RESUMO
Acute symptomatic portal vein obstruction related to biliary stenting is an extremely rare but life-threatening complication. This usually occurs in patients with either tumor invasion into the portal vein or pre-existing portal vein thrombus. Therefore, the portal vein should be carefully evaluated before placing a biliary metallic stent in such patients. We describe a case of acute portal vein obstruction after placing metallic biliary stents in a patient with a periductal-infiltrating type of hilar cholangiocarcinoma.
Assuntos
Humanos , Colangiocarcinoma , Veia Porta , Stents , TromboseRESUMO
Mucinous adenocarcinoma is a rare histologic type of gastric carcinoma. Most mucinous gastric carcinoma is diagnosed by histology after surgical resection. However, in this report, we preoperatively predicted the type of a tumor (mucinous type) from its characteristic endoscopic finding. An endoscopic examination showed a cauliflower-like mass on the upper body of the posterior wall. At first we could not find the mass because it was covered with a thick mucin-like substance. After gastric lavage and mucin aspiration we found a tumor mass which was surrounded with a characteristic mucin pool. Abdominal CT showed a 6 cm sized-mass connected with the gastric fundus. Total gastrectomy with esophagojejunostomy was performed. The pathology of the tumor proved to be a mucinous adenocarcinoma.
Assuntos
Adenocarcinoma , Adenocarcinoma Mucinoso , Gastrectomia , Fundo Gástrico , Lavagem Gástrica , Mucinas Gástricas , Mucinas , Patologia , Tomografia Computadorizada por Raios XRESUMO
Upper gastrointestinal bleeding is one of the most common complications in patients with chronic renal failure. Common causes are peptic ulcer, gastritis, duodenitis, esophagitis, Mallory-Weiss tear, and angiodysplasia. However, gastric polyp is a rare cause of upper gastrointestinal bleeding. We diagnosed a bleeding hyperplastic polyp in chronic renal failure patient with melena. He had a bleeding polyp with a Y-shaped stalk. This polyp was treated effectively by endoscopic snare polypectomy.
Assuntos
Humanos , Angiodisplasia , Duodenite , Esofagite , Gastrite , Hemorragia , Falência Renal Crônica , Síndrome de Mallory-Weiss , Melena , Úlcera Péptica , Pólipos , Proteínas SNARERESUMO
Upper gastrointestinal bleeding is one of the most common complications in patients with chronic renal failure. Common causes are peptic ulcer, gastritis, duodenitis, esophagitis, Mallory-Weiss tear, and angiodysplasia. However, gastric polyp is a rare cause of upper gastrointestinal bleeding. We diagnosed a bleeding hyperplastic polyp in chronic renal failure patient with melena. He had a bleeding polyp with a Y-shaped stalk. This polyp was treated effectively by endoscopic snare polypectomy.
Assuntos
Humanos , Angiodisplasia , Duodenite , Esofagite , Gastrite , Hemorragia , Falência Renal Crônica , Síndrome de Mallory-Weiss , Melena , Úlcera Péptica , Pólipos , Proteínas SNARERESUMO
The lithium is widely employed as a psychotropic agent, specially in manic illness. Lithium nephrotoxicity can be divided into three main categories: nephrogenic diabetes insipidus, acute intoxication, chronic nephropathy including interstitial nephropathy and glomerulopathy manifested as nephrotic syndrome. But, nephrotic syndrome induced by lithium is very rare. We reported a nephrotic syndrome induced by lithium in a 27-year-old woman who was taking lithium carbonate for 11 years due to bipolar disorder. Renal biopsy showed membranous nephropathy. After withdrawal of lithium, clinical symptoms and proteinuria significantly improved.
Assuntos
Adulto , Feminino , Humanos , Biópsia , Transtorno Bipolar , Diabetes Insípido Nefrogênico , Glomerulonefrite Membranosa , Carbonato de Lítio , Lítio , Síndrome Nefrótica , ProteinúriaRESUMO
Carotidynia is defined as an atypical craniofacial pain syndrome caused by the dilatation or distension of the extracranial arteries. We report an unusual case of carotidynia mimicking trigeminal neuralgia caused by an arterioscle-rotic tortous carotid artery. A 68-year-old woman suffered from frequent episodes of severe electrical shock-like radiating pain around her left ophthalmic and maxillary division of the trigeminal nerve for 5 years. Initially, under the impression of trigeminal neuralgia, carbamazepine was tried. She was reevaluated due to an unsatisfactory pharmacological response. On examination, no abnormalities were found on the craniofacial region except for a tortous pulsating tender mass on the region of the left carotid artery. Routine laboratory findings and a connective tissue study were normal. Neck sonography and a 4-vessel angiography showed a tortous left internal carotid artery with stenosis extending near to the skin. The patient was treated for 2 weeks with a nonsteroidal anti-inflammatory agent, steroids, a prophylctic beta blocker, and a TCA antidepressant. The pain gradually subsided.
Assuntos
Idoso , Feminino , Humanos , Angiografia , Artérias , Carbamazepina , Artérias Carótidas , Artéria Carótida Interna , Tecido Conjuntivo , Constrição Patológica , Dilatação , Neuralgia Facial , Pescoço , Pele , Esteroides , Nervo Trigêmeo , Neuralgia do TrigêmeoRESUMO
Monoclonal gammopathy of undetermined significance(MGUS) is one of the monoclonal plasma cell disorder. According to the recent reports, polyneuropathy associated with MGUS may be treatable disease due to potential relationship between the monoclonal protein and immune-mediated nerve damage. It is reported that plasmapheresis is highly effective in the treatment of polyneuropathy associated with IgG type MGUS. We present 53-year-old male with slowly progressive motor weakness and sensory change since 1 year ago. Electrophysiologic studies were compatible with demyelinating neuropathy showing conduction block and temporal dispersion in upper and lower extremities. Abnormal arc against anti-lamda on serum immunoelectrophoresis and M-band in the gamma region on serum protein electrophoresis were shown. After the combined therapy of plasmapheresis (5 times) and steroid, clinical and electrophysiologic findings were markedly improved. We report a case of demyelinating neuropathy associated with IgG lamda type MGUS, which showed good response to combined therapy of plasmapheresis and steroid.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Eletroforese , Imunoeletroforese , Imunoglobulina G , Extremidade Inferior , Gamopatia Monoclonal de Significância Indeterminada , Paraproteinemias , Plasmócitos , Plasmaferese , PolineuropatiasRESUMO
Vertebral hemangioma is a slow-growg, benign tumor which is often discovered incidentally during evaluation of neck or back pain.1,2 It is easily demonstrated by spine MRI, but in some cases did not show typical radiological appearance. In that case, Tc-99m RBC SPECT may be another confirmatory diagnostic tool. We report a case of vertebral hemangioma diagnosed with the assistance of Tc-99m RBC SPECT.