RESUMO
BACKGROUND: A villous adenoma is an extremely rare benign tumour in the appendix, in contrast to other benign appendiceal lesions. The clinical features are usually asymptomatic. Acute appendicitis is the most common complication with the lesion obstructing the orifice of the appendiceal lumen. Thus, a villous adenoma is usually found during surgical intervention for acute appendicitis. Mechanical obstruction induced by acute perforated appendicitis has been previously reported. Acute appendicitis caused by a villous adenoma presenting with acute intestinal obstruction has not been previously reported. CASE PRESENTATION: A 78-year-old woman presented to our Emergency Department with diffuse abdominal pain and tenderness. The abdominal plain film and computed tomography revealed an intestinal obstruction. After surgical intervention, the ruptured appendix was shown to be associated with intestinal obstruction. The post-operative pathologic diagnosis was an appendiceal villous adenoma. CONCLUSIONS: This is the first report describing an appendiceal villous adenoma, which is an occasional cause of perforated acute appendicitis, presenting as a complete intestinal obstruction. We emphasize that in elderly patients without a surgical history, the occult cause of complete intestinal obstruction must be determined. If an appendiceal tumour is diagnosed, an intra-operative frozen section is suggested prior to selecting a suitable method of surgical intervention.
Assuntos
Adenoma Viloso/complicações , Neoplasias do Apêndice/complicações , Apendicite/etiologia , Obstrução Intestinal/etiologia , Doença Aguda , Adenoma Viloso/diagnóstico , Adenoma Viloso/cirurgia , Idoso , Neoplasias do Apêndice/diagnóstico , Neoplasias do Apêndice/cirurgia , Apendicite/diagnóstico , Apendicite/cirurgia , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Resultado do TratamentoAssuntos
Hepatite B Crônica/complicações , Hepatite B Crônica/diagnóstico , Hipertensão Portal/diagnóstico , Hipertensão Portal/patologia , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Abdome/patologia , Hepatite B Crônica/patologia , Cirrose Hepática/patologia , Tomografia Computadorizada por Raios X , Veias/patologiaAssuntos
Gastroparesia/etiologia , Doença de Parkinson/complicações , Idoso de 80 Anos ou mais , Benserazida/administração & dosagem , Benserazida/uso terapêutico , Dopaminérgicos/administração & dosagem , Dopaminérgicos/uso terapêutico , Combinação de Medicamentos , Inibidores Enzimáticos/administração & dosagem , Inibidores Enzimáticos/uso terapêutico , Seguimentos , Gastroparesia/diagnóstico por imagem , Gastroparesia/tratamento farmacológico , Humanos , Levodopa/administração & dosagem , Levodopa/uso terapêutico , Masculino , Radiografia Abdominal , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Candida lipolytica candidemia is a rare but an emerging pathogenic yeast infection in humans. It can gain access to the bloodstream through intravascular catheterization, especially through central venous catheters in immunocompromised or critically ill patients during hospitalization. In this report, we present a noncatheter-related C. lipolytica candidemia infection in an 84-year-old man who was admitted due to acute pancreatitis. The possible pathogenesis and management of C. lipolytica candidemia are highlighted. It was an unusual infectious complication of acute pancreatitis. Clinicians should be aware that such an opportunistic pathogen can lead to invasive candidemia infection. In clinical practice, systemic antifungal therapy and the removal of the potentially infected central venous catheter might be recommended for the treatment of C. lipolytica candidemia.