RESUMO
The growing incidence of cystic pancreatic tumours has become a major problem in daily clinical practice. These patients usually undergo follow-up programmes of questionable clinical efficacy that put significant strain on endoscopy units. Safe and effective alternatives to surgery are desperately needed in these cases. The aim of this study was to critically review the utility of ablative therapies in cystic pancreatic tumours.
Assuntos
Técnicas de Ablação , Cisto Pancreático/cirurgia , Endossonografia , Humanos , Cisto Pancreático/diagnóstico por imagemRESUMO
Ménétrier disease is a rare condition of an unknown origin, with a wide spectrum of clinical signs and symptoms at presentation. Diagnosis is made through the combination of clinical, analytical, endoscopic and histological data. Surgery is the classical treatment. However, new medical approaches have emerged.
Assuntos
Anemia Ferropriva/etiologia , Gastrite Hipertrófica/complicações , Anemia Ferropriva/diagnóstico , Gastrectomia , Gastrite Hipertrófica/diagnóstico , Gastrite Hipertrófica/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Syphilis is a chronic systemic infection mainly transmitted through sexual contact that shows a great variety of clinical manifestations. Liver involvement is an unusual complication mainly reported in HIV patients. In this case report we present a case of a 42-year-old immunocompent man with acute cholestatic hepatitis who was finally diagnosed of luetic hepatitis. Liver disease was the only manifestation of syphilis infection difficulty it's diagnostic. We emphasize the importance of including syphilis in the differential diagnosis of abnormal liver function tests in patients at risk of sexually transmitted diseases due to its resolution with appropriate antibiotic treatment.
Assuntos
Hepatite/microbiologia , Sífilis/complicações , Doença Aguda , Adulto , Hepatite/diagnóstico , Humanos , Imunocompetência , Masculino , Sífilis/diagnósticoRESUMO
BACKGROUND: Missed gastric cancer (MGC) is poorly documented in Mediterranean populations. AIMS: (1) To assess the rate, predictors and survival of MGC. (2) To compare MGC and non-MGC tumors. METHODS: This is a retrospective-cohort study conducted at four centers. MGC was defined as cancer detected within three years after negative esophagogastroduodenoscopy. Gastric adenocarcinomas diagnosed between 2008-2015 were included. Patients with no follow-up were excluded. RESULTS: During the study period 123,395 esophagogastroduodenoscopies were performed, with 1374 gastric cancers being diagnosed (1.1%). A total of 1289 gastric cancers were finally included. The overall rate of MGC was 4.7% (61/1289, 3.7-6%). A negative esophagogastroduodenoscopy in MGC patients was independently associated with PPI therapy (pâ¯<â¯0.001), previous Billroth II anastomosis (pâ¯=â¯0.002), and lack of alarm symptoms (pâ¯<â¯0.001). The most frequent location for MGC was the gastric body(52.4%). MGCs were smaller than non-MGCs (31 vs 41 mm, pâ¯=â¯0.047), more often flat or depressed (pâ¯=â¯0.003) and less likely to be encountered as advanced disease. Overall 2-year survival was similar between MGC (34.1%) and Non-MGC (35.3 %) (pâ¯=â¯0.59). CONCLUSION: MGC accounted for nearly five percent of newly-diagnosed gastric adenocarcinomas. Overall survival was poor and not different between MGC and non-MGC.