Jejunal diverticulitis as a cause of acute abdomen / Abdome agudo por diverticulite de jejuno

Jejunoileal diverticulosis is an uncommon and underdiagnosed condition. Most patients are asymptomatic and require no specific treatment. A few patients, however, present life-threatening complications that may require surgical intervention. The purpose of this report is to illustrate a case of jejunoileal diverticulosis manifested as an acute abdomen.

A doença diverticular do intestino delgado é uma entidade incomum e pouco diagnosticada. A maioria dos casos não apresenta sintomas e não necessita de tratamento específico. Alguns pacientes, no entanto, podem evoluir com complicações da doença e necessitar de tratamento cirúrgico. O objetivo deste relato é ilustrar um caso de diverticulose jejunal que evoluiu para um quadro de abdome agudo.

Clinical Characteristics of 130 Patients With Hepatocellular Carcinoma Followed at a Tertiary Hospital From Brazil.

BACKGROUND: Hepatocellular carcinoma (HCC) is a primary malignant tumor of the liver that represents a serious public health problem all over the world, corresponding to the third cause of cancer death worldwide. The object was to present the clinical characteristics and follow-up of patients with HCC attended at the University Hospital of the Faculty of Medicine of Ribeirao Preto-USP (HCFMRP-USP), Ribeirao Preto, Sao Paulo, Brazil. METHODS: Epidemiological and clinical data were revised from medical records. RESULTS: A total of 130 patients participated in the study, 81.5% of them being males. Mean (± SD) age at the time of HCC diagnosis was 55.6 ± 11.2 years. Cirrhosis was present in 89.2% of cases, with 53.4% of the patients being Child-Pugh A; chronic hepatitis B or C without cirrhosis was detected in 3.2%, non-alcoholic steatohepatitis (NASH) in 3.8%, and a normal liver in 3.8%. Orthotopic liver transplantation was performed in 26.2% of the subjects, 16.9% of the patients were submitted to surgical resection, and 6.2% to percutaneous ethanol infusion (PEI). Transarterial embolization and transarterial chemoembolization were performed in 9.2% of the patients. Systemic chemotherapy was applied to 4.6% of cases and 24.6% of the patients received symptomatic treatment. CONCLUSION: Thus, in the present series cirrhosis was the main risk factor for HCC, with 53.4% of the patients being Child-Pugh A. Liver transplantation or surgical resection of the tumor, potentially curative techniques, were possible in only 43.1% of cases.