RESUMO
We report a rare case of achalasia coexistent with megacolon. The patient, a 25-year-old woman, presented at our hospital with a history of abdominal pain with distension, and was finally operated on for a megacolon. Five months later she presented symptoms of progressive dysphagia and heartburn. Oesophageal manometry of the upper and lower oesophageal sphincter and X-ray studies showed images compatible with achalasia. Oesophagomyotomy of the oesophagogastric junction (Heller procedure with Dor haemifundoplication technique) was performed. In the specimens taken for biopsy, neither pathology of the myenteric plexuses, nor atrophy of the muscle fibres was evident. Chagas' disease serological diagnosis for Trypanosoma cruzii, neurological disease, diabetes and all the pathological events related with neuromuscular disorders of the gastrointestinal tract proved negative. We believe that the pathological findings are related to a dysfunction of the physiological mediators of the upper and lower digestive tract motility. The present case is extraordinary and, to our knowledge, extremely rare. The association of the two pathological diseases is questionable, and the literature is reviewed.
Assuntos
Acalasia Esofágica/complicações , Megacolo/complicações , Adulto , Sulfato de Bário , Enema , Feminino , HumanosRESUMO
We describe two patients, brother and sister, with identical pathology, whose only clinical presentation was recurrent massive lower digestive tract bleeding. Haemorrhage was due to a complex form of familial venous vascular malformation in the digestive tract, represented by the existence of varices of colon, small intestine and, to a lesser extent, oesophagus and gastric funcus. We have been able to study, examine and treat both patients for 9 and 3 years respectively.
Assuntos
Malformações Arteriovenosas/genética , Colo/irrigação sanguínea , Intestino Delgado/irrigação sanguínea , Varizes/genética , Adolescente , Colo/patologia , Neoplasias do Colo/patologia , Hemorragia Gastrointestinal/etiologia , Hemangioma Cavernoso/patologia , Humanos , Masculino , Varizes/patologiaRESUMO
Splenic abscess remains a rare condition which is difficult to diagnose and is usually only an autopsy finding. However, it is a serious situation despite surgical treatment which is curative for most abscesses. The authors report 3 cases of single splenic abscess seen at random over a short period of 9 months. Urinary tract infection and diabetes as favoring factors, with a clinical picture of fever, pain in the left hypochondrium and leucocytosis led to additional investigations (CT scan and echotomography) confirming the diagnosis. Splenectomy with drainage of the splenic bed, as surgical treatment, was successful in all 3 cases.