RESUMO
Diverticulitis is the most common clinical complication of diverticular disease, affecting 10-25% of the patients with diverticula. The prevalences of diverticulitis and colon cancer tend to increase with age and are higher in industrialized countries. Consequently, diverticulitis and colon cancer have been reported to have similar epidemiological characteristics. However, the relationship between these diseases remains controversial, as is the performance of routine colonoscopy after an episode of diverticulitis to exclude colon cancer. Recently, we experienced three cases of colon cancer after treating acute diverticulitis, based on which we suggest the importance of follow-up colonoscopy after acute diverticulitis.
Assuntos
Humanos , Colo , Neoplasias do Colo , Colonoscopia , Países Desenvolvidos , Diverticulite , Divertículo , Seguimentos , PrevalênciaRESUMO
Coronary artery anomalies are rare presentations in primary percutaneous coronary interventions of acute myocardial infarction. Herein, we report the case of a 59-year-old man with acute anterior myocardial infarction who had anomalous separate origin of left anterior descending artery (LAD) and left circumflex artery (LCX) from the left coronary aortic sinus. Coronary angiography showed a normal right coronary artery and LCX, but no visualization of the LAD. After several unsuccessful attempts to cannulate the LAD, we found the LAD ostium located by the side of the LCX ostium. There was total occlusion at proxymal LAD. Coronary computed tomography angiography demonstrated the precise, separate origin of LAD and LCX from the left coronary aortic sinus.
Assuntos
Angiografia , Infarto Miocárdico de Parede Anterior , Artérias , Angiografia Coronária , Anomalias dos Vasos Coronários , Vasos Coronários , Infarto do Miocárdio , Intervenção Coronária Percutânea , Seio AórticoRESUMO
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. It is mainly found in the stomach and small intestine. Based on tumor size and mitotic index, it is classified into very low risk, low risk, intermediate risk and high risk. Generally, the recurrence of low risk GIST is extremely rare, but the recurrence rate can be different according to its location. Recently, it has been reported that the recurrence rate of low risk small bowel GIST is higher than the recurrence rate of low risk stomach GIST. We report a hepatic recurrence of low risk duodenal GIST that was removed completely through pancreaticoduodenectomy 11 years earlier. Regular long term follow-up must be considered, even for low risk GISTs.
Assuntos
Duodeno , Seguimentos , Tumores do Estroma Gastrointestinal , Trato Gastrointestinal , Intestino Delgado , Fígado , Índice Mitótico , Pancreaticoduodenectomia , Recidiva , EstômagoRESUMO
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. It is mainly found in the stomach and small intestine. Based on tumor size and mitotic index, it is classified into very low risk, low risk, intermediate risk and high risk. Generally, the recurrence of low risk GIST is extremely rare, but the recurrence rate can be different according to its location. Recently, it has been reported that the recurrence rate of low risk small bowel GIST is higher than the recurrence rate of low risk stomach GIST. We report a hepatic recurrence of low risk duodenal GIST that was removed completely through pancreaticoduodenectomy 11 years earlier. Regular long term follow-up must be considered, even for low risk GISTs.
Assuntos
Duodeno , Seguimentos , Tumores do Estroma Gastrointestinal , Trato Gastrointestinal , Intestino Delgado , Fígado , Índice Mitótico , Pancreaticoduodenectomia , Recidiva , EstômagoRESUMO
Tube thoracostomy is known to cause complications such as bleeding or infection, but the incidence of chylothorax secondary to tube thoracostomy is under-reported, and therefore, we report this case. A patient was diagnosed as systemic lupus erythematosus with pleural and pericardial involvement. During repeated therapeutic thoracentesis, which were performed because of poor response to steroids and cylophosphamide, hemothorax developed and we therefore inserted a chest tube. The pleural effusion changed from red to milky color in several hours and we diagnosed the pleural effusion as chylothorax. Total parenteral nutrition based on medium-chain triglycerides was supplied to this patient and chylothorax was improved after 4 days.