ABSTRACT
Pancreatic panniculitis is a rare condition, affecting 2 to 3% of patients with pancreatic diseases, such as acute pancreatitis or pancreatic carcinoma. The clinical manifestations of panniculitis are painful erythematous nodules, predominantly affecting the lower limbs. From an anatomopathological point of view, the subcutaneous nodules are made of fat necrosis and vacuolated macrophages. The treatment consists in resolving the underlying diseases. We present the case of a 56-year-old female, admitted on the Emergency Department, who presented with acute abdominal pain and subcutaneous erythematous nodules. The combination of laboratory data, clinical and anatomopathological results confirmed the pancreatic panniculitis, in an underlying acute pancreatitis. The treatment focused on the resolution of the pancreatic disease.
ABSTRACT
Xanthelasma, also known as Xanthoma or lipid island, is an uncommon gastrointestinal tract (GIT) tumor-like lesion and the stomach is its most frequent location in upper GI lesions, specifically in the gastric antrum, as a single lesion. The pathogenesis appears to be related to healing processes in response to tissue damage provoked by inflammation induced by Helicobacter pylori infection. Many studies have reported that successful H. pylori eradication helps prevent gastric cancer (GC) development. We present a case of a 77 years old patient that showed endoscopic diagnosis of erythematous gastropathy, a gastric antrum xanthelasma and H. Pylori infection. After confirmed H. pylori eradication, the lesion had complete regression. The successful eradication of H. pylori probably led to a total regression of the lesion. Gastric xanthelasma (GX) has been shown to be an independent predictive marker for early GC detection after H. pylori eradication. GX could be a useful marker for predicting the development of gastric cancer.
ABSTRACT
Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed surgeries for morbid obesity. Perforated duodenal ulcers are very rare in these patients (with a 0.25% incidence reported) and the diagnosis can be challenging. We report a case of a 43-year-old woman who presented with severe acute abdominal pain to the emergency department. She had undergone a laparoscopic RYGB 5 years previously. Exploratory laparoscopy revealed a duodenal perforation, which was repaired by primary closure. As Helicobacter pylori has been implicated in the formation of ulcers in this population, eradication therapy should be started.
ABSTRACT
Iatrogenic diaphragmatic hernia is a rare complication of esophageal and upper abdominal surgery. The use of the gastric band has been an established and popular surgical treatment for morbid obesity. We describe a rare case of a patient who had undergone laparoscopic surgery to remove an adjustable gastric band, who presented 5 months later with an acute intense thoracic pain. The computed tomography scan revealed a diaphragmatic hernia containing the stomach. The patient required emergent laparoscopic surgery to reduce the hernia, repair the defect and resection of the ischemic stomach. In this case report, we discuss the etiology, diagnosis and treatment of this very rare complication of laparoscopic gastric banding removal.