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INTRODUÇÃO: Constipação na gravidez é sintoma comum, mas para seu diagnóstico são necessários dois ou mais sintomas persistentes, como ritmo intestinal mais lento, dificuldade para evacuar, fezes endurecidas ou sensação de evacuação incompleta. Existem múltiplos fatores envolvidos, hormonais, sedentarismo, ingestão de fibras ou líquidos, uso de medicamentos, etc. OBJETIVO DO ESTUDO: analisar a incidência de constipação em 41 gestantes sadias do Ambulatório de Obstetrícia da Santa Casa de São Paulo. MÉTODO: a pesquisa se fez através do preenchimento de um questionário sobre ritmo intestinal, hábitos de vida, sintomas digestivos antes e após a gravidez. RESULTADOS: observamos que constipação incidiu em 27,6% daquelas que não sofriam sintomas pregressos. CONCLUSÃO: a incidência de constipação na gestação é menor que o usualmente estimado, começa no início da gravidez, e devido ao baixo índice encontrado não há razão para uso indiscriminado de laxativos.BACKGROUND: constipation is a common problem during pregnancy, but for a definitive diagnosis, symptoms such as low motility, defecation difficulties, hard feces and incompletet evacuation should be evaluated. There are a number of factors involved, including hormones, physical activity, water and fiber intake, medication, etc. OBJECTIVE: the objective of the present study was to analyse the occurence of constipation in 41 normal pregnant women from the Ambulatory of Obstetrics and Gynecology Department at Santa Casa Hospital in São Paulo. METHOD: the patients filled a questionnaire with questions related to the frequency of stools, personal habits, symptoms and any other related conditions, before and after pregnancy. RESULTS: the overall incidence of constipation was 27.6%, excluding the subjects with previous history. CONCLUSION: we concluded that the incidence of constipation is lower than expected and generally occurs since the beginning of pregnancy. There seems to be no reason for the prescription of laxatives in most cases in pregnancy.

Endosonography-guided biliary drainage has been used over the last few years as a salvage procedure when endoscopic retrograde cholangiopancreatography fails. Malignant gastric outlet obstruction may also be present in these patients. We report the results of both procedures during the same session in patients with duodenal and biliary obstruction due to malignant disease.A retrospective review from a prospective collected database.Technical success was achieved in all five patients; however, only three patients experienced relief of jaundice and gastric outlet obstruction.Endosonography-guided biliary drainage and duodenal stenting in the same session is feasible. However, severe complications may limit the procedure. This is a challenging procedure and should be done by experts with special attention to patient's selection.