RESUMO
CONTEXT: Anaplastic carcinoma of the pancreas is a rare variant of ductal adenocarcinoma. The histogenesis and biologic behavior of these tumors are still controversial. They occur in elderly men and are associated with a very poor prognosis. CASE REPORT: We report a case of advanced anaplastic carcinoma in a 41-year-old man who presented with splenic infarction. He had a prolonged survival of 16 months from diagnosis. CONCLUSION: Splenic infarction is a most unusual acute presentation of pancreatic carcinoma, which may require emergency tumor resection and splenectomy.
Assuntos
Abdome Agudo/etiologia , Carcinoma/complicações , Carcinoma/patologia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/patologia , Infarto do Baço/etiologia , Abdome Agudo/cirurgia , Adulto , Carcinoma/cirurgia , Progressão da Doença , Evolução Fatal , Humanos , Masculino , Neoplasias Pancreáticas/cirurgia , Doenças Raras , Infarto do Baço/diagnóstico , Infarto do Baço/cirurgiaRESUMO
A 67-year-old woman, with a past medical history of diabetes mellitus and hypertension, underwent an elective laparoscopic anterior resection for sigmoid colon adenocarcinoma. She was readmitted on the tenth postoperative day with complaints of abdominal pain and a foul smelling discharge from her abdominal wound. She was later diagnosed with necrotizing fasciitis (NF) over the extraction wound. To our knowledge there has only been one other case of NF after laparoscopic colonic surgery reported in the literature. We reviewed the literature on NF after laparoscopic surgery, and discussed the clinical diagnosis; diagnostic adjuncts such as magnetic resonance imaging, bedside exploration under local anesthesia, frozen section of deep incisional biopsies, and laboratory tests; and management principles of NF. Although there is a low incidence of wound infections associated with laparoscopic colonic surgery, necrotizing infections although rare, are a very real possibility.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Fasciite Necrosante/etiologia , Laparoscopia/efeitos adversos , Neoplasias do Colo Sigmoide/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Adenocarcinoma/cirurgia , Idoso , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/terapia , Feminino , Humanos , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/terapia , Resultado do TratamentoRESUMO
INTRODUCTION: Gas is rarely found within the viscera outside the lumen of the gastrointestinal tract. Emphysematous gastritis is a rare form of infection of the stomach wall by gas producing organisms. CLINICAL PICTURE: A 45-year-old Chinese lady underwent hepatectomy for hepatocellular carcinoma. Postoperatively, she turned septic and encephalopathic with worsening liver function. Computed tomography scan revealed a thickened, oedematous stomach wall with air pockets within. TREATMENT: The patient was started on a course of broad spectrum antibiotics. OUTCOME: She responded and was discharged well. CONCLUSION: Emphysematous gastritis is a rare condition with high mortality. There is however, still no preferable approach of treatment despite therapeutic advances.
