ABSTRACT
We report a case of a 79-year-old man who had undergone partial gastrectomy with Billroth-II (B-II) anastomosis 42 years ago for benign peptic ulcer. He presented with abdominal pain, distention and acute pancreatitis. Esophagogastroduodenoscopy showed a malignant mass obstructing the afferent stoma; surgical resection was performed. Pathogenesis of acute pancreatitis in this case and the problem of gastric stump carcinoma are discussed.
Subject(s)
Afferent Loop Syndrome/etiology , Gastric Stump , Pancreatitis/etiology , Acute Disease , Afferent Loop Syndrome/diagnostic imaging , Aged , Humans , Male , Tomography, X-Ray ComputedSubject(s)
Anemia/etiology , Anemia/surgery , Gastric Antral Vascular Ectasia/complications , Gastric Antral Vascular Ectasia/surgery , Pyloric Antrum/surgery , Serum Albumin/deficiency , Anemia/pathology , Gastric Antral Vascular Ectasia/pathology , Humans , Male , Middle Aged , Pyloric Antrum/pathologyABSTRACT
Heterotopic gastric tissue in the duodenal bulb is a rare congenital lesion. Its prevalence has been reported to be 0.5-2%. It must be differentiated from gastric metaplasia of the duodenal bulb because the two entities have different clinical implications. During one year, we found three cases of gastric heterotopia of the duodenal bulb. In one of the cases, active acid-secreting gastric mucosa was documented by performing the pentagastrin Congo red dye test. The differences between gastric heterotopia of the duodenal bulb and gastric metaplasia of the duodenal bulb have been discussed.
Subject(s)
Adenocarcinoma/pathology , Choristoma/pathology , Duodenal Diseases/pathology , Stomach Neoplasms/pathology , Stomach , Adenocarcinoma/diagnosis , Aged , Biopsy, Needle , Choristoma/diagnosis , Diagnosis, Differential , Duodenal Diseases/diagnosis , Duodenoscopy , Gastric Mucosa/pathology , Humans , Male , Middle Aged , Stomach Neoplasms/diagnosisABSTRACT
Comparison of thyroxine, triiodothyronine, and parathormone levels in antemortem and postmortem sera was done by radioimmunoassay. In all but one of twelve cases, thyroxine levels irregularly declined after death, but this was statistically significant in only five patients. Triiodothyronine was assayed in eleven patients; two levels fell, six rose, and two remained unchanged as late as 17.75 h after death. One patient had a decline in hormone level, followed by an elevation. Five of the eleven patients assayed for parathormone maintained stable levels for as long as 17.75 h after death. Five levels showed an elevation, and one, a decline followed by an elevation. The erratic behavior of triiodothyronine and parathormone after death may be due to conversion from thyroxine or from heterologous forms of parathormone, respectively. It was noted that hormone levels from the inferior vena cava tended to be higher than those from femoral veins, with diffusion of hormone from decomposing glands in the neck as a possible cause.
