RESUMO
The embryologic defect that results when the ventral and dorsal anlages of the pancreas do not fuse has been referred to as pancreas divisum. The patients who present with recurrent pancreatitis or pancreatitis-like pain in association with pancreas divisum should be investigated to determine the presence of minor papilla stenosis. In the present study of 11 patients, 9 became asymptomatic with surgical decompression of the dorsal pancreatic duct. Two surgical failures were related to wrong diagnosis and restenosis of the sphincteroplasty. A delay in the clearance of dye from the dorsal pancreatic duct after endoscopic retrograde cholangiopancreatography was utilized to determine minor papilla stenosis. In the future, secretin ultrasound tests should prove of value in assessing minor papilla stenosis. Once the diagnosis is made, sphincteroplasty of the minor papilla is the most logical procedure because of the good results obtained. In the present study, pancreaticojejunostomy provided good duct decompression as well.
Assuntos
Pâncreas/anormalidades , Pancreatite/cirurgia , Abdome , Adulto , Amilases/sangue , Ensaios Enzimáticos Clínicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Pâncreas/cirurgia , Pancreaticojejunostomia , Pancreatite/diagnóstico , Pancreatite/etiologia , Complicações Pós-Operatórias , RecidivaRESUMO
An adult with the late onset immunodeficiency syndrome developed intractable diarrhea. Widespread cytomegalovirus (CMV) infection of the gastrointestinal tract was detected antemortem with detailed morphological studies and viral culture. The CMV-type cells were especially numerous in his severely ulcerated colon. Electron microscopy of infected cells in rectal biopsy material revealed the characteristic features of CMV infection. It is likely that the CMV infection contributed to the symptom complex and the mucosal injury. Unusual opportunistic infections as a cause of diarrhea should be considered in patients with late onset immunodefociency, especially if Giardiasis is ruled out.
Assuntos
Agamaglobulinemia/complicações , Infecções por Citomegalovirus/imunologia , Gastroenterite/imunologia , Adulto , Citomegalovirus/isolamento & purificação , Duodeno/microbiologia , Duodeno/patologia , Humanos , Corpos de Inclusão Viral , Intestino Delgado/microbiologia , Intestino Delgado/patologia , Masculino , Antro Pilórico/microbiologia , Antro Pilórico/patologia , Reto/microbiologia , Reto/patologia , Reto/ultraestruturaAssuntos
Neoplasias Abdominais/complicações , Doença Celíaca/complicações , Dermatite Herpetiforme/complicações , Linfoma/complicações , Adulto , Idoso , Doença Celíaca/diagnóstico , Doença Celíaca/patologia , Dermatite Herpetiforme/diagnóstico , Duodeno/patologia , Feminino , Humanos , Mucosa Intestinal/patologia , Jejuno/patologia , Linfoma/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
A patients with a cytomegalovirus (CMV) post-transfusion syndrome developed upper gastrointestinal tract bleeding; subsequently, a gastric ulcer was found. CMV was searched for in the gastroscopic biopsy material because the gastric ulcer had occurred in a setting of CMV mononucleosis. CMV cells were found in gastroscopic biopsy sections and CMV was also cultured from biopsy material. This study illustrates the feasibility of antemortem diagnosis of CMV-associated disease of the upper gastrointestinal tract.