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Esophageal Perforation-I: Introduction01:22

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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
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Esophageal Perforation-II: Clinical Manifestations and Management01:28

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
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Perforación intestinal asociada a bevacizumab que causa evisceración

Maziar Fazel Darbandi1, Garrett Johnson1, Krista Hardy1

  • 1Department of Surgery, University of Manitoba, Winnipeg, CAN.

Cureus
|December 30, 2025
PubMed
Resumen

El bevacizumab, utilizado para el cáncer de recto metastásico, puede causar raramente perforación gastrointestinal. Este caso destaca a un paciente que experimentó evisceración del intestino delgado a través de una perforación en el sitio de la colostomía, que requirió intervención quirúrgica y recuperación.

Palabras clave:
terapia con bevacizumabevisceración intestinalcáncer de recto metastásicohernia parastomalperforación intestinal espontánea

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Área de la Ciencia:

  • Oncología; Gastroenterología; Cirugía Oncológica

Sus antecedentes:

  • El bevacizumab es un anticuerpo monoclonal dirigido contra el factor de crecimiento endotelial vascular (VEGF), que inhibe la angiogénesis en tumores sólidos. Es eficaz en el manejo del cáncer colorrectal (CCR) metastásico cuando se combina con quimioterapia basada en fluorouracilo. La perforación gastrointestinal es una complicación rara pero conocida de la terapia con bevacizumab.

Objetivo del estudio:

  • Informar un caso raro de evisceración del intestino delgado a través de una perforación en el sitio de la colostomía. Discutir la posible contribución del bevacizumab y una hernia parastomal a esta complicación. Ilustrar el manejo quirúrgico de emergencia y la recuperación de dicho paciente.

Principales métodos:

  • Informe de caso de un paciente varón de 70 años con cáncer de recto metastásico en tratamiento con bevacizumab. Presentación con evisceración del intestino delgado a través de un sitio de colostomía perforado, asociado con una hernia parastomal. Descripción de la intervención quirúrgica de emergencia que incluye resección, reparación y creación de colostomía.

Principales resultados:

  • El paciente se sometió a cirugía de emergencia por evisceración del intestino delgado y perforación del colon. Los procedimientos quirúrgicos incluyeron resección de intestino isquémico, colon perforado, reparación de hernia y formación de una nueva colostomía. El paciente se recuperó bien y fue dado de alta dos semanas después de la cirugía, continuando con la quimioterapia paliativa.

Conclusiones:

  • Este caso subraya el riesgo raro de perforación gastrointestinal, específicamente en el sitio de una colostomía, en pacientes que reciben bevacizumab. La interacción entre la hernia parastomal crónica y la terapia con bevacizumab puede predisponer a complicaciones tan graves. La intervención quirúrgica rápida es crucial para el manejo de la evisceración y perforación intestinal en este contexto, permitiendo la continuación del tratamiento oncológico.