0210570520302594/v2_202109150625/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2444382421000274" "issn" => "24443824" "doi" => "10.1016/j.gastre.2020.05.013" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1597" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Gastroenterol Hepatol. 2021;44:130-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Familial adenomatous polyposis associated with pancreatic neuroendocrine tumour" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "130" "paginaFinal" => "131" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Poliposis adenomatosa familiar asociada a tumor neuroendocrino de páncreas" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 947 "Ancho" => 1750 "Tamanyo" => 154465 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Computed tomography transverse view showing a hypervascularised tumour with central necrosis at the head of the pancreas, suggestive of a pancreatic neuroendocrine tumour. (B) Computed tomography coronal view.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Pardillos Tomé, Eduardo Bajador Andreu, Ana Comín Orce, Francisco Marcilla Córdoba" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Pardillos Tomé" ] 1 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Bajador Andreu" ] 2 => array:2 [ "nombre" => "Ana" "apellidos" => "Comín Orce" ] 3 => array:2 [ "nombre" => "Francisco" "apellidos" => "Marcilla Córdoba" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421000274?idApp=UINPBA00004N" "url" => "/24443824/0000004400000002/v1_202102270718/S2444382421000274/v1_202102270718/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2444382421000316" "issn" => "24443824" "doi" => "10.1016/j.gastre.2020.05.014" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1602" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Gastroenterol Hepatol. 2021;44:126-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Giant colon lipoma complicated with intussusception and low digestive hemorragy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "126" "paginaFinal" => "128" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lipoma cólico gigante complicado con intususcepción y hemorragia digestiva baja" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 697 "Ancho" => 1305 "Tamanyo" => 105969 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Computed tomography. A) Transverse view of intestinal intussusception; a “target” or “doughnut” image can be seen (arrow) with a lipoma in its centre, as well as mesenteric vessels and fat in the periphery (arrowhead). B) Longitudinal view of the intussusception; the colon can be seen with thickened walls and mesenteric fat and vessels entering the intussusception.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Martín Domínguez, J.A. Moreno-Monteagudo, C. Santander" "autores" => array:3 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Martín Domínguez" ] 1 => array:2 [ "nombre" => "J.A." "apellidos" => "Moreno-Monteagudo" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Santander" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210570520302673" "doi" => "10.1016/j.gastrohep.2020.05.025" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520302673?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421000316?idApp=UINPBA00004N" "url" => "/24443824/0000004400000002/v1_202102270718/S2444382421000316/v1_202102270718/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Abscess secondary to complicated peptic ulcer managed by endoscopic ultrasound-guided drainage with a lumen-apposing metal stent" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "128" "paginaFinal" => "130" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gonzalo Hijos, Daniel Abad, Viviana Laredo, Enrique Alfaro, Pablo Cañamares, Sandra García, Raúl Velamazán, María Hernández, Nuria Saura, Carlos Sostres" "autores" => array:10 [ 0 => array:4 [ "nombre" => "Gonzalo" "apellidos" => "Hijos" "email" => array:1 [ 0 => "gonzahijos@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Daniel" "apellidos" => "Abad" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Viviana" "apellidos" => "Laredo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Enrique" "apellidos" => "Alfaro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Pablo" "apellidos" => "Cañamares" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Sandra" "apellidos" => "García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Raúl" "apellidos" => "Velamazán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "María" "apellidos" => "Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 8 => array:3 [ "nombre" => "Nuria" "apellidos" => "Saura" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 9 => array:3 [ "nombre" => "Carlos" "apellidos" => "Sostres" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital San Jorge, Huesca, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Absceso secundario a úlcera péptica complicada resuelto mediante drenaje guiado por ecoendoscopia con prótesis de aposición luminal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1513 "Ancho" => 2917 "Tamanyo" => 483767 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A-B) Abdominal CT images showing a large hypodense collection with an air-fluid level compatible with abscess, showing contact with the left lobe of the liver and with the gastric antrum. C) First gastroscopy. Duodenal bulb ulcer with a hole in its interior suggestive of perforation. D) Endoscopic ultrasound image of the abdominal collection from the gastric antrum. E) Moment of placement of the Hot-Axios® lumen-apposing stent with drainage of purulent material. F) Check-up after one week; open stent allowing access to a cavity now free of purulent material.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 67-year-old female patient with no relevant medical history or history of smoking or alcohol or substance abuse. She was admitted to Gastroenterology with a six-day history of epigastric pain, for which she had already visited the Accident and Emergency Department five days earlier, but had been discharged home as investigations were normal (lab tests, abdominal ultrasound) and good pain control was achieved with analgesia. On this occasion, analyses showed slight elevation of liver enzymes (AST 64 U/l, ALT 104 U/l, GGT 143 U/l, alkaline phosphatase 187 U/l) and elevation of acute phase reactants (<span class="elsevierStyleSmallCaps">C</span>-reactive protein >350<span class="elsevierStyleHsp" style=""></span>mg/l, fibrinogen 1000<span class="elsevierStyleHsp" style=""></span>mg/dl), but abdominal ultrasound was normal once again. During her stay in hospital, good pain control was achieved, the patient's general condition remained good and to complete the tests, an abdominal computed tomography (CT) scan was requested, which she had on day four. The CT scan showed an intra-abdominal collection with a high air-fluid level (12<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>14<span class="elsevierStyleHsp" style=""></span>cm) in contact with the left lobe of the liver and gastric antrum (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A–B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A gastroscopy was performed to make a differential diagnosis between abscess of biliary or gastroduodenal origin. In addition to an image of extrinsic compression of the gastric antrum, the duodenal bulb was found to have oedema and inflammation and, on its anterior surface, a small 5-mm ulcer covered with fibrin with spontaneous drainage of purulent content through a 2-mm hole in the interior, suggestive of perforation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). As the patient was virtually asymptomatic and there were no signs of alarm, we opted for non-surgical management and endoscopic ultrasound was performed, again visualising the collection (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D) and placing a Hot-Axios® 10<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>mm lumen-apposing stent at the level of the antrum which enabled drainage of abundant purulent material (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E). Due to its large size, easy access, and low output from the orifice of the fistula, we decided to drain the collection, as we considered that conservative management would not resolve the problem and would substantially prolong hospital admission. A repeat gastroscopy was performed a week later, showing a collection containing no purulent material (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F), covered with granulation tissue. Two weeks later, the stent was removed after complete resolution of the condition. As regards the aetiology of the ulcer, biopsies taken to rule out <span class="elsevierStyleItalic">H. pylori</span> came back negative, and it was assumed that the ulcer was related to the patient taking non-steroidal anti-inflammatory drugs (NSAID) prescribed for joint pain weeks prior to admission. The patient had been started on treatment with proton pump inhibitors (PPI) at diagnosis, with subsequent follow-up endoscopies showing the ulcer to have completely healed.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Endoscopic ultrasound-guided drainage, less invasive than percutaneous or surgical, is a procedure increasingly used in a range of indications. Lumen-apposing stents are shorter than conventional metal stents and have wider ends, which reduces the risk of migration. They are currently one of the most widely used stents for endoscopic ultrasound-guided drainage of infected encapsulated pancreatic necrosis, with data suggesting that they may be superior to drainage with plastic stents, although as yet there is a lack of solid evidence. These stents have a big enough diameter to facilitate adequate drainage and even perform endoscopic necrosectomy through them.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> They have also been used successfully for endoscopic drainage of the bile duct (choledochoduodenostomy), treatment of acute cholecystitis in patients with high surgical risk (cholecystogastrostomy) and to perform gastroenteroanastomosis in patients with gastric outflow tract obstruction or other indications (enable endoscopic retrograde cholangiopancreatography [ERCP] in patients with Roux-en-Y anatomy).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The incidence of admissions for peptic ulcer is declining. The most common complication is gastrointestinal bleeding. Perforation is less common; it usually manifests as an acute abdomen with a CT finding of pneumoperitoneum and requires urgent surgery in most cases. Less often, if the perforation is contained by neighbouring organs or if concomitant treatments interfere with its clinical course, it can present in a more latent form, giving rise to an intra-abdominal abscess.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> We have presented a case of intra-abdominal abscess secondary to a perforated duodenal ulcer with an atypical clinical presentation, which we were able to completely resolve by inserting a lumen-apposing stent. There is very little evidence on the use of this technique for the drainage of non-pancreatic intra-abdominal collections. It has mainly been used for post-surgical collections, with good outcomes.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> A Spanish series of 18 intra-abdominal abscesses, which were neither pancreatic nor postoperative, recently reported high technical and clinical success rates (both 88.9%) for endoscopic ultrasound drainage, including eight lumen-apposing stents and ten conventional metal or plastic stents.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Although controlled studies are required, using our case as illustration, we believe this technique could be useful for the management of intra-abdominal abscesses.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">This study has received no specific funding from public, private or non-profit organisations.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hijos G, Abad D, Laredo V, Alfaro E, Cañamares P, García S, et al. Absceso secundario a úlcera péptica complicada resuelto mediante drenaje guiado por ecoendoscopia con prótesis de aposición luminal. Gastroenterol Hepatol. 2021;44:128–130.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1513 "Ancho" => 2917 "Tamanyo" => 483767 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A-B) Abdominal CT images showing a large hypodense collection with an air-fluid level compatible with abscess, showing contact with the left lobe of the liver and with the gastric antrum. C) First gastroscopy. Duodenal bulb ulcer with a hole in its interior suggestive of perforation. D) Endoscopic ultrasound image of the abdominal collection from the gastric antrum. E) Moment of placement of the Hot-Axios® lumen-apposing stent with drainage of purulent material. F) Check-up after one week; open stent allowing access to a cavity now free of purulent material.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.H. Baron" 1 => "C.J. DiMaio" 2 => "A.Y. Wang" 3 => "K.A. Morgan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.gastro.2019.07.064" "Revista" => array:6 [ "tituloSerie" => "Gastroenterology." "fecha" => "2020" "volumen" => "158" "paginaInicial" => "67" "paginaFinal" => "75" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31479658" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current uses and outcomes of lumen-apposing metal stents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Mussetto" 1 => "A. Fugazza" 2 => "L. Fuccio" 3 => "O. Triossi" 4 => "A. Repici" 5 => "A. Anderloni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.20524/aog.2018.0287" "Revista" => array:6 [ "tituloSerie" => "Ann Gastroenterol." "fecha" => "2018" "volumen" => "31" "paginaInicial" => "535" "paginaFinal" => "540" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30174389" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic subclinical perforation of a duodenal ulcer presenting with an abdominal abscess in a patient with seronegative rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Ashfaq" 1 => "Ab. Chapital" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "BMJ case reports." "fecha" => "2015" "volumen" => "2015" "itemHostRev" => array:3 [ "pii" => "S0261561418301201" "estado" => "S300" "issn" => "02615614" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EUS-guided drainage of postsurgical fluid collections using lumen-apposing metal stents: a multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.R. Mudireddy" 1 => "A. Sethi" 2 => "A.A. Siddiqui" 3 => "D.G. Adler" 4 => "J. Nieto" 5 => "H. Khara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.gie.2017.08.011" "Revista" => array:6 [ "tituloSerie" => "Gastrointest Endosc." "fecha" => "2018" "volumen" => "87" "paginaInicial" => "1256" "paginaFinal" => "1262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28843581" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retrospective cohort study comparing endoscopic ultrasound-guided and percutaneous drainage of upper abdominal abscesses" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.Y. Carbajo" 1 => "F.J. Brunie Vegas" 2 => "F.J. Garcia-Alonso" 3 => "M. Cimavilla" 4 => "R. Torres Yuste" 5 => "P. Gil-Simon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/den.13342" "Revista" => array:6 [ "tituloSerie" => "Dig Endosc" "fecha" => "2019" "volumen" => "31" "paginaInicial" => "431" "paginaFinal" => "438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30629764" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004400000002/v1_202102270718/S2444382421000304/v1_202102270718/en/main.assets" "Apartado" => array:4 [ "identificador" => "77930" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004400000002/v1_202102270718/S2444382421000304/v1_202102270718/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421000304?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 0 | 4 |
| 2024 October | 66 | 2 | 68 |
| 2024 September | 53 | 3 | 56 |
| 2024 August | 66 | 9 | 75 |
| 2024 July | 50 | 4 | 54 |
| 2024 June | 39 | 4 | 43 |
| 2024 May | 37 | 2 | 39 |
| 2024 April | 46 | 24 | 70 |
| 2024 March | 74 | 4 | 78 |
| 2024 February | 61 | 3 | 64 |
| 2024 January | 71 | 0 | 71 |
| 2023 December | 91 | 8 | 99 |
| 2023 November | 67 | 5 | 72 |
| 2023 October | 94 | 7 | 101 |
| 2023 September | 32 | 2 | 34 |
| 2023 August | 38 | 2 | 40 |
| 2023 July | 43 | 3 | 46 |
| 2023 June | 13 | 3 | 16 |
| 2023 May | 6 | 0 | 6 |
| 2023 April | 11 | 1 | 12 |
| 2023 March | 9 | 1 | 10 |
| 2023 February | 8 | 2 | 10 |
Show all
