RESUMO
BACKGROUND: Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy, especially if the patient has none of the common risk factors associated with pancreatitis; such as alcoholism, gallstones, hypertriglyceridemia, hypercalcemia or the use of certain drugs. CASE SUMMARY: A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy. The pain was predominantly in the upper and middle abdomen and was persistent and severe. The patient was diagnosed with acute pancreatitis. Treatment included complete fasting, octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion, ulinastatin injection to inhibit pancreatic enzymes activity, esomeprazole for gastric acid suppression, fluid replacement and nutritional support. Over the next 3 d, the patient's symptoms improved. The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state. CONCLUSION: Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.
RESUMO
BACKGROUND: The nonspecific clinical, radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases. The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis. CASE SUMMARY: A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week, which was aggravated for two days. The patient had been sexually active with the same male partner for the past years, but her partner was promiscuous. Abdominal contrast-enhanced computed tomography (CT) and positron emission tomography/CT suggested gastric cancer. The gastroscopy revealed an antral gastric ulcer with gastric retention, and also suggested gastric cancer. But no cancer cells were found in the biopsies taken during the two gastroscopies. Treponema pallidum (T. pallidum) antibodies: ELISA positive, rapid plasma reagin titer 1:16. Hematoxylin and eosin (HE) stain showed macrophage infiltration in the lamina propria. Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T. pallidum. The patient was finally diagnosed with gastric syphilis. CONCLUSION: Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer. Penicillin can relieve symptoms of gastric syphilis.
