RESUMO
We report a male patient with carcinoma arising on the basis of neglected sacrococcygeal pilonidal sinus disease. Following initial operation, performed without suspicion of malignancy, histology demonstrated cellular atypia and an increased mitotic rate. A second, wider tissue excision was recommended but the patient declined further surgery. Two years later, he presented with fungating carcinoma involving the rectum but again declined surgery. This rare case demonstrates that the presence of carcinoma should be suspected in long-standing, although innocent-looking, pilonidal sinus disease. In the circumstance of uncertain histologic diagnosis, more generous surgical sampling is required. Every effort must be made to overcome patient's reluctance to accept a second, possibly life-saving procedure.
Assuntos
Carcinoma de Células Escamosas/patologia , Seio Pilonidal/patologia , Neoplasias Retais/patologia , Doença Crônica , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Recusa do Paciente ao TratamentoAssuntos
Traumatismos Abdominais , Íleo/lesões , Mesentério/lesões , Ferimentos por Arma de Fogo , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/cirurgia , Adulto , Desbridamento , Emergências , Humanos , Laparoscopia/métodos , Laparotomia/métodos , Masculino , Valor Preditivo dos Testes , Fatores de Tempo , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/diagnóstico , Ferimentos por Arma de Fogo/cirurgiaAssuntos
Doenças do Ducto Colédoco/cirurgia , Equinococose Hepática/cirurgia , Adulto , Feminino , Humanos , LigamentosRESUMO
A patient is described who was found to have both eosinophilic enterocolitis and visceral neuropathy with chronic idiopathic intestinal pseudo-obstruction. The etiology and pathogenesis of this rare combined disorder of the gastrointestinal tract are discussed. Although eosinophilic enterocolitis is amenable to conservative treatment, surgery may be necessary for palliation in selected patients with pseudo-obstruction due to visceral neuropathy.
Assuntos
Enterocolite/complicações , Eosinófilos/patologia , Pseudo-Obstrução Intestinal/complicações , Plexo Mientérico/patologia , Adulto , Doença Crônica , Enterocolite/patologia , Gastroenteropatias/complicações , Gastroenteropatias/patologia , Motilidade Gastrointestinal , Humanos , Pseudo-Obstrução Intestinal/patologia , MasculinoAssuntos
Neoplasias do Colo/complicações , Hemorragia Gastrointestinal/etiologia , Paraganglioma Extrassuprarrenal/complicações , Adulto , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/cirurgia , Feminino , Humanos , Paraganglioma Extrassuprarrenal/diagnóstico , Paraganglioma Extrassuprarrenal/cirurgiaRESUMO
A case of an anomalous extrahepatic biliary system is reported in which the common hepatic duct was found to enter the gallbladder, whereas the cystic duct drained the entire biliary system into the duodenum. In this case, the gangrenous gallbladder was removed and the continuity between the common hepatic duct and the gastrointestinal tract was restored by means of Roux-en-Y anastomosis. The identification and treatment options of this rare anomaly are briefly discussed.
