ABSTRACT
Se presenta el caso de un varón que tras estudio de una hemorragia digestiva no filiada con técnicas endoscópicas fue diagnosticado por angiografía selectiva y TAC de lesión sangrante en primeras asas yeyunales, que resultó ser un tumor estromal CD34+ sin diferenciación neural o miógena. Se analizan las características ultraestructurales e inmunohistoquímicas de los diferentes grupos de tumores estromales del tracto gastrointestinal, así como la dificultad diagnóstica cuando éstos se localizan en intestino delgado y requieren actitud terapéutica agresiva por presentar hemorragia (AU)
Subject(s)
Male , Middle Aged , Humans , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Gastrointestinal Hemorrhage/therapy , Jejunal Neoplasms/diagnosis , Jejunal Neoplasms/pathology , Jejunal Neoplasms/therapy , Jejunal Neoplasms/etiology , Angiography/trends , Angiography , Colonoscopy/trends , Colonoscopy , Intestinal Polyps/diagnosis , Intestinal Polyps/therapyABSTRACT
Report of a retrospective study on 303 patients operated from colorectal carcinoma to whom colonic resection was done in B and C stages of Astler-Coller's classification. The aim was to try to find a relation between blood transfusion and colorectal carcinoma recurrence. The statistical study is made with the program LOGIT, studying the surgical incision, evolutive stage and blood transfusion variables. The significant contribution of each variable in the occurrence of recurrence is studied with the Wald Test. As a result it can be deduced that the prognosis of colorectal cancer is influenced by three factors: the evolutive stage, the surgical incision (1.87 times more frequent for the abdomino-perineal) and the transfusion of more of three units of blood in the perioperative period which multiplies by 2.85 the risk of recurrence of colorectal carcinoma. In our hospital almost exclusively red cell concentrates (including red cells, white cells and minimal fraction of plasma), are transfused; possibly the white cells are responsible for the recurrence.
Subject(s)
Adenocarcinoma/etiology , Colorectal Neoplasms/etiology , Neoplasm Recurrence, Local/etiology , Transfusion Reaction , Adenocarcinoma/epidemiology , Adenocarcinoma/pathology , Age Factors , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/pathology , Humans , Logistic Models , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Postoperative Period , Risk Factors , Sex Factors , Spain/epidemiologyABSTRACT
A solid and papillary neoplasm of a mesocolonic ectopic pancreas, 6 cm of diameter, was found by chance in a woman age 33 and resected surgically. The histologic study showed a well delimited tumor made up of uniform eosinophilic cells forming papillae, with solid and cystics areas. Pancreatic tissue was detected in the periphery of the neoplasm. The presence of ectopic pancreas with a solid and papillary tumor is extremely rare. We have only found one case in the literature (5).
Subject(s)
Carcinoma, Papillary/pathology , Choristoma/pathology , Colonic Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Pancreas , Adult , Female , HumansABSTRACT
Morgagni's hernia is an uncommon type of diaphragmatic hernia. We present two cases presenting as gastric volvulus; the patients underwent elective surgery after resolution of the acute event. The clinical manifestations and diagnostic procedures to reach the diagnosis before surgery are explained, as well as the advantages of the abdominal over the thoracic approach.
Subject(s)
Hernia, Diaphragmatic/complications , Stomach Volvulus/etiology , Aged , Aged, 80 and over , Female , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/surgery , Humans , Male , Middle Aged , Stomach Volvulus/diagnosis , Stomach Volvulus/surgeryABSTRACT
A retrospective study was made of 23 cases of spontaneous biliodigestive fistulae collected from bile tract surgery performed in our center from 1979 to 1987, representing 1.05% of the total number of cases. The etiology was cholelithiasis in almost all cases and the most frequent connection was to the duodenum. Forty-eight percent of the cases presented as biliary ileus. In each case surgery depended on the etiology, clinical manifestations and status of the patient. The mortality was 8.7% and the morbidity 52%. Results are analyzed and a bibliographic review of the topic is offered.
Subject(s)
Biliary Fistula/surgery , Colonic Diseases/surgery , Duodenal Diseases/surgery , Gallbladder Diseases/surgery , Gastric Fistula/surgery , Intestinal Fistula/surgery , Adult , Aged , Aged, 80 and over , Biliary Fistula/diagnosis , Biliary Fistula/etiology , Colonic Diseases/diagnosis , Colonic Diseases/etiology , Duodenal Diseases/diagnosis , Duodenal Diseases/etiology , Female , Gallbladder Diseases/diagnosis , Gallbladder Diseases/etiology , Gastric Fistula/diagnosis , Gastric Fistula/etiology , Humans , Intestinal Fistula/diagnosis , Intestinal Fistula/etiology , Male , Middle Aged , Pylorus , Retrospective StudiesABSTRACT
We present a retrospective study of 208 colorectal cancers, 131 of them followed during more than 5 years. Overall survival was 38%. We have tried to correlate clinical findings with prognosis and survival. The analyzed parameters have been the following: age, sex, site and size of the tumor, time and cause of surgical treatment, stage of the lesion, cytologic grade of differentiation of the tumor, delay between the presenting symptom and surgery, surgical procedure, local invasion and number of positive lymph nodes. The results show that the main factors related to prognosis are local extension through the intestinal wall and the presence of positive lymph nodes (particularly if more than 4) and, of course, distant metastases.
Subject(s)
Adenocarcinoma/mortality , Colorectal Neoplasms/mortality , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adult , Aged , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Prognosis , Retrospective StudiesABSTRACT
From 1980 to 1986, 569 patients with colonic disease underwent surgery in the General Surgery Service of "Nuestra Sra. de Aránzazu" Hospital, 131 of them over 75 and representing 23% of the total. In this group, neoplasms were the most common lesion, for a total of 108 cases (83.2%). Among nontumoral diseases, half corresponded to diverticula. Colonic surgery was practiced as an emergency in 35.87% of the cases and in 72.7% of the non-neoplastic lesions, with an overall operative mortality of 28 patients (21.37%). We analyze the distribution of the different lesions of the colon, the urgency of the operation and operative mortality as related to age, evaluating the limitations in elderly patients and their increased surgical risk.
Subject(s)
Colonic Diseases/surgery , Age Factors , Aged , Cause of Death , Colonic Diseases/mortality , Colonic Neoplasms/mortality , Colonic Neoplasms/surgery , Female , Humans , Male , Middle Aged , Risk FactorsABSTRACT
From 1979 to 1987, 5 patients with cholecystocolonic fistula were operated on in our service, which represents 25% of a total of 20 external biliodigestive fistulas complied over this period. Admission was as an emergency in 4 of the 5 patients (80%), and in one for elective programmed surgery. External biliodigestive fistula was suspected in 3 patients (60%) and biliocolonic fistula in one (20%), on observing aerobilia and leakage of contrast into the hepatic angle of the colon. On two occasions (40%) associated choledocholithiasis was detected, by means of echographic study in one case and intraoperative cholangiography in the other. Antecedents of biliary pathology were present in 3 of our 5 observations (60%), with a mean time of evolution of 12 years.
