RESUMO
A 62-year-old man was admitted to receive extracorporeal shock wave lithotripsy (ESWL) for a right renal pelvic calculus. During the operation, the patient complained of right upper quadrant pain. Later in the day, laboratory data showed elevated serum amylase levels, and abdominal CT revealed an enlarged pancreas. These findings led to a diagnosis of acute pancreatitis. The following day, urine output had decreased, and pleural and ascitic fluid had accumulated. For these reasons, the patient was transferred to our hospital to receive combination therapy, including arterial infusion therapy with protease inhibitors, antibiotics and continuous hemodiafiltration. The condition of the patient improved, and he was discharged on day 30. Acute pancreatitis should be considered as an early complication after ESWL for urinary tract calculus.
Assuntos
Cálculos Renais/terapia , Cálices Renais , Litotripsia/efeitos adversos , Pancreatite/etiologia , Doença Aguda , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A78-year-old female was admitted to our hospital with anorexia due to ascites. We were not able to diagnose by cytological diagnosis. For a definite diagnosis she underwent an open biopsy. Histological findings revealed observable papillary adenocarcinoma with psammoma body, carcinoma cells were positive for Ber-EP4 on immunostaining, and ovaries were normal. Thus, we made a diagnosis of peritoneal serous papillary adenocarcinoma. She was treated by intraperitoneal administration of CDDP(20 mg/day: day 1, every four weeks). Ascites vanished and CA125 was within the normal range. There was no recurrence after 3 years, but Virchow's lymph node metastasis occurred. The patient is still alive 12 months after metastasis with CDDP intraperitoneal administration.
Assuntos
Adenocarcinoma Papilar/patologia , Neoplasias Peritoneais/patologia , Adenocarcinoma Papilar/tratamento farmacológico , Adenocarcinoma Papilar/cirurgia , Idoso , Antineoplásicos/uso terapêutico , Feminino , Humanos , Invasividade Neoplásica , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
A-46-year-old male with advanced-stage IV multicentric gastric cancer was treated with S-1/CDDP as neoadjuvant chemotherapy. S-1 (initially 100 mg/day, up to 120 mg/day) was orally administered for 3 weeks (day 1-21) followed by 1 drug-free week as a course, and CDDP (initially 60 mg/day, up to 100 mg/day) was administered by intravenous drip on day 8. After the fourth course, a significant tumor reduction was obtained and curative surgery was performed. Thereafter, S-1 therapy was continued. There has not been any recurrence for 19 months postoperatively.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/uso terapêutico , Ácido Oxônico/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Tegafur/uso terapêutico , Combinação de Medicamentos , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
An 84-year-old male was admitted to our hospital due to diarrhea. Fourteen years ago, he underwent a graft replacement for an abdominal aortic aneurysm. Three years ago, he was pointed out left internal iliac artery aneurysm about 8cm in diameter. During the hospital stay, he experienced sudden massive hematochezia. Colonoscopic examination revealed a fistula at the rectum. Abdominal CT showed left internal iliac artery aneurysm with aorto-enteric fistula (AEF). An emergent aneurysmectomy and Hartmann's procedure was performed and the patient recovered. This case might show the usefulness of colonoscopy and CT for early diagnosis of secondary AEF. Early diagnosis and surgical treatment are necessary to recover from secondary AEF.
