RESUMO
Primary hepatic gastrinoma is a very rare ectopic gastrinoma with less than 20 cases reported worldwide. We report the case of a patient with hypergastrinemia who was subjected to exhaustive preoperative and intraoperative imaging and also careful surgical exploration of the duodenum and pancreas which failed initially to identify the primary tumour. Eventually the patient was subjected to left liver lobectomy, as a small palpable lesion was noted intraoperatively. The diagnosis of gastrinoma requires a high index of clinical suspicion and the flawless cooperation of many specialties.
RESUMO
BACKGROUND/AIMS: Emergency surgery for obstructing colorectal carcinoma is thought to be associated with poor survival. The aim of the study is to assess the results of surgery for obstructing colorectal cancer. MATERIALS AND METHODS: From 1987 to 2004, 80 patients underwent emergency surgery for completely obstructing colorectal carcinoma (COC), and 171 patients underwent elective surgery for non-obstructing cancer (NOC). Morbidity, mortality, and the late outcome were assessed. RESULTS: The groups were comparable for age, gender, tumor distribution, histopathologic characteristics, stage, morbidity, concomitant operations, recurrence, and sites of recurrence. High ASA class, poor performance status, and high mortality rate were recorded in COC group (p < 0.05). Mortality was related to ASA class (p < 0.001), performance status (p < 0.001), and obstruction (p = 0.014). ASA class was the single independent factor of morbidity (p < 0.001). The groups were comparable for survival (p > 0.05). CONCLUSIONS: Obstructing colorectal carcinoma seems to be associated with high mortality rate, but long-term survival seems to be the same with non-obstructing carcinoma.
