RESUMO
Squamous cell carcinoma of the pancreas is very rare as pancreas does not have any squamous cells. Only a few cases have been reported in the literature so far. We describe such a case where in the patient presented with painless jaundice. CT and EUS confirmed the pancreatic mass biopsy of which showed squamous cell cancer.
Assuntos
Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia , Idoso , Carcinoma de Células Escamosas/diagnóstico , Humanos , Masculino , Neoplasias Pancreáticas/diagnósticoAssuntos
Fístula Biliar/cirurgia , Colangiopancreatografia Retrógrada Endoscópica/métodos , Colecistectomia Laparoscópica/efeitos adversos , Ducto Cístico/cirurgia , Adesivo Tecidual de Fibrina/farmacologia , Complicações Pós-Operatórias , Adulto , Fístula Biliar/diagnóstico , Fístula Biliar/etiologia , Coledocolitíase/cirurgia , Ducto Cístico/diagnóstico por imagem , Feminino , Humanos , Adesivos Teciduais/farmacologia , Tomografia Computadorizada por Raios XAssuntos
Adenocarcinoma/diagnóstico , Lipossarcoma/patologia , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/patologia , Cárdia/diagnóstico por imagem , Cárdia/patologia , Diagnóstico Diferencial , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Endossonografia , Fundo Gástrico/diagnóstico por imagem , Fundo Gástrico/patologia , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Tumores do Estroma Gastrointestinal/diagnóstico , Gastroscopia , Humanos , Leiomioma/diagnóstico , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Tomografia Computadorizada por Raios XAssuntos
Carcinoma Verrucoso/diagnóstico , Neoplasias Esofágicas/diagnóstico , Idoso , Carcinoma Verrucoso/patologia , Carcinoma Verrucoso/cirurgia , Endossonografia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Esofagostomia , Esôfago/diagnóstico por imagem , Esôfago/patologia , Esôfago/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios XAssuntos
Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/secundário , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Testiculares/patologia , Adulto , Endossonografia , Humanos , Masculino , Neoplasias Testiculares/diagnóstico por imagemAssuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Cisto do Colédoco/diagnóstico por imagem , Cisto do Colédoco/patologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Idoso , Biópsia , Carcinoma Hepatocelular/patologia , Colangiopancreatografia Retrógrada Endoscópica , Cisto do Colédoco/cirurgia , Diagnóstico Diferencial , Endossonografia , Humanos , Testes de Função Hepática , Neoplasias Hepáticas/patologia , Masculino , Stents , Tomografia Computadorizada por Raios XRESUMO
Pseudomelanosis duodeni is a rare finding usually described as a black/brown speckled or tattooed appearance of the intestinal mucosa. Although an incidental finding, it has been associated with different medications and chronic medical conditions such as diabetes mellitus and chronic renal failure. We describe an elderly male who presented with epigastric pain and melena. Endoscopy showed pseudomelanosis duodeni related to intravenous (IV) iron transfusion. To our knowledge, this is the first report of pseudomelanosis duodeni related to IV iron use. In spite of its benign nature, the diagnosis of pseudomelanosis duodeni is essential to rule out other serious medical conditions that mimic its physical findings.
Assuntos
Doenças dos Ductos Biliares/cirurgia , Artéria Hepática/diagnóstico por imagem , Isquemia/cirurgia , Trombose/diagnóstico por imagem , Angiografia , Doenças dos Ductos Biliares/etiologia , Procedimentos Cirúrgicos do Sistema Biliar , Colangiopancreatografia Retrógrada Endoscópica , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Endoscopia do Sistema Digestório , Hepatite C Crônica/cirurgia , Humanos , Isquemia/etiologia , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Trombose/complicaçõesRESUMO
The current outbreak of COVID-19 pandemic caused by SARS-CoV-2 has affected nearly 188 countries. Patients with severe COVID-19 are more commonly elderly and suffer from comorbidities such as hypertension, diabetes mellitus, coronary artery disease, chronic pulmonary disease, obesity, and cancer. Inflammatory bowel disease (IBD) affects as many as 6.8 million people globally, and a significant proportion of them are treated with immunosuppressants. Hence, there is an ongoing concern over the impact of COVID-19 on IBD patients and their susceptibility to it. So far, there are about 1439 IBD patients in the Surveillance Epidemiology of Coronavirus under Research Exclusion (SECURE-IBD) registry reported to be infected with SARS-CoV-2. There are many unique challenges and dilemmas that need to be taken into account when managing an IBD patient with COVID-19. The management of each patient should be individualized. The IBD societies and experts have strongly recommended that patients should not discontinue their IBD medications. If the patients have symptoms of COVID-19 or IBD flare-up, they are recommended to call their IBD physician first to discuss their medication. In addition, IBD patients are urged to practice social distancing strictly to minimize the chances of infection. As COVID-19 is rapidly evolving, our experience and understanding of its impact on the IBD population may potentially change in the near future.
Assuntos
Adenocarcinoma/secundário , Hemorragia Gastrointestinal/patologia , Neoplasias Pulmonares/patologia , Melena/patologia , Neoplasias Gástricas/secundário , Adenocarcinoma/complicações , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Melena/etiologia , Pessoa de Meia-Idade , Neoplasias Gástricas/complicações , Trato Gastrointestinal Superior/patologiaRESUMO
The indications for endotracheal intubation (ETI) during an esophagogastroduodenoscopy (EGD) procedure remain unclear. This study performed a descriptive analysis of patients who underwent prophylactic tracheal intubation during or before an EGD to prevent pulmonary aspiration. We selected patients with an upper gastrointestinal bleed in an intensive care unit who underwent EGD between 2000 and 2013. Eighty-nine patients who underwent pre-EGD tracheal intubation were analyzed. The main outcomes in this study were pulmonary aspiration, length of stay, and mortality. The average age of patients undergoing pre-EGD intubation was 61 years. The incidence of pulmonary aspiration was 38% in patients who underwent pre-EGD tracheal intubation. The patients requiring tracheal intubation had a mortality rate of 22% during hospitalization. Other complications in pre-EGD ETI patients included myocardial infarction (9%), acute respiratory distress syndrome (10%), and pulmonary edema (7%). In conclusion, the incidence of pulmonary aspiration with pre-EGD tracheal intubation in our patients was high (38%). Cardiopulmonary complications including myocardial infarction, acute respiratory distress syndrome, and pulmonary edema were high in intubated patients.
RESUMO
Gallbladder (GB) carcinomas are adenocarcinomas (AC) in the majority of cases. Adenosquamous carcinoma (ASC) and pure squamous cell carcinoma (SCC) of the gallbladder are rarely encountered and comprise 1-3% of gallbladder cancer cases. Pure squamous cell carcinoma of the gallbladder is rarer with less than 1% of the incidence. Most of the published literature is based on case reports and case series. The survival rates of ASC and SCC of the gallbladder are significantly lower (mean of five months) compared to the AC of the gallbladder (mean survival of 11.4 months). Most of these lesions are advanced at presentation, rendering them unresectable and resulting in a poor prognosis. However, if the lesions are diagnosed at an early stage, they could potentially be resectable. We report one such rare case of pure SCC GB presenting as a hepatic mass. The patient subsequently underwent resection of the gallbladder and liver mass with complete recovery and is currently planned for chemotherapy and radiation treatment.
RESUMO
Cholangiocarcinoma offers poor prognosis. Infrequent sites of metastasis are poorly described and often diagnostically delayed or missed. Bile duct brush cytologies provide poor diagnostic sensitivity/specificity. We present an unusual case of cholangiocarcinoma in a 34-year-old woman with rare distant metastasis to the psoas muscle and urinary bladder. It is the first case of metastatic cholangiocarcinoma presenting as linitis plastica, and our patient is the youngest to be described with metastatic cholangiocarcinoma to the psoas muscle leading to diagnosis. We conclude that seemingly idiopathic biliary strictures that fail to respond to testing should prompt alarm and referral for cholangioscopy, where available.
RESUMO
Mushroom poisoning is common in the United States. The severity of mushroom poisoning may vary, depending on the geographic location, the amount of toxin delivered, and the genetic characteristics of the mushroom. Though they could have varied presentation, early identification with careful history could be helpful in triage. We present a case of a 69-year-old female of false morel mushroom poisoning leading to hepatotoxicity with painless jaundice and biochemical pancreatitis.