RESUMO
La nesidioblastosis es una causa conocida de hipoglicemia persistente en neonatos, pero las publicaciones acerca de su presencia en adultos son escasas. Se describe el caso de una mujer de 44 años de edad que se presentó con hipoglicemia grave asociada a hiperinsulinismo, en la cual no fue posible el diagnóstico de insulinoma mediante los métodos disponibles en el país ni durante la exploración quirúrgica, siendo sometida a una pancreatectomía corporocaudal. El examen histológico reveló la presencia de nesidioblastosis, dado el hallazgo de hiperplasia de células de los islotes provenientes del páncreas endocrino. El seguimiento demostró el control de la glicemia y actualmente la paciente se encuentra asistomática
Assuntos
Humanos , Adulto , Feminino , Pancreatopatias/cirurgia , Pancreatectomia , Adenoma de Células das Ilhotas Pancreáticas , Pancreatopatias/complicações , Pancreatopatias/diagnóstico , Pancreatopatias/etiologia , Hiperinsulinismo , HipoglicemiaRESUMO
We report a 65 years old female undergoing hemodialysis, presenting with intense pain in the lower right quadrant and moderate hematochezia. Since symptoms did not abate after an appendectomy, a colonoscopy and barium enema were performed, whose results suggested an advanced cecal carcinoma. Biopsies were negative for cancer. A new surgical abdominal exploration disclosed a cecal inflammatory and transmural lesion. A right colectomy was performed and the patient had a satisfactory postoperative evolution. Pathological study of the surgical piece showed a six cm perforated profound ulceration and a two cm ulcer. Both had precise limits. Unspecific cecal ulcers are rare entities that must be born in mind in the differential diagnosis of abdominal pain or hematochezia, specially in patients undergoing chronic hemodialysis
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doenças do Ceco/etiologia , Insuficiência Renal Crônica/complicações , Doenças do Ceco/diagnóstico , Fenilbutazona/efeitos adversos , Colonoscopia , Colectomia , Hemorragia Gastrointestinal/etiologia , Laparotomia , Obesidade/complicações , Diálise Renal , Hipertensão , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/terapiaAssuntos
Humanos , Feminino , Gravidez , Adulto , Recém-Nascido , Malária/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Malária Cerebral/etiologia , Malária Falciparum , Malária/complicações , Malária/tratamento farmacológico , Malária/etiologia , Plasmodium falciparum/efeitos dos fármacos , Plasmodium falciparum/patogenicidade , Complicações Infecciosas na Gravidez/tratamento farmacológico , Quinina/uso terapêuticoRESUMO
El sarcoma botrioides de localización uterina es muy poco frecuente, habiendo tenido su tratamiento y pronóstico una importante evolución a la fecha. Se presenta un caso clínico, analizando la experiencia al respecto
Assuntos
Humanos , Feminino , Adolescente , Rabdomiossarcoma/diagnóstico , Neoplasias Uterinas/diagnóstico , Protocolos Clínicos , Intervalo Livre de Doença , Estadiamento de Neoplasias , Prognóstico , Rabdomiossarcoma/tratamento farmacológico , Rabdomiossarcoma/etiologia , Rabdomiossarcoma/cirurgiaRESUMO
We report the retrospective analysis of 86 patients with primary gastric lymphoma diagnoses in a period of 12 years, that constitute 5.6 percent of malignant gastric lesions diagnosed in that lapse. Upper gastrointestinal endoscopy diagnosed a malignant lesion in 93 percent and lymphoma in 36 percent of cases. Endoscopic biopses disclosed malignant lesions in 79 cases (93 percent) and were diagnostic of lymphoma in 70 (82 percent). All patients were operated, including the seven subjects in which the biopsy did not show malignant lesions; the surgical indication on the latter was based in clinical grounds. The macroscopic examination of the surgical piece showed ilcerated lesions in 45 (52 percent) and mixed lesions (ulcerated and protruded with and without multiple erosions) in 15 (18 percent) patients. 17 patients (33 percent) had an early lesion of the MALT type (mucosa associated lymphoid tissue) and 87 percent of lesions were of low or intermediate histological type
