ABSTRACT
Ampullary tumors can occasionally ulcerate and present as frank gastrointestinal bleeding. The most common clinical presentation is jaundice like in other tumors of the biliary tree. We report on a 68-year-old man who presented with severe upper gastrointestinal hemorrhage secondary to an asymptomatic mass of the ampulla of Vater. An endoscopic biopsy specimen revealed a villous adenoma with moderate dysplasia. A curative resection was performed, and pathological work-up revealed the presence of an infiltrating, moderately differentiated ampullary adenocarcinoma.
Subject(s)
Adenocarcinoma/diagnosis , Ampulla of Vater , Common Bile Duct Neoplasms/diagnosis , Gastrointestinal Hemorrhage/diagnosis , Adenocarcinoma/surgery , Aged , Ampulla of Vater/pathology , Biopsy , Common Bile Duct Neoplasms/surgery , Endoscopy, Digestive System , Gastrointestinal Hemorrhage/surgery , Humans , Laparotomy , Male , Severity of Illness Index , Tomography, X-Ray ComputedSubject(s)
Carcinoma, Squamous Cell/therapy , Coated Materials, Biocompatible , Esophageal Neoplasms/therapy , Metals , Stents , Tracheoesophageal Fistula/therapy , Zenker Diverticulum/therapy , Aged , Carcinoma, Squamous Cell/diagnostic imaging , Esophageal Neoplasms/diagnostic imaging , Esophageal Stenosis/diagnostic imaging , Esophageal Stenosis/therapy , Humans , Male , Palliative Care , Radiography , Tracheoesophageal Fistula/diagnostic imaging , Zenker Diverticulum/diagnostic imagingABSTRACT
Sclerosing encapsulating peritonitis, or abdominal cocoon, is a relatively rare cause of intestinal obstruction, described mostly in young adolescent girls. It is characterized by a thick fibrotic peritoneum that wraps the bowel in a concertinalike fashion with some adhesions. Because of its peculiar characteristics, this condition presents many difficulties in preoperative diagnosis. Recognition of the entity results in proper management and prevents unnecessary bowel resection. We report a man with intermittent intestinal obstruction and an abdominal cocoon encasing the small bowel that was diagnosed preoperatively by radiology. To the best of our knowledge, this represents the fourth male patient reported in the medical literature to develop this condition. We briefly review the literature and discuss the preoperative diagnosis and management of sclerosing encapsulating peritonitis.
Subject(s)
Intestinal Obstruction/diagnostic imaging , Peritonitis/diagnostic imaging , Adult , Follow-Up Studies , Humans , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestine, Small , Laparotomy , Male , Peritonitis/complications , Peritonitis/surgery , Sclerosis , Tomography, X-Ray ComputedABSTRACT
Leptomeningeal involvement is usually reported as a secondary event in advanced, already diagnosed, gastric adenocarcinoma. We report a case of leptomeningeal carcinomatosis in which identification of mucus-secreting "signet-ring" carcinoma cells in the cerebrospinal fluid allowed the diagnosis of an otherwise asymptomatic gastric cancer. This is one of the very few reported cases manifesting as such in the medical literature.