Patient of 34 years old. With a history of malabsorption of 2 years with low weight of 18 kilos. Do not have a family history of genetic diseases, diabetes, chronic diarrhea etc.No. It started with pasty stools green and yellow semiformed there with enough white blood cells . In the analysis is repeated stool fat globules. Has several positive sudan. In one of them shows the presence of neutral fat. Your stools are semi-formed, pasty consistency. Yellowish. Sometimes found parasites like Entamoeba coli , Endolimax nana. Giardia was not found. He was treated with antibiotics for bacterial overgrowth. Patient says that before starting with their discomfort, I was taking enough antibiotics for urinary tract infections and dental problems. X-small intestine is showing signs of malabsorption. Snowflakes and trumpeted column fragmented. Dxilosa test positive. Capsule endoscopic image of erythema and edema in jejunum and images of ileal lymphoid hyperplasia. Negative tests for celiac disease. Was gluten-free diet for about 2 months, noticing a slight improvement. In feces is enough muscle fibers, starch and fat. And cellulose. Presents a Maldigestion and malabsorption at a time. Curiously this case because the patient normal.Lo albumin greater than it is contradictory because it has no hypoalbuminemia but that would do as hiperalbumina na dehydration. It has good hemoglobin, the lowest with 12. Most with 14. Anisocytosis presented on several occasions. Prothrombin time also appears elongated. Monocytes out of range once. Profile liver within range, except that this albumin higher than normal. ESR and C reactive protein normal. Only once a high VCM. Gallbladder ultrasound with hypotrophic. Resonance with very distended gallbladder as tomography. Endoscopy with biopsy is the gastric antrum with erythema without the presence of helicobacter. Examination of Ig for helicobacter positive. Breath test, undetermined. Normal colonoscopy with biopsy does not specify non-specific chronic colitis. Biopsy of the ileum with nonspecific severe chronic enteritis. With slightly shorter and broader villi in realción with celiac disease. Trypsin fecal negative. After the last exam was given the diagnosis of pancreatic insufficiency. Despite tell digestive enzymes (Creon) patient continues with steatorrhea. Discussed whether it could have a secondary biliary insufficiency due to yellowish color of the stool. Patient reports that sometimes the stools are a little more formed but almost remain the same and kept the yellow, white.
Asked On : Sat, 18 Dec 2010