ABSTRACT
OBJECTIVE: To identify predisposing factors, clinical characteristics and effective treatment in patients with nonneoplastic cavernomatous transformation of the portal vein in our gastroenterology service. METHODS: We retrospectively reviewed the clinical records of 2,201 patients diagnosed as having portal hypertension (2,165 with cirrhosis and 36 with noncirrhotic portal vein hypertension) during the period from 1977 to 1998. The diagnosis of cavernomatous transformation was confirmed with angiographic or Doppler echographic studies, or both. RESULTS: Thirteen patients (6 males, 7 females, age range 8 to 69 years) with cavernomatous transformation were found. Predisposing factors were omphalitis (1), echinococcal cyst (1), major abdominal surgery (3), liver cirrhosis (3), Sjögren syndrome (1), and no apparent cause (4). Eleven of the 13 patients had upper digestive tract bleeding from varices, 9 had splenomegaly, and 2 had cirrhotic decompensation. Splenectomy was done in 3 patients on admission, and in 5 patient shunts were used (splenorenal in 4, mesenteroatrial in 1) because of repeated bleeding. CONCLUSIONS: Of the patients with noncirrhotic portal hypertension, 27.7% had nontumoral cavernomatous transformation of the portal vein. Previous abdominal surgery was the most frequent predisposing factor; the 2 cases of echinococcal liver disease and Sjögren disease were exceptional. Age younger than 30 years, bleeding esophageal varices and splenomegaly were the most frequent clinical features. Portosystemic shunt was the only effective treatment alternative in these patients.
Subject(s)
Portal Vein , Thrombosis/diagnosis , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Retrospective Studies , Thrombosis/complications , Vascular Diseases/diagnosis , Vascular Diseases/etiologyABSTRACT
FUNDAMENTO: conocer las enfermedades predisponentes, las características clínicas y el tratamiento de los pacientes con cavernomatosis portal no neoplásica en nuestro Servicio de Digestivo. PACIENTES Y MÉTODOS: se revisan retrospectivamente los informes clínicos de 2.201 pacientes con el diagnóstico de hipertensión portal (2.165 con cirrosis y 36 con hipertensión portal no cirrótica) durante el período 1977-1998. El diagnóstico de cavernomatosis se confirmó por estudio angiográfico y/o ecografía Doppler. RESULTADOS: el número de pacientes con esta patología fue de 13 (seis varones y siete mujeres). La edad osciló entre 8 y 69 años. Las enfermedades predisponentes fueron onfalitis (uno), cirugía mayor abdominal (cuatro), cirrosis hepática (tres), síndrome de Sjögren (uno) y sin causa aparente (cuatro). De los 13, 11 presentaron hemorragia digestiva alta por varices, nueve esplenomegalia y dos descompensación cirrótica. En tres se hizo esplenectomía a su ingreso y en cinco derivaciones (cuatro esplenorrenales y uno mesentérico-atrial) por recidiva hemorrágica. CONCLUSIONES: de los enfermos con hipertensión portal no cirrótica, el 27,7 por ciento tuvo una cavernomatosis portal no turnoral. La cirugía abdominal previa fue la situación predisponente más habitual y dos casos de hidatidosis hepática y enfermedad de Sjögren son excepcionales. La edad menor de 30 años, las varices sangrantes y la esplenomegalia fueron las características clínicas más frecuentes. Las derivaciones portosistémicas son la única alternativa terapeútica definitiva en este tipo de pacientes (AU)
Subject(s)
Middle Aged , Child , Adolescent , Adult , Aged , Male , Female , Humans , Portal Vein , Vascular Diseases , Thrombosis , Retrospective StudiesABSTRACT
BACKGROUND: The risk of developing a second neoplasm in a person with gastric carcinoma (GC) is higher than among general population. OBJECTIVE: To analyze the clinical findings in patients with GC associated with other primary malignant neoplasms. PATIENTS AND METHODS: A total of 25 patients with GC associated with extragastric tumours were retrospectively studied. The following characteristics were studied: age, sex, location and staging, free interval, therapy, and survival. Survival of 13 patients with GC diagnosed as primary tumour was compared with that observed in a control group of 62 patients with GC alone. RESULTS: Twenty-five out of 792 (3.1%) patients with GC had other primary malignant neoplasms (seven synchronous and 18 metachronous). GC was associated with respiratory tumours in 7 cases. Sixty percent of patients with GC who had a second neoplasm had it diagnosed within the first year after gastric tumour was diagnosed (8 out of 13). Survival at 18 months was similar, both in the GC group with a second tumour as in the control group. CONCLUSIONS: The development of a second neoplasm among patients with GC usually occurs within the first year after diagnosis. Most commonly, the second neoplasm seats in the respiratory tract.
Subject(s)
Carcinoma/mortality , Neoplasms, Multiple Primary/mortality , Neoplasms, Second Primary/mortality , Stomach Neoplasms/mortality , Adult , Aged , Aged, 80 and over , Carcinoma/pathology , Female , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms, Multiple Primary/pathology , Neoplasms, Second Primary/pathology , Retrospective Studies , Spain/epidemiology , Stomach Neoplasms/pathology , Survival AnalysisABSTRACT
Objetivo. El riesgo de padecer una segunda neoplasia en una persona con carcinoma gástrico (CG) es superior al de la población general. El objetivo del estudio ha sido valorar los datos clínicos de los pacientes con CG asociado a otras neoplasias malignas primarias. Pacientes y método. Se estudian retrospectivamente 25 enfermos con CG asociado a tumores extragástricos. Se evaluaron edad, sexo, tipo, localización y estadio de las neoplasias, intervalo libre, tratamiento y supervivencia. Se compara la supervivencia de 13 pacientes con un CG diagnosticado como primera neoplasia con la de un grupo control de 62 pacientes con sólo un CG. Resultados. De 792 pacientes con CG, 25 (3,1 por ciento) tuvieron otras neoplasias malignas primarias (siete eran sincrónicas y 18 metacrónicas). El CG se asoció a tumores respiratorios en siete casos. De los pacientes con CG que tuvieron una segunda neoplasia, en el 60 por ciento ésta apareció en el primer año después del diagnóstico del tumor gástrico (ocho de trece). La supervivencia fue la misma a los 18 meses, tanto en el grupo de CG con una segunda neoplasia como en el grupo control. Conclusiones. Los pacientes con un CG que desarrollan una segunda neoplasia lo hacen en un 60 por ciento en el primer año. Esta segunda neoplasia es, más frecuentemente, del tracto respiratorio. (AU)
Subject(s)
Middle Aged , Adult , Aged , Aged, 80 and over , Male , Female , Humans , Spain , Survival Analysis , Retrospective Studies , Carcinoma , Stomach Neoplasms , Neoplasms, Second Primary , Neoplasm Staging , Neoplasms, Multiple PrimaryABSTRACT
Bronchogenic lung carcinoma, melanoma and breast cancer are the neoplasms which have most frequently been reported to metastasize to the stomach. These lesions are usually located on the fundus and on the upper part of the gastric body. They are usually asymptomatic with the diagnosis being made at necropsy. We present a patient who developed gastrointestinal bleeding as the first symptom of squamous lung cancer secondary to a gastric metastasis.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/secondary , Gastrointestinal Hemorrhage/etiology , Lung Neoplasms/pathology , Stomach Neoplasms/diagnosis , Stomach Neoplasms/secondary , Carcinoma, Squamous Cell/complications , Fatal Outcome , Humans , Male , Middle Aged , Stomach Neoplasms/complicationsSubject(s)
Bacterial Infections/diagnosis , Esophagitis/diagnosis , Mycoses/diagnosis , Protozoan Infections/diagnosis , Virus Diseases/diagnosis , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Esophagitis/drug therapy , HIV-1 , Humans , Mycoses/drug therapy , Virus Diseases/drug therapyABSTRACT
Pyogenic liver abscess is a relatively rare disease, often concerning elderly patients in bad general condition and with underlying diseases. We report the case of a 77-year-old female with gastric cancer and liver abscesses by Streptococcus anginosus.
