RESUMO
The article tries to address the dilemma confronting the repair of paraesophageal hernia (PEH). The case has been made for repair upon diagnosis. The initial results of laparoscopic repair were projected as successful. However, recurrence and reflux have plagued many studies. Whereas adjunct fundoplication is now consistently performed by most surgeons, the basis is uncertain. Recurrence rate is often higher than that reported if only the 'imaged' follow-up patients are considered. Esophageal lengthening is believed to potentially benefit both the hallmark complications. The worldwide experience with laparoscopic esophageal lengthening is scanty (although it was not uncommon in the days of open surgery). Compared to the open repair, the laparoscopic method has a higher recurrence rate, higher major specific complication rate, comparable symptom outcome and a shorter hospital stay.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Fundoplicatura/métodos , Hérnia Hiatal/cirurgia , Laparoscopia/métodos , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Feminino , Seguimentos , Fundoplicatura/efeitos adversos , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/etiologia , Hérnia Hiatal/diagnóstico , Humanos , Incidência , Laparoscopia/efeitos adversos , Tempo de Internação , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Recidiva , Medição de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Adenocarcinoids are rare and aggressive tumors with histological features of both carcinoid tumor and adenocarcinoma. We report a case of a 32-year-old man with diffuse infiltration of the appendix wall and mesoappendix by an adenocarcinoid. Due to the involvement, a hemicolectomy was performed at a later date. We suggest that patients with diffuse appendiceal involvement require an aggressive surgical therapy and follow-up.
Assuntos
Neoplasias do Apêndice/diagnóstico , Tumor Carcinoide/diagnóstico , Adulto , Neoplasias do Apêndice/diagnóstico por imagem , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/cirurgia , Apendicite/diagnóstico , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/patologia , Tumor Carcinoide/cirurgia , Diagnóstico Diferencial , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Melanosis coli is associated with an increased risk of colorectal tumors but is not agreed to be a precancerous lesion. The condition has been associated with the ingestion of anthracene laxatives and is believed to be caused by increased epithelial apoptosis. Although melanosis coli is a frequent finding in colonic biopsies and resection specimens, to our knowledge severe jet black melanosis coli with pseudoobstruction has not been reported in literature. Such gross Melanosis is exceptional and particularly striking.
