ABSTRACT
A 53-year-old man was admitted hospital because of frequent vomiting and poor digestion. Abdominal computed tomography showed a tumor, about 5 cm in diameter at the duodeno-jejunal junction. A barium contrast duodeno-small bowel series revealed stenosis in the therd portion, where push enteroscopy could not pass with normal mucosa. The preoperative diagnosis was submucosal or mesenteric tumor. Open surgery was performed. The tumor derived from the mesenterium and involved the anal side of the small intestine. The tumor was removed with partial excision of the upper jejunum. The diagnosis of mesenteric desmoid tumor was confirmed, histologically.
Subject(s)
Fibromatosis, Abdominal/diagnosis , Ileus/etiology , Mesentery , Peritoneal Neoplasms/diagnosis , Fibromatosis, Abdominal/pathology , Fibromatosis, Abdominal/surgery , Humans , Male , Middle Aged , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/surgerySubject(s)
Anti-Inflammatory Agents/adverse effects , Antibodies, Monoclonal/adverse effects , Azathioprine/adverse effects , Crohn Disease/complications , Immunosuppressive Agents/adverse effects , Pneumonia, Pneumocystis/etiology , Prednisolone/adverse effects , Crohn Disease/drug therapy , Female , Humans , Infliximab , Middle AgedABSTRACT
Acute organophosphate poisoning (OP) shows several severe clinical symptoms due to its strong blocking effect on cholinesterase. Acute pancreatitis is one of the complications associated with acute OP, but this association still may not be widely recognized. We report here the case of a 73-year-old man who had repeated abdominal pain during and after the treatment of acute OP. Hyperamylasemia and a 7-cm pseudocyst in the pancreatic tail were noted on investigations. We diagnosed pancreatic pseudocyst that likely was secondary to an episode of acute pancreatitis following acute OP. He was initially treated with a long-term intravenous hyperalimentation, protease inhibitors and octerotide, but eventually required surgical intervention, a cystgastrostomy. Acute pancreatitis and hyperamylasemia are known to be possible complications of acute OP. It is necessary to examine and assess pancreatic damage in patients with acute OP.
Subject(s)
Organophosphate Poisoning , Pancreatic Pseudocyst/etiology , Acute Disease , Aged , Humans , MaleABSTRACT
The patient was a 66-year-old man who had advanced gastric cancer with metastasis to liver and lymph nodes. He received daily oral administration of 100 mg of TS-1 for 28 days followed by 14 days rest as one treatment course. After 2 coures, regression of the primary lesion and reduction in size of the liver and lymph metastases were observed.
Subject(s)
Adenocarcinoma/drug therapy , Antimetabolites, Antineoplastic/administration & dosage , Oxonic Acid/administration & dosage , Pyridines/administration & dosage , Stomach Neoplasms/drug therapy , Tegafur/administration & dosage , Adenocarcinoma/secondary , Administration, Oral , Drug Administration Schedule , Drug Combinations , Humans , Liver Neoplasms/secondary , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Stomach Neoplasms/pathology , SurvivorsABSTRACT
We report a case of steroid-induced osteonecrosis in a patient with refractory ulcerative colitis. A 31 year-old woman presented suffering from refractory ulcerative colitis. She had been treated by prednisolone for ten years. Sharp pain and swelling appeared suddenly in her right knee. Conventional radiography revealed neither osteoporosis nor a fracture. However, magnetic resonance imaging by T1-, T2 and T2*-weighted images revealed irregular heterogeneous areas of low- and high-intensity in her right femur and tibia. For a precise early diagnosis of osteonecrosis, bone magnetic resonance imaging was found to be an excellent diagnostic tool.
Subject(s)
Anti-Inflammatory Agents/adverse effects , Colitis, Ulcerative/drug therapy , Osteonecrosis/drug therapy , Prednisolone/adverse effects , Adult , Female , Humans , Magnetic Resonance Imaging , Osteonecrosis/diagnosis , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: EUS has recently been shown to be efficacious for the preoperative assessment of depth of invasion of gallbladder carcinoma. This study assessed the value of EUS for determining T stage (International Union Against Cancer). METHODS: Preoperative EUS findings in 41 patients with gallbladder carcinoma were analyzed retrospectively. EUS images were classified according to the shape of the tumor and the adjacent gallbladder wall structure as follows: type A, pedunculated mass with preserved adjacent wall structures; type B, sessile and/or broad-based mass with a preserved outer hyperechoic layer of the gallbladder wall; type C, sessile and/or broad-based mass with a narrowed outer hyperechoic layer; type D, sessile and/or broad-based mass with a disrupted outer hyperechoic layer. EUS and histopathologic findings were compared, including the depth of invasion of the tumor in the resection specimen. RESULTS: The 4 categories of EUS images of gallbladder carcinoma correlated with the histologic depth of invasion and T stage. Accuracies for the EUS classification as type A corresponding to pTis, type B to pT1, type C to pT2, and type D to pT3-4 were, respectively, 100%, 75.6%, 85.3%, and 92.7%. CONCLUSIONS: Preoperative EUS imaging accurately depicts T stage of gallbladder carcinoma and allows for effective therapeutic decision making.
