RESUMO
Gastric carcinoids are uncommon tumors, reportedly associated with pathological hypergastrinemic states such as Zollinger-Ellison syndrome (ZES). Gallbladder carcinoids are also very rare, but have not previously been reported in association with ZES. In this report we discuss a patient with ZES in whom both gastric and gallbladder carcinoid tumors were found.
Assuntos
Tumor Carcinoide/etiologia , Neoplasias da Vesícula Biliar/etiologia , Neoplasias Gástricas/etiologia , Síndrome de Zollinger-Ellison/complicações , Tumor Carcinoide/patologia , Neoplasias da Vesícula Biliar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/etiologia , Neoplasias Gástricas/patologiaRESUMO
Aggressive control of intragastric pH in the burn patient has essentially eliminated upper gastrointestinal bleeding. The recent spectrum of complications in the thermally injured patient has shifted. Vascular occlusion and missed associated injury were the most frequent early complications in this review. Those complications occurring late in the course were attributed to sepsis originating in the burn wound. The common diagnostic error was to blame the burn injury for the patient's signs and symptoms. A high index of suspicion of an occult process must be exercised when caring for the burn patient who has burn shock with a decreasing hematocrit value or a compartment syndrome that does not respond to escharotomy or fasciotomy or the septic patient with a clean burn wound.