ABSTRACT
Eosinophilic esophagitis in adults (EE) is a disease of unknown cause, characterized by symptoms such as reflux and dysphagia that traditionally do not respond to antacid treatment. It affects mostly young men with a strong personal or familial history of a topy asthma and allergies. We repot three male patients aged 10, 14 and 15years, all with symptoms of dysphagia, two of them with chest pain caused by spasm of the esophagus, with heterogeneous endoscopic findings which included from leucoplakia to stenosis that needed endoscopic dilatation. All of them had abnormal findings in immunity studies (prick test or IgE levels). They received treatment based on diet measures, acid suppression and leukotriene inhibitors, with satisfactory clinical, endoscopic and histological response. EE should be suspected in children and adults with esophageal symptoms and personal or family history of allergy and asthma.
Subject(s)
Adolescent , Child , Humans , Male , Eosinophilia/pathology , Esophagitis/pathology , /therapeutic use , Acetates/therapeutic use , Eosinophilia/drug therapy , Esophagitis/drug therapy , Esophagoscopy , Omeprazole/therapeutic use , Quinolines/therapeutic useABSTRACT
Background: Chile has a high frequency of gallbladder cancer. Polyps are common lesions of gallbladder mucosa but there is little information about their morphological features. Aim: To report the clinical and pathological features of 219 gallbladder polyps. Material and methods: Cholecystectomies samples in which a polypoid lesion was diagnosed microscopically. In all cases, complete clinical information and digitalized images of the complete surgical specimens was reviewed. Results: In a period of 10 years, 21.412 gallbladders were processed. Among these, 884 carcinomas were diagnosed and in 219 cases (1 percent) a polyp was found. One hundred and eighty three patients were females (mean age 49.3 years) and 36 males (mean age 53.4 years). The preoperative diagnosis of gallbladder polyp was done only in 26 cases (12 percent). Eighty five percent of polyps were non-neoplastic (metaplastic in 32 percent, cholesterol in 29 percent, hyperplastic in 22 percent and inflammatory in 2 percent). The remaining 15 percent were adenomas. Seventy five percent of non-neoplastic polyps were located in the proximal half of the gallbladder and 88 percent of adenomas in the distal half. Ninety five percent of non-neoplastic polyps measured less than 10 mm. Among adenomas, 47 percent measured less than 5 mm and 28 percent more than 10 mm. Smaller polyps were of cholesterol and larger polyps were adenomas. Eight adenomas were associated with an adenocarcinoma, two had less than 5 mm lenght. Mean age of patients with adenomas associated to cancer was higher than patients with pure adenomas (64.6 and 44.3 years respectively, p >0.001). Conclusions: There are size and location differences between non neoplastic polyps and adenomas. Adenomas associated to cancer may measure less than 5 mm. Therefore the polyp size criteria to decide surgical behavior in symptomatic gallstone patients may be misleading (Rev Méd Chile 2004; 132: 673-9).