RESUMO
Gastric lipomas are rare, representing 2-3% of all benign tumours of the stomach. Most of these stomach neoplasms are small and detected incidentally during endoscopic or radiology evaluations. Computed tomography is highly specific imaging for lipoma diagnosis. Endoscopy and endoscopic ultrasound are other important diagnostic modalities to confirm the diagnosis. Identifying typical features can avoid biopsy or surgery in asymptomatic patients. In patients with larger lesions, usually more than 2 cm, clinical presentation may encompass haemorrhage, abdominal pain, pyloric obstruction and dyspepsia. As a result of its extreme low incidence, treatment is not standardized, though it is widely accepted that a symptomatic tumour mandates resection. Here, we present the case of a 60-year-old female presenting with abdominal pain and recurrent vomiting due to a giant gastric lipoma (80 × 35 × 35 mm). The patient underwent laparotomy and an enucleation was performed.
RESUMO
Angiotensin-converting enzyme (ACE) inhibitors are the leading cause of drug-induced angioedema, being the face, tongue, lips and upper airway the most affected ones. We describe a case of a 32-year-old white female with angioedema of small intestine after 1 month of perindopril therapy. The patient presented severe abdominal pain, nausea and vomiting. Laboratory analyses revealed mild leukocytosis and abdominal computed tomography (CT) showed unspecific findings, including segmental jejunal wall thickening without obstruction and ascites. Regarding the clinical findings, similar to an acute abdomen with no clear cause, the patient underwent an emergency laparoscopy that excluded other pathological features. The symptoms recurred 1 month after and the CT scan revealed the same pattern. Perindopril was stopped and the patient improved, concluding that ACE inhibitor-induced visceral angioedema was responsible for this clinical presentation.
RESUMO
[This corrects the article DOI: 10.1093/jscr/rjaa348.].
