RESUMO
We present the case of a 67-year-old female with recent cholecystectomy for symptomatic cholelithiasis. She was admitted to our hospital with right upper quadrant abdominal pain and vomiting. Laboratory analysis revealed hyperbilirubinemia with cytolysis and cholestasis. Abdominal ultrasound revealed a choledocholithiasis of 8 mm. Endoscopic retrograde cholangiopancreatography (ERCP) was scheduled. With the duodenoscope, after the reduction maneuver from the second duodenal portion to face the major papilla, a perforation of approximately 18 mm was identified in the contralateral wall distal to it. A gastroscope identified the perforation and a 9.5-11 x 6 mm over-the-scope-clip (OTSC) was placed after inserting its edges into the cap with aspiration (without approximation forceps).
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Coledocolitíase , Feminino , Humanos , Idoso , Coledocolitíase/complicações , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/cirurgia , Duodeno , Hospitalização , Doença IatrogênicaRESUMO
We present the case of a 37-years old male, who consulted for an extended history of intermittent nausea and vomiting. Laboratory tests showed moderate elevated bilirubin (1.30 mg/dL) and GGT (106 U/L). An abdominal CT scan performed showed a solid 18-centimetres (cm) mass located in the right liver lobe. A biopsy of the lesion was performed, revealing metastastic cells of a well-differentiated neuroendocrine tumour (NET, G3 (Ki-67: 25%). Further study was performed with MRI, and SPECT-CT, showing a 2-cm lesion in the pancreatic tail suggestive of being the primary NET. Chromogranin A levels were high (114.100 ng/ml). In our case, despite the large size of the liver metastasis a full resection of the tumours was achieved.
Assuntos
Neoplasias Hepáticas , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Adulto , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologiaRESUMO
We report the case of an 89-year-old female who presented with progressive weight loss, oropharyngeal dysphagia and food regurgitation.
Assuntos
Transtornos de Deglutição , Divertículo de Zenker , Idoso de 80 Anos ou mais , Biópsia , Transtornos de Deglutição/etiologia , Feminino , Humanos , Divertículo de Zenker/complicações , Divertículo de Zenker/diagnóstico por imagemRESUMO
An 86-year-old female presented with anemia and dyspepsia. She underwent esophagogastroduodenoscopy, which revealed a giant pedunculated polyp located in the gastric corpus, protruding into the duodenal bulb, causing gastric outlet obstruction (GOO). Thus, an endoscopic resection was scheduled.