Cases reported "Stomach Ulcer"

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1/18. Metastasis of an esophageal carcinoma to a giant gastric ulcer.

    In patients with esophageal carcinoma it is considered that stomach metastasis is induced mainly via the lymphatic route rather than via the bloodstream route that is common in other types of distant organ metastasis. A 56 year-old patient is reported who underwent synchronous subtotal esophagectomy and total gastrectomy for a middle third esophageal carcinoma and a giant peptic ulcer within the gastric fundus. The final histopathologic examination revealed a squamous cell carcinoma of the esophagus with concomitant squamous tumor implantation within the gastric ulcer. The increased cell proliferation in the ulcer margin can serve as a "biological background or base" for implantation.
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2/18. Chronic gastritis and helicobacter pylori.

    helicobacter pylori is the major cause of chronic gastritis. The predominant anatomic distribution of the gastritis is antral in the majority of individuals. In a small minority, the corpus is predominantly involved. The former pattern is associated with duodenal ulceration in some patients, but the majority of those infected never develop either symptoms or disease. The latter form is associated with the development of gastric ulcer and carcinoma and may be protective against the development of Barrett's esophagus. It is the physiological changes associated with the histological changes and the, as yet poorly, defined host response, which are of paramount importance in determining the evolution of a disease or whether the infected individual remains asymptomatic and disease free. This article addresses the various relationships between H. pylori infection, histology, gastric physiology, and disease.
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3/18. carcinosarcoma of the stomach.

    In the gastrointestinal tract, carcinosarcomas are most frequently seen in the esophagus. carcinosarcoma in the stomach is a rare tumor. We report a carcinosarcoma of the antrum of stomach. The tumor was polypoid and exophytic in appearance and located in the antrum. Immunohistochemical studies showed positivity for cytokeratin, epithelial membrane antigen and cytoplasmic carcinoembryonic antigen in the epithelial component. Positive staining with vimentin, desmin and focal smooth muscle actin and negative staining with chromogranin were observed in spindle cells. Nuclear positive staining was observed with p53 and Ki-67 in both glandular and spindle atypical cells.
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4/18. Coexistent multiple adenocarcinomas arising in Barrett's esophagus 23 years after total gastrectomy and esophageal small cell carcinoma.

    A 69-year-old Japanese man undergoing total gastrectomy for multiple gastric ulcers at age 46 was found endoacopically to have multiple esophageal cancers in the upper, mid, and lower esophagus. Esophageal mucosa associated with tumors was replaced with columnar epithelium. He underwent total esophagectomy combined with laryngectomy, pharyngectomy, and lymph node dissection using the large bowel for reconstruction. The resected esophagus had multiple cancers, including well-differentiated adenocarcinoma, poorly differentiated adenocarcinoma, and small-cell carcinoma. Barrett's mucosa consisted mainly of specialized columnar epithelium while both junctional and fundic Barrett's epithelium was observed partially but not clearly. This case is indicative of the high and totipotential carcinogenetic risk of Barrett's epithelium and the relationship between duodenal content reflux and esophageal carcinogenesis after total gastrectomy.
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keywords = esophagus
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5/18. Acute oral selenium intoxication with ten times the lethal dose resulting in deep gastric ulcer.

    A 48-year-old woman presented after taking 2000 mg of selenium dioxide, corresponding to 10 times the experimental lethal dose in animals. She presented with mildly altered consciousness and hematemesis. endoscopy revealed mucosal damage throughout the oral cavity, esophagus, and stomach. There was no evidence of perforation. After intubation and gastric lavage, hemodialysis was performed. The patient was discharged uneventfully on the 16(th) day. This case highlights a very rare acute selenium intoxication. serum and urinary selenium levels and serum glutathione peroxidase activities during the patient's course were followed, as well as the mucosal corrosive damage caused by the selenium.
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keywords = esophagus
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6/18. Oesophageal candidiasis after omeprazole therapy.

    Oesophageal candidiasis was diagnosed incidentally at endoscopy in two patients receiving omeprazole therapy. There were no other predisposing factors for the development of candidiasis. The infection was resolved rapidly by anti-candidal therapy and by stopping omeprazole. These findings suggest that gastric acid secretion and physiological reflux of acid into the oesophagus may play a protective role in preventing candida infection.
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7/18. granular cell tumor of the esophagus--report of a case and review of the literature.

    We report herein a case of a 46 year old man presenting with a gastric ulcer in whom an endoscopy happened to detect an elevated lesion in the lower esophagus. Endoscopic biopsy proved sufficient for determining the diagnosis of a granular cell tumor (GCT). Electron and microscopic studies suggest that GCT are derived from schwann cells. Although commonly found in the tongue and skin, GCT are rarely seen in the gastrointestinal tract, especially in the esophagus. However, advances in endoscopic techniques will increase the opportunity of detecting GCT of the esophagus.
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ranking = 7
keywords = esophagus
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8/18. Spontaneous resolution of acid gastric injury.

    While alkali ingestion nearly always injures the esophagus, acid usually spares the esophagus and damages the gastric outlet. Most reported cases of acid gastric injury have required resection. We report a case of acid ingestion managed with parenteral nutrition and histamine blockers in which healing is documented without operation.
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keywords = esophagus
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9/18. Benign peptic ulcers penetrating pericardium and heart: clinicopathological features and factors favoring survival.

    Penetration of the pericardium and heart by benign peptic ulcers is rare. Before 1965 it was almost invariably fatal, but about 20% of recently reported cases have survived. We report 4 representative cases and review 91 additional cases from the literature. The ulcers arose in esophagus, hiatus hernias, abdominal stomach, and near anastomoses, and the predominant predisposing factor was previous surgery to the esophagogastric region. Whereas penetrating esophageal ulcers had a slightly better prognosis than gastric lesions, the principal determinant of clinical presentation, findings, and prognosis was the site of cardiac involvement. The clinicopathological features of pericardial, atrial, and ventricular involvement are distinct. We evaluate the different implications of these features for diagnosis, management, and prognosis and make some tentative recommendations regarding diagnostic procedures and treatment. early diagnosis and prompt surgical intervention are critical to successful treatment of this entity, which may present with predominantly cardiac or gastrointestinal symptomatology.
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keywords = esophagus
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10/18. Nonreflux complications of hiatal hernia.

    patients with massive incarcerated hiatal hernia and no appreciable esophagitis present with a distinctly different clinical picture from those with hiatal hernia and reflux peptic esophagitis. In a recent review, 17 patients were encountered with this problem. The patients were often elderly and presented with the following grave complications: upper gastrointestinal obstruction; upper gastrointestinal bleeding, both acute and chronic, from gastric ulcerations; and perforated gastric ulcerations. In these patients, the surgical approach is better accomplished through the abdominal route. These patients should be distinguished from those with a shortened esophagus resulting from chronic reflux peptic esophagitis who often require thoracotomy for surgical correction.
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