Cápsula endoscópica de intestino delgado / No disponible

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Endoscopic ultrasonography features of calcified gastric cancer.

Calcifications are a rare finding described in benign and malignant tumors located in any site of the body. Their presence in stomach and colon carcinomas is very rare. Most of the cases described are mucinous adenocarcinomas. We present the case of one patient with this disease studied with endoscopic ultrasonography. There were punctate calcifications in the submucosa layer that tended to take on a crown-like shape in the outer-most area, producing an acoustic shadow. The pathological study of the surgical specimen showed amorphic calcifications inside some mucin lakes. More cases need to be studied with this technique in order to define their endosonographic characteristics.

[Endoscopic diagnosis of an ileocolic intussusception in an adult]. / Diagnóstico endoscópico de una intususcepción ileocólica en un adulto.

Although intussusception is the most frequent cause of intestinal obstruction in children, it only represents 5-10% of all adults. The preoperative diagnosis is difficult and it is rarely done by endoscopy. We present a case of adult ileocolic intussusception caused by an ileon terminal hamartoma. The diagnosis was done by colonoscopy.

Nitrite/nitrate and cytokine levels in bronchoalveolar lavage fluid of lung cancer patients.

BACKGROUND: Cytokines are produced by tumor cells in vitro, but evidence for in vivo increased production of cytokines in cancer patients is controversial. Conversely, nitric oxide (NO) is implicated increasingly in the mediation of cytokine effects. Lung cancer patients may show an increased local production of cytokines and NO, and chronic paracrine exposure of epithelial lung cells to these medicators may influence the production of surfactant phosphatidylcholine. METHODS: The presence of the cytokine tumor necrosis factor (TNF alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6), as well as NO, cyclic guanosine 3'5' monophosphate (cGMP) and phosphatidylcholine levels in bronchoalveolar lavage fluid (BLF) of lung cancer patients were investigated. Bronchoalveolar lavage fluid was obtained from 30 male smokers: 22 patients with squamous cell lung cancer and 8 subjects without cancer. RESULTS: When compared with the control subjects, the cancer patients had elevated BLF levels of TNF alpha (1.58 +/- 0.47 vs. 0.04 +/- 0.02 pg/microgram protein, P < 0.001), IL-6 (1.39 +/- 0.29 vs. 0.04 +/- 0.02 pg/microgram protein, P < 0.001), and NO2-/NO3- (23.3 +/- 5.6 vs 1.1 +/- 0.6 nmol/mg protein, P < 0.001). However, phosphatidylcholine levels were lower in those with cancer than in the control subjects (3.0 +/- 1.2 vs. 24.8 +/- 6.4 micrograms protein, P < 0.001). CONCLUSIONS: The results showed in vivo production of inflammatory cytokines in human lung cancer and increased tumor-associated NO production, as suggested by increased levels of nitrite/nitrate in the BLF. A decreased phosphatidylcholine content in the BLF also was found in patients with lung cancer.

Acetylator polymorphism in human colorectal carcinoma.

Acetylator phenotype has been determined using sulfamethazine in 109 patients histologically diagnosed with colorectal carcinoma (resected in 74 patients by the time of the study) and in 96 age-matched controls. Fifty-five % of patients and 58.3% of controls were classified as slow acetylators (chi 2 = 0.11, not significant). No differences were observed in the distribution of acetylator phenotype when analyzing separately male and female, surgically treated and untreated, and colonic and rectal carcinoma patients. We conclude that acetylator polymorphism is not a genetic trait related to the risk of developing colorectal carcinoma in human beings.

Cancer of the gastric stump.

28,500 fiberoptic endoscopies were reviewed. 97 cancers of the stump were found in 1,119 patients who had had gastric resection (8.66%), in contrast to the 3.9% of cancers found in nonoperated patients. This suggests that the gastric remnant has a higher tendency to develop cancer than the nonresected stomach. A policy of periodic follow-up of these patients must be considered in order to detect the tumor at an early stage.

Spontaneous intramural oesophageal perforation.

Spontaneous intramural oesophageal perforation appears at any level, but preferably on the posterior wall, and is usually longitudinal. Unlike the Mallory Weiss and the Boerhaave syndromes, females are more frequently affected. It appears with sudden retrosternal pain radiating to the epigastrium, neck and back, followed by haematemesis of small quantity and dysphagia. Vomiting is rare. In contrast to complete rupture, neither pneumomediastinum nor emphysema is observed, barium swallow being the diagnostic test of choice whenever this pathology is suspected. However, when the symptoms are not typical, endoscopy is a useful method for diagnosis. Treatment must be conservative, while surgery is suggested in the case of recurrent symptoms or big intramural haematomas with a high risk of perforation. A 74-year-old woman is presented. Endoscopy was performed as an emergency in suspected food impaction in the oesophagus. This case was diagnosed as spontaneous intramural oesophageal perforation. The patient also presented with oesophageal diverticulum and hiatal hernia. Conservative treatment was given, and the lesion cured.