ABSTRACT
Constrictive Pericarditis (CP) is an unusual disease. Its most common causes are idiopathic or secondary to cardiac surgery. Less frequently it is caused by connective tissue diseases. We report a 30 years old woman hospitalized due to progressive dyspnea, chest pain and signs of right sided heart failure. During her stay, a Systemic Lupus Erythematosus (SLE) was diagnosed. The echocardiogram suggested a CP and the diagnosis was confirmed by cardiac catheterization. Pericardiectomy was successfully performed. The biopsy confirmed a nonspecific chronic pericarditis, with extensive fibrosis and absence of caseating granulomas. The patient had a satisfactory recovery.
Subject(s)
Adult , Female , Humans , Lupus Erythematosus, Systemic/complications , Pericarditis, Constrictive/etiology , Cardiac Catheterization , Chronic Disease , Pericardiectomy , Pericarditis, Constrictive/diagnosisABSTRACT
Background: First degree relatives of patients with colorectal carcinoma are at a higher risk of having the disease than the general population. Therefore, they should be subjected to screening colonoscopy. Aim: To assess the effectiveness of colonoscopy among first degree relatives of patients with colorectal carcinoma. Material and methods: A free colonoscopy was offered to first degree relatives of patients operated on for colorectal cancer between 1998 and 2000. As inclusion criteria, subjects had to be asymptomatic, older than 40 years or less than 10 years younger than the index case. Each subject was contacted twice, inviting him/her to have a colonoscopy performed. Results: Two hundred forty three relatives were contacted for the study and in 76, a colonoscopy was performed. Among the latter, a neoplasm was found in 13 (17 percent): One adenocarcinoma and 12 adenomas. Three of these lesions were located in the right colon. The main reason given by the 176 subjects that did not agree to have a colonoscopy was lack of interest. Conclusions: Screening colonoscopy is effective to detect adenoma and adenocarcinomaamong first degree relatives of patients with colorectal carcinoma, however only 31 percent of all potential relatives agreed to undergo a colonoscopy.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenoma/diagnosis , Colonoscopy/standards , Colorectal Neoplasms/diagnosis , Family Health , Mass Screening/psychology , Adenocarcinoma/diagnosis , Adenocarcinoma/genetics , Adenoma/genetics , Age Factors , Attitude , Colonoscopy/psychology , Colonoscopy , Colorectal Neoplasms/genetics , Genetic Predisposition to Disease , Mass Screening/methods , Pedigree , Prospective Studies , Risk AssessmentABSTRACT
We report a 67 years old male with a history of pulmonary tuberculosis at the age of 15, that consults for malaise, weight loss and productive cough. Chest X ray examination showed a left pleural effusion. A pleural tap obtained a sterile exudate. A thorax CAT scan showed a proliferating mass in the splenic angle of the colon, with left lung and diaphragmatic invasion. Endoscopic biopsies confirmed the diagnosis of adenocarcinoma. The patient underwent a subtotal colectomy with partial excision of diaphragm and left lung. The pathological report showed a mucosecretory adenocarcinoma, infiltrating the pericolonic adipose tissue without adjacent organ infiltration and a chronic inflammatory process involving colonic serosa, diaphragm pleura, and lung. Adjuvant chemotherapy was indicated and the patient is asymptomatic and without evidences of tumor recurrence after a 24 months follow up (Rev Méd Chile 2004; 132: 985-88).
Subject(s)
Male , Humans , Aged , Colorectal Neoplasms , Adenocarcinoma, Mucinous/surgery , Adenocarcinoma, Mucinous/pathology , Muscle Neoplasms , Follow-Up StudiesABSTRACT
Background: Hereditary nonpolyposis colorectal cancer (HNPCC) accounts for 3 to 5 percent of all colorectal cancer (CC). It is an autosomal dominant syndrome with 80 percent of penetrance for this disease. Aim: To analyze the pedigree and surgical treatment of HNPCC. Patients and methods: We retrospectively analyzed our database of CC selecting patients with HNPCC according to clinical criteria (Amsterdam II). We characterized our patient's pedigrees with telephonic interviews. Results: From 1111 patients operated on with CC we identified 13 (1.17 percent) with HNPCC. The mean age at diagnosis was 41.6 years (range: 23-75). Sixty two percent presented in International Union Against Cancer (UICC) stages I or II and none in stage IV. Seventy one percent of tumors were proximal to splenic flexure. In 5 patients the diagnosis of HNPCC was made postoperatively, after diagnosis of CC in their relatives. In all but one of the 8 patients with preoperative diagnosis of HNPCC, we performed a total colectomy. From the remaining 6 patients with partial colectomy, 2 developed metachronic CC. Two patients died of cancer. From 101 persons in the 4 families, 25 have developed neoplasia: 18 CC, 3 endometrial cancer and 4 other tumors. Twenty eight relatives were eligible for colonoscopic screening, but only 21 percent of them have been screened appropriately. Conclusions: Preoperative diagnosis should change the surgical treatment of HNPCC, preventing metachronic disease. Primary colonoscopic screening allowed us to diagnose CC in early stages, nonetheless most of eligible relatives have not followed recommended frequency for colonoscopy (Rev MÚd Chile 2004; 132: 539-47).