RESUMO
BACKGROUND: Primary appendiceal adenocarcinoma is a rare tumor, mucinous variety being common. This case is reported to highlight the unusual presentation and diagnostic difficulty of appendiceal adenocarcinoma. CASE PRESENTATION: Patient presented with acute appendicitis with ill-defined tender lump which responded to conservative management. CONCLUSIONS: High index of suspicion should be kept in mind for elderly patients presenting with appendicular lump. Every effort should be made during elective appendectomy to remove stump in case of sloughed out appendix.
Assuntos
Adenocarcinoma/diagnóstico , Neoplasias do Apêndice/diagnóstico , Apendicite/diagnóstico , Apêndice/patologia , Excisão de Linfonodo , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/etiologia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Fatores Etários , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Apendicectomia/métodos , Neoplasias do Apêndice/tratamento farmacológico , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/cirurgia , Apendicite/complicações , Apendicite/patologia , Apendicite/cirurgia , Apêndice/cirurgia , Antígeno Carcinoembrionário/sangue , Quimioterapia Adjuvante , Colectomia , Diagnóstico Diferencial , Procedimentos Cirúrgicos Eletivos , Feminino , Fluoruracila/uso terapêutico , Humanos , Leucovorina/uso terapêutico , Linfonodos/patologia , Linfonodos/cirurgia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Compostos Organoplatínicos/uso terapêutico , Doenças Raras/diagnóstico , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
BACKGROUND: Tuberculosis is a major health problem worldwide. Gastrointestinal tuberculosis presenting as isolated involvement of the duodenum is a rare case. CASE PRESENTATION: A 13 year male, presented with features of gastric outlet obstruction. CT enterography scan showed circumferential mural thickening in first and second part of duodenal junction causing luminal narrowing. Upper GI endoscopy confirmed the narrowing of D1-D2 junction. Duodenal biopsy showed duodenitis with negative result for AFB stain, Helicobacter Pylori. Patient underwent roux-en-y gastro-jejunostomy. Histo-pathological findings were consistent with tuberculosis. Patient was started on AKT and discharged. At 3 months follow up; patient asymptomatic. CONCLUSION: The unusual location of gastrointestinal tuberculosis, lack of specific signs and symptoms, radiological studies and endoscopy findings makes diagnosis a challenge. The treatment of duodenal tuberculosis is still medical and surgery should be reserved for emergency like gastric outlet obstruction causing nutritional compromise.