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1.
Z Gastroenterol ; 53(10): 1183-6, 2015 Oct.
Article in German | MEDLINE | ID: mdl-26480054

ABSTRACT

Fibrovascular polyps are rare mesenchymal tumors that arise mainly in the cricopharyngeal portion of the esophagus. They may protrude distally to become "giant" pedunculated lesions filling almost the entire esophageal lumen. Histologically they contain varying amounts of adipose, fibrous and vascular tissues and belong to spindle cell lipomas according to the classification of soft tissue tumors. Immediate resection of these benign lesions is warranted as they may be regurgitated and cause asphyxia. These lesions are usually treated by open surgery (left cervicotomy) or, less invasively, by peroral endoscopic surgery. Polyp removal by flexible endoscopy has been described but may be hazardous if its stalk is broad-based. In this report the case of a 73-year-old male with dysphagia is described in whom a "giant" fibrovascular polyp was diagnosed endoscopically and promptly removed surgically by the peroral route. At control endoscopy 14 months later, the asymptomatic patient was free of polyp recurrence.


Subject(s)
Esophageal Diseases/pathology , Esophageal Diseases/surgery , Esophagoscopy/methods , Polyps/pathology , Polyps/surgery , Aged , Diagnosis, Differential , Esophageal Diseases/diagnostic imaging , Humans , Male , Polyps/diagnostic imaging , Radiography , Treatment Outcome
2.
Z Gastroenterol ; 50(2): 209-12, 2012 Feb.
Article in German | MEDLINE | ID: mdl-22298100

ABSTRACT

A 29-year-old man presented with abdominal cramps and bloody diarrhoea. Blood tests revealed elevated C-reactive protein (21.3 mg/dL; normal range 0.01 - 0. 82 mg/dL) and white blood cells (28200/µL, normal range 4000 - 10000/µL). Stool tests were negative for enteropathogenic bacteria and Clostridium difficile toxins A/B. Ultrasound and computed tomography showed massive swelling of the transverse colon and right colonic flexure. At endoscopy, circular necrosis of the mucosa was encountered in the proximal segments of the colon whereas distal parts of the organ showed patchy inflammation of minor severity. Extended stool testing identified Escherichia coli type O104:H4 as the causative microorganism. There was no evidence for haemolytic uraemic syndrome. Under conservative treatment the patient recovered clinically, serologically and endoscopically. At follow-up endoscopy, longitudinal ulcers and vital mucosa were present. In this case report the segmental pattern of mucosal necrosis in a patient with EHEC infection is noteworthy.


Subject(s)
Colitis/diagnosis , Colitis/microbiology , Colon/diagnostic imaging , Colon/pathology , Enterohemorrhagic Escherichia coli/isolation & purification , Escherichia coli Infections/diet therapy , Escherichia coli Infections/microbiology , Adult , Colitis/therapy , Escherichia coli Infections/therapy , Humans , Male , Necrosis/diagnosis , Radiography
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