ABSTRACT
Intestinal duplications are rare developmental abnormalities that may occur anywhere in the gastrointestinal tract. The possibility of a malignant change occurring in these duplications is very low. We present a case of adenocarcinoma arising in a duplication of the cecum. A 41-year-old male patient was admitted because of a palpable abdominal mass. Abdominal computed tomography revealed a 6-cm, peripheral wall-enhanced, round, cystic mass in the cecal area. Excision of the mesenteric mass and a right hemicolectomy was performed. Upon histologic examination, the patient was diagnosed with adenocarcinoma arising in a duplication of the cecum.
Subject(s)
Adenocarcinoma/pathology , Cecal Neoplasms/pathology , Cecum/abnormalities , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/surgery , Adult , Biopsy , Cecal Neoplasms/diagnostic imaging , Cecal Neoplasms/surgery , Cecum/diagnostic imaging , Cecum/surgery , Colectomy , Humans , Male , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Primary natural killer (NK) cell like T cell lymphoma of the terminal ileum is extremely rare. It most frequently occurs in the nasal or paranasal areas and less frequently in the skin, the soft tissue, and the gastrointestinal tract. NK/T cell lymphoma involving gastrointestinal tract has characteristic endoscopic features of Inflammatory bowel disease. We herein describe a first case of primary NK/T cell lymphoma misdiagnosed as Behcet's enteritis of the terminal ileum colonoscopically and complicated by cecal bleeding and perforation.
Subject(s)
Killer Cells, Natural/immunology , Lymphoma, T-Cell/diagnosis , Adult , Behcet Syndrome/diagnosis , CD56 Antigen/metabolism , Colonoscopy , Diagnostic Errors , Female , Humans , Ileal Diseases/diagnosis , Lymphoma, T-Cell/immunology , Lymphoma, T-Cell/pathology , Tomography, X-Ray ComputedSubject(s)
Duodenal Neoplasms/pathology , Gastrointestinal Stromal Tumors/pathology , Adult , Duodenal Neoplasms/surgery , Duodenum/pathology , Duodenum/surgery , Female , Gastrointestinal Hemorrhage/pathology , Gastrointestinal Hemorrhage/surgery , Gastrointestinal Stromal Tumors/surgery , Humans , Intestinal Mucosa/pathology , Intestinal Mucosa/surgery , Neoplasm Invasiveness , Positron-Emission Tomography , Tomography, X-Ray ComputedABSTRACT
BACKGROUND/AIMS: Although a few recent studies have reported the effectiveness of endoscopic pancreatic sphincterotomy (EPST), none has compared physicians' skills and complications resulting from the procedure. Thus, we examined the indications, complications, and safety of EPST performed by a single physician at a single center. METHODS: Among 2,313 patients who underwent endoscopic retrograde cholangiopancreatography between January 1996 and March 2008, 46 patients who underwent EPST were included in this retrospective study. We examined the indications, complications, safety, and effectiveness of EPST, as well as the need for a pancreatic drainage procedure and the concomitant application of EPST and endoscopic sphincterotomy (EST). RESULTS: Diagnostic indications for EPST were chronic pancreatitis (26 cases), pancreatic divisum (4 cases), and pancreatic cancer (8 cases). Therapeutic indications for EPST were removal of a pancreaticolith (10 cases), stent insertion for pancreatic duct stenosis (9 cases), nasopancreatic drainage (7 cases), and treatment of sphincter of Oddi dysfunction (1 case). The success rate of EPST was 95.7% (44/46). Acute complications of EPST included five cases (10.9%) of pancreatitis and one of cholangitis (2.2%). EPST with EST did not reduce biliary complications. Endoscopic pancreatic drainage procedures following EPST did not reduce pancreatic complications. CONCLUSIONS: EPST showed a low incidence of complications and a high rate of treatment success; thus, EPST is a relatively safe procedure that can be used to treat pancreatic diseases. Pancreatic drainage procedures and additional EST following EPST did not reduce the incidence of procedure-related complications.
Subject(s)
Pancreatic Diseases/surgery , Sphincterotomy, Endoscopic/methods , Adult , Aged , Bile Ducts/surgery , Female , Humans , Male , Middle Aged , Pancreatic Ducts/surgery , Sphincterotomy, Endoscopic/adverse effectsABSTRACT
Acute pancreatitis is a serious disease with fatality rate up to 15%. We recently experienced a case of acute pancreatitis induced by multiple drugs in a patient with ulcerative colitis. A 20-year-old female visited with abdominal pain and hematochezia and diagnosed of ulcerative colitis. Sulfasalazine and prednisolone were used. However, acute pancreatitis occurred after 4 weeks of treatment with additional azathioprine treatment. Drug-induced pancreatitis was suspected, and she was recovered with conventional therapy for acute pancreatitis. Therefore, it was proposed that acute pancreatitis was induced by azathioprine. However, after the administration of sulfasalazine, pancreatitis relapsed. Furthermore, even the re-administration of 5-ASA and azathioprine induced relapse of acute pancreatitis. We concluded that acute pancreatitis was induced by multiple drugs in this patient with ulcerative colitis.
