ABSTRACT
We report a clinic case of renal-cell carcinoma presenting as sinistral portal hypertension; a clinical syndrome consisting of esplenic vein thrombosis manifested as isolated gastric varices with patent portal vein and normal hepatic function. The most frequent cause of this syndrome is pancreatic pathology. Renal-cell carcinoma is characterized by a wide variety of symptoms as initial manifestation. In our case, the patient developed a massive gastrointestinal bleeding secondary to isolated gastric varices caused by splenic vein thrombosis due to extrinsic compression by a hypernephroma that infiltrated the pancreas.
Subject(s)
Carcinoma, Renal Cell/diagnosis , Esophageal and Gastric Varices/etiology , Gastrointestinal Hemorrhage/etiology , Hypertension, Portal/etiology , Kidney Neoplasms/diagnosis , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/pathology , Female , Humans , Kidney Neoplasms/complications , Kidney Neoplasms/pathology , Middle Aged , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/secondary , Splenic Vein , Venous Thrombosis/etiologyABSTRACT
Describimos un caso clínico en el que la manifestación inicial de un hipernefroma fue un sangrado digestivo alto, secundario a una hipertensión portal siniestra o izquierda. La hipertensión portal izquierda es un síndrome clínico que consiste en la trombosis de la vena esplénica, que se manifiesta por un sangrado por varices gástricas aisladas, con una vena porta permeable y una función hepática normal. La causa más frecuente de este síndrome es la patología pancreática. El hipernefroma se caracteriza por su diversidad de manifestaciones clínicas motivo por el cual se ha llamado el tumor del internista. En este caso clínico la paciente presenta un sangrado masivo por varices gástricas secundarias a la trombosis de la esplénica por una masa retroperitoneal. Se realizó un TAC abdominal en el que se apreció dicha masa, siendo compatible con un hipernefroma que infiltraba la cola del páncreas y producía una trombosis de la vena esplénica. La paciente fue operada con resección completa del tumor y esplenectomía no volviendo a presentar sangrado digestivo (AU)
Subject(s)
Middle Aged , Female , Humans , Hypertension, Portal , Esophageal and Gastric Varices , Carcinoma, Renal Cell , Gastrointestinal Hemorrhage , Splenic Vein , Venous Thrombosis , Kidney Neoplasms , Pancreatic NeoplasmsABSTRACT
The authors' experience with splenic hydatidosis is presented. Sixteen cases, representing 3% of the hydatidosis treated surgically in our center, are reviewed. Pain in the left upper quadrant, splenomegaly and calcifications detected by simple abdominal radiology are the most suggestive indications. The definitive diagnosis is based on abdominal echography and CT scan, which have the greatest sensitivity and specificity. The treatment should be surgical, attempting to preserve as much splenic tissue as possible, although in our experience, it is infrequent that conservative treatment can be used due to massive involvement of the spleen.
Subject(s)
Echinococcosis/diagnosis , Splenic Diseases/diagnosis , Adolescent , Adult , Aged , Child , Echinococcosis/surgery , Humans , Middle Aged , Postoperative Complications/epidemiology , Splenectomy , Splenic Diseases/surgeryABSTRACT
We report a rare case of acute abdomen caused by the spontaneous rupture of a splenic hydatid cyst into the abdominal cavity, causing a massive hemoperitoneum due to accompanying rupture of the spleen which required splenectomy. A review is made of the literature on this rare entity, its treatment and its consequences and their prevention and treatment.
Subject(s)
Abdomen, Acute/etiology , Echinococcosis/complications , Splenic Diseases/complications , Adult , Female , Humans , Rupture, SpontaneousABSTRACT
We present two cases of acute cholecystitis occurring more than two years after renal transplantation. The course of the acute event was complicated by the presence of hemobilia in one of the patients and severe hemoperitoneum in both patients. We comment the possible etiologic factors, the high efficiency of the diagnostic procedures and the importance of prompt cholecystectomy as the best treatment method.
Subject(s)
Cholecystitis/complications , Hemoperitoneum/etiology , Kidney Transplantation , Postoperative Complications , Adult , Humans , Male , Middle AgedABSTRACT
We present a case of cancer of a choledochal cyst in a patient with antecedents of cholecystectomy, who complained of pain in the right hypochondrium. Echography and CAT disclosed a cystic mass of biliary location, and the diagnosis was confirmed by intraoperative cholangiography and biopsy of the cyst margin. Cysto-jejunostomy on a Roux-en-Y loop was performed. The patient survived 11 months and died of tumoral dissemination. We reviewed 130 cases of cancer of a choledochal cyst published up until 1986 and possible etiopathogenic causes, and we discuss the diagnostic problems and related treatment.
Subject(s)
Adenocarcinoma/complications , Common Bile Duct Diseases/complications , Common Bile Duct Neoplasms/complications , Cysts/complications , Adenocarcinoma/surgery , Common Bile Duct Diseases/diagnosis , Common Bile Duct Neoplasms/surgery , Cysts/diagnosis , Diagnosis, Differential , Echinococcosis, Hepatic/diagnosis , Female , Humans , Middle AgedABSTRACT
A case is presented of intestinal duplication in the duodenum of a 17-year-old patient initially diagnosed as anorexia nervosa due to her extreme thinness and scant accompanying symptomatology. The etiopathogenesis, anatomic, clinical and diagnostic features, and different treatments of duodenal duplication are briefly reviewed.
Subject(s)
Duodenum/abnormalities , Adolescent , Age Factors , Body Weight , Duodenum/diagnostic imaging , Duodenum/pathology , Duodenum/surgery , Humans , RadiographyABSTRACT
A new case is presented of peritoneal pseudomyxoma secondary to a mucinous cystadenocarcinoma of the appendix discovered in the course of repair of a strangulated umbilical hernia. This is an uncommon entity which is only exceptionally diagnosed before operation and has a controversial treatment. The evolution and prognosis are unpredictable and are directly related to the degree of cellular differentiation.
