Assuntos
Fístula/cirurgia , Fístula Pancreática/cirurgia , Doenças Pleurais/cirurgia , Esfinterotomia Endoscópica/métodos , Stents , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Fístula/diagnóstico por imagem , Seguimentos , Humanos , Pessoa de Meia-Idade , Fístula Pancreática/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Esfinterotomia Endoscópica/instrumentação , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Adenomatous colonic polyps are accepted as premalignant lesions. There is controversy regarding the significance of the hyperplastic polyp. The aim of this study was to determine the incidence of further polyps in patients with only hyperplastic polyps on a first colonoscopy in comparison with patients without polyps and with adenomatous polyps. METHODS: Ninety patients had only hyperplastic polyps (group I). These patients were paired according to age and sex with subjects having no polyps (group II) and with patients having adenomas (group III). RESULTS: Fifty-six patients in group I had at least one follow-up examination. New polyps were found in 46.4% in group I versus 15.5% in group II (p < 0.001) and 50% in group III (NS). In group I, 30.7% of new polyps were hyperplastic and 69.3% were adenomas. In fact, 32.2% of group I patients developed further adenomas (mean 1.5 +/- 0.8 adenomas). These adenomas occurred 1 to 4 years after the first polypectomy (mean 2.4 +/- 0.8 years). Most of these adenomas were small and tubular, but 16.6% were villous or had severe dysplasia. CONCLUSION: Patients with hyperplastic polyps were 2.4 times more likely to have further adenomas than were those without polyps.
Assuntos
Pólipos Adenomatosos/epidemiologia , Pólipos do Colo/epidemiologia , Adenoma Viloso/epidemiologia , Estudos de Casos e Controles , Colo/patologia , Pólipos do Colo/patologia , Colonoscopia , Feminino , Seguimentos , Humanos , Hiperplasia , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
Twelve consecutive patients admitted for bleeding from ruptured gastric varices were treated with transjugular intrahepatic portosystemic shunts and followed for a mean of 6 +/- 3 months (range: 8-293 days). The shunt was performed successfully in all 12 patients. The shunt occluded in 3 patients (respectively 19, 101 and 103 days after insertion) of whom one remained asymptomatic and two experienced rebleeding. Four patients presented with acute encephalopathy, spontaneously in two and after rebleeding in two. Three patients died, two after rebleeding and one of septic shock secondary to pneumonia. Overall, 9 patients survived a mean of 211 +/- 92 days with no rebleeding, 8 of whom have not yet experienced any complications. These results suggest that transjugular intrahepatic portosystemic shunts could be useful in treating hemorrhages from ruptured gastric varices and in preventing their recurrence.
