RESUMO
Background: hypercalcemia in patients with diagnosed carcinoma has predominantly a humoral basis mediated by parathyroid hormone-related protein (PTH-rP). Among the reported cases, hypercalcemia associated with the majority of abdominal malignancies indicates an advanced stage of disease. Case report: we present a case of a 78-year-old patient with an adenosquamous pancreatic carcinoma associated with humoral hypercalcemia mediated by PTH-rP. Conclusion: in this case, demonstration of unexpectantly rapid increase in calcium serum correlated with aggressive tumor growth led us to raise the hypothesis that PTH-rP could be a mediator of invasion and dissemination secreted by some tumors, and probably indicates the appropriate time to initiate palliative treatment (AU)
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Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hipercalcemia/complicações , Hipercalcemia/cirurgia , Hipercalcemia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Hipercalcemia/fisiopatologia , Cuidados Paliativos/métodos , Cuidados Paliativos/tendências , Carcinoma Adenoescamoso/diagnóstico , Carcinoma Adenoescamoso/fisiopatologia , Carcinoma Adenoescamoso/cirurgia , Difosfonatos/uso terapêuticoRESUMO
Localization of digestive hemorrhage is essential for the management of this entity. However, management is difficult in the small bowel, where emergency situations are rare but may require surgery without precise location of the lesion. We present a case of hemorrhage caused by jejunal diverticulum diagnosed by angiography. A highly selective microcatheter was placed in the bleeding site to achieve staining of the lesion with intraoperative methylene blue.
Assuntos
Divertículo/diagnóstico , Hemorragia Gastrointestinal/etiologia , Doenças do Jejuno/diagnóstico , Idoso , Diagnóstico Diferencial , Divertículo/complicações , Evolução Fatal , Feminino , Humanos , Indicadores e Reagentes , Doenças do Jejuno/complicações , Azul de MetilenoRESUMO
La localización de la hemorragia digestiva es fundamental para controlarla, algo que se complica en el caso del intestino delgado, donde las situaciones de emergencia son infrecuentes pero pueden requerir una laparotomía sin una clara localización de la lesión. Presentamos un caso de una hemorragia secundaria a divertículos yeyunales que se diagnosticó por angiorradiología y canulación selectiva del vaso sangrante, para conseguir el tatuaje de la lesión mediante inyección intraoperatoria de azul de metileno (AU)
Localization of digestive hemorrhage is essential for the management of this entity. However, management is difficult in the small bowel, where emergency situations are rare but may require surgery without precise location of the lesion. We present a case of hemorrhage caused by jejunal diverticulum diagnosed by angiography. A highly selective microcatheter was placed in the bleeding site to achieve staining of the lesion with intraoperative methylene blue (AU)
