ABSTRACT
A case of a patient with symptoms of gastric obstruction secondary to cholecystogastric fistula is presented and a brief review of the literature is done.(AU)
Subject(s)
Humans , Male , Aged , Biliary Fistula/diagnostic imaging , Gallbladder Diseases/diagnostic imaging , Gastric Fistula , Endosonography , Gastroscopy , Esophagitis , Biliary Fistula/etiology , Biliary Fistula/surgery , Gallbladder Diseases/surgery , Inpatients , Physical Examination , Symptom AssessmentABSTRACT
Melanoma is a cancer that frequently metastasises to the small bowel, but most cases are asymptomatic and are diagnosed postmortem. Therefore, CT and PET CT cannot detect all lesions and conventional endoscopic study only detects 10-20% of lesions. In this study, we present the case of a 68-year-old patient with a history of cutaneous melanoma and a diagnosis of intestinal melanoma. Thanks to capsule endoscopy, two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected, allowing a much more effective surgical planning. Capsule endoscopy is an innovative technique that improves preoperative diagnosis, as it is able to detect bowel segments that cannot be inspected by conventional endoscopy. It also has a better resolution than conventional CT, improving sensitivity in the detection of lesions.(AU)
Subject(s)
Humans , Male , Middle Aged , Capsule Endoscopes , Intestine, Small , Melanoma/diagnostic imaging , Endoscopy, Gastrointestinal , Intestinal Neoplasms/surgery , Inpatients , Physical Examination , Treatment OutcomeABSTRACT
A case of a patient with symptoms of gastric obstruction secondary to cholecystogastric fistula is presented and a brief review of the literature is done.
Subject(s)
Biliary Fistula , Gallbladder Diseases , Gastric Fistula , Humans , Endosonography , Biliary Fistula/diagnostic imaging , Biliary Fistula/etiology , Biliary Fistula/surgery , Gallbladder Diseases/diagnostic imaging , Gallbladder Diseases/surgery , Gastric Fistula/diagnostic imaging , Gastric Fistula/etiologySubject(s)
Humans , Female , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde , Choledocholithiasis/complications , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery , Situs Inversus/complications , Situs Inversus/diagnostic imaging , Duodenum , Jaundice, Obstructive/diagnostic imaging , Jaundice, Obstructive/etiologyABSTRACT
An 85-year-old female with situs inversus totalis was admitted due to obstructive jaundice, secondary to multiple choledocholithiasis and distal biliary stenosis due to adenocarcinoma of the head of the pancreas, with duodenal infiltration and metastatic liver disease. An endoscopic retrograde cholangiopancreatography (ERCP) was attempted in the supine position but bile duct cannulation was not possible due to duodenal infiltration. Finally, a palliative biliary stent was placed percutaneously, with resolution of the jaundice.
Subject(s)
Choledocholithiasis , Jaundice, Obstructive , Situs Inversus , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde , Choledocholithiasis/complications , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery , Duodenum , Female , Humans , Jaundice, Obstructive/diagnostic imaging , Jaundice, Obstructive/etiology , Situs Inversus/complications , Situs Inversus/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Ulcer/etiology , Rectum/injuries , Syphilis/complications , Gastrointestinal Hemorrhage/etiology , Penicillins/therapeutic use , Diagnosis, DifferentialABSTRACT
Shyphilis is a chronic infectious disease caused by Treponema Pallidum bacteria. Syphilis is most commonly spread through sexual activity, by direct contact with the inoculation point of the spirochete. It has been demonstrated that the desease is more prevalent in men who have sex with men. In primary syphilis, the chancre appears 2-3 weeks after the initial exposure mostly in genitals, but also in oral cavity, pharynx or anus. Secondary syphilis is a systemic disease. It occurs weeks or months later in about 25% of people with primary syphilis that has not been treated. Although many people who present with secondary syphilis do not report previosly having had the classic chancre of primary syphilis.
Subject(s)
Rectal Diseases/pathology , Ulcer/pathology , Anti-Bacterial Agents/therapeutic use , Humans , Male , Middle Aged , Penicillin G/therapeutic use , Rectal Diseases/drug therapy , Syphilis/complications , Syphilis/drug therapy , Treponema pallidum , Ulcer/drug therapyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Immunoglobulin G/analysis , Pancreatitis/diagnosis , Autoimmune Diseases/diagnosis , Cholangitis, Sclerosing/diagnosis , Jaundice/etiologyABSTRACT
No disponible
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma/pathology , Adenocarcinoma , Endometrial Neoplasms/diagnosis , Neoplasm Metastasis/diagnosis , Neoplasm Metastasis/pathology , Endoscopy, Gastrointestinal , Endometrium/pathology , Endometrium , Endometrial Neoplasms/pathology , Immunohistochemistry/methods , ImmunohistochemistrySubject(s)
Autoimmune Diseases/etiology , Hypergammaglobulinemia/complications , Immunoglobulin G , Pancreatitis, Chronic/etiology , Adrenal Cortex Hormones/therapeutic use , Autoimmune Diseases/drug therapy , Autoimmune Diseases/immunology , Autoimmune Diseases/pathology , Dacryocystitis/diagnosis , Dacryocystitis/etiology , Dacryocystitis/pathology , Diagnostic Errors , Early Diagnosis , Humans , Hydronephrosis/etiology , Hydronephrosis/pathology , Hypergammaglobulinemia/diagnosis , Hypergammaglobulinemia/drug therapy , Hypergammaglobulinemia/immunology , Lacrimal Apparatus/pathology , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/pathology , Lymphoma/diagnosis , Male , Middle Aged , Pancreatitis, Chronic/diagnostic imaging , Pancreatitis, Chronic/drug therapy , Pancreatitis, Chronic/immunology , Pancreatitis, Chronic/pathology , Plasma Cells/pathology , Remission Induction , Tomography, X-Ray ComputedABSTRACT
Introducción La epidermólisis ampollosa engloba un conjunto de enfermedades caracterizadas por la formación de lesiones ampollosas en piel y mucosas ante traumatismos mínimos. La afectación gastrointestinal es casi una constante en la forma distrófica recesiva, siendo el esófago una de las localizaciones más frecuentes de las manifestaciones extracutáneas. El síntoma más común es la disfagia, habitualmente secundaria a la formación de ampollas a este nivel que condicionan la aparición posterior de estenosis esofágicas cicatriciales. Observación clínica Presentamos el caso de una paciente de 48 años con epidermólisis ampollosa distrófica recesiva remitida para estudio de disfagia, con sospecha de estenosis esofágica. La imposibilidad de progresión del gastroscopio pediátrico debido a la aparición de lesiones ampollosas en hipofaringe secundarias al roce del instrumento y la aparente existencia de una compresión extrínseca esofágica nos condujo a realizar una TC cervical para continuar el estudio, la cual mostró una imagen compatible con absceso de localización paraesofágica. Tras valorar el riesgo-beneficio de realizar punción-drenaje endoscópico, optamos por tratamiento conservador consiguiendo buenos resultados y resolución completa de la sintomatología. Conclusiones Se presenta el caso de un absceso paraesofágico asociado a epidermólisis ampollosa, una causa poco común de disfagia en estos pacientes, resuelto con tratamiento antibiótico y esteroideo. En este contexto clínico los procedimientos invasivos, incluyendo los endoscópicos, presentan una elevada tasa de éxito, no obstante y a pesar de su seguridad, es preciso extremar las precauciones, usar la técnica adecuada y considerar otras posibilidades diagnósticas(AU)
Introduction Epidermolysis bullosa encompasses a group of disorders characterized by the development of blisters on the skin and mucous membranes after minimal trauma. Gastrointestinal involvement is almost always present in the recessive dystrophic form, with the esophagus being one of the most frequent sites of extracutaneous manifestations. The most common symptom is dysphagia, which is usually secondary to esophageal blisters that evolve to scar tissue and stenosis. Case report We report the case of a 48-year-old woman with recessive dystrophic epidermolysis bullosa who was referred because of dysphagia, with suspected esophageal stenosis. Pediatric gastroscopy was abandoned due to the development of blistering of the hypopharynx caused by the instrument and the apparent presence of extrinsic esophageal compression. To continue the examination, cervical computed tomography was performed, showing an image compatible with a paraesophageal abscess. After evaluating the risk-benefit ratio of performing endoscopic biopsy-drainage, we decided on conservative treatment, achieving favorable results and complete symptom resolution. Conclusions We describe a case of paraesophageal abscess associated with epidermolysis bullosa, a rare cause of dysphagia in these patients, which was resolved with antibiotic and steroid treatment. In patients with this disease, invasive procedures, including endoscopy, have a high success rate. Despite the safety of these techniques, the utmost precautions should be taken, an appropriate technique should be used, and other diagnostic options should be considered (AU)
