Assuntos
Neoplasias Duodenais/cirurgia , Ressecção Endoscópica de Mucosa/métodos , Laparoscopia/métodos , Neoplasias Gástricas/cirurgia , Terapia Combinada/métodos , Neoplasias Duodenais/patologia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Duodeno/cirurgia , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Mucosa Gástrica/cirurgia , Gastroenterologia/métodos , Gastroenterologia/normas , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/patologia , Mucosa Intestinal/cirurgia , Japão , Neoplasias Gástricas/patologia , Resultado do TratamentoRESUMO
Cronkhite-Canada syndrome is rarely encountered in clinical practice. Notably, most patients with Cronkhite-Canada syndrome exhibit hypoalbuminemia. Because the cause of Cronkhite-Canada syndrome is unknown, no specific treatment method has been established. Here, we describe a 59-year-old woman with Cronkhite-Canada syndrome in whom clinical manifestations were considerably relieved after treatment with prednisone.
Assuntos
Hipoalbuminemia/imunologia , Polipose Intestinal/diagnóstico , Prednisona/uso terapêutico , Endoscopia Gastrointestinal , Feminino , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/imunologia , Mucosa Gástrica/patologia , Humanos , Hipoalbuminemia/sangue , Hipoalbuminemia/diagnóstico , Hipoalbuminemia/tratamento farmacológico , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/imunologia , Mucosa Intestinal/patologia , Polipose Intestinal/complicações , Polipose Intestinal/tratamento farmacológico , Polipose Intestinal/imunologia , Pessoa de Meia-Idade , Albumina Sérica Humana/análise , Resultado do TratamentoRESUMO
BACKGROUND AND AIMS: To clarify optimal therapeutic strategies for early gastric cancers without vestigial remnant or recurrence, we evaluated the benefits of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) according to tumor size and location. METHODS: From January 2000 to December 2007, a total of 328 gastric lesions were treated using conventional EMR, while 572 lesions were treated by ESD. Patients who underwent surgery on the upper gastrointestinal tract before EMR or ESD were excluded from the study. We compared tumor size, location and rates of complete resection, curative resection, postoperative bleeding, perforation and local recurrence between EMR and ESD according to tumor situation. RESULTS: Overall local complete resection rate (EMR, 64.2%; ESD, 95.1%) and overall curative resection rate (EMR, 59.5%; ESD, 82.7%) were significantly higher in ESD than in EMR. No significant differences were seen in complication rates between EMR and ESD. Local recurrence was detected in 13 lesions (4.0%) of the EMR group during follow up. In contrast, no local recurrence was detected in the ESD group. For lesions 5 mm or less in diameter, complete resection rate in the EMR group was not significantly inferior to that in the ESD group at any location. However, rates were overwhelmingly better in the ESD group than in the EMR group for lesions more than 5 mm in diameter, regardless of location. CONCLUSION: We concluded that lesions exceeding 5 mm in diameter should be treated by ESD, although a high resection rate is obtained also with EMR for lesions of 5 mm or less in diameter.
Assuntos
Endoscopia do Sistema Digestório , Mucosa Gástrica/cirurgia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Endossonografia , Feminino , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Complicações Pós-Operatórias , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Resultado do TratamentoRESUMO
A 29-year-old man presented to the Accident and Emergency department with abdominal cramping following ingestion of a 50 p coin 2½ weeks prior to presentation. He had not observed it pass in his stools. An abdominal radiograph confirmed the presence of the 50 p coin in his stomach. Subsequently, he had an oesophagogastroduodenoscopy (OGD) performed with a failure to visualise the coin. 1½ weeks later, he returned to the department as he was still unable to observe its passing in his stools. A repeated abdominal radiograph and a CT of the abdomen and pelvis revealed that the coin was still in his stomach. A second OGD was performed once again with a failure to visualise the coin. It appeared that the coin had migrated into his gastric mucosa.
Assuntos
Mucosa Gástrica/diagnóstico por imagem , Numismática , Estômago/diagnóstico por imagem , Adulto , Assistência ao Convalescente , Ingestão de Alimentos , Endoscopia do Sistema Digestório/métodos , Corpos Estranhos/diagnóstico por imagem , Mucosa Gástrica/patologia , Humanos , Masculino , Radiografia Abdominal/métodos , Doenças Raras , Estômago/patologia , Resultado do Tratamento , Conduta Expectante/métodosAssuntos
Adenoma/diagnóstico por imagem , Neoplasias da Vesícula Biliar/diagnóstico por imagem , Mucosa Gástrica/diagnóstico por imagem , Pólipos/diagnóstico por imagem , Adenoma/cirurgia , Adulto , Colecistectomia Laparoscópica , Neoplasias da Vesícula Biliar/cirurgia , Mucosa Gástrica/cirurgia , Humanos , Masculino , Pólipos/cirurgia , Resultado do Tratamento , UltrassonografiaRESUMO
INTRODUCTION: the only way of improving prognosis and survival in gastrointestinal cancer is early diagnosis, with intramucosal localization as confirmed by endoscopic ultrasonography (EUS) or 20-MHz miniprobes (MPs) (T1) being most appropriate. Endoscopic mucosal resection (EMR) has proven effective in the treatment of this sort of lesions. PATIENTS AND METHOD: in a group (18 cases) with 15 cases of superficial gastrointestinal cancer and 3 cases of severe gastric dysplasia, 9 cases (3 esophageal, 4 gastric, 2 rectal) underwent a classic EMR following EUS or a 7.5- and 20-MHz miniprobe exploration. RESULTS: ultrasonographic studies showed a T1 in all but one esophageal case (Tis), and in both gastric dysplasias, with no changed layer structure being demonstrated in the latter (T0). No complications arose with classic EMR, and all 9 patients are alive and free from local or metastatic recurrence, except for one esophageal case, which recurred distally to the esophageal lesion (metachronous). CONCLUSIONS: echoendoscopically-assisted EMR is a safe, effective technique in the endoscopic management of superficial gastrointestinal (esophageal, gastric, colorectal) cancer. Recurrence most likely depends upon cancer multiplicity.
Assuntos
Mucosa Gástrica/cirurgia , Neoplasias Gastrointestinais/cirurgia , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/cirurgia , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos do Sistema Digestório , Endoscopia do Sistema Digestório , Endossonografia , Feminino , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Neoplasias Gastrointestinais/diagnóstico por imagem , Neoplasias Gastrointestinais/patologia , Humanos , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Resultado do TratamentoAssuntos
Anemia/etiologia , Fibroma/diagnóstico , Melena/etiologia , Neoplasias Gástricas/diagnóstico , Úlcera Gástrica/etiologia , Idoso , Anemia/cirurgia , Endossonografia , Feminino , Fibroma/complicações , Fibroma/patologia , Fibroma/cirurgia , Gastrectomia , Mucosa Gástrica/irrigação sanguínea , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Gastroscopia , Humanos , Melena/cirurgia , Recidiva , Neoplasias Gástricas/complicações , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Úlcera Gástrica/cirurgia , Resultado do TratamentoRESUMO
A 38-year-old woman was hospitalized in August 2007. This visit was her fifth episode of acute pancreatitis. Computed tomography revealed a cystic structure located near the antrum. Communication between this structure and the pancreatic duct was revealed by endoscopic retrograde cholangiopancreatography. Ultrasonography revealed that the cyst wall had a layered structure. Thus, we regarded it as a gastric duplication cyst. We thought that the gastric duplication cyst communicating with an aberrant pancreatic duct was responsible for the recurrent acute pancreatitis. In August 2008, a cyst gastrostomy was performed between the gastric duplication cyst and the stomach. No recurrence of acute pancreatitis has since occurred.