Giant transmural lipoma of the sigmoid colon.

Lipomas of the colon are relatively rare benign tumors of mesenchymatic origin. They are usually asymptomatic but as they become larger they can cause symptoms including abdominal pain, diarrhea, nausea, constipation, haematochezia, loss of body weight, anemia or even intussusception and colonic obstruction. We present a 52 year old male patient who visited the emergency room complaining of constipation, rectal bleeding, mucus in stools and a palpable rectal mass. Colonoscopy revealed a polypoid mass of the sigmoid colon lying about 30 cm from the anal verge. Sigmoidectomy was performed. The postoperative recovery was uneventful and he was discharged five days later. At follow up a month after surgery the patient was asymptomatic. The pathological examination revealed a transmural tumor of the sigmoid colon measuring a 9x5x2.5cm and histologically compatible with a lipoma.

Primary malignant melanoma of the small intestine: a case report.

The small intestine is the most common site of gastro-intestinal metastasis from cutaneous malignant melanoma. A primary origin at this site has been reported in rare cases. We report a case of a 71-year-old man with a primary malignant melanoma in the jejunum. The patient presented with weakness, weight loss, non-specific abdominal pain and episodes of fainting. After clinical examination, laboratory evaluation and radiological work-up, which included CT of the abdomen, the patient was diagnosed with a tumour mass in the jejunum. This diagnosis was confirmed at laparotomy. The patient underwent enterectomy with wide excision of the tumour. A primary malignant melanoma of the small intestine is an extremely rare neoplasm. A definite diagnosis can only be made after a thorough investigation has been made to exclude the co-existence of a primary lesion elsewhere. Curative resection of the tumour remains the treatment of choice.

Early propranolol administration does not prevent development of esophageal varices in cirrhotic rats.

BACKGROUND AND AIMS: Variceal bleeding is the most serious complication of portal hypertension associated with high mortality. This study was conducted to investigate any protective effect of early propranolol administration in the development and degree of esophageal varices in cirrhotic rats with portal hypertension. This topic is controversial in the literature. METHODS: For the development of liver cirrhosis and esophageal varices, 60 rats underwent ligation of the left adrenal vein and complete devascularization of the left renal vein, followed by phenobarbital and carbon tetrachloride (CCl(4)) administration. This operation enhances the development of cephalad collaterals, responsible for the induction of esophageal varices. After 2 weeks of CCl(4) administration, the rats were randomly separated into 2 groups. In group I, propranolol was continuously administered intragastrically throughout the study, whereas in group II normal saline (placebo) was administered instead. Cirrhosis was detected clinically by ascites development. Hemodynamic studies and morphometric analysis of the lower esophagus were performed after complete induction of cirrhosis, measuring the following parameters: portal pressure, total number of submucosal veins, total submucosal vessel area, mean cross-sectional submucosal vessel area, relative submucosal area (percentage) occupied by vessels and area of the single most dilated submucosal vein. RESULTS: The statistical analysis revealed no statistically important difference between the 2 groups for the morphometrically studied parameters. However, portal venous pressure was lower in group I. CONCLUSION: Early propranolol administration did not protect rats from developing esophageal varices, despite the fact that a significant decrease in portal pressure was detected.

False aneurysm of the proper palmar digital artery--report of a case.

A case of false aneurysm of the radial proper palmar digital artery located in the tip of the right index finger is presented. The aneurysm was the result of blunt trauma and the diagnosis was made by contrast enhanced magnetic resonance angiography. The patient was treated by ligation and resection of the aneurysm.

A rat model of liver cirrhosis and esophageal varices.

In an effort to develop a reproducible model of liver cirrhosis and esophageal varices, we administered phenobarbital (PhB) and carbon tetrachloride (CCl4) in 32 rats that had previously undergone complete devascularization of the left renal vein (DLRV). The operation was conducted to enhance the development of cephalad collaterals mainly responsible for the induction of esophageal varices. Thirty-two rats underwent sham operation and PhB and CCl4 administration, and 24 only sham-operated rats comprised the control group. After the induction of liver cirrhosis, histopathologic examination and morphometric analysis of the lower esophagus were performed to study the submucosal veins. We separately studied number of vessels in the submucosa, mean vessel area, percentage of submucosa occupied by vessels, and area of the single most dilated vein. All variables except the number of vessels were significantly higher in cirrhotic rats that had undergone DLRV (P<0.001). We conclude that induction of liver cirrhosis in rats that previously undergo complete DLRV could present a reproducible and reliable model for the induction of liver cirrhosis and esophageal varices.