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1.
Acta Gastroenterol Latinoam ; 44(2): 125-8, 2014 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-25199307

RESUMO

This case report describes a 37-year-old woman who develops an intraparenchymal hepatic haematoma after an endoscopic retrograde cholangiopancreatography with papillotomy and stone extraction. The procedure requires the passage of a guidewire. The patient develops acute abdominal pain 72 hours later and a magnetic resonance shows a hematoma of 124 x 93 mm. She remains under observation. Twenty one days later she complains of upper right abdominal pain and fever. Consequently, a percutaneous drainage is performed isolating Citrobacter freundii and Klebsiella pneumoniae BLEE. The patient has a good evolution.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Coinfecção/microbiologia , Infecções por Enterobacteriaceae/etiologia , Hematoma/microbiologia , Hepatopatias/microbiologia , Adulto , Citrobacter freundii , Feminino , Humanos , Klebsiella pneumoniae
2.
Acta gastroenterol. latinoam ; 44(2): 125-8, 2014 Jun.
Artigo em Espanhol | LILACS-Express | LILACS, BINACIS | ID: biblio-1157440

RESUMO

This case report describes a 37-year-old woman who develops an intraparenchymal hepatic haematoma after an endoscopic retrograde cholangiopancreatography with papillotomy and stone extraction. The procedure requires the passage of a guidewire. The patient develops acute abdominal pain 72 hours later and a magnetic resonance shows a hematoma of 124 x 93 mm. She remains under observation. Twenty one days later she complains of upper right abdominal pain and fever. Consequently, a percutaneous drainage is performed isolating Citrobacter freundii and Klebsiella pneumoniae BLEE. The patient has a good evolution.

3.
Acta Gastroenterol. Latinoam. ; 44(2): 125-8, 2014 Jun.
Artigo em Espanhol | BINACIS | ID: bin-133452

RESUMO

This case report describes a 37-year-old woman who develops an intraparenchymal hepatic haematoma after an endoscopic retrograde cholangiopancreatography with papillotomy and stone extraction. The procedure requires the passage of a guidewire. The patient develops acute abdominal pain 72 hours later and a magnetic resonance shows a hematoma of 124 x 93 mm. She remains under observation. Twenty one days later she complains of upper right abdominal pain and fever. Consequently, a percutaneous drainage is performed isolating Citrobacter freundii and Klebsiella pneumoniae BLEE. The patient has a good evolution.

4.
Acta Gastroenterol Latinoam ; 40(4): 361-6, 2010 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-21381411

RESUMO

Primary hepatic lymphoma (PHL) is confined to the liver with no evidence of extrahepatic lymphomatosis. Histopathologically, the PHL belongs to the group of non-Hodgkin's lymphomas and the most common subtype is the diffise large B-cell lymphoma. We present a 72-year-old woman, with no relevant antecedents and the following symptoms: early satiety, abdominal discomfort and rapid weight loss. Liver function tests are normal, erythrocyte sedimentation rate is accelerated and LDH progressively increases during the hospitalization. Imaging studies (ultrasound, CT scan, nuclear magnetic resonance) show a multilobued mass of around 12 cm of diameter in the right hepatic lobe. Tumoral and virological markers are negative. The pathology of an echo-guided biopsy informs a massive infiltration by a diffuse large B-cell lymphoma. The immunohistochemical study shows CD20+, CD45+ and negative CD3, CKAE1, AE3, Hepatocyte and HMB45. The citology of pleural liquid is negative for atypia, peripheral blood smear shows no signs of leukemia, bone marrow biopsy is negative for lymphomatous infiltration, and gallium scintigraphy and body CT scan do not reveal extrahepatic lesions. The patient starts chemotherapy with cyclophosphamide and methylprednisolone but worsens and dies two weeks after beginning treatment. We conclude that our patient had a rare disease with an unresectable lesion, poor prognostic factors and high recurrence risk. Chemotherapy is the treatment of choice in these cases.


Assuntos
Neoplasias Hepáticas/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Idoso , Antineoplásicos Alquilantes/uso terapêutico , Biomarcadores Tumorais/sangue , Ciclofosfamida/uso terapêutico , Evolução Fatal , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Prednisona/uso terapêutico
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