ABSTRACT
Visceral pentastomiasis is usually found incidentally during surgery. We describe a case of visceral pentastomiasis discovered during inguinoscrotal hernia surgery for a man from Benin, Africa. Because surgical removal of nymphs is needed for symptomatic patients only, this patient's asymptomatic pentastomiasis was not treated and he recovered from surgery uneventfully.
Subject(s)
Hernia, Inguinal/surgery , Parasitic Diseases/diagnosis , Pentastomida/anatomy & histology , Adult , Animals , Benin , Hernia, Inguinal/diagnosis , Hernia, Inguinal/parasitology , Herniorrhaphy/methods , Humans , Male , Nymph/anatomy & histology , Nymph/pathogenicity , Parasitic Diseases/parasitology , Parasitic Diseases/surgery , Pentastomida/physiologyABSTRACT
We report two new cases of gastric cancer diagnosed after a bariatric operation. The first case is a 66-year-old male who 3 years after gastric bypass suffered from a perforation of the fundus that was found to be secondary to a diffuse large B-cell lymphoma of the distal stomach. The second case is a 47-year-old woman who presented 12 years after a vertical banded gastroplasty with a gastric pouch outlet obstruction caused by a gastrointestinal stromal tumor (GIST). Based on the few reports of cancer in the literature, analysis of these cases suggests that the main risk of gastric cancer after bariatric surgery comes from the delayed diagnosis of malignancy.
Subject(s)
Bariatric Surgery/adverse effects , Lymphoma/surgery , Stomach Neoplasms/surgery , Aged , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Lymphoma/drug therapy , Male , Middle Aged , Postoperative Complications/drug therapy , Postoperative Complications/surgery , Stomach Neoplasms/drug therapyABSTRACT
The authors discuss the potential influence of obesity surgery on the risk of cancer, focusing on the upper GI tract directly affected by operations. There is currently no substantiation for an increased risk of cancer after bariatric surgery, because there are only about 25 reports of subsequent cancer of the esophagus and the stomach. However, this review emphasizes the need to detect potential precancerous conditions before surgery. Candidates for postoperative endoscopic surveillance may include patients >15 years after gastric surgery, but also patients symptomatic for gastroesophageal reflux disease in whom a high incidence of Barrett's metaplasia has been reported. The greatest concern is a delay in diagnosis from inadequate investigation due to mistaking serious upper GI symptoms as a consequence of the past operation.
