RESUMO
Solid and papillary epithelial neoplasm (SPEN) of the pancreas is a rare tumor with low malignant potentiality that usually occurs in young females. Preoperative evaluation, especially radiologic tests, including ultrasonography and CT scan, is helpful in the diagnosis. These studies demonstrate a well-demarcated large mass with solid and cystic portions, frequently in the tail or body of the pancreas. Complete resection is usually curative, however local invasion and/or metastasis may occur. The authors report a case of a solid and papillary epithelial neoplasm of the pancreatic body in a 14-year old child at St. Benedict Hospital and review the literature.
Assuntos
Adolescente , Criança , Feminino , Humanos , Diagnóstico , Metástase Neoplásica , Neoplasias Epiteliais e Glandulares , Pâncreas , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
An elastofibroma, which is a rare soft tissue tumor, was excised from the left subscapular region of a 82-year-old woman. An elastofibroma is a slow-growing, pseudotumoral lesion of the soft tissues of the chest wall with peculiar radiological (CT, MR) and ultrasonographic images, and histological patterns. All cases need to undergo a biopsy in order to rule out a sarcoma. An elastofibroma is a benign tumor. If left untreated, it can grow to a considerable size and become symptomatic. Therefore it needs to be closely observed and its nature confirmed by a biopsy. This condition is rarely encountered in Korea. However, more patients could be diagnosed if more careful attention to elastofibroma is paid.
Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Biópsia , Coreia (Geográfico) , Sarcoma , Parede TorácicaRESUMO
Malignant tumors of the small bowel are uncommon by comparison with those in other parts of the gastrointestinal tract. Adenocarcinomas account for about half of the malignant tumors of the small intestine, which account for 1% to 2% of the gastrointestinal neoplasma. Small-bowel tumors are often asymptomatic and without clinical significance, and later became symptomatic and are eventually fatal. Patient's with regional enteritis, especially those who have had segments of the intestine surgically by passed, have an increased incidence of small-bowel cancer. The author experienced a case of an adenocarcinoma at the jejunostomy site (Braun anastomosis) which was treated by using a B II type subtotal gastrectomy for stomach cancer. That case of a jejunostomy site adenocarcinoma is reported and the literature on small-bowel malignancy is reviewed.
Assuntos
Adenocarcinoma , Doença de Crohn , Gastrectomia , Trato Gastrointestinal , Incidência , Intestino Delgado , Intestinos , Jejunostomia , Neoplasias GástricasRESUMO
PURPOSE: The results for treatment of fistula-in-ano have much improved, along with the development of anatomical knowledge, classification, and operative techniques, during last several decades. The authors retrospectively reviewed the results for treatment of fistula-in-ano, especially complex fistulas, during the last 11 years. METHODS: A retrospective study of fistula-in-ano was performed for 229 patients who had been operated on in St. Benedict Hospital between January 1988 and December 1998. Complex fistulas (IIH, III & IV) were analyzed separately. RESULTS: The most common type was IILs (92 cases, 40.2%), and the most common horseshoe type was IIIBc (5 cases, 2.2%). The average hospital stay was 11.5 days for all fistula-in-ano types, but 15.1 days for complex fistulas. Non-specific inflammation (209 cases, 91.3%) was the most common pathologic finding. Various operative procedures were used : fistulotomy (80 cases, 34.9%), fistulectomy (74 cases, 32.3%), coring out fistulectomy (63 cases, 27.5%), seton technique (11 cases, 4.8%), and muscle-filling technique (1 case, 0.4%). There was no difference in the recurrence rate among the operative types. Various procedures were tried for complex fistulas, but the sphincter-preserving fistulectomy by Takano seemed to have a low recurrence rate and a short postoperative course. However, because of the small number of cases, this difference in recurrence rate and postoperative course was not statistically significant. The overall postoperative complication rate was 7%: anal infection (4 cases, 1.7%), anal bleeding (3 cases, 1.3%), and urinary retention (2 cases, 0.9%). CONCLUSIONS: The operations for most of the fistulae, IH, IL & IIL, were simple and uneventful. However, the operations for complex fistulae were complicated and more skill was required. We have thought Takano's operation to be a good curative procedure with less postoperative deformity and shortened postoperative course. However this research couldn't prove that with statistical significance, probably because of the insufficient number of patients. If further cases are collected and continuous follow-up is done, then a better result can be expected.
Assuntos
Humanos , Classificação , Anormalidades Congênitas , Fístula , Hemorragia , Inflamação , Tempo de Internação , Complicações Pós-Operatórias , Recidiva , Estudos Retrospectivos , Procedimentos Cirúrgicos Operatórios , Retenção UrináriaRESUMO
Intrahepatic stones are found predominantly in southeast Asia and causes serious problems including obstructive jaundice, cholangitis, and liver abscesses. The operative principles for resolving these problems are complete removal of the stones within intrahepatic and extrahepatic ducts and establishment of adequate drainage. The clinical features and follow-up results of 90 patients with intrahepatic stones who were treated surgically at the Department of Surgery of St. Benedict Hospital during the period of 10 years from January 1987 to December 1996 are presented. This study includes all the gallstones located in the intrahepatic ducts above the confluence of the main hepatic ducts. Biliary bypass operations were performed in 30 cases (33%) with 29 biliojejunostomies and one choledochoduodenostomy. Five of the 29 hepaticojejunostomies had subcutaneous jejunal limb. Partial hepatectomies were performed in 20 cases (22%) with 16 left lateral segmentectomy and 4 of left hepatic lobectomies. The overall postoperative complication rate was 40%: 70% in the hepatic resection group and 31% in the non-hepatic resection group. The relative incidence of good results was higher in the hepatic resection group (68%) than in the non-hepatic resection group (41%) and in the biliary bypass operation group (54%) than in the non-biliary bypass operation group (41%). In conclusion, an aggressive hepatic resection with biliary bypass operation should be performed, if permitted, in patients with intrahepatic stones.
Assuntos
Humanos , Sudeste Asiático , Colangite , Coledocostomia , Drenagem , Extremidades , Seguimentos , Cálculos Biliares , Hepatectomia , Ducto Hepático Comum , Incidência , Icterícia Obstrutiva , Abscesso Hepático , Mastectomia Segmentar , Complicações Pós-OperatóriasRESUMO
There have been some differences between the manifestations of biliary tract diseases in the Korean population and those in the populations of western countries, and these differences have been varying recently. A clinical analysis of 1000 patients who had been treated surgically for biliary diseases at the Department of General Surgery, St. Benedict Hospital, during the period of 10 years from January 1986 to December 1995 was done, and the results were compared with those of previous reports. The following subjects emerged as points of variance : 1) The incidence of the each biliary tract disease, 2) In calculous biliary disease, the location of the stone and the chemical composition of the stone, 3) Parasitic biliary disease, 4) The sex ratio and the age distribution, 5) The duration of illness, 6) Common symptoms and signs and their frequency, 7) Positive laboratory findings and the availability of radiologic diagnoses, 8) Common organisms in the bacterial culture, 9) The management of biliary diseases, and 10) Postoperative complications and the mortality rate. The clinical manifestations of biliary diseases have changed gradually and have been influenced by multiple factors: improvements inf living, education, and the environment, advances in diagnostic and therapeutic methods, etc.. Although these changes are due to the influences of westernization, they should also exhibit Korean-unique charecteristics. Also, we l expect further improvements in the future, and keep in mind those different points, there should be further suitable management, depending on changing features.
Assuntos
Humanos , Distribuição por Idade , Doenças Biliares , Sistema Biliar , Diagnóstico , Educação , Incidência , Mortalidade , Complicações Pós-Operatórias , Razão de MasculinidadeRESUMO
No abstract available.
