We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
Crohn's disease is a chronic inflammatory intestinal disease that causes recurring lesions anywhere in the gastrointestinal tract. It particularly affects young people who present episodes of stomach symptoms such as diarrhoea, abdominal pain, fever, blood in faeces or fistulas. Crohn's disease can cause various health problems that may result in changes to the patient's personal, social and family life.
Changes in health directly depend on:
All these changes may make the patient feel their quality of life is getting worse and that they should see their doctor often.
Caring for patients with this disease requires a multidisciplinary approach centred around their needs in order to avoid repeat visits. For this reason patients are treated in specialised unit, such as the Crohn’s-Colitis Unit at Vall d’Hebron Hospital.
The disease manifests as flare-ups. In other words, there are periods when symptoms are active and the patient feels unwell (“flare-ups”) and others when the disease calms down (“periods of remission”).
The most common symptoms during a flare-up are:
The incidence rate of Crohn's disease is 1-10 patients/100,000 people a year and its prevalence is 300 per every 100,000 people. It can appear at any age, but is most common in young adults aged 20-40. It affects men and women equally, and factors leading to a predisposition to the disease include smoking, first degree family members with the disease or changes to the faecal microbiota.
Diagnosis is based on the doctor's assessment of the combined symptoms and subsequent complementary tests that identify and locate lesions in the intestine.
The most important test is the colonoscopy, which consists of inserting a flexible tube into the rectum to see inside the intestine, and through which biopsies can be obtained. Radiological tests can also be used such as MRI or CT scans. The results of the biopsies are used to confirm diagnosis.
Recovery begins with pharmacological treatment, which has vastly improved in recent years, and adopting a healthy lifestyle.
There are several treatment options such as corticosteroids, immunosuppressants, and biological agents, which are used depending on the activity and location of the disease, and taking into account any complications that may arise. Once treatment is agreed it is very important not to stop it, as this would result in a relapse and lack of control over the disease.
Diphtheria is an acute infectious disease caused by the Corynebacterium diphtheriae bacteria and which only affects humans. It may show up as a condition of the upper respiratory tract (tonsils, pharynx and nasal mucosa). The bacteria produces an exotoxin that is responsible for the clinical symptoms of the disease. In adults, it can be fatal in 5-10% of cases, and in children this rises to 20%.
The characteristic symptom of respiratory diphtheria is a greyish white membrane (pseudomembrane) covering the tonsils and pharynx. The membrane tends to be difficult to remove and in doing so the area bleeds easily.
The most common symptoms are:
Thanks to vaccination, there have been no cases diagnosed in Spain for over thirty years. In 2015, however, there was one case in a child who had not been vaccinated.
Diphtheria is transmitted through respiration or close physical contact with an infected person or a healthy person carrying the bacteria but who has never shown symptoms.
The incubation period is two to seven days and it can be spread from seven days before symptoms appear up to two or three weeks afterwards.
Diagnosis is confirmed via microbial culture of clinical samples (swabs from the nasal mucosa, pharynx or pseudomembranes).
Diphtheria antitoxin medication and an antibiotic such as penicillin G procaine must be given as soon as possible (in the first 48 hours after showing symptoms, without waiting for the laboratory diagnosis).
Vaccination is the main measure to prevent diphtheria and is effective in 95% of cases. It must be periodically boosted as the effects of the vaccination do not last for ever.
Epidemiological monitoring and prophylaxis are essential to control the bacteria and to avoid secondary cases.
Diabetes is a chronic disease brought about by the body’s inability to process sugar effectively. It occurs when the pancreas cannot produce insulin, or when the body cannot put it to use. This means there are high levels of glucose in the blood, which can damage organs, tissues and limbs if it remains high for a long time.
There are two types of diabetes: 1 and 2. Type 1 can only be treated with insulin, whereas type 2 can be prevented through doing sport, taking exercise and diet.
There are different types of diabetes depending on the harm they cause:
There are several symptoms which may or may not appear. The most common are:
In the case of type 1 diabetes, these symptoms may appear suddenly or over time, and may significantly affect general well-being.
Between 1980 and 2014, diabetes in adults rose from 4.7 % to 8.5 %. In addition, it has been found to be on the increase in countries with low and middle incomes.
It can be detected with a blood test analysed in the laboratory to measure glucose levels. Diabetes is confirmed if the level is equal to or higher than 126 mg/dL on two occasions. A normal glucose level would be between 110 and 125 mg/dL.
In the case of type 2 diabetes, it can be in the body for many years without detection. For this reason, it is often diagnosed when a complication arises or as the result of a routine blood test.
There are several types of medication that lower blood glucose levels. Each type of diabetes requires different treatment.
Type 1 diabetes cannot be prevented, but environmental factors leading to the process that destroys insulin producing cells in the pancreas are being studied.
On the other hand, a balanced diet and increased physical exercise can help prevent type 2 diabetes. In other words, obesity should be avoided.
Meningitis is an inflammation of the meninges, which are the membranes covering the brain and spinal cord. This is generally caused by an infection that is bacterial, viral or fungal.
Meningitis may also have various non-infectious origins such as trauma and tumours.
There are two types of meningitis:
Bacterial meningitis is a serious disease requiring immediate medical attention. Three microorganisms are the cause of the disease. They are naturally present in the pharynx, where they are commensal, or “friendly”, bacteria. The disease can progress very quickly. This happens when these microorganisms invade the blood stream. Bacterial meningitis is spread through respiratory secretions, for example when we cough or kiss. People sharing a home are likely to be infected.
Meningitis may also include nausea and vomiting, sensitivity to bright light, drowsiness, falling into a coma or convulsions.
The first symptoms of bacterial and viral meningitis are similar. However, bacterial meningitis is generally severe and can cause serious complications such as brain damage or learning difficulties.
In bacterial meningitis, the bacteria in the blood can give rise to another serious disease, septicaemia, which is the body’s generalized reaction to infection and which may have various consequences such as:
In the most serious cases it can be fatal. In this case, the appearance of small spots on the skin is cause for alarm.
Bacterial meningitis can be contracted by any age group but the elderly and young children are most at risk. In the last twenty years its epidemiology has changed significantly with the introduction of new vaccines linked to child vaccination programmes.
Whilst meningococcus is the main cause of bacterial meningitis around the world, in Spain meningococcal disease is not endemic, with an annual rate of fewer than 5 cases for every 100,000 people. Meningococcal meningitis may lead to death in 3-15 % of cases.
Many of the viruses that cause the disease are present worldwide and others are specific to particular regions.
If meningitis is suspected, blood and cerebrospinal fluid (the liquid around the spinal cord and brain) samples will be analysed. Cerebrospinal fluid is obtained via lumbar puncture. Analysis will help confirm the disease and will identify the microorganism causing it.
Most cases of infectious or viral meningitis improve without treatment in 7-10 days. However, it is very important that people with symptoms of meningitis receive immediate medical care to make a correct diagnosis of the disease, to determine the type of meningitis and to receive the right treatment.
In the case of bacterial meningitis, antibiotic treatment must be administered intravenously as soon as possible. Anti-inflammatories may also be used to treat any complications that may arise.
It is a hole that may be found in any part of the partition dividing the ventricles, and may be one hole or multiple, and of varying sizes and shapes. VSD may be associated with more complex heart defects such as tetralogy of Fallot, transposition of the great arteries or atrioventricular canal.
Small ventricular septal defects reduce in size over time and in many cases may close up by themselves, particularly during the first two years of a child’s life. The overall rate of spontaneous closure is 30-35% of cases.
In general, children with small VSD do not show any symptoms and So their eating habits, growth and development are all normal. This hole is detected via the presence of a murmur during the first weeks of life.
Children with a medium or large VSD develop symptoms in the first few weeks after being born. These may be:
VSD is one of the most common heart defects, if we do not include bicuspid aortic valve. It represents around 20% of all heart defects.
VSD is detected by an echocardiogram, which can confirm the number, size, location and functional repercussions.
Babies with small VSD do not need surgical treatment.
Those with medium to large VSD who develop cardiac insufficiency, on the other hand, must undergo medical treatment. If symptoms persist, early corrective surgery will be carried out, which consists of closing the hole with a patch, or a device implanted by cardiac catheterization.
If there are no other defects associated with the VSD, surgical mortality is 0%. After the operation, patients can lead a normal life the same as the rest of the population.
This syndrome is one of the most frequently treated gastrointestinal disorders in gastroenterology. It is characterized by chronic abdominal pain accompanied by changes in bowel movements in the form of diarrhoea or constipation. It is common in young women and can have a significant impact on the patient’s personal life, health, and economic and social welfare.
Scientific evidence from recent years suggests there are many different factors involved in developing this disease:
It is currently considered to be a disorder caused by an imbalance in the gut-brain-microbe axis This imbalance negatively affects the functioning of the intestinal barrier and activates the digestive system’s immune and nervous system. This creates visceral hypersensitivity and motor disturbances.
It is classified according to consistency:
It affects 7.8% of the population in Spain and twice the number of women compared to men: 1. IBS is the reason for 10-15 % of primary care appointments and 25-30 % of gastroenterology consultations. Over 50 % of patients are affected by other pain conditions such as fibromyalgia, headache or pelvic pain, and also by other gastrointestinal disorders such as dyspepsia or by anxiety disorders and depression.
IBS is diagnosed by fulfilling a set of clinical criteria based on symptoms and on the exclusion of other organic causes that may act in a similar way.
Diagnostic criteria known as the Rome IV criteria have been established by medical consensus by committees of experts. The following are required for diagnosis:
When determining treatment, it is important patients understand the chronic and fluctuating nature of the disease. To draw up an appropriate treatment plan, the doctor must identify the dietary and psychic-social causes of the illness.
Specific treatments are beginning to be introduced for IBS, such as linaclotide, eluxadoline and lubiprostone, but not all are available in Spain. There are also many treatments designed to control symptoms, such as anti-spasmodic drugs, laxatives and anti-diarrhoeals.
It is a hole in the partition that separates the two atria and that causes the right side of the heart to be overloaded. Children with ASD do not show symptoms, even though the right side of the body has to work with a much larger volume of blood.
Depending on the position of the atrial septal defect, ASD is classified into three types:
“Ostium Primum” is considered a different defect due to the damage associated with it.
ASD is one of the most common heart defects (6-10%) and is more common in women.
In most cases, children with ASD show no symptoms. For this reason, it is detected when listening to the heart during a routine examination detects a heart murmur. In that case, an echocardiogram should be carried out on the patient to identify the defect and determine treatment options.
When the defect is small with no significant blood flow no procedure may be necessary. On the other hand, if this is significant, the characteristics of the ASD must be assessed to decide if it is necessary to close it via catheterization or surgery.
Closure via catheterization consists of inserting a device to close the defect and stop blood passing from one chamber of the heart to the other.
When the defect is large or its shape prevents the percutaneous device entering, this closure must be performed through surgery. The procedure consists of fitting a patch over the hole in the partition, made either from synthetic material or tissue taken from the patient themselves.
Children who have undergone ASD closure have a similar life expectancy and quality of life to healthy patients. In fact, the survival rate is over 99.7%. In contrast, patients with ASD who do not undergo surgery see a decline in their life expectancy after forty years old.
Chagas disease is an infection caused by the “Trypanosoma cruzi” parasite which is transmitted through the bites of an insect (the “kissing bug”). The disease can also be spread from mother to child (vertical transmission), through blood transfusion, organ donation from people infected with the disease or from eating food contaminated with the parasite. For the moment, the number of new cases has been reduced thanks to policies to eliminate the insect in countries where it is endemic, as well as thanks to screening programmes aimed at blood and organ donors and pregnant women. The future challenges to cure this disease are maintaining and increasing these measures in addition to developing new treatment evolution and response markers for patients in the chronic phase, and new drugs to treat the disease.
Chagas disease is endemic to Latin America and is a global health challenge due to migration from countries in the region. Transmission via insect is mainly found in Bolivia, which has the highest number of cases. There are also infections in north-west Argentina, Peru, Paraguay, Ecuador, Nicaragua and southern Mexico. Outside these areas it is more commonly transmitted from mother to child.
Most patients with Chagas disease do not show any symptoms, which makes it difficult to detect. The disease develops in two phases:
This disease affects six to seven million people, but 60 million are estimated to be at risk of infection. There are 11,000 cases in Catalonia.
There are currently two drugs that are used to treat Chagas disease: Benznidazole and Nifurtimox. Specific treatment is needed to address any cardiac and/or gastrointestinal complications that may arise.
Since 2011, Catalonia has implemented the “Protocol for screening and diagnosing Chagas disease in pregnant Latin American women and their babies”. This programme allows possible congenital cases to be detected, and at the same time actively screens blood and organ donations from donors.
Strokes are a medical condition caused by an alteration in blood circulation to the brain. This alteration is due to an artery becoming blocked (ischemic stroke) or the rupture of a blood vessel (haemorrhagic stroke), preventing blood from reaching the brain and therefore temporarily or permanently altering brain functions. When blood flow is impeded, the affected part of the brain does not get the nutrients and oxygen it needs. As a result, brain cells can die, causing severe after-effects.
For this reason, if a person is suspected of having a stroke, the Emergency Medical Service should be notified immediately by calling 112. Acting quickly is essential in order to minimise or eliminate possible after-effects.
Strokes can be grouped into two broad categories depending on the reasons behind them:
When blood flow is temporarily interrupted (for between one and 24 hours), this is known as a Transient Ischemic Attack (TIA); however, if the duration is longer or the brain scanner detects necrosis (neuronal death), it is considered an ischemic stroke. TIA is a predictor of vascular disease and, in the case of stroke, is a warning that the person is at risk. In fact, 40% of people who suffer a stroke have previously suffered a TIA.
In the event of the sudden onset of one or more of the following symptoms, action should be taken quickly by calling 112:
Anyone can suffer a stroke, regardless of age and physical condition, although they are more common in the elderly. About 75% of cases occur in people over 65, although they increasingly affect young adults due to their lifestyle habits (between 15 and 20% are under 45). Strokes can also affect children: in Catalonia alone, 900 children live with a disability as a result of a stroke.
This disease can also be known by other names, such as apoplexy, cerebral vascular accident, seizure and thrombosis. In Catalonia, more than 13,000 people are admitted each year for a stroke and, unfortunately, they are not always reached in time to save the patient.
To determine the cause of a stroke it is necessary to perform a brain scan (CT). The scan can be completed by reviewing the condition of the cerebral and cardiac vessels, taking into account risk factors and chronic diseases presented by the patient. However, it is not always possible to discover the origin.
Knowing the cause of a stroke allows us to establish the most appropriate treatment to prevent it from happening again. Depending on the aetiology (cause), it can be classified as:
If a stroke is suspected, a neuroimaging test (a CT or MRI) should be performed as soon as possible, which will tell us about:
Specialists may request other tests such as a chest x-ray (performed upon admission as a first assessment), a doppler or transcranial duplex (to see whether there is a possible intracranial occlusion or stenosis, and where it is located), blood tests (to find out the status of risk factors, immunological and coagulation study, serologies, hormones, renal function, etc.) or a cardiological study (if a cardioembolic stroke is suspected).
After diagnosis, specialists may ask to repeat the tests to detect any changes by comparing the images, or request other tests.
Stroke treatment should be applied immediately, as rapid action can lessen the effects. However, a rehabilitation period is usually needed to eliminate or reduce possible after-effects.
After suffering a stroke, the risk of having another is higher, so it is necessary to take medication to reduce the risk, always following medical guidelines. The first year after suffering a stroke is when there is the highest risk of relapse.
Suffering a second stroke may have a fatal outcome. In survivors, it leads to an increase in the degree of disability and risk of dementia, as well as a higher rate of institutionalisation.
The impact may be different for each patient. Symptoms will be more or less severe depending on the area and volume of the brain affected, as well as the general state of health prior to the event.
In the case of a transient ischemic attack (TIA), which does not usually leave after-effects, or ischemic strokes, if the patient responds well to treatment, recovery is virtually immediate. At other times, the recovery is longer term and takes weeks or months, leaving some sort of after-effects.
There may also be a worsening of the patient due to neurological causes or complications such as fever, infections or others. In more severe cases, it can lead to death.
Once the patient is discharged, the primary care team takes responsibility for the patient, and will monitor risk factors and other chronic diseases. In complex cases, patients will need to visit specialists, such as neurologists.
The return home after hospital discharge will vary depending on the severity of the incident and the patient's family situation. Similarly, reintegration into daily life will depend on the after-effects experienced by each patient.
Total anomalous pulmonary venous connection (TAPVC) means that there is no connection from the pulmonary veins to the left atrium. Instead, they are redirected to the right atrium through an unusual connection. This defect affects new-borns and may need urgent surgery depending on its severity. Other, less severe cases may be detected when the baby is a few weeks or months old. In these cases, surgery is also necessary.
In a heart that functions normally, veins take oxygenated blood from the lungs to the left side, and from here to all parts of the body.
In people with TAPVC, oxygenated blood reaches the right side, where it mixes with deoxygenated blood and passes through a hole in the interatrial wall to the left atrium. This means that oxygen levels are lower in these children.
This anomaly works in different ways depending on the level of severity:
An echocardiogram can detect if a child has TAPVC. This is carried out within a few hours of birth for babies with TAPVC with obstruction. In other children, it is customary to carry out the test after listening to the heart and detecting a murmur and observing low blood oxygen levels.
In addition, an additional imaging test is usually done, such as computed tomography (CT scan) or an MRI to study the anomaly or defect.
Patients with TAPVC have to undergo surgery. In this procedure, the pulmonary vein flow is redirected to the left atrium and the anomalous communication with the right atrium corrected.
New-borns with TAPVC with obstruction are in a life-threatening situation. It is therefore necessary to perform surgery as soon as they are born to correct the anomaly.
For patients with TAPVC without obstruction, elective surgery can be performed once diagnosis is made.
Children who have had surgery for TAPVC can live a normal life and do not require further procedures. However, cardiological monitoring is necessary.
Select the newsletter you want to receive:
By accepting these conditions, you are agreeing to the processing of your personal data for the provision of the services requested through this portal, and, if necessary, for any procedures required by the administrations or public bodies involved in this processing, and their subsequent inclusion in the aforementioned automated file. You may exercise your rights to access, rectification, cancellation or opposition by writing to web@vallhebron.cat, clearly stating the subject as "Exercising of Data Protection Rights". Operated by: Hospital Universitari Vall d'Hebron - Institut Català de la Salut. Purpose: Manage the user’s contact information. Legitimisation: Express acceptance of the privacy policy. Rights: To access, rectify, and delete personal information data, as well to the portability thereof and to limit and/or oppose their use. Source: The interested party themselves.