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
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
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.
