RESUMEN
Objective To research early pathological morphology and clinical significance of perforated duodenal ulcer (PDU) closed after non-surgical treatment. Methods Observed morphological changes of duodenal ulcer (DU) lesion with gastroscopy for 302 patients of PDU with non-surgical treatment in early period,when the perforation closed and measured up the clinical indicators during this hospitalization.Results There were 255 patients to be diagnosed with DU caused the perforation. These lesions were characteristic and shown the PDU closed at the bottom and the deep concave ulcers, except for 1 case which complicated by duodenal fistula. These ulcer types were diverse according to the time difference after treatment. No case of re-perforated ulcers or recurrence of peritonitis caused by gastroscopy. Conclusions Deep concave ulcer with A1 phase mainly is an early pathological manifestations of the DU after treated the PDU with non-surgical method characteristically. The wall of the closure of the serosal side is an original form closed perforated ulcer by non-surgical treatment. The risk of perforation associated with the following factors:( 1 )A single DU is located in the anterior wall region. (2)The shape of two kissing DU. (3)The diameter of DU ≥ 1.1 cm. In this case,early diagnosis by using endoscopy is a safe way.
RESUMEN
Objective To summarize the diagnosis and treatment of 25 cases of colonic cancer occurred after cholecystectomy ,and to explore the correlation between colonic cancer and cholecystectomy. Methods The clinical data of the 25 cases were retrospectively analysed. Results The onset time of the cancer was 10 years after cholecystectomy in 3 cases(12%) and over 12 years in 22 cases(88%). Six cases had family history of canceration(24%), 5 had colonic polyps(20%) and 2 had colonic adenoma (8%). Tumor located in appendix in 10 cases (40%),in ascending colonic in 7 cases (28%),in transverse colonic in 3 cases(12%),in descending colonic in 3 cases (12%) and in sigmoid colonic in 2 cases (8%). Eighteen patients underwent radical operation (72%),and 7 had palliative operation (28%). All patients recovered successfully after the operation. Conclusions Periodical postoperative follow up of the patients after cholecystectomy is an effective method to discover colonic cancer in early stage.