Filter by keywords:



Filtering documents. Please wait...

21/153. Therapeutic approaches to anergy in surgical patients. Surgery and levamisole.

    skin tests (ST) in 1332 patients are associated with increased morbidity from sepsis. patients with normal skin tests had a 7% major sepsis rate and 2% mortality rate. Thirty-six per cent of anergic (A) patients and 21% of relatively anergic (RA) patients died; 52% of A patients and 34% of RA patients had sepsis. These data include all patients studied and represent their worst skin test. Two studies were done. The first was a retrospective evaluation of effect of surgery upon 49 anergic patients with biliary tract disease, colon cancer, bowel obstruction, hypovolemia and visceral abscesses. The patients did not receive total parenteral nutrition (TPN). The data show that surgery without TPN can reverse the anergic state and did so in 84% of patients reported. The second study was a prospective, double-blind, randomized trial of the effect of levamisole on skin tests, neutrophil chemotaxis (CTX), sepsis and mortality iin 39 preoperative anergic patients. Major sepsis was significantly increased in placebo group (p less than 0.05). mortality, minor sepsis, restoration of skin tests and chemotaxis were somewhat better in levamisole patients but not statistically so. These studies show that in addition to TPN, surgery and immunorestorative drugs are viable approaches to the management of selected anergic patients.
- - - - - - - - - -
ranking = 1
keywords = cancer
(Clic here for more details about this article)

22/153. Gastric stromal tumor--a rare cause of an upper gastrointestinal bleeding.

    gastrointestinal stromal tumors (GISTs) are rare neoplasms arising from connective tissue elements of the gastrointestinal wall. They show a great heterogeneity with respect to their histogenetic, morphologic and prognostic characteristics. GISTs are known with myoid, neural or mixed features of differentiation. Clinical findings are gastrointestinal bleeding, abdominal pain and weight loss. We report on the case of a 50-year-old male patient who presented with melena and acute anemia (hemoglobin 10.5 g/dl). Esophagogastroduodenoscopy revealed a broad-based, centrally ulcerated polypoid formation of 3 cm in the gastric corpus as the cause of the upper gastrointestinal bleeding. Multiple endoscopic biopsies were negative for neoplastic changes. Because of no tendency of healing after triple eradication therapy of helicobacter pylori and following proton pump inhibitor medication, the patient underwent distal gastrectomy with gastrojejunostomy. GIST of combined smooth muscle and neural type was diagnosed by histological and immunohistochemical examination. The features with increased mitotic activity and cellularity were those of a borderline stromal tumor. 6 months after surgery the patient is well with no signs of residual malignancy. This case demonstrates that rare stromal neoplasms have to be taken into account in the differential diagnosis of gastrointestinal tumors even if endoscopic biopsies are negative for neoplastic changes. Because of the uncertain biological behavior of the GISTs an early surgical intervention is recommended.
- - - - - - - - - -
ranking = 1.027670980447
keywords = neoplasm
(Clic here for more details about this article)

23/153. Penile metastasis from rectal carcinoma.

    We are presenting a 65-year old patient with metastatic carcinoma of the penis which was discovered 19 months after abdomino-perineal resection for rectal cancer (Duke A). There was also metastasis in the perineum and one rib. Penile biopsy and cavernosography were carried out and established the metastatic nature. The patient declined further therapy and died 5 months after diagnosis.
- - - - - - - - - -
ranking = 1
keywords = cancer
(Clic here for more details about this article)

24/153. A case of parotid mucoepidermoid carcinoma complicated by fatal gastrointestinal bleeding.

    Mucoepidermoid carcinoma is one of the most common of the salivary gland neoplasms. Histologically, it is classified as either a low-, intermediate-, or high-grade tumor, and there are significant differences in prognosis among the different grades. patients with low-grade disease have an excellent chance of survival. High-grade tumors behave aggressively, and they frequently manifest as local recurrences and distant metastases. We describe a case of a high-grade mucoepidermoid carcinoma of the parotid gland that had metastasized to the skin, stomach, and liver. The disease culminated in a rapidly fatal bleeding from the stomach metastasis. Such a complication is unusual and to our knowledge has not been previously reported. We briefly discuss the clinical features, biologic behavior, and treatment of this tumor.
- - - - - - - - - -
ranking = 0.51383549022351
keywords = neoplasm
(Clic here for more details about this article)

25/153. Neuroendocrine pancreatic carcinoma causing sinistral portal hypertension.

    BACKGROUND: Non-functioning neuroendocrine pancreatic tumors are usually connected with non-specific syndromes. CASE REPORT: This case history presents the diagnosis and treatment of a non-functioning neuroendocrine pancreatic tumor causing sinistral portal hypertension and gastrointestinal bleeding in a 36-year-old man. RESULTS: A peripheral resection of the pancreas with splenectomy was performed. Intraoperative examination of the specimen revealed a malignant neoplasm, probably neuroendocrinal carcinoma. CONCLUSIONS: Peripheral resection of the pancreas with splenectomy treats not only the symptoms of segmental portal hypertension caused by pathology of this organ, but also allows the etiology of the disease to be determined.
- - - - - - - - - -
ranking = 0.51383549022351
keywords = neoplasm
(Clic here for more details about this article)

26/153. Primary gastric choriocarcinoma: a case report and review of the literature.

    choriocarcinoma is a rapidly invasive, widely metastatic human chorionic gonadotropin (HCG)-producing neoplasm, usually intrauterine and gestational. Primary gastric choriocarcinoma is very rare, and its pathogenesis is still uncertain. We report a case of primary gastric choriocarcinoma associated with adenocarcinoma in a 36-year-old woman. The patient presented with gastrointestinal bleeding and a gastric mass clinically suspicious of gastric adenocarcinoma. Histopathologic evaluation proved the tumor to be a choriocarcinoma, with a minor component of a poorly differentiated adenocarcinoma. The patient was treated with a standard nongestational choriocarcinoma chemotherapy regimen. An impressive initial response was evidenced by clinical reduction of the tumor volume and drop of the serum beta-HCG levels after the first cycle. However, the tumor rapidly recurred in the abdomen and disseminated to the lungs, which were documented by new elevation of serum beta-HCG levels and computed tomographic scans despite continuing with 3 more cycles of chemotherapy. The patient died 6 months after diagnosis.
- - - - - - - - - -
ranking = 0.51383549022351
keywords = neoplasm
(Clic here for more details about this article)

27/153. Ruptured esophageal varices caused by metastatic liver tumors.

    We herein report a case of a 50-year-old male with hematemesis due to the rupture from esophageal varices coexisting with multiple liver tumors metastasizing from sigmoid colon cancer. The causal etiology of esophageal varices rupture in the current case was considered to be the intrahepatic portal hypertension brought by the stagnation of the blood flow of the intrahepatic portal vein suppressed by the metastatic liver tumors.
- - - - - - - - - -
ranking = 1
keywords = cancer
(Clic here for more details about this article)

28/153. Gastroduodenal artery stump haemorrhage following pylorus-sparing Whipple procedure: treatment with covered stents.

    BACKGROUND/AIMS: To report a case of bleeding after pancreatoduodenectomy in a patient with pancreatic leak and portal thrombosis who was successfully treated with an endovascular approach. methods: A 58-year-old male, suffering from neoplasm of the distal bile duct, underwent a pylorus-preserving Whipple procedure. On the 18th day, following a sudden drop in pressure and low haematocrit values, the patient underwent surgery. The source of the bleeding was not found. Six days later, following the appearance of bleeding from the abdominal drainage and haematemesis with shock, the patient had an immediate angiography. Bleeding from the gastroduodenal artery stump was evident, the portography showed no portal flow. With respect to the shortness of the stump, safe embolisation with coils, while preserving the common hepatic artery patency, was difficult to obtain. RESULTS: By transcatheter placement of covered stents into the hepatic artery and thereby occluding the origin of the gastroduodenal artery, the bleeding was stopped. After 2 months, CT angiography showed patency of both the common and proper hepatic arteries. Nine months after the procedure the patient is in good health. CONCLUSIONS: Percutaneous placement of covered stents can be the solution in cases where transcatheter embolisation is not recommendable because of portal vein thrombosis.
- - - - - - - - - -
ranking = 0.51383549022351
keywords = neoplasm
(Clic here for more details about this article)

29/153. Esophageal and gastric Kaposi's sarcomas presenting as upper gastrointestinal bleeding.

    Kaposi's sarcoma (KS) is an uncommon malignant neoplasm of mesenchymal tissue that occurs in immunocompromised patients and people of Mediterranean descent. It is most common in males, and skin lesions are usual presentations. However, visceral lesions are common in organ transplant recipients and involve the gastrointestinal tract. Although the gastrointestinal tract is a site for extracutaneous lesions, most lesions are asymptomatic. Herein, a case of a 41-year-old female with cadaveric renal transplantation and immunosuppressive therapy but without human immunodeficiency virus infection is reported. She was admitted due to tarry stool passage and bilateral neck and inguinal lymph node enlargement. Esophagogastroduodenoscopy revealed multiple grayish-purple plaques in the esophagus and stomach with active oozing from one of the stomach lesions. Histological examination demonstrated characteristic spindle cell stroma and vascular slits with hemorrhage. Furthermore, KS was the impression. The site of gastric bleeding produced by KS was injected locally with bosmin 1:10,000, and heat probe coagulation was performed. No further bleeding was discovered during follow-up. Following modification of the immunosuppressive therapy regimen, the lesions disappeared.
- - - - - - - - - -
ranking = 0.51383549022351
keywords = neoplasm
(Clic here for more details about this article)

30/153. A case of haemorrhagic radiation proctitis: successful treatment with argon plasma coagulation.

    argon plasma coagulation (APC) has been used extensively for a wide range of indications in gastrointestinal endoscopy. We describe a case of haemorrhagic radiation proctitis treated successfully with APC. A 54-year-old Japanese woman presented with daily rectal bleeding 4 months after cessation of radiotherapy for uterine cancer. Colonoscopic examination showed friable bleeding teleangiectasias in the rectum. Her haemoglobin level was decreased to 5.4 g/dl, requiring frequent blood transfusions. Endoscopic APC set at 1.2 l/min and 45 W was applied. After four treatment sessions without any complications, the patient showed complete resolution of haematochezia and subsequent haematological improvement. Standard and magnifying endoscopic follow-up revealed complete eradication of the vascular lesions and cicatrization of the treated areas, and mucosal covering with normal crypt lining. Endoscopic APC is an effective and well-tolerated treatment modality for the management of haemorrhagic proctitis.
- - - - - - - - - -
ranking = 1
keywords = cancer
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Gastrointestinal Hemorrhage'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.