RESUMO
Immune thrombocytopaenia (ITP) was referred to previously as idiopathic thrombocytopaenic purpura and is usually of autoimmune or viral aetiology. Colorectal cancer liver metastasis with concomitant ITP is rare and only three cases have been reported in the English literature. Adverse effects of adjuvant chemotherapy may aggravate ITP. The sequencing of chemotherapy, operation for the primary and liver metastasis, and a decision on splenectomy is important. We present our experience in the management of a 52-year-old man who, having undergone anterior resection one year earlier for carcinoma of the rectum, presented with liver metastasis and ITP. He underwent splenectomy with hepatectomy prior to chemotherapy.
Assuntos
Neoplasias Hepáticas/secundário , Púrpura Trombocitopênica Idiopática/complicações , Neoplasias Retais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Masculino , Metastasectomia/métodos , Pessoa de Meia-IdadeRESUMO
Biliary papillomatosis is a rare condition usually detected on imaging or postoperative histopathology. It may be asymptomatic or present with features of cholangitis. We report the management of a patient presenting with haemobilia.
Assuntos
Neoplasias do Sistema Biliar/complicações , Colangiocarcinoma/complicações , Cisto do Colédoco/complicações , Hemobilia/etiologia , Papiloma/complicações , Neoplasias do Sistema Biliar/cirurgia , Colangiocarcinoma/cirurgia , Cisto do Colédoco/cirurgia , Feminino , Hemobilia/cirurgia , Humanos , Pessoa de Meia-Idade , Papiloma/cirurgiaRESUMO
BACKGROUND: Radiation proctitis is a common complication following radiation therapy for pelvic malignancies. This is associated with significant morbidity which adversely affects the quality of life. Local application of formalin has been used effectively in the treatment of radiation proctitis. METHODOLOGY: Thirty patients with haemorrhagic radiation proctitis who underwent endoluminal application of 4% formalin between January 1998 to October 2002 were followed up prospectively to assess the efficacy of the treatment. RESULTS: The follow up ranged from 5 to 36 months (mean 18.1 months). Nineteen (63.3%) patients had complete response to formalin application while 7 (23.3%) patients had partial response. There were 4 (13.3%) failures. No procedure related complication was observed. CONCLUSION: Local application of formalin is a simple, safe, inexpensive and fairly effective outpatient treatment modality for chronic radiation proctitis.
Assuntos
Formaldeído/administração & dosagem , Hemorragia Gastrointestinal/tratamento farmacológico , Hemostáticos/administração & dosagem , Proctite/tratamento farmacológico , Lesões por Radiação/tratamento farmacológico , Radioterapia/efeitos adversos , Adulto , Idoso , Colonoscopia , Feminino , Seguimentos , Hemorragia Gastrointestinal/etiologia , Humanos , Pessoa de Meia-Idade , Proctite/etiologia , Estudos Prospectivos , Lesões por Radiação/etiologia , Resultado do TratamentoRESUMO
Cavernous haemangioma of the rectum is an uncommon cause of rectal bleeding. Initial diagnosis is often elusive because of lack of awareness. For accurate diagnosis, investigations such as endoscopy, plain X-ray of the abdomen, barium enema and selective angiography of the inferior mesenteric artery are required. Complete surgical excision of the haemangioma and colo-anal sleeve anastomosis is the most favoured operative procedure to eradicate the disease. We report a case of cavernous haemangioma of the rectum and discuss its salient clinical features, investigations and management.
