RESUMEN
BACKGROUND: A strong association has been reported between gallbladder carcinoma, premalignant epithelial or metaplasic inflammatory lesions and cholelithiasis, varying the incidence among different ethnic groups. PURPOSE: To determine the frequency of association between such lesions and gallbladder lithiasis. MATERIAL AND METHODS: We examined histopathologic changes in 1,367 cholecystectomy specimens with (1,096) or without (271) lithiasis and established its frequency of association, correlating with main clinical data. RESULTS: Overall, 80% had lithiasis. In this group, pseudopyloric metaplasia (50%), intestinal metaplasia (16%), low grade dysplasia (40%), high grade dysplasia (16%), carcinoma in situ (1.5%) and invasive carcinoma (2.6%) were observed compared to 25%, 2%, 17%, 2%, 0%, and 0% in the control group. The findings of 80% with lithiasis, 65% with carcinoma in situ and 90% of invasive carcinoma, all were in women. Median age of patients with low and high grade dysplasia, carcinoma in situ and invasive carcinoma was 42, 48, 53 and 61 years, respectively. CONCLUSIONS: Acute and xanthogranulomatous cholecystitis, adenomyomatosis, pseudopyloric and intestinal metaplasia, hyperplastic polyps, low and high grade dysplasia, tubular adenomas, carcinoma in situ and invasive carcinoma were more frequent when cholelithiasis was present (p < .05) than in cases without lithiasis.
Asunto(s)
Adenoma/complicaciones , Carcinoma in Situ/complicaciones , Carcinoma/complicaciones , Colelitiasis/complicaciones , Neoplasias de la Vesícula Biliar/complicaciones , Vesícula Biliar/patología , Lesiones Precancerosas/complicaciones , Enfermedad Aguda , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Adenoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/patología , Carcinoma in Situ/patología , Estudios de Casos y Controles , Niño , Preescolar , Colecistitis/patología , Colelitiasis/patología , Femenino , Neoplasias de la Vesícula Biliar/patología , Humanos , Masculino , Metaplasia/patología , Persona de Mediana Edad , Pólipos/patología , Lesiones Precancerosas/patología , Factores de RiesgoRESUMEN
PURPOSE: To analyse the transseptal catheterization technique, its indications and possible complications. METHODS: The transseptal catheterization has been undertaken in 233 patients, 202 children (aged 0.1 to 16 years) with congenital heart disease and 31 adults (aged 37 to 73 years) submitted to mitral valvuloplasty. The Mullins technique was employed to access left heart chambers. RESULTS: In the pediatric group, the indications for transseptal catheterization were coarctation of the aorta and valvular or subvalvular aortic stenosis. By this technique, multiple diagnostic analysis and therapeutic procedures, such as blade atrioseptostomy and mitral valvuloplasty, became available. Among the complications in the 2 groups, pericardial perforation was the most frequent, depending on the laboratory practice with this technique. CONCLUSION: The transseptal cardiac catheterization is a safe and effective technique to investigate hemodynamic data in several congenital heart diseases and is essential to many therapeutic procedures. The technique has a low incidence of complications when employed by experienced teams.
Asunto(s)
Cateterismo Cardíaco/métodos , Cateterismo , Cardiopatías Congénitas/terapia , Tabiques Cardíacos/cirugía , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Cardiopatías Congénitas/diagnóstico , Hemodinámica/fisiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estenosis de la Válvula Mitral/terapiaRESUMEN
The authors report on two patients with large partial congenital defect of the left pericardium, as observed at post-mortem examination. In both cases, diagnosis was made during life thanks to the clinical syndrome described by Abbott, Sothworth and Stenvenson. In the first case diagnosis was confirmed by pneumothorax proposed by Ellis et al and the second case was recognized by the clinical-radiological syndrome. The first patient was followed until his death. Because of an abnormal echogram, he was submitted to exploratory cardiotomy and small ASD, aneurysmatic dilation of Valsalva sinus and mitral regurgitation by ruptured chordae tendineae were found. The autopsy, besides the findings at the operation, showed residual adhesive pericarditis with a cavity at the postero-superior region of the heart behind the left auricle and a redundant tricuspid cusp. The association of congenital pericardium defect to mitro-tricuspid redundant cusps and aneurysmatic dilatation of the sinus of Valsalva--suggesting myxomatous degeneration--plus atrial septal defect as in case 1, has not been found in the medical literature. In the second patient the defect was recognized in spite of congestive heart failure and severe tricuspid regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Cardiopatías Congénitas/diagnóstico , Pericardio/anomalías , Adulto , Diagnóstico Diferencial , Electrocardiografía , Humanos , Masculino , Pericardio/diagnóstico por imagen , Pericardio/patología , RadiografíaRESUMEN
E descrito um paciente com a forma do "cor-triatriatum" dando enfase aos achados da radiologia simples do torax e da ecocardiografia que ainda nao foram acentuados na literatura. No presente caso foi de fundamental importancia diagnostica uma forma inusitada de crescimento atrial esquerdo, vista na radiografia simples, que poderia ser um elemento utilissimo para o reconhecimento da anomalia