RESUMO
PURPOSE: Sleeve gastrectomy is a new bariatric surgical procedure with promising early results and low morbidity and mortality. We have evaluated the early imaging findings and value of upper GI study (UGI) and CT. PATIENTS AND METHODS: Twenty five patients (mean age=38.9 years, mean BMI=51.5 kg/m2) following sleeve gastrectomy for morbid obesity underwent UGI at day 1. CT was immediately performed in patients with suspected leak or as a follow-up examinations in patients with suspected complication. The different imaging features observed were recorded. RESULTS: UGI demonstrated 13 normal examinations (52%), an abnormal appearance in 11 cases (44%) with opacification of a lateral pouch, and one complication (leak confirmed on CT). Two patients underweent CT (day 3 and day 15) for suspected complication, with demonstration of leak in both cases. CONCLUSION: An abnormal appearance after sleeve gastrectomy is frequently observed on UGI. Routine UGI at day 1 is useful to detect large leaks. CT with oral contrast should be performed in all patients with imaging or clinical suspicion of leak.
Assuntos
Gastrectomia/métodos , Estômago/diagnóstico por imagem , Estômago/cirurgia , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Adulto JovemRESUMO
Ileal idiopathic forms of ganglioneuromatosis in adults are extremely rare and represent a challenging pathologic condition for the clinician. We present two cases of ileal ganglioneuromatosis consisting of stricturing lesions that mimicked clinical and radiologic features commonly observed in Crohn's disease patients with ileal involvement.
Assuntos
Doença de Crohn/diagnóstico , Ganglioneuroma/diagnóstico , Doenças do Íleo/diagnóstico , Adulto , Idoso de 80 Anos ou mais , Constrição Patológica , Diagnóstico Diferencial , Feminino , Ganglioneuroma/complicações , Ganglioneuroma/patologia , Humanos , Doenças do Íleo/etiologia , Doenças do Íleo/patologiaAssuntos
Gastrectomia/efeitos adversos , Gastrectomia/psicologia , Pancreaticoduodenectomia/efeitos adversos , Pancreaticoduodenectomia/psicologia , Qualidade de Vida , Diarreia/etiologia , Diarreia/prevenção & controle , Diarreia/psicologia , Síndrome de Esvaziamento Rápido/etiologia , Síndrome de Esvaziamento Rápido/prevenção & controle , Síndrome de Esvaziamento Rápido/psicologia , Gastrectomia/métodos , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/prevenção & controle , Refluxo Gastroesofágico/psicologia , Trânsito Gastrointestinal , Gastroparesia/etiologia , Gastroparesia/prevenção & controle , Gastroparesia/psicologia , Humanos , Distúrbios Nutricionais/etiologia , Distúrbios Nutricionais/prevenção & controle , Distúrbios Nutricionais/psicologia , Pancreaticoduodenectomia/métodosRESUMO
Between 1981 and 1995, 4 patients (3 females, 1 male; aged 48-80) were diagnosed with squamous cell carcinoma of the esophagus, following mediastinal irradiation for breast cancer. The interval between irradiation and the presentation of esophageal cancer was 10.75 years on average (7-19). The treatment consisted of: radiotherapy only; a partial esophagectomy with proximal gastrectomy without post-operative radiotherapy; laser photocoagulation for a superficial tumor; and, palliative treatment including gastrostomy, tracheal photocoagulation and chemotherapy for 1 patient suffering from advanced stage cancer with tracheal invasion, respectively. Radiotherapy of the esophageal cancer (exclusive or adjuvant) should take into account previous esophageal radiation therapy. The indications of curative excision surgery are the same as for other types of esophageal cancer, but the anastomoses should be performed in a non-irradiated area. Excision by esophageal stripping without thoracotomy is contraindicated because of the presence of peri-esophageal sclerosis. Preventive measures in radiation therapy for breast cancer are suggested.
