RESUMEN
BACKGROUND: Recent advances in colonoscopy have resulted in an increasing number of endoscopic resections of colorectal neoplasms. However, endoscopic resection of submucosal invasive cancer remains a controversial issue. METHODS: The subjects for this study were the surgically treated patients with submucosal invasive colorectal cancer. These patients were classified into two groups: those with versus those without preoperative endoscopic resection. Clinicopathologic features and prognosis were compared and analyzed. RESULTS: Fifty patients underwent surgery for submucosally invasive colorectal cancer. Numbers of patients with and without preoperative endoscopic resection were 22 and 28, respectively. In 36.4% of the patients, endoscopic resections were incomplete. Two patients in whom the preoperative endoscopic resections had revealed a positive cancer margin, had nodal metastasis. One of these patients also developed hepatic metastasis. Endoscopic findings such as diameter and shape were not indicative of either lymphatic or vascular invasion. There were no morbidities or mortalities associated with endoscopic resection or surgery. CONCLUSIONS: Preoperative endoscopic resection for colorectal submucosal cancer is feasible, provided the resection is complete. The indications for surgical treatment should be determined after pathologic examination.
Asunto(s)
Neoplasias Colorrectales/cirugía , Endoscopía/métodos , Estudios de Casos y Controles , Colon/patología , Colonoscopía , Neoplasias Colorrectales/patología , Estudios de Factibilidad , Femenino , Humanos , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Invasividad NeoplásicaRESUMEN
Appendico-vesical fistula is a rare condition. In total, 109 cases, most secondary to appendicitis, have been reported in the English-language literature. We report the first case, to our knowledge, of appendico-ileo-vesical fistula secondary to appendiceal diverticulitis. An enterovesical fistula was diagnosed by urine culture, cystoscopy, and computed tomography. The locations of enteric opening sites were demonstrated by barium enema and colonoscopy. Ileocecal resection and fistulectomy with primary reconstruction were performed. We believe that accurate pre- and intra-operative diagnosis is essential for cure. This case demonstrates the importance of barium enema and colonoscopic examinations in the diagnosis and treatment of complicated enterovesical fistula.
Asunto(s)
Apéndice/cirugía , Íleon/cirugía , Fístula Intestinal/diagnóstico , Fístula Intestinal/cirugía , Fístula de la Vejiga Urinaria/diagnóstico , Fístula de la Vejiga Urinaria/cirugía , Vejiga Urinaria/cirugía , Adulto , Anastomosis Quirúrgica/métodos , Colonoscopía , Diverticulitis del Colon/complicaciones , Diverticulitis del Colon/diagnóstico , Estudios de Seguimiento , Humanos , Fístula Intestinal/etiología , Imagen por Resonancia Magnética , Masculino , Resultado del Tratamiento , Fístula de la Vejiga Urinaria/etiologíaRESUMEN
We present a non-icteric case, in which an ampullary polypoid lesion was clearly demonstrated by ultrasonography, suggesting carcinoma of the ampulla of Vater. The lesion was a 3 cm in diameter, spherical tumor with a polypoid surface, and internal hyperechogenicity. The patient underwent a curative pylorus-preserving pancreaticoduodenectomy.
Asunto(s)
Adenocarcinoma Papilar/diagnóstico por imagen , Ampolla Hepatopancreática/diagnóstico por imagen , Neoplasias del Conducto Colédoco/diagnóstico por imagen , Adenocarcinoma Papilar/patología , Adenocarcinoma Papilar/cirugía , Anciano , Neoplasias del Conducto Colédoco/patología , Neoplasias del Conducto Colédoco/cirugía , Femenino , Humanos , UltrasonografíaRESUMEN
A 30 year old female was admitted with right upper abdominal pain and fever. Ultrasonography and computed tomography revealed a large cystic mass in the right lobe of the liver, and aspiration bacteriology was negative. A right hepatic lobectomy was performed for a suspected cystadenocarcinoma, however, the tumor was histologically diagnosed as a hemangiopericytoma with prominent venous invasion. The patient died within a short time of multiple pulmonary metastases. Primary hepatic hemangiopericytoma is extremely rare, and according to our research, this is only the 4th case reported in the literature.