RESUMO
A study was conducted to determine the value of peritoneoscopy in the diagnosis of opisthorchiasis. Peritoneoscopic findings in 203 proven cases of Opisthorchis viverrini infection are presented. The authors found that cholangiocarcinoma is frequently encountered in patients presenting with prolonged jaundice and hepatomegaly as well as with the peritoneoscopic findings of dilated superficial intrahepatic bile ducts, a bile-stained liver surface and a markedly enlarged gallbladder.
Assuntos
Doenças dos Ductos Biliares/diagnóstico , Doenças da Vesícula Biliar/diagnóstico , Laparoscopia , Opistorquíase/diagnóstico , Adulto , Idoso , Ductos Biliares Intra-Hepáticos/patologia , Feminino , Humanos , Laparoscopia/métodos , Hepatopatias Parasitárias/diagnóstico , Masculino , Pessoa de Meia-IdadeRESUMO
Pancreozymin-secretin-stimulated secretion was measured for volume, bicarbonate concentration and total amylase output in 16 noninsulin-dependent patients and 23 age-, sex-, and weight-matched similar control subjects. Another group of 17 insulin-dependent patients was studied using secretin stimulation and the secretory response compared to a similar group of 37 control subjects. Pancreozymin-secretin-stimulated pancreatic function was normal in noninsulin-dependent patients. Abnormal values for at least one parameter of secretion were found in 82% of insulin-dependent patients. Amylase output was low in 35% and bicarbonate concentration was low in 30%. Hypersecretion occurred in 35%. One patient had abnormal values for all three parameters and three patients had two abnormal values. Hypersecretory response to secretin stimulation is considered to be an early finding of pancreatic exocrine dysfunction among insulin-dependent patients. Progressive secretory failure occurs as the pathological process increases, and a decrease in total amylase output becomes the most significant abnormality.
Assuntos
Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Pâncreas/fisiopatologia , Adolescente , Adulto , Idoso , Amilases/metabolismo , Bicarbonatos/metabolismo , Colecistocinina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Pancreática , Secretina , TailândiaRESUMO
Among 4569 cases of peritoneoscopy performed in a period of 10 years (1972-1981), 108 patients with liver abscesses were encountered. The diagnosis of hepatic abscess was made on the basis of gross liver inspection and confirmed or disproved by needle puncture biopsy, histopathologic study, or surgery. Peritoneoscopy is a valuable procedure for the diagnosis of liver abscess. Liver aspiration under direct vision during peritoneoscopy yields more dependable material for the diagnosis of liver abscess than blind liver aspiration. Moreover, during peritoneoscopy one can choose more accurately the site for the insertion of the aspirating needle.
Assuntos
Laparoscopia , Abscesso Hepático/diagnóstico , Adolescente , Adulto , Idoso , Biópsia por Agulha , Feminino , Humanos , Abscesso Hepático/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
A case of paraganglioma arising in the common hepatic duct is reported. The patient presented with obstructive jaundice. At operation, a soft mass, 5 X 2 X 1.8 cm, was found firmly adherent to the intraluminal surface of the common hepatic duct. At cholecystectomy, exploration of the common hepatic duct was performed and the mass was partially removed. T-tube choledochostomy and operative cholangiography were performed. The final pathological report was paraganglioma of the common hepatic duct. The patient was clinically improved on discharge.
Assuntos
Neoplasias dos Ductos Biliares , Ducto Hepático Comum , Paraganglioma , Neoplasias dos Ductos Biliares/patologia , Neoplasias dos Ductos Biliares/cirurgia , Catecolaminas/urina , Colestase Extra-Hepática/etiologia , Ducto Hepático Comum/patologia , Ducto Hepático Comum/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Paraganglioma/patologia , Paraganglioma/cirurgiaRESUMO
During the past 20 years, trends have been observed in primary hepatocellular carcinoma in Thailand. There is a definite increase in the association between HCC and cirrhosis of liver from 16.6% in 1958 to 50.78% in 1968 and 73.93% in 1978 series. The increase in percentage is associated with increase in mean age group from 44.61 +/- 9.77 in 1958, to 48.84 +/- 12.35 (p < 0.01) in 1978. This reflects the important role which hepatitis B plays in the etiology of HCC-associated with cirrhosis in Thailand. Also, the aggregation of people in the city of Bangkok may cause an increase in the hepatitis B carrier.
Assuntos
Neoplasias Hepáticas/epidemiologia , Adenoma de Ducto Biliar/etiologia , Aflatoxinas/intoxicação , Fatores Etários , Neoplasias dos Ductos Biliares/etiologia , Carcinoma Hepatocelular/etiologia , Feminino , Humanos , Cirrose Hepática/complicações , Neoplasias Hepáticas/etiologia , Masculino , TailândiaRESUMO
Serum vitamin B12, folic acid, vitamin B12 and folic acid binding protein concentration were determined in 31 patients with primary carcinoma of the liver. Serum vitamin B12 level was found to be higher in 16 of 31 (52%) patients with carcinoma of the liver and the mean value was also significantly higher than that of the control group. There was no significant difference between the mean values of serum UBBC of these 2 groups. TCI and TCIII increased while TCII decreased considerably in the patient group. Serum folate level in patients with primary carcinoma of the liver was significantly lower than that of the control group. About 39% of these patients had serum folate level lower than the lowest value of the control group. Serum FABP in the former group was also significantly higher than that of the latter group.
