RESUMEN
Lymphangiomyomyoma is a tumor of lymphatic channels and lymph nodes, clinically manifested by recurrent chylous pleural effusions and ascites. The disease is usually progressive and unresponsive to surgery, chemotherapy, or irradiation. A case of lymphangiomyomatosis in a 24-year-old woman who presented with chylous ascites is described. The patient was treated with dietary fat restriction supplemented with medium chain triglycerides and has remained free of recurrent effusions for 2 years.
Asunto(s)
Ascitis/dietoterapia , Ascitis Quilosa/dietoterapia , Grasas de la Dieta/uso terapéutico , Linfangioma/dietoterapia , Triglicéridos/uso terapéutico , Adulto , Ascitis/etiología , Ascitis Quilosa/etiología , Femenino , Humanos , Linfangioma/complicaciones , Linfangioma/patología , Remisión EspontáneaRESUMEN
Transjugular liver biopsy was attempted in 32 cases of hepatocellular dysfunction with hemocoagulation disorders, ascites or marked obesity. A catheter was inserted in the right internal jugular vein and advanced into a hepatic vein under fluoroscopic control. A long needle was passed through the catheter and into the liver parenchyma for the biopsy. Diagnostic specimens were obtained in 28 instances (88%). The procedure was always well tolerated and no complications occurred. The transjugular approach offers a safe, practical alternative for liver biopsy in cases where direct percutaneous puncture is contraindicated.
Asunto(s)
Biopsia con Aguja/métodos , Venas Yugulares , Hígado/patología , Biopsia con Aguja/efectos adversos , Biopsia con Aguja/instrumentación , Cateterismo/instrumentación , Cateterismo/métodos , Estudios de Evaluación como Asunto , HumanosRESUMEN
A case of pancreatic carcinoma, presenting with the uncommon initial manifestation of vomiting secondary to duodenal obstruction without jaundice, is reported. A review of 72 consecutive biopsy-proven cases of pancreatic carcinoma admitted to our institution in the past five years revealed an 8.3% incidence of this unusual primary complaint. Although infrequently reported previously, pancreatic carcinoma should be considered in the differential diagnosis of gastric outlet obstruction in the absence of jaundice. The classic triad of progressive jaundice, weight loss and abdominal pain suggests carcinoma of the head of the pancreas. Emesis, secondary to high grade duodenal obstruction in the absence of jaundice, is an infrequent clinical presentation. The case described is illustrative of widespread pancreatic carcinoma that remained silent until obstruction developed.