RESUMO
Carcinoid tumors are malignancies originating from neuroendocrine cells, most commonly encountered in the gastrointestinal tract, in a rate of 64%, with the majority affecting the ileum. Certain genetic syndromes sometimes include carcinoid tumors in their phenotype. These malignancies may be rather asymptomatic, although occasionally they behave aggressively. They are typically diagnosed due to the effects of a locally advanced disease, or when producing symptoms because of hormone secretion (carcinoid syndrome). A better understanding of their molecular biology and behavior is demanded so that these tumors to be diagnosed precociously and managed effectively.
Assuntos
Tumor Carcinoide/diagnóstico , Tumor Carcinoide/terapia , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/terapia , Intestino Delgado/patologia , Antineoplásicos Hormonais/uso terapêutico , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/metabolismo , Biomarcadores Tumorais/urina , Tumor Carcinoide/tratamento farmacológico , Tumor Carcinoide/epidemiologia , Tumor Carcinoide/cirurgia , Diagnóstico Diferencial , Procedimentos Cirúrgicos do Sistema Digestório , Neoplasias Gastrointestinais/tratamento farmacológico , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Gastrointestinais/cirurgia , Saúde Global , Humanos , Incidência , Síndrome do Carcinoide Maligno/diagnóstico , Síndrome do Carcinoide Maligno/terapia , Octreotida/uso terapêutico , Romênia/epidemiologiaRESUMO
BACKGROUND: The introduction of foreign bodies into the rectum is not an uncommon medical problem. The phenomenon has increased in the homosexual population. In a 25-year period we have encountered 34 patients with retained rectal foreign bodies. MATERIAL AND METHODS: We have performed five laparotomies due to perforation and a laparotomy in order to retrieve a large wooden object. RESULTS: We have observed only one complication in a woman who developed a retrovaginal fistula. CONCLUSIONS: In order to obtain successful extraction of the foreign body the surgeon, apart from the well-known techniques, must exercise a high degree of ingenuity. Finally, it should be emphasized that the appropriate respect should be shown to all patients who seek treatment for this problem.
Assuntos
Corpos Estranhos/cirurgia , Laparotomia/métodos , Reto , Adulto , Idoso , Exame Retal Digital , Feminino , Corpos Estranhos/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Abdominal , Estudos Retrospectivos , Sigmoidoscopia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
Insulinomas are functional endocrine tumors originating from the pancreatic b-cells. In 1902 Nicholls described the first adenoma of pancreatic islets, while the first insulinoma was described in 1927 in Mayo Clinic, which was dissected two years later in 1929 in Toronto. The first enucleation of insulinoma took place in a St. Jouis hospital in 1931, and after four years, in 1935, Whipple described the classic diagnostic triad: symptoms of fasting hypoglycemia or fatigue, blood glucose levels under 50 mg/dl and disappearance of symptoms after glucose administration.
Assuntos
Insulinoma/diagnóstico , Tumores Neuroendócrinos/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Doenças Raras , Diagnóstico Diferencial , História do Século XX , Humanos , Hipoglicemia/etiologia , Insulinoma/epidemiologia , Insulinoma/história , Insulinoma/cirurgia , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/história , Tumores Neuroendócrinos/cirurgia , Pancreatectomia , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/história , Neoplasias Pancreáticas/cirurgia , Prevalência , Doenças Raras/diagnóstico , Doenças Raras/epidemiologia , Doenças Raras/história , Doenças Raras/cirurgia , Romênia/epidemiologia , Resultado do TratamentoRESUMO
Hydatid disease is an endemic zoonosis caused by the cestode Echinococcus granulosus. The most common affected organs are the liver and the lungs. Echinococcal cyst located in the subcutaneous tissue constitutes an extremely rare manifestation of the hydatid disease. Here we present a case report with a cystic mass in the subcutaneous tissue of the left gluteal area, diagnosed as being a hydatid cyst.
Assuntos
Nádegas/diagnóstico por imagem , Doenças do Tecido Conjuntivo/parasitologia , Equinococose/parasitologia , Tela Subcutânea/parasitologia , Idoso , Nádegas/parasitologia , Nádegas/cirurgia , Doenças do Tecido Conjuntivo/diagnóstico por imagem , Doenças do Tecido Conjuntivo/cirurgia , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Humanos , Masculino , Tela Subcutânea/diagnóstico por imagem , Tela Subcutânea/patologia , Tela Subcutânea/cirurgia , UltrassonografiaRESUMO
The modern tendency of surgery is to perform a constantly rising number of operations under local anaesthesia. Superficial parotidectomy under local anaesthesia has not been widely attempted. However only few reports show that this kind of procedure could be feasible. If this is the case, standard assessment of benign parotid tumors will change radically.
Assuntos
Anestesia Local/métodos , Procedimentos Cirúrgicos Bucais/métodos , Doenças Parotídeas/cirurgia , Adenoma Pleomorfo/cirurgia , Adolescente , Adulto , Idoso , Anestésicos Locais/farmacologia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/cirurgia , Satisfação do Paciente , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The case of a patient, victim of a car accident, with rupture of the left adrenal gland associated with splenic rupture and liver laceration is reported. Injury of the adrenal glands is most frequently caused by blunt abdominal trauma and is usually associated with injuries of other abdominal organs. Careful exploration of the upper retroperitoneal space where adrenals are located is considered necessary during laparotomy for severe blunt abdominal trauma. If adrenal lesion has been overlooked continuous hemorrhage may occur, which could be lethal if not promptly treated.
Assuntos
Traumatismos Abdominais/cirurgia , Glândulas Suprarrenais/lesões , Hemorragia/etiologia , Traumatismo Múltiplo/cirurgia , Ferimentos não Penetrantes/cirurgia , Acidentes de Trânsito , Glândulas Suprarrenais/cirurgia , Adrenalectomia , Adulto , Feminino , Humanos , Fígado/lesões , Fígado/cirurgia , Ruptura , Ruptura Esplênica/cirurgia , Resultado do TratamentoRESUMO
Gallstone ileus representing 1-4% of all bowel obstructions cholelithiasis. Impaction of a gallstone in the human of the bowel is a surgical emergency. Relief of the obstruction is the treatment of choice, but controversy exists regarding the repair of the fistula and cholecystectomy. Our experience in the management of gallstone ileus is presented in the following article.
Assuntos
Fístula Biliar/cirurgia , Cálculos Biliares/cirurgia , Íleus/cirurgia , Laparoscopia , Idoso , Idoso de 80 Anos ou mais , Fístula Biliar/diagnóstico , Fístula Biliar/etiologia , Colecistectomia Laparoscópica/métodos , Feminino , Seguimentos , Cálculos Biliares/complicações , Cálculos Biliares/diagnóstico , Humanos , Íleus/diagnóstico , Íleus/etiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Cytomegalovirus infection of the gastrointestinal tract of normal hosts is very rare. On the other hand, this is a common cause of morbidity in immunocompromised hosts. Herein we describe the case of a 52-year-old male who underwent a gastrectomy due to a severe gastrointestinal hemorrhage. Histological examination showed the characteristic cytomegalovirus inclusion bodies. The diagnosis was confirmed with immunohistochemistry and his immune system revealed no abnormality. We believe that, although it is very rare, cytomegalovirus infection should be kept in mind for non-immunocompromised patients with upper gastrointestinal bleeding or multiple gastric ulcers.
Assuntos
Infecções por Citomegalovirus/diagnóstico , Citomegalovirus/metabolismo , Hemorragia Gastrointestinal/diagnóstico , Trato Gastrointestinal/microbiologia , Antivirais/uso terapêutico , Infecções por Citomegalovirus/complicações , Gastrectomia/métodos , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Imunoglobulina G/química , Imuno-Histoquímica/métodos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
In 1891 O. Sprengel described a successful side-to-side choledochoduodenostomy and since then this has been a method frequently used in dealing with the problem of constriction of the lower third-portion of the bile duct, due to malignant or benign causes. Taking in consideration that the first choledochoduodenostomy was performed by H. Riedel in 1888 and the patient died 9 hours after surgery due to leakage of the anastomosis (disclosed in autopsy), it is evident to conclude that hermetic anastomosis is the main factor for fast and uncomplicated recovery of the patient. In order to ensure intraoperatively a hermetic "bile-proof" anastomosis, we have applied a technical tip, which has been proved to be efficient.
Assuntos
Coledocostomia/métodos , Duodeno/cirurgia , Cálculos Biliares/cirurgia , Anastomose Cirúrgica/métodos , Procedimentos Cirúrgicos do Sistema Biliar/métodos , HumanosRESUMO
This article deals with the dilemma of the surgeon to choose the optimal surgical procedure in case of coexistence of ischiorectal abscess and a rectal carcinoma. The case of a patient suffering from ischiorectal abscess in association with rectal carcinoma is reported.
Assuntos
Abscesso/cirurgia , Carcinoma/cirurgia , Ísquio , Doenças Retais/cirurgia , Fístula Retal/cirurgia , Neoplasias Retais/cirurgia , Abscesso/complicações , Idoso , Carcinoma/complicações , Humanos , Masculino , Doenças Retais/complicações , Fístula Retal/etiologia , Neoplasias Retais/complicações , Resultado do TratamentoRESUMO
In most cases of echinococcal disease the liver is the mainly affected organ. The clinical manifestations are defined by the size and the localization of the hydatid cyst. The appearance of complications, such as purulence and rupture of the cyst, aggravate the patients' clinical condition. Intrabiliary rupture, although rare, carries severe health risks; timely diagnosis and appropriate management of this entity are vital for the patient's survival.
Assuntos
Ductos Biliares Intra-Hepáticos , Doenças Biliares/etiologia , Equinococose Hepática/complicações , Animais , Doenças Biliares/diagnóstico , Doenças Biliares/terapia , Procedimentos Cirúrgicos do Sistema Digestório , Equinococose Hepática/diagnóstico , Equinococose Hepática/terapia , Humanos , Ruptura Espontânea , Resultado do TratamentoRESUMO
The main goal of the paper is to clarify anthelminthic treatment as an alternative hydatic cyst therapy, its indications and contraindications. Chemotherapy constitutes a non-invasive treatment and is less limited by the patient's status than surgery or PAIR. Many investigators have employed benzoimidazole carbonates for the management of human hydatid disease. Both, albendazole and mebendazole have, a favourable effect in patients suffering from multiorgan and multicystic disease, in inoperable primary liver or lung echinococcosis, and they can also prevent secondary echinococcosis. Chemotherapy is contraindicated for large cysts that are at risk to rupture and for inactive or calcified cysts. The main adverse events are related to changes in liver enzyme levels. The best efficacy is observed with liver, lung, and peritoneal cysts. Certain various factors influence the therapeutic results of medical treatment. The vast majority of the recurring cysts show good susceptibility to re-treatment.