1/47. Dieulafoy's lesion of the jejunum.Dieulafoy's lesion is a rare vascular anomaly but a potentially life-threatening disease. This lesion can also be found in the small intestine, which can be diagnosed only by angiography. However, the angiography may be normal when the bleeding is inactive. We report a case of jejunal Dieulafoy's lesion with a repeated attack of massive gastrointestinal bleeding with a normal initial angiography. The pathological examination found an unusual picture as a dilated submucosal vessel protruded like a submucosal tumor.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
2/47. Novel gastrointestinal tract manifestations in juvenile dermatomyositis.We report a case of juvenile dermatomyositis in which a dilated atonic esophagus was associated with delayed gastric emptying and intestinal mucosal thickening, resulting in a radiographic "stacked coin" appearance. These findings, which can also occur in infectious, neoplastic, or other immune-mediated diseases, broaden the spectrum of gastrointestinal tract manifestations in juvenile dermatomyositis. physicians should be alert for these treatable manifestations in children with myositis who present with unexplained gastrointestinal symptoms, which are reversible with immunosuppressive therapy.- - - - - - - - - - ranking = 0.5keywords = mucosa (Clic here for more details about this article) |
3/47. Recurrent pancreatitis in a child with pancreas divisum. Endoscopic therapy of a Santorinicele.pancreas divisum is a rare congenital anomaly of the pancreatic ducts that has been implicated in pancreatitis. In addition, the finding of a Santorinicele, which is a cystic dilatation of the dorsal duct, suggests that there is an obstruction associated with a congenital or acquired weakness of the mucosa. We used an endoscopic technique to treat a child with recurrent pancreatitis who was found to have pancreas divisum and a large Santorinicele.- - - - - - - - - - ranking = 0.5keywords = mucosa (Clic here for more details about this article) |
4/47. Synchronous carcinoma of the gallbladder in a patient with intrahepatic bile duct carcinoma.An 83-year-old woman, diagnosed as having cholelithiasis, was admitted to the Department of Surgery, Nippon Medical School, with right hypochondrial pain. ultrasonography and computed tomography revealed a mass in the gallbladder fundus and a hypovascular tumor in the anterior segment of the liver. magnetic resonance imaging showed stenosis of the intrahepatic bile duct and dilatation of its proximal portion. She was diagnosed as having intrahepatic bile duct carcinoma combined with gallbladder carcinoma. At laparotomy, there was evidence of multiple peritoneal metastases and intraoperative histological examination of the gallbladder tumor revealed adenocarcinoma. Accordingly, only cholecystectomy and needle biopsy of the liver tumor was performed. Histological examination of the gallbladder revealed papillary adenocarcinoma invading the muscularis propria with medullary growth or intermediate stroma. There was no microvessel invasion, no perineural invasion and no lymph node involvement. On the other hand, the liver tumor was a cholangiocarcinoma with a well-differentiated tubular pattern. Therefore, this was a rare case of synchronous carcinoma of the gallbladder associated with intrahepatic bile duct carcinoma.- - - - - - - - - - ranking = 8.0574744403763keywords = muscularis (Clic here for more details about this article) |
5/47. Spontaneous necrosis of gallbladder carcinoma in patient with pancreaticobiliary maljunction.While gallbladder carcinoma is occasionally associated with pancreaticobiliary maljunction, spontaneous necrosis of carcinoma is extremely rare. We herein present a case of spontaneous necrosis of gallbladder carcinoma associated with direct invasion of viable cancer cell nests to the muscularis propria and subserosal layer located beneath the primary nodules. A 65-year-old Japanese man was admitted to a local hospital, complaining of repeated discomfort in the right hypochondrium. ultrasonography and computed tomography scanning revealed cholecystitis associated with gallstones. cholecystectomy was performed, and operative cholangiography demonstrated pancreaticobiliary maljunction. The resected gallbladder showed multiple mixed stones filled with necrotic debris and bile sludge. Scrutiny of the mucosal surface revealed multiple small necrotic nodules in the fundus, which were histologically confirmed to be necrotic remnants of a cancerous glandular structure. Small nests of papillary adenocarcinoma were found beneath the nodules in the muscularis propria and in the venous structure located in the connective tissues next to the divided margin of the gallbladder bed. Resection of S4a and S5 of the liver and resection of the extrahepatic bile duct was then performed to remove the remaining cancerous tissues and/or micrometastasis in the liver and bile duct. The biliary tree was reconstructed with a hepaticoduodenostomy. No cancer nests or any precancerous lesions were found in the additionally resected specimens. This case indicates a unique morphological feature of gallbladder carcinoma associated with pancreaticobiliary maljunction, which provides some insight into the pathogenesis of spontaneous necrosis of gallbladder carcinoma.- - - - - - - - - - ranking = 16.614948880753keywords = muscularis, mucosa (Clic here for more details about this article) |
6/47. Pneumosinus dilatans multiplex, mental retardation, and facial deformity.Pneumosinus dilatans is a term used to describe enlargement of one or more paranasal sinuses without radiological evidence of localized bone destruction, hyperostosis, or mucous-membrane thickening. To date, many cases have been reported that involved frontal, ethmoid, sphenoid, and maxillary sinus. However, no case has been reported that involved all paranasal sinuses. Our case involved mastoid air cells as well as all paranasal sinuses. It is named pneumosinus dilatans multiplex by us. This is the first case to be reported in English literature that has this syndromic condition of pneumosinus dilatans multiplex, mental retardation, and facial deformity.- - - - - - - - - - ranking = 0.037496701158566keywords = membrane (Clic here for more details about this article) |
7/47. Pneumosinus dilatans of the frontal and ethmoidal sinuses: case report.Enlargement of paranasal sinuses with air is rare with less than 50 cases reported in the medical literature. This craniofacial malformation was first described by Meyes in 1898 and its aetiology still remains unknown. Local pain, ocular alterations, anosmia, headache and cosmetic disturbances are the most common symptoms. We present a case of pneumosinus dilatans diagnosed in a male, 8 years of age. He presented with left fronto-orbital bossing that enlarged slowly until he was 12 years old, at which point its growth appeared to increase dramatically. Computerized tomography revealed an enlargement of the frontal and ethmoidal sinuses, with marked deformation of the anterior wall and of the roof of the left frontal sinus, as well as the roof of the ethmoid and upper sinus medial orbital wall. The sinus walls were of normal thickness. Access was via a bicoronal incision and osteotomy of the deformed fronto-orbital bossing. Reconstruction was undertaken with a periosteal flap and hydroxyapatite bone cement (Norian) following sinus mucosal stripping and obliteration of the sinus with fat. Six months postoperatively, the patient was without recurrence and had a good cosmetic result.- - - - - - - - - - ranking = 0.5keywords = mucosa (Clic here for more details about this article) |
8/47. Massive bleeding from Dieulafoy's lesion of the small intestine in a child--therapy for the bleeding from gastrointestinal tract out of endoscopic observation.Dieulafoy's lesion is recognized as a submucosal artery associated with a minute mucosal defect and a rare cause of severe gastrointestinal hemorrhage. Especially, that of distal jejunum or ileum is extraordinarily rare. It is very difficult to detect the lesion in these parts. We experienced massive bleeding from Dieulafoy's lesion of the distal jejunum in a 12-year-old girl. Preoperative angiography and intraoperative palpation detected the point of bleeding. She was rescued by partial jejunectomy. Compiled reports suggested that careful palpation was useful for detection of the location of the bleeding point, which was enhanced as vascular dilatation by the angiogram, during the operation comparatively.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
9/47. Segmental dilatation of the ileum presenting with acute intestinal bleeding.The authors report a case of acute intestinal bleeding caused by ulcerated segmental ileal dilatation occurring in a 5-month-old infant. The profuse emission of dark red blood per rectum caused acute anemia (Hb 5.3 g/dL). Because of absence of any other sign and symptom and normal plain x-ray, a bleeding Meckel's diverticulum was suspected. laparoscopy was performed showing the ileal dilatation, and through an enlarged port incision the bowel was exteriorized and resected. histology results showed an ulcer caused by heterotopic gastric mucosa. The etiopathogenesis and clinical manifestations of segmental intestinal dilatation are discussed.- - - - - - - - - - ranking = 0.5keywords = mucosa (Clic here for more details about this article) |
10/47. Uveal effusion and angle-closure glaucoma in primary pulmonary hypertension.PURPOSE: To report a patient with uveal effusion and intermittent angle-closure glaucoma associated with primary pulmonary hypertension. methods: Observational case report. RESULTS: A 78-year-old woman with primary pulmonary hypertension noticed pain and decreased vision in her right eye. Ocular examination disclosed excessive dilation of conjunctival and episcleral veins and uveal effusion with annular ciliochoroidal detachment in both eyes. The right eye revealed corneal edema with folds in the descemet membrane, congested iris vessels, and a markedly shallow anterior chamber with a partially closed angle, corresponding to a recent attack of angle-closure glaucoma. Systemic treatment of her congestive heart failure with an angiotensin-II receptor antagonist resulted in a partial resolution of the uveal effusion and complete normalization of the anterior chamber depth. CONCLUSION: Primary pulmonary hypertension may cause uveal effusion, leading to a forward displacement of the lens-iris diaphragm and intermittent angle-closure glaucoma.- - - - - - - - - - ranking = 0.037496701158566keywords = membrane (Clic here for more details about this article) |
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