RESUMEN
Objective To explore the clinical characteristics of huge pancreatic pseudocysts and to evaluate the effect of different surgical treatments. Method We retrospectively analyzed the clinical data of 27 patients with huge pancreatic pseudocyst managed from Feb 1991 to Feb 2008. Result Among a total of 129 patients with pancreatic pseudocyst treated during this period of time,27 (20.9% ) patients were diagnosed as with huge pancreatic pseudocyst (diameter > 10cm). As to the etiology, 51.9% of the psudoeyst was caused by acute pancreatitis, 33.3% by pancreatic trauma and previous surgery, 11.1% by chronic pancreatitis. Pseudoeysts in the majority of cases(21/27)had a history less than 6 weeks. Upper GI obstruction complicated 30% cases (8/27). Imaging showed that all huge pancreatic pseudocysts were single. ERCP showed communication with the main pancreatic duct in 9 out of 11 cases. Nine cases underwent catheter drainage, 10 cases underwent cystogastrostomy,2 cases underwent endoscopic drainage of pancreatic pseudocyst via ERCP, 17 cases underwent Roux-en-Y cystojejunostomy including 11 cases in which other previous procedures failed. All 27 cases were finally cured. Conclusions Huge pancreatic pseudocyst might have unique clinical characteristics. Anatomical changes of main pancreatic duct were found in most cases under ERCP. The proper time and indication for surgical intervention might be different from minor pancreatic pseudocyst.
RESUMEN
Objective To explore clinical manifestations, image findings, histopathological characteristics and surgical treatment for glomus tumor. Methods Clinical data of 18 patients with glomus tumor, who underwent surgical treatment from 1992 to 2002 was analysed retrospectively. Results There were 11 males and 7 females. The mean age was (39?7) years old, with 11.1% (2/18) cases of multiple tumors. Glomus tumor was located in the subungual region or extremities of limbs in 61.1% (11/18) cases, the diameter of the tumor was less than 10 mm in 88.9% (16/18) cases. The clinical misdiagnosis rate was as high as 61.1% (13/18).B ultrasound made correct diagnosis in 85.7% (6/7) cases with tumor location other than in the subungual region or extremities of limbs, while radiological finding rate was only 33.3% (4/12).There were 16 glomus tumors histopathologically classified as the glomangiomatous type, and 2 the solid type. The immunochemistry in 10 cases were all positive for Vementin. Conclusions Glomus tumor in the subungual region or extremities of limbs could be diagnosed without difficulty, while it was usually difficult to make correct diagnosis in cases with tumor at the other site for lack of specific symptoms and physical signs. Surgical removal should be the golden standard for the treatment of this tumor.
RESUMEN
Objective To explore the feasibility of endovascular intervention for the treatment of Klippel-Trenaunay-Weber syndrome ( KTWS ). Methods Fourteen KTWS patients underwent arteriography followed by endovascular intervention with bleomycin( A5) + extraliquid lipiodol, PVA, NBCA, steel coil, respectively. Results Both haemangioma ( nevus) lesion and varicosities of the superficial vein in the involved limb improved in all 14 patients significantly. Main complications were pain, swelling of the embolized area. Severe swelling of the whole limb occurred in 3 cases, which subsided spontaneously within 7 - 9 days. At one month follow-up limb girth at the middle part of the thigh and at the point of 10 cm below the knee reduced by 2. 1 ?0. 3 cm and 2.0 ?0.2 cm respectively. Preoperative lymphatic edema of the limb in 3 cases (3/4) and the regurgitation of the superficial femoral vein in 3 cases also improved significantly. Conclusion Endovascular intervention of KTWS leads to symptomatic improvement of patients with KTWS.
RESUMEN
Pulmonary edema is associated with pancreatic enzymes released into the blood stream during acute pancreatitis.Acute hemorrhagic pancreatitis in rats was established by injecting 5%sodium taurocholate into the pancreatic duct.Before and at the time of induction,SMS201-995 2?g/kg was injected subcutaneously,and followed by 3 h continuous I.V.infusion of NS solution containing SMS201-995 5?g?kg-1?h-1 at a rate of 6ml?kg-1?h-1.The results of this experiment showed that SMS201-995 could:(1) decrease the serum levels of amylase and lipase effectively;(2)reduce lung index and lung extravascular water volume siginficantly;(3)ameliorate the pathologic changs of lung and pancreas evidently.These results also suggested that SMS201-995 could both prevent and treat acute pancreatitis and pulmonary edema induced by it in rats.Therefore,it is theoretically sound that evidence can be proviede by the results obtained in this experiment for the application of SMS201-995,a long acting analogue of somatostatin,to treat clinical acute pancreatitis by its inhibitory effect towards pancreatic exocrine secretion.