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1.
Arq Bras Cir Dig ; 32(4): e1463, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31859916

RESUMO

BACKGROUND: Primary intrahepatic lithiasis is defined when the stones are formed in the liver and associated with local dilatation and biliary stricture. Liver resection is the ideal procedure. AIM: To evaluate the results of liver resection in the treatment of non-oriental intrahepatic lithiasis. METHODS: Fifty-one patients with symptomatic benign non-oriental hepatolithiasis underwent surgical resection in six institutions in Brazil. Demography data, clinical symptoms, classification, diagnosis, management and postoperative course were analyzed. RESULTS: Of the 51 patients, 28 were male (54.9%), with a mean age of 49.3 years. History of cholangitis was observed in 15 (29.4%). The types of intrahepatic lithiasis were type I in 39 (76.5%) and type IIb in 12 (23.5%), with additional type Ea in six (11.8%). Liver function test were normal in 42 patients (82.4%). Segmental atrophy was observed in 12 (23.5%). Treatments included left lateral sectionectomy in 24 (47.1%), left hepatectomy in 14 (27.5%) and right hepatectomy in eight (15.7%), with associated hepaticojejunostomy in four (7.8%). Laparoscopic liver resection was performed in eight (15.7%). Postoperative complications were observed in 20 (39.2%) with no mortality. CONCLUSION: Liver resection in patients with hepatolithiasis is the ideal procedure as it removes stones, stricture, atrophic parenchyma, and minimizes the risk of cholangiocarcinoma.


Assuntos
Hepatectomia/métodos , Litíase/cirurgia , Hepatopatias/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
2.
Acta otorrinolaringol. esp ; 70(6): 342-347, nov.-dic. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-184879

RESUMO

Introducción: El tratamiento de la enfermedad obstructiva salival mediante técnicas mínimamente invasivas ha sido objeto de valoración por diferentes estudios desde hace décadas. Las litiasis a nivel del conducto salival serán la causa más frecuente de obstrucción, representando más del 50% de la enfermedad de las glándulas salivales mayores afectando hasta en un 80% de casos al conducto de Wharton. Material y métodos: Estudio prospectivo, comparando los resultados de las técnicas de sialolitectomía transoral combinada (STC) y submaxilectomía abierta mediante cervicotomía en 2 grupos de pacientes tratados por cálculos a nivel del hilio de la glándula submaxilar. Resultados: Veintidós pacientes fueron incluidos en el estudio, 16 (72,7%) eran hombres y 6 (27,3%) eran mujeres, la edad promedio fue de 54,41 años ± 12,75 (mín: 30/máx: 77). En cuanto a las variables asociadas a la enfermedad: promedio de litiasis, tamaño medio de la litiasis, tiempo medio de estancia, alteración del nervio lingual o complicaciones para ambas técnicas, no se encontraron diferencias para ambos grupos. Existiendo solo diferencias estadísticamente significativas en la estancia promedio a favor de la STA (p = 0,001). Conclusión: Los abordajes mínimamente invasivos al sistema ductal salival, asociados o no a sialoendoscopia, han demostrado una eficacia contrastada y un menor número de complicaciones en su variante submaxilar transoral. La tendencia natural debería ir dirigida a sustituir paulatinamente las técnicas de sialoadenectomía abierta, reservando su indicación para el tratamiento de enfermedad tumoral


Introduction: The treatment of salivary obstructive pathology by minimally invasive techniques has been an object of assessment by different studies for decades. Lithiasis at the level of the salivary duct will be the most frequent cause of obstruction, representing more than 50% of the pathology of the major salivary glands and almost 80% of these affecting the Wharton duct. Material and methods: A prospective study comparing the results of combined transoral sialolitectomy (CTS) and open submaxillectomy techniques by cervicotomy in 2 groups of patients treated by lithiasis at the level of the hilum of the submaxillary gland. Results: 22 patients were included in the study 16 (72.7%) were men and 6 (27.3%) were women, the average age was 54.41 years ± 12.75 (Min: 30/Max: 77). Regarding the variables associated with the disease: average lithiasis, size of the stone, hospital stay, lingual nerve alteration or complications for both techniques, differences were not found between both groups. There were only statistically significant differences in the average stay in favor of the CTS (P=.001). Conclusion: The minimally invasive approaches to the salivary ductal system, associated or not with sialoendoscopy, can be efficacy and can be associated with lower number of complications. The natural tendency should be aimed to gradually replacing open sialoadenectomy techniques, reserving its indication for the treatment of tumor pathology


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Litíase/diagnóstico , Litíase/cirurgia , Glândula Submandibular/patologia , Glândula Submandibular/cirurgia , Estudos Prospectivos , Procedimentos Cirúrgicos Minimamente Invasivos , Nervo Lingual/cirurgia
3.
Ethiop J Health Sci ; 29(3): 417-419, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31447512

RESUMO

Background: Appendicitis is the most common cause of acute abdomen. The diagnosis of appendicitis can be easy when it presents with the classical symptoms or is very challenging when present with atypical presentation. Around 20-30% of patients operated on for appendicitis have appendicolithiasis. Appendicolithiasis are usually small in size, and are called giant when more than 2cm in size. Case Detail: A 36 years old man was referred from a district hospital with a diagnosis of cecal cancer. His complaints were right lower quadrant (RLQ) abdominal mass of 03 months and pain of 18 months duration. Colonoscopy was normal but abdominal CT showed a RLQ mass with a dense radio-opaque shadow at its center. Conclusions: Giant appendicolith is a rare condition. A high index of suspicion and careful review of imaging findings is the key in early diagnosis and improved patient outcomes.


Assuntos
Apendicite/diagnóstico , Litíase/diagnóstico , Dor Abdominal/etiologia , Adulto , Apendicectomia , Apendicite/diagnóstico por imagem , Apendicite/patologia , Apendicite/cirurgia , Apêndice/diagnóstico por imagem , Apêndice/patologia , Apêndice/cirurgia , Dor Crônica/etiologia , Humanos , Litíase/diagnóstico por imagem , Litíase/patologia , Litíase/cirurgia , Masculino , Tomografia Computadorizada por Raios X
4.
Zhonghua Wai Ke Za Zhi ; 57(7): 527-533, 2019 Jul 01.
Artigo em Chinês | MEDLINE | ID: mdl-31269616

RESUMO

Objective: To explore the risk factors of long-term treatment outcomes and establish predicting model for laparoscopic left hepatectomy in hepatolithiasis. Methods: Clinical data of 108 patients with hepatolithiasis who underwent laparoscopic left sided hepatectomy and with complete follow-up data were retrospectively collected from June 2011 to June 2016 at the Second Affiliated Hospital of Nanchang University. Twenty-six males and 82 females were enrolled. The age was (52.4±11.7) years (range:20-80 years) , and the median follow-up time was 36 months (range: 24-83 months) . Patients were randomly divided into training group (79 cases) and validation group (29 cases) with a ratio of about 3∶1. Twenty-five preoperative and intraoperative clinical factors were selected for potential factors that might affect long-term outcomes, and quality of life was used as an surrogate evaluation index. Univariate analysis and multivariate logistic regression analysis were used to investigate the potential risk factors, and to construct and validate the predictive nomogram for surgical outcomes. Results: Among 108 patients, 10 patients (9.3%) had residual stones, 8 patients (7.4%) had recurrent stones, 12 patients (11.1%) had recurrent cholangitis and 3 patients (2.8%) died. Univariate analysis showed that history of hepatobiliary surgery, gender, activation of partial thromboplastin time, alkaline phosphatase, use of choledochoscopy, postoperative stone residual, serum creatinine, postoperative biliary drainage and operation time were risk factors that may affect long-term outcomes (all P<0.15) . Multivariate analysis showed that the history of previous hepatobiliary surgery (OR=2.305, 95% CI: 0.383-4.227, P=0.019) , postoperative biliary drainage (OR=2.043, 95% CI: 0.182-4.209, P=0.048) , operation time ≥262.5 minutes (OR=1.971, 95% CI: 0.154-4.023, P=0.045) were independent risk factor affecting long-term outcomes. Based on the above factors, the predictive nomogram model was constructed. Internal and external validations showed good discrimination (area under the curve of receiver operating curve>0.7) and calibration (Hosmer-Lemeshow test: P>0.05) performance, which indicated that the prediction effect was favorable. Conclusions: History of previous hepatobiliary surgery, postoperative biliary drainage and operation time ≥262.5 minutes are independent risk factors for long-term outcome. The predictive nomogram model based on risk factors relates to surgical outcomes presented good clinical predictive effects, which might contribute to the prediction of the long-term outcomes of laparoscopic left sided hepatectomy for hepatolithiasis.


Assuntos
Hepatectomia/métodos , Litíase/cirurgia , Hepatopatias/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hepatectomia/efeitos adversos , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Nomogramas , Qualidade de Vida , Distribuição Aleatória , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
5.
BMJ Case Rep ; 12(7)2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31302623

RESUMO

Female-to-male transsexual patient, 22 years old, with neophallus from radial forearm free flap (phalloplasty in March 2014), history of urethral fistula and urethral stricture 1 year later treated with surgical correction (fistulectomy) and suprapubic urinary diversion. Subsequently, he developed a new urethral stenosis located in the urethral anastomosis. Immediately proximal to the stenosis, there was a urethral dilatation (pseudodiverticulum) with a fibrous septum and several retracted stones. The stones were fragmented, the fibrous septum destroyed and the urethral stricture corrected, all with holmium laser. After 40 months of follow-up the patient shows satisfactory urinary flow with no signs of residual lithiasis or stricture.


Assuntos
Terapia a Laser/instrumentação , Litíase/cirurgia , Doenças Uretrais/cirurgia , Feminino , Hólmio , Humanos , Lasers de Estado Sólido/uso terapêutico , Masculino , Complicações Pós-Operatórias/cirurgia , Cirurgia de Readequação Sexual/efeitos adversos , Adulto Jovem
6.
Pan Afr Med J ; 32: 23, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31143328

RESUMO

Prostatic lithiases are characterized by the development of stones in the prostatic tissue (acini, channels). They rarely occur in children but they are frequent in men. We report the case of a 24-year old patient with a few month-history of micturation disorders including dysuria and pollakiuria followed by perineal urinary leakage during minction. Reno-vesico-prostatic ultrasound showed voluminous prostatic calcification. Standard radiographic evaluation of the urinary tract and fistulography of the perineal orifice showed a communication with the bladder and showed large calcification projecting over the pubis. The diagnosis of prostatic lithiasis was retained. The patient was treated with antibiotic therapy before, during and after surgical extraction of the voluminous lithiasis. Surgical outcomes were favorable.


Assuntos
Fístula/diagnóstico , Litíase/diagnóstico , Períneo/patologia , Doenças Prostáticas/diagnóstico , Fatores Etários , Fístula/patologia , Humanos , Litíase/patologia , Litíase/cirurgia , Masculino , Doenças Prostáticas/patologia , Doenças Prostáticas/cirurgia , Resultado do Tratamento , Adulto Jovem
7.
Medicine (Baltimore) ; 98(17): e15364, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027122

RESUMO

There is no specific method for the preoperative diagnosis of atypical bile duct hyperplasia, which is a precursor of cholangiocarcinoma. This study aimed to create a new model for diagnosing atypical bile duct hyperplasia based on routine laboratory tests in patients with intrahepatic lithiasis.The new diagnostic model was developed with a derivation cohort that included 375 patients with intrahepatic lithiasis. Clinical and pathological data were retrospectively collected. Prognostic factors were evaluated with univariate and logistic regression analyses. The validation cohort included 136 patients who were retrospectively screened to quantify the model's predictive value.Age and Carbohydrate Antigen 19-9 (CA-199) were revealed to be diagnostic indicators of atypical bile duct hyperplasia in patients with intrahepatic lithiasis. The new diagnostic model was created with the formula: -6.612 + (0.002 × CA-199) + (0.072 × Age). The area under the receiver operating curve of the model was 0.721. With 0.25 as the cutoff point, the sensitivity and specificity of this model in the derivation cohort were 13.9% and 95.9%, respectively. In the validation cohort, these values were 28.5% and 88.7%, respectively. The novel model has an acceptable and stable ability to predict atypical hyperplasia in the intrahepatic bile duct.This novel model provides a simple system for diagnosing atypical bile duct hyperplasia before surgery in patients with intrahepatic lithiasis.


Assuntos
Doenças dos Ductos Biliares/diagnóstico , Ductos Biliares/patologia , Cálculos Biliares/complicações , Lesões Pré-Cancerosas/diagnóstico , Doenças dos Ductos Biliares/complicações , Doenças dos Ductos Biliares/patologia , Doenças dos Ductos Biliares/cirurgia , Feminino , Cálculos Biliares/diagnóstico , Cálculos Biliares/patologia , Cálculos Biliares/cirurgia , Humanos , Hiperplasia/diagnóstico , Litíase/complicações , Litíase/diagnóstico , Litíase/patologia , Litíase/cirurgia , Fígado , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Lesões Pré-Cancerosas/complicações , Lesões Pré-Cancerosas/patologia , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade
8.
BMC Surg ; 19(1): 16, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30717712

RESUMO

BACKGROUND: To evaluate the perioperative and long-term results of intrahepatic bile duct exploration lithotomy (IHBDIL) combined with hepatectomy for patients with complicated bilateral primary hepatolithiasis. METHODS: A study was conducted involving 56 patients with complicated bilateral primary hepatolithiasis who underwent IHBDIL combined with hepatectomy at our hospital from January 2006 to December 2014. The perioperative and long-term outcomes that were retrospectively analysed included the stone clearance rate, operative morbidity and mortality, and stone recurrence rate. Patients with a preoperative diagnosis of cholangiocarcinoma were excluded. RESULTS: In all 56 patients, hepatic duct stones were located in the bilateral IHBD. The surgical method was IHBDIL combined with hepatectomy. Postoperative complications occurred in 15 patients (26.8%), 14 patients responded to conservative management, and there was 1 case of postoperative mortality because of hepatic failure. The overall initial success rate of stone clearance was 85.7%, and the final clearance rate was 92.9% following postoperative choledochoscopic lithotripsy. The stone recurrence rate was 13.5%, and the occurrence of postoperative cholangitis was 10.9% during the follow-up period. CONCLUSION: IHBDIL combined with hepatectomy is a safe, effective, and promising treatment for patients with complicated bilateral primary hepatolithiasis. The perioperative and long-term outcomes are satisfactory for complicated bilateral primary hepatolithiasis.


Assuntos
Ductos Biliares Intra-Hepáticos/cirurgia , Hepatectomia/métodos , Litíase/cirurgia , Hepatopatias/cirurgia , Adulto , Idoso , Procedimentos Cirúrgicos do Sistema Biliar , Feminino , Humanos , Laparoscopia/métodos , Hepatopatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
9.
Auris Nasus Larynx ; 46(4): 542-547, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30598232

RESUMO

OBJECTIVE: Rhinolith is a hard nasal mass formed in time by the mineral salts around an endogenous or exogenous-originating nidus. Rhinolith, which is seen rarely, has been reported in the literature as case reports. In this study, we are presenting the demographic and clinical features together with accompanying sinonasal pathologies of 23 rhinolith cases. METHODS: The medical records and radiological findings of 23 cases, who were operated for rhinolith between January 2010 and June 2018 in Tokat State Hospital, were analyzed retrospectively. The age, gender, the side where rhinolith exists, nidus presence, type of surgery and sinonasal pathologies that accompany rhinolith, and accompanying secondary sinonasal surgeries were examined. RESULTS: A total of 17 (73.2%) of the 23 cases were female, and 6 (26.8%) were male. The mean age was 24.9 years. The symptoms that were seen in the patients were nasal obstruction (100%), rhinorrhea (82.6%), nasal malodor (78.2%), oral malodor (26%), headache (26%), epistaxis (17.3%), face pain (4,3%), respectively. Nidus could be detected in 6 patients. The most frequent localization of rhinolith was between the inferior concha and the nasal septum (n=21). The most common concomitant sinonasal pathology in rhinolith was septum deviation (43.4%); and the second most common pathology was mucosal thickening (30.4%) in the maxillary sinus. The surgery type that accompanied rhinolith at the highest frequency was septoplasty (n=5). Other surgeries were septorhinoplasty (n=1), antrochoanal polyp excision (n=1), adenoidectomy (n=1). CONCLUSION: The most common symptoms of rhinolith, which is a rare nasal pathology, are nasal obstruction and rhinorrhea. Radiological imaging together with a rigid endoscopy is important especially to evaluate the placement of rhinolith. In addition to this, radiological imaging, evaluation of the sinuses that are not sufficiently evaluated with rigid endoscope are important for planning the type of the operation and secondary surgical procedures which may accompany.


Assuntos
Cálculos/diagnóstico por imagem , Doenças Nasais/diagnóstico por imagem , Adolescente , Adulto , Cálculos/complicações , Cálculos/cirurgia , Criança , Feminino , Humanos , Litíase/complicações , Litíase/diagnóstico por imagem , Litíase/cirurgia , Masculino , Seio Maxilar , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Septo Nasal/anormalidades , Procedimentos Cirúrgicos Nasais , Doenças Nasais/complicações , Doenças Nasais/cirurgia , Odorantes , Mucosa Respiratória , Estudos Retrospectivos , Adulto Jovem
10.
BMJ Case Rep ; 11(1)2018 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-30567272

RESUMO

We describe a case of a 15-year-old girl who presented to our clinic with long-standing right-sided rhinorrhoea which was occasionally foul-smelling and blood-stained with no other symptom of note. She had been treated many times with antibiotics. On examination, a rhinolith was discovered impacted posteriorly in right nasal cavity with mucopurulent discharge. Plain X-ray and later CT scan of paranasal sinuses confirmed the diagnosis but it was found to be large in size with irregular shape like a 'staghorn'. It was removed under general anaesthesia and she recovered uneventfully. We also describe the review of literature.


Assuntos
Antibacterianos/uso terapêutico , Corpos Estranhos/complicações , Litíase/diagnóstico por imagem , Cavidade Nasal/diagnóstico por imagem , Doenças Nasais/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Adolescente , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Litíase/etiologia , Litíase/cirurgia , Cavidade Nasal/patologia , Doenças Nasais/etiologia , Doenças Nasais/cirurgia , Seios Paranasais/patologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Medicine (Baltimore) ; 97(46): e13080, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30431577

RESUMO

Laparoscopic left hemihepatectomy (LLH) followed by biliary tract exploration is used to treat left-sided hepatolithiasis (LSH). The purpose of this study was to compare the efficacy of 2 methods of biliary tract exploration in LLH:biliary tract exploration through a common bile duct (CBD) incision (with T-tube drainage) or through the left hepatic duct (LHD) stump (without T-tube drainage).LSH patients (113 patients) were recruited retrospectively in our hospital from December 2008 to January 2016. To compare different methods of biliary tract exploration during LLH, the patients were divided into 2 groups: 41 patients underwent biliary tract exploration through the LHD stump (LHD group), and 72 patients underwent biliary tract exploration through a CBD incision (CBD group). Baseline characteristics, surgical outcomes, surgery-related complications, postoperative hospital stay (PHS) and long-term results were compared between the 2 groups.There was no unplanned reoperation in the 2 groups. One patient in the CBD group had a residual stone, which was removed by choledochoscopy 2 months postoperation. Two patients in the LHD group and 3 patients in the CBD group had bile leakage and were cured with abdominal drainage. There were no significant differences in the total operation time, incidence of residual stones and bile leakage between the 2 groups (P > .05). The PHS and the incidence of hypokalemia or hyponatremia in the LHD group were significantly lower than those in the CBD group (P < .05). T-tube-related complications occurred in 13.9% (10/72) of the CBD patients. The mean follow-up period was 37.2 ±â€Š13.8 months. There were no significant differences in the incidence of recurrence stones or cholangitis (P > .05) between the 2 groups.Exploration of the biliary tract through the LHD stump without T-tube drainage is safe with satisfactory short- and long-term results for selected LSH patients.


Assuntos
Ducto Colédoco/cirurgia , Hepatectomia/métodos , Ducto Hepático Comum/cirurgia , Litíase/cirurgia , Hepatopatias/cirurgia , Adulto , Idoso , Estudos de Casos e Controles , Ducto Colédoco/patologia , Feminino , Ducto Hepático Comum/patologia , Humanos , Laparoscopia/métodos , Tempo de Internação , Litíase/patologia , Fígado/patologia , Fígado/cirurgia , Hepatopatias/patologia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
12.
Ugeskr Laeger ; 180(46)2018 Nov 12.
Artigo em Dinamarquês | MEDLINE | ID: mdl-30417821

RESUMO

This is a case report of multiple uterine lithiasis in a 66-year-old, healthy woman. The patient had postmenopausal bleeding but no other complaints. She underwent uneventful vaginal hysterectomy, and multiple loose pieces of detached uterine lithiasis in the uterine cavity were found. It is very rare to find stones in the human uterus without any intrauterine device, neoplasia or malignancy.


Assuntos
Cálculos , Litíase , Doenças Uterinas , Idoso , Feminino , Humanos , Histerectomia , Litíase/diagnóstico , Litíase/cirurgia , Doenças Uterinas/diagnóstico , Doenças Uterinas/cirurgia , Útero
17.
Pancreas ; 47(6): 708-714, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29851750

RESUMO

OBJECTIVES: The aim of this study was to assess prevailing treatment of pancreatolithiasis in Japan. METHODS: We surveyed clinical data from 1834 patients (1479 men and 355 women) at 125 hospitals. RESULTS: Extracorporeal shock-wave lithotripsy (ESWL) was performed alone in 103 patients (5.6%), ESWL plus an endoscopic procedure in 446 (24.3%), endoscopic treatment alone in 261 (14.2%), and surgery in 167 (9.1%). Other treatments were given to 358 (19.5%), whereas 499 (27.2%) received no treatment. Symptoms were relieved in 85.7% after ESWL, 80.8% after endoscopic treatment alone, and 92.8% after surgery. Early complication rates within 3 months after ESWL, endoscopic treatment alone, and surgery were 8%, 4.5%, and 27.1%, respectively. Late complications after ESWL, endoscopic procedures alone, and surgery were 1.7%, 2.5%, and 8.2%, respectively. Symptom relief but also early and late complications were greater after surgery than after ESWL and endoscopic treatment. Among 417 patients undergoing ESWL, 61 (14.6%) required surgery, as did 32 (16%) of 200 patients treated endoscopically. Surgery was required less frequently following initial operative treatment (11/164 patients [6.7%]). Nonsurgical initial treatments were chosen more frequently. CONCLUSIONS: First-line treatment of pancreatolithiasis should be ESWL with or without endoscopy because of minimal invasiveness and fewer complications.


Assuntos
Inquéritos Epidemiológicos/métodos , Litíase/terapia , Litotripsia/métodos , Pancreatopatias/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Criança , Terapia Combinada , Endoscopia/métodos , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Japão , Litíase/etnologia , Litíase/cirurgia , Masculino , Pessoa de Meia-Idade , Pancreatopatias/etnologia , Pancreatopatias/cirurgia , Resultado do Tratamento , Adulto Jovem
20.
Wiad Lek ; 71(1 pt 2): 237-241, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29602940

RESUMO

OBJECTIVE: Introduction: Information on chemical and phase composition of pancreoliths is limited and discrepant. There are reports, that pancreoliths are composed by calcium, phosphate, calcium carbonate or combination of calcium with fatty acids The aim of the work is studying of structural characteristics of pancreatoliths in 5 clinical cases. PATIENTS AND METHODS: Materials and methods: Morphological and crystal-chemical study of five cases of pathological biomineralization in the pancreas were conducted in the work. RESULTS: Results: Two stones were located in the pancreatic duct, in other cases - in the ductal system of pancreas. Concretion sizes ranged from 0.5 to 1.5 cm in diameter. Pancreatic lithiasis' form depended on the location: in the duct of Wirsung single concretions were found (they were relatively large, oval stones with smooth, regular edges); multiple, small concretions with irregular edges, coral-like stones dominated in the ductal system of pancreas. Histological study of pancreas showed the signs of chronic pancreatitis, tissue fibrosis, atrophy and edema of glandular component, system distension of ducts, nidal mix-cell inflammatory infiltrates, vessels' plethora. Structural phase and chemical analysis of pathological biominerals responded calcite in all studied cases. CONCLUSION: Conclusion: The presence of pancreatic lithiasis was found to be accompanied by significant morphological changes of the pancreas. The pancreatolith crystal phase was established to be calcium carbonate in the form of calcite.


Assuntos
Litíase/patologia , Ductos Pancreáticos/patologia , Adulto , Humanos , Litíase/diagnóstico , Litíase/cirurgia , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Pâncreas/cirurgia , Ductos Pancreáticos/cirurgia , Resultado do Tratamento
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