ABSTRACT
Diagnostic approach can be difficult in pediatric pancreatic masses. Our case shows that even though radiologic appearance was not conclusive, surgery remains the main treatment in resectable masses especially in children.
ABSTRACT
Confocal endomicroscopy (EMC) is a thriving technology that allows real-time and non-invasive imaging in vivo. EMC demonstrated its effectiveness to differentiate neoplastic from normal tissue and to search dysplasia. In addition to the significant developments of this technique in Barrett oesophagus, celiac disease, characterization of colonic polyps, or monitoring of chronic inflammatory bowel disease, EMC is currently developing in bilio-pancreatic pathology. Indeed, it is currently used to characterize biliary stenosis as well as pancreatic lesions (especially cystic). The aim of our study was to evaluate through a review of the literature the value of this technique in the characterization of pancreatic lesions.
Subject(s)
Colonic Polyps , Inflammatory Bowel Diseases , Microscopy, Confocal , Pancreatic Neoplasms , Humans , Inflammatory Bowel Diseases/diagnosis , Pancreatic Neoplasms/diagnosisSubject(s)
Intestinal Polyps/diagnosis , Liver Neoplasms/diagnostic imaging , Neuroendocrine Tumors/diagnostic imaging , Rectal Neoplasms/diagnosis , Antineoplastic Agents/therapeutic use , Colonoscopy , Female , Humans , Intestinal Polyps/pathology , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Middle Aged , Neuroendocrine Tumors/drug therapy , Neuroendocrine Tumors/secondary , Peptides, Cyclic/therapeutic use , Rectal Neoplasms/pathology , Somatostatin/analogs & derivatives , Somatostatin/therapeutic use , Tomography, X-Ray ComputedSubject(s)
Biliary Fistula/etiology , Duodenal Ulcer/complications , Gastric Fistula/etiology , Aged, 80 and over , Humans , MaleSubject(s)
Lymphoma, B-Cell, Marginal Zone/diagnosis , Stomach Neoplasms/diagnosis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Diagnosis, Differential , Doxorubicin/therapeutic use , Female , Gastric Mucosa , Humans , Lymphoma, B-Cell, Marginal Zone/drug therapy , Prednisone/therapeutic use , Remission Induction , Stomach Neoplasms/drug therapy , Vincristine/therapeutic useSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Burkitt Lymphoma/pathology , Immunocompetence , Stomach Neoplasms/pathology , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Adult , Biopsy, Needle , Burkitt Lymphoma/diagnostic imaging , Burkitt Lymphoma/drug therapy , Follow-Up Studies , Gastroscopy/methods , Humans , Immunohistochemistry , Male , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/drug therapy , Tomography, X-Ray Computed/methods , Treatment OutcomeSubject(s)
Colitis/diagnostic imaging , Colitis/microbiology , Tuberculosis, Gastrointestinal/diagnosis , Acute Disease , Adolescent , Colitis/pathology , Colonoscopy , Crohn Disease/complications , Female , Humans , Severity of Illness Index , Tuberculosis, Gastrointestinal/complications , Tuberculosis, Gastrointestinal/pathologyABSTRACT
BACKGROUND: Ischemic colitis is the most common form of intestinal ischemia. The presence of diarrhea and mild lower gastrointestinal bleeding should guide the diagnosis. Although many laboratory tests and radiographic images may suggest the diagnosis, colonic endoscopic with histological analysis of biopsies is the gold standard for identification of colonic ischemia. aim : The aim of this study was to resume in 5 points: the epidemiology, the clinical features, the diagnostic approach and the management of ischemic colitis in five points. methods: Review of literature. results: Incidence of ischemic colitis was between 3 and 10%. The clinical presentation is predominated by the non gangrenous form associating abdominal pain, tenderness, diarrhea and lower gastrointestinal bleeding. The most frequent causes are represented by systemic hypoperfusion. Laboratory tests can orientate the diagnosis but are unspecific. Radiographic images based on computed tomography or more recently magnetic resonance imaging may suggest the diagnosis, but the confirmation will be given by endoscopic visualization of colonic mucosa with histological analysis of biopsies. Conservative treatment is the most often sufficient to improve colonic lesions. Surgical treatment is reserved for perforations and strictures. CONCLUSION: The incidence of colonic ischemia is difficult to ascertain. The diagnosis is usually made by medical history, examination, and endoscopy which have become the diagnostic procedure of choice. A high index of suspicion and prompt management are essential for optimum outcomes in patients with colonic ischemia.
