RESUMO: O abdome agudo configura um quadro clínico de dor dos mais importantes e freqüentes na prática clínica. Pela sua gravidade necessita de condutas diagnósticas e terapeuticas urgentes. Pode ser decorrente de inúmeras doenças. O texto discorre sobre diferentes etiopatogenias e as bases do quadro clínico, essenciais para o diagnóstico e tratamento. Descritores: Abdome Agudo. Quadro 1: Causas comuns de abdômen agudo • Distúrbios do trato gastrintestinal Dor abdominal inespecífica* Apendicite aguda* Obstrução intestinal* Ulcera péptica perfurada* Hérnia encarcerada Perfuração intestinal Diverticulite aguda* Diverticulite de Meckel Síndrome de Boerhaave Distúrbios intestinais inflamatórios Gastrenterite aguda e gastrite aguda Adenite mesentética Infecções parasitárias • Distúrbios do fígado, baço e trato biliar Colecistite aguda* Colangite aguda Abscesso hepático íntegro ou roto

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BACKGROUND Ulcerative colitis (UC) is a chronic inflammatory bowel disease which affects the colorectal mucosa with a relapsing–remitting pattern. The therapeutic options currently available for the medical management of UC include many options. Tofacitinib is an oral small molecule, JAK inhibitor, more selective for JAK 1 and JAK 3, which reduces the inflammatory process involved in the pathogenesis of UC. METHODS Retrospective observational multicentric study of patients with ulcerative colitis (UC) who used tofacitinib in any phase of their treatment. Clinical remission and response (according to Mayo Score), mucosal healing, primary and secondary loss of response, discontinuation of the drug with possible causes, and the need for dose optimization or switching to biologicals, need for surgery and adverse events were evaluated. RESULTS From a total of 56 included patients, clinical remission was observed in 43.6% at week 12, 54.5% at week 26, 57.9% at week 52 and 40% at the last follow-up visit. Clinical response was observed in 71.4%, 81.8%, 89.5% and 61.8% at the same time periods, respectively. Mucosal healing rates were 50% and 17,8% needed colectomy. CONCLUSION Tofacitinib was effective in induction and maintenance of clinical response and remission rates, compatible to other international real-word studies and meta-analyses.

Background: Reports on the development of Fournier's Gangrene (FG) in patients with coronavirus disease 2019 (COVID-19) are rare. Aim: This study reports a series of cases of patients with both diseases and to summarize the literature on the subject. Methods: We retrospectively examined electronic medical records dated between March 2020 and December 2021 of all adult patients with COVID-19 admitted to the Clinics Hospital of Ribeirão Preto (HCFMRP-USP) to identify those who had a diagnosis of FG. The diagnosis of COVID-19 was made by RT-PCR. We assessed the following patient characteristics: age; sex; tobacco use; laboratory data; and comorbidities such as human immunodeficiency virus (HIV), obesity, diabetes mellitus, systemic arterial hypertension, and alcoholism. Results: Four patients met the inclusion criteria. All the patients were female and had at least two comorbidities, including obesity (n=4, 100%), systemic arterial hypertension (n=3, 75%), diabetes mellitus (n=2, 50%), cardiovascular disease (n=1, 25%), chronic kidney disease (n=1, 25%), and hematologic disorders (n=1, 25%). They were all admitted to the intensive care unit and underwent surgical debridement under anesthesia. All the patients received hyperbaric oxygen therapy. The mean age was 62.75 years (range 60-66 years), and the mean length of stay was 30 days (range 22-37 days). One patient died (n=1, 25%). Conclusion: This is the first report in the literature on a series of cases of FG in patients with COVID-19. FG associated with COVID-19 is a serious, potentially lethal condition.

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