ABSTRACT
An 82-year-old woman presented with abdominal pain, nausea, emesis, and weight loss of ~25 lb over 6 months. A CT scan and MRI of the abdomen revealed a mass in the tail of the pancreas that was suspicious for malignancy. The patient underwent successful laparoscopic distal pancreatectomy and was discharged home on the 4th postoperative day after an uneventful course. Pathology revealed an inflammatory pseudotumor of the pancreas (IPT). Pancreatic IPT is a rare entity, and this case represents the first report of laparoscopic resection of this lesion. The presentation, diagnosis, histologic features, and therapy of IPT of the pancreas are reviewed.
Subject(s)
Granuloma, Plasma Cell/surgery , Laparoscopy/methods , Pancreatectomy/methods , Pancreatic Diseases/surgery , Aged , Aged, 80 and over , Diagnosis, Differential , Female , Granuloma, Plasma Cell/diagnosis , Granuloma, Plasma Cell/diagnostic imaging , Humans , Magnetic Resonance Imaging , Pancreatic Diseases/diagnosis , Pancreatic Diseases/diagnostic imaging , Pancreatic Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
Spontaneous hemorrhage of a parathyroid adenoma is a rare occurrence which may manifest with a variety of symptoms including cervical pain, hoarseness, respiratory distress, and dysphagia. We report a case of an elderly woman with a parathyroid adenoma diagnosed 10 years ago and for which she had refused surgery. Throughout this period her hypercalcemia was carefully monitored, and she experienced no symptoms or adverse sequelae from her disease. However, the patient subsequently presented with a 1 day history of a sore throat and a nonproductive cough followed by the acute onset of dysphagia. At this time she was found to have an anterior neck hematoma extending to the midthorax. Computerized tomography and direct laryngoscopy were suggestive of the diagnosis and neck exploration confirmed the presence of a large hematoma beginning at the site of the 3 x 4 cm parathyroid adenoma and extending into the left strap musculature. We report this case of spontaneous hemorrhage of a cervical parathyroid adenoma to bring to mind a rare etiology of acute pharyngoesophageal dysphagia.
Subject(s)
Adenoma/complications , Deglutition Disorders/etiology , Esophageal Diseases/etiology , Hemorrhage/etiology , Parathyroid Diseases/etiology , Parathyroid Neoplasms/complications , Pharyngitis/etiology , Acute Disease , Aged , Aged, 80 and over , Female , Hematoma/etiology , Humans , Rupture, SpontaneousABSTRACT
Complete rectal prolapse or procidentia is an uncommon condition long recognized but of uncertain pathogenesis. We report two patients, seen a decade apart, both of whom developed complete rectal prolapse after ingestion of oral cathartics in preparation for diagnostic studies. To our knowledge, cathartic-induced complete rectal prolapse has not been reported previously in the current medical literature, despite the thousands of bowel preparations performed annually. These two cases address the implications of such an occurrence, and we discuss the pertinent management issues.
Subject(s)
Cathartics/adverse effects , Rectal Prolapse/chemically induced , Aged , Citrates/adverse effects , Citric Acid , Colonoscopy , Electrolytes/adverse effects , Female , Humans , Polyethylene Glycols/adverse effects , Solutions , UrographyABSTRACT
Dysphagia in the elderly is most often oropharyngeal or hypopharyngeal in location and neuropathologic in etiology. Aging itself, although causing demonstrable structural and functional changes in the esophagus, does not cause any clinically relevant esophageal dysphagia. A variety of pathologic conditions seen in the geriatric population affect the esophagus and can alter esophageal function, resulting in symptomatic dysphagia. Accurate diagnosis requires a thorough evaluation performed in an unhurried fashion, often with the assistance of ancillary personnel. Treatment of these esophageal disorders is multidisciplinary and may involve dietary manipulations, the administration of medications, therapeutic endoscopic procedures, and occasionally surgery.
Subject(s)
Aging , Deglutition Disorders/etiology , Esophageal Diseases/complications , Aged , Deglutition Disorders/diagnosis , Deglutition Disorders/therapy , Esophageal Diseases/pathology , Esophageal Diseases/physiopathology , HumansABSTRACT
Hepatitis may be caused by hepatitis A virus, hepatitis B virus, hepatitis C virus (classic non-A non-B viral hepatitis), hepatitis D virus (delta agent), and hepatitis E virus (epidemic non-A non-B viral hepatitis). Cytomegalovirus, Epstein-Barr virus, and herpes simplex virus may also occasionally cause hepatitis. Some forms of hepatitis carry the risks of chronic infection, cirrhosis, or hepatocellular carcinoma. Treatment options for viral hepatitis are limited and, in many cases, still under investigation. Prophylaxis is available for many forms of hepatitis and should be offered to those at risk.
Subject(s)
Hepatitis, Viral, Human/diagnosis , Diagnosis, Differential , Hepatitis A/diagnosis , Hepatitis B/diagnosis , Hepatitis C/diagnosis , Hepatitis D/diagnosis , Hepatitis E/diagnosis , Hepatitis, Chronic/etiology , Hepatitis, Viral, Human/complications , Hepatitis, Viral, Human/therapy , HumansSubject(s)
Diverticulum , Gastrointestinal Diseases , Diverticulum/pathology , Diverticulum, Colon/complications , Diverticulum, Colon/pathology , Diverticulum, Esophageal/pathology , Diverticulum, Stomach/pathology , Duodenal Diseases/pathology , Gastrointestinal Diseases/pathology , Gastrointestinal Hemorrhage/etiology , Humans , Ileal Diseases/pathology , Jejunal Diseases/pathology , Meckel Diverticulum/pathology , Pharyngeal Diseases/pathologyABSTRACT
The occurrence of transient leukopenia with relative neutropenia in a patient treated with a short course of high-dose mebendazole therapy for inoperable hydatid disease is reported. The toxicology of mebendazole is reviewed.
