ABSTRACT
No disponible
Subject(s)
Humans , Endoscopy, Gastrointestinal/adverse effects , Intestinal Perforation/etiology , Intestinal Perforation/therapy , Colonic Diseases/etiology , Colonic Diseases/therapyABSTRACT
Diverticular disease of the duodenum is uncommon. Perforation is the least frequent complication. Diagnosis and treatment are not well defined as the presentation and symptomatology are nonspecific. Diagnostic delay carries high rates of postoperative mortality (30%). Early diagnosis is essential to reduce morbidity and mortality. We present the case of a male patient with perforated duodenal diverticulum. This case suggests that computed tomography can be highly useful in the preoperative diagnosis of this entity. Treatment consisted of duodenal exclusion and retroperitoneal drainage.
Subject(s)
Diverticulum , Duodenal Diseases , Intestinal Perforation , Diverticulum/complications , Diverticulum/diagnosis , Diverticulum/surgery , Duodenal Diseases/complications , Duodenal Diseases/diagnosis , Duodenal Diseases/surgery , Humans , Intestinal Perforation/complications , Intestinal Perforation/diagnosis , Intestinal Perforation/surgery , Male , Middle AgedABSTRACT
La enfermedad diverticular del duodeno es una entidad clínica poco frecuente. La perforación es la complicación menos habitual. La secuencia diagnóstica y terapéutica no está definida debido a que su forma de presentación y sus síntomas son muy inespecíficos. La demora diagnóstica comporta tasas de mortalidad operatoria elevadas (30%). El diagnóstico precoz es fundamental para reducir la morbimortalidad. Se presenta el caso de un paciente con un divertículo duodenal perforado. Este caso indica que la tomografía computarizada es de gran utilidad en el diagnóstico preoperatorio. El tratamiento consistió en la exclusión duodenal y el drenaje del retroperitoneo (AU)
Diverticular disease of the duodenum is uncommon. Perforation is the least frequent complication. Diagnosis and treatment are not well defined as the presentation and symptomatology are nonspecific. Diagnostic delay carries high rates of postoperative mortality (30%). Early diagnosis is essential to reduce morbidity and mortality. We present the case of a male patient with perforated duodenal diverticulum. This case suggests that computed tomography can be highly useful in the preoperative diagnosis of this entity. Treatment consisted of duodenal exclusion and retroperitoneal drainage (AU)
Subject(s)
Male , Middle Aged , Humans , Diverticulum/complications , Intestinal Perforation/surgery , Duodenum/surgery , Retroperitoneal Space/surgery , Drainage , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: We present a new case of small renal mass in which monitoring was chosen, no surgical intervention, and review of literature about this. METHODS AND RESULTS: We present a case of a female, 80 years of age, who was diagnosed of small renal mass (2 cms). We monitored the patient every 6 months through C.T. After more two years the renal mass is the same. CONCLUSIONS: In case of renal mass lower than 4 cm without local invasion we can choose the option of periodical monitoring with C.T. (6 monthly). It is important that the patient is assymptomatic. So therefore given the age (80 years), size of the tumor, and absence of symptoms, we can do monitoring without surgery.
Subject(s)
Kidney Neoplasms/pathology , Aged , Aged, 80 and over , Female , Humans , Incidental Findings , Kidney Neoplasms/diagnostic imaging , Radiography , Treatment Refusal , UltrasonographyABSTRACT
OBJETIVOS: Presentamos un nuevo caso de tumor renal pequeño en el que se decidió realizar monitorización sin intervención quirúrgica. Revisamos la literatura sobre esta situación. CONCLUSIONES: En el caso de tumores renales menores de 4 cm, sin invasión local, podemos elegir la opción de monitorización periódica con TAC (cada 6 meses). Es importante que el paciente esté asintomático. Por lo tanto, dada la edad de la paciente (80 años), el tamaño del tumor, y la ausencia de síntomas pudimos elegir la monitorización sin cirugía (AU)
No disponible
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Treatment Refusal , Incidental Findings , Kidney NeoplasmsABSTRACT
OBJECTIVE: The aim of our study was to prospectively evaluate the accuracy of dual-phase helical CT in the preoperative assessment of resectability in patients with suspected pancreatic cancer using surgical and histopathologic correlation. SUBJECTS AND METHODS: Between January 1999 and December 2000, 76 patients with suspected pancreatic cancer underwent preoperative evaluation and staging with dual-phase helical CT (3-mm collimation for pancreatic phase, 5-mm collimation for portal phase). Iodinated contrast material was injected IV (170 mL at a rate of 4 mL/sec); acquisition began at 40 sec during the pancreatic phase and at 70 sec during the portal phase. Three radiologists prospectively evaluated the imaging findings to determine the presence of pancreatic tumor and signs of unresectability (liver metastasis, vascular encasement, or regional lymph nodes metastasis). The degree of tumor-vessel contiguity was recorded for each patient (no contiguity with tumor, contiguity of < 50%, or contiguity of > or =50%). RESULTS: Thirty-nine patients with pancreatic adenocarcinoma were surgically explored. Curative resections were attempted in 34 patients and were successful in 25. The positive predictive value for resectability was 73.5%. Nine patients considered resectable on the basis of CT findings were found to be unresectable at surgery because of liver metastasis (n = 5), vascular encasement (n = 2), or lymph node metastasis (n = 2). We found that the overall accuracy of helical CT as a tool for determining whether a pancreatic adenocarcinoma was resectable was 77% (30/39 patients). CONCLUSION: Dual-phase helical CT is a useful technique for preoperative staging of pancreatic cancer. The main limitation of CT is that it may not reveal small hepatic metastases.
