Subject(s)
Bariatric Surgery , Craniopharyngioma/surgery , Hypothalamic Diseases/therapy , Incretins/therapeutic use , Liraglutide/therapeutic use , Neurosurgical Procedures/adverse effects , Obesity/therapy , Pituitary Neoplasms/surgery , Postoperative Complications/therapy , Binge-Eating Disorder/etiology , Binge-Eating Disorder/physiopathology , Binge-Eating Disorder/therapy , Humans , Hypothalamic Diseases/etiology , Hypothalamic Diseases/physiopathology , Male , Obesity/etiology , Obesity/physiopathology , Postoperative Complications/etiology , Satiety Response/physiology , Treatment Failure , Weight Gain , Young AdultABSTRACT
UNLABELLED: We hereby present a case report of a patient with an unusual neoplasic and surgical history. M.V. is a 54-year-old patient who had been operated, two years ago, for intestinal obstruction caused by a sigmoid tumor; a segmental rectal and sigmoid resection (Hartmann's procedure) was then performed. Two other surgical procedures were attempted during the last two years, in another surgical department: a colo-rectal anastomosis and a repair of the parastomal hernia, both failed due to postoperative adhesions syndrome. The patient was hospitalized for peristomal gangrene with necrotizing fasciitis. Emergency action was taken to resolve the parietal gangrene. The postoperative local evolution of the wound was favourable and allowed a skin graft for parietal restoration. An intestinal obstruction occurred 2 months later, caused by an extended metachronous tumor of the splenic flexure. The patient underwent other surgeries including the completion of the left hemicolectomy, total gastrectomy, caudal splenopancreatectomy and left adrenalectomy. The patient has a favourable postoperative evolution after 1 year. CONCLUSION: We noticed a very severe evolution of the peristomal gangrene and the rapid growth towards intestinal obstruction of the metachronous colonic tumor.
Subject(s)
Colectomy/adverse effects , Colonic Neoplasms/surgery , Fasciitis, Necrotizing/surgery , Gangrene/surgery , Neoplasms, Second Primary/surgery , Surgical Stomas/adverse effects , Adrenalectomy , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/microbiology , Gangrene/etiology , Gastrectomy , Humans , Male , Middle Aged , Pancreatectomy , Reoperation , Skin Transplantation , Splenectomy , Treatment OutcomeABSTRACT
The gastric plasmacytoma represents a rarely encountered, so that, the diagnosis criteria, the medical attitude and the evolution of this disease are less coded. It is known the fact that this tumours, extramedullary plasmacytomas with gastric localization, develop in soft submucous tissue, therefore it's very difficult or even impossible preoperative diagnosis through an upper endoscopy including biopsy. We present the case of a 54 years old patient, with no significant pathological personal record, that was admitted in our Clinic for having melenic dark stools which have repeated within a 6 months period prior to this hospitalisation. Repeated gastric mucosal samples taken in another medical unit shown normal aspects, contrary to all imaging testing (e.g. ultrasonography, upper endoscopy and barium swallow) which revealed a tumor mass of considerable extent at the level of the gastric corpus. First-line therapy was gastric resection followed by radiotherapy, because it is well known that the tumour is highly radiosensitive. The patient's postoperative course was satisfactory, showing no signs or recurrence 6 months after surgery at upper endoscopy and CT-scan.
