RESUMEN
The authors report their experience of 8 cases of congenital cysts of the liver describing instrumental examinations used for diagnosis and different surgical operation performed. The Authors believe that the choice of surgical procedure, performed in symptomatic patients and large cysts, has to be according to different parameters as morphology and localization of the cysts and coexisting pathologies. Being non-malignant pathology, conservative surgery often avoids the complications of liver resection.
Asunto(s)
Quistes/congénito , Quistes/cirugía , Hepatopatías/congénito , Hepatopatías/cirugía , Adulto , Anciano , Biopsia con Aguja , Quistes/diagnóstico , Femenino , Hepatectomía , Humanos , Hígado/diagnóstico por imagen , Hígado/patología , Hepatopatías/diagnóstico , Masculino , Persona de Mediana Edad , Radiografía , UltrasonografíaAsunto(s)
Divertículo Esofágico/complicaciones , Trastornos de la Motilidad Esofágica/complicaciones , Reflujo Gastroesofágico/complicaciones , Divertículo Esofágico/fisiopatología , Trastornos de la Motilidad Esofágica/fisiopatología , Femenino , Reflujo Gastroesofágico/fisiopatología , Humanos , Masculino , Manometría , Persona de Mediana EdadRESUMEN
Twelve partially gastrectomized subjects who have consecutively undergone total biliary diversion for severe bilious vomiting were studied before and after operation in order to assess the effects of surgery on gastric histology and enterogastric reflux. Before and six months after operation, the following protocol was performed: (1) blood examinations including serum basal gastrin; (2) endoscopy with multiple gastric biopsies; and (3) quantitation of bile acids in the gastric aspirate. Of the preoperative symptoms, bilious vomiting and heartburn completely disappeared postoperatively in all the subjects. Fasting bile reflux was significantly reduced (bile reflux was annulled in six and considerably lowered in the remaining six subjects), and erythema of the gastric mucosa completely disappeared in all the subjects after diversion. Among histological findings, while a significant regression of foveolar hyperplasia was found both in the perianastomotic area and in the body of gastric remnant, none of the other aspects identifiable in postgastrectomy gastric mucosa (chronic gastritis changes included) were affected by diversion. These results show that biliary diversion is effective in correcting reflux, bilious vomiting, erythema, and foveolar hyperplasia of the gastric mucosa and confirm the suggested relationship between bile reflux and gastric foveolar hyperplasia.
Asunto(s)
Procedimientos Quirúrgicos del Sistema Biliar , Gastrectomía , Gastritis/etiología , Complicaciones Posoperatorias/etiología , Adulto , Reflujo Biliar/complicaciones , Femenino , Mucosa Gástrica/patología , Gastritis/cirugía , Gastroscopía , Humanos , Hiperplasia/patología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/cirugíaAsunto(s)
Angina de Pecho/diagnóstico , Dolor en el Pecho/diagnóstico , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Enfermedades del Esófago/complicaciones , Unión Esofagogástrica , Femenino , Reflujo Gastroesofágico/complicaciones , Humanos , Masculino , Manometría , Persona de Mediana Edad , Monitoreo FisiológicoRESUMEN
A case of a variety of Ehlers-Danlos syndrome (EDS) type IV presenting with haematemesis and melaena and symptoms of gastro-esophageal reflux is described. At referral, the manometric esophageal findings similar to scleroderma and the abundant gastroesophageal reflux seemed noteworthy. 3 years after surgery, bleeding and reflux symptoms appeared, perfectly cured by a total biliary diversion operation. The reported case suggests that patients with EDS type IV especially when presenting with haematemesis and melaena should be investigated for reflux, since bleeding might be due to the action of reflux on the fragile-walled vessels of such patients.