RESUMO
There is great evidence that both gastric lymphoma andadenocarcinoma are related in their pathogenesis to Helicobacter pylori infection.It has been stablished that mucosa associated lymphoid tissue (MALT) is anacquired condition following H. pylorl infection and that B cell gastriclymphoma derives from this cell linage. Low grade MALT lymphoma transformsto high grade lymphoma. Furthermore, MALT B cell lymphoma seems toproliferate in response to an antigenic stimulus provided by T cell line of cells specificately activated by H. pylori. The use of antibiotics in the erradication of H. pylori is considered one of the strongest evidence for this association, based on the remission rates of gastric MALT lymphoma.For adenocarcinoma the rationale is: H. pylori induces chronic superficialgastritis and profound gastritis; the effect of the bacteria itself,nutritional and inmunological factors as well as the asumption of funtionalhyposecretion, could lead to an atrophic phenomena, intestinal metaplasia, dysplasia and finally adenocarcinoma. An hypoclorhidric/aclorhidric condition produced due to atrophy of the mucosa and a relative funtional state, lead to bacterial overgrowth with the subsequente production of N-nitrous compounds, well known because of its mutagenic and carcinogenic effects.Also, the secretion of vitamin C and ascorbic acid which have a protective mechamism against free radicals and decreasing production of N-nitrous compound formation, are afected for H. pylori infection.
RESUMO
We report a clinic-endoscopical study about 365 patients, both of sex, between 26-95 years old, with colonoscopic diagnosis of colorectal cancer. Results showed that 61,92% were men and 38,08% women; in 92,60% the disease ocurred over 40 years old. 13,42% had malignant personal history -colorectal cancer, uterus and breast cancer, and others-; 13,97% had bening personal history-colorectal adenoma, cholecystectomy, and others-; Abdomina pain, change in intestinal habits, and bleeding were the moist frequent symptoms, with differences depending of the tumors localization in the colon or rectum. 62,57% of patients had anemia under 10g% of hernoglobin; in 85,23% the fecal occult blood test was positive. On 199 patients, the simple barium enema diagnosed the tumor in 66,33% only; but in the same group, colonoscopy diagnosed the cancer in 96,49% at first examination. In all patients, colonoscopywas excellent for diagnosis of the principal lesion, and for the identification of synchronous neoplasia. On 365 patients, colonoscopy diagnosed the cancer in 98,08% at first examination. The localization of tumors was: 57,63% in left colon (49,47% in rectum and sigmoid colon); 34,21% in the right colon; and 8,16% in transverse. Pathology showed that adenocarcinoma was the most frequent tumor 95,23%; 1,06% mucoid carcinoma; 1,06% epidermoid carcinoma; and 2,65% lymphorna. In 32,05% of cases there were synchronous lesions; 3,01% had other cancer, and 54 patients had 112 polyps (62,50% adenomatous polyp, 6,25% adenoma with non invasive or invasive adenocarcinoma, and 31,25% hiperplastic polyp. Authors emphasize the value of the detection and early diagnosis to decrese the colorectal cancer mortality.
Assuntos
Colonoscopia , Neoplasias Colorretais/epidemiologia , Dor Abdominal/etiologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adenocarcinoma Mucinoso/diagnóstico , Adenocarcinoma Mucinoso/epidemiologia , Adenocarcinoma Mucinoso/patologia , Adenoma/diagnóstico , Adenoma/epidemiologia , Adenoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bário , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Doenças do Colo/diagnóstico , Doenças do Colo/epidemiologia , Doenças do Colo/patologia , Pólipos do Colo/diagnóstico , Pólipos do Colo/epidemiologia , Pólipos do Colo/patologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/patologia , Doença de Crohn/diagnóstico , Doença de Crohn/epidemiologia , Doença de Crohn/patologia , Divertículo do Colo/diagnóstico , Divertículo do Colo/epidemiologia , Divertículo do Colo/patologia , Humanos , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/epidemiologia , Neoplasias Primárias Múltiplas/patologia , Sangue Oculto , Peru/epidemiologia , Estudos RetrospectivosRESUMO
Achalasia is very uncommon in children. It is still more when it is associated with alacrima and adrenal insufficiency, a disorder known as Allgrove's Syndrome (Triple-A-Syndrome). This paper describes a 21-years-old man with lack of lacrimation, achalasia and glucocorticoid deficiency. Additional features included: Hyperreflexia, pes cavus, muscle weakness, and nasal speech. Indicating that the disorder has a wide spectrum of clinical manifestations. This case has been diagnosed at adulthood.
Assuntos
Insuficiência Adrenal , Síndromes do Olho Seco , Acalasia Esofágica , Adulto , Humanos , Masculino , SíndromeRESUMO
318 adenomatous polyps were removed by colonoscopic polypectomy, from two hundred patients, between 25 to 88 years old; 60.50% men, and 39.50% women. 86.50% of patients were older than 50 years old. In 64.50% of patients the adenomatous polyp was single, and 35.50% had "multiple adenoma"; the lesions distribution was 72.64% in the rectum-sigmoid colon. The grade of dysplasia was severe in adenomas over 20mm, and in those of villous type. The malignant percentage was: 1.61% in the adenomatous polyp under 10mm in diameter, 8.49% in those of 10mm to 19mm, and 30.68% in the adenomas of 20mm or more. The adenocarcinomatous focus increased from 1.69% in the adenomas under 10mm to 58.33% in those of 40mm or more in diameter. The relationship between type of adenomatous polyp and his adenocarcinoma incidence was 7.66% in tubular type, 22.22% in tubular-villous, and 26.32% in villous type. The carcinoma incidence in all of the adenomas of this series was 11.95%.
Assuntos
Adenoma/cirurgia , Neoplasias Colorretais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colonoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
598 colorectal polyps were removed by therapeutic colonoscopy from 377 patients, of both sexes, between 1 and 88 years old, most of them with lower digestive symptoms. The polyps were unique in 67.37% and multiple in 32.63% of patients, and mostly located in rectum and sigmoid colon; 42.14% were pedunculated, 33.95% sessile++/sub-pedunculated, and 23.91% sessile in shape. In 51% the size was over 10 mm in diameter. Histologically, 68.68% were of epithelial neoplastic type: 60.91% adenoma; 6.42% adenoma with adenocarcinoma, and 1.35% polypoid carcinoma. 30.64 were epithelial non-neoplastic type: 20.32% hyperplastic polyp, and 0.51% hyperplastic polyp with tubular adenoma. Two patients (0.53%) had lower digestive hemorrhage immediately after the polypectomy. The complications were controlled with conservative measures without blood transfusion.
Assuntos
Pólipos do Colo/cirurgia , Colonoscopia , Pólipos/cirurgia , Neoplasias Retais/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pólipos do Colo/complicações , Pólipos do Colo/diagnóstico , Colonoscópios , Colonoscopia/estatística & dados numéricos , Feminino , Seguimentos , Hemorragia Gastrointestinal/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/complicações , Pólipos/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Neoplasias Retais/complicações , Neoplasias Retais/diagnósticoRESUMO
Between 1974 and 1992, we perform 3,054 colonoscopies for diagnosis in 2,770 patients, both of sexes, between the ages of 1 and 101 yr, most of them over the fifth decade of life. In 300 procedures the bowel cleansing was made with the standard method of liquid diet and enemas, and in the other 2,754 with the oral administration of saline solution 9% with optimal results. We get the sedation of patients with the intravenous administration of diazepam 10mg, or pethidine 50 mg, or midazolam 2.5 to 5 mg, and in children with ketamine and the anesthesiologist assistance. In 95% of the procedures we can see the cecum and the ileum; the diagnosis was abnormal in 52.78% of cases, normal in 45.20%, and insufficient in 02.02% specially for a bad cleansing of the bowel. In the abnormal group, the most frequent diseases we diagnose were: polyps, cancer, diverticular disease, and specific inflammatory disease of the bowel like TBC, radiation proctosigmoiditis, amebiasis, and non-specific bowel disease: "colitis", ulcerative proctocolitis, erosive colitis, and Crohn's disease. Colonoscopy is a very important method for diagnosis of colon diseases, alone or complementary of double contrast X-ray of the colon.
Assuntos
Doenças do Colo/diagnóstico , Colonoscopia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doenças do Colo/diagnóstico por imagem , Colonoscopia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
23 patients that they swallowed foreign bodies, were treated. There were 16 male and 7 female, between 3 and 85 years old; 6 children and 17 adults. Of all, 7 were psychiatric patients. 15 foreign bodies were removed by upper digestive fiberendoscopy and 2, by procto/colonoscopy, without early nor late complications. 8 foreign bodies were eliminated spontaneously through the rectum/anus. Fiberendoscopy is an excellent method for treatment in these clinical problems.
Assuntos
Sistema Digestório , Endoscopia , Corpos Estranhos/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Tecnologia de Fibra Óptica , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Primary Sclerosing Cholangitis (PSC) is an unusual chronic, cholestatic disease of unknown etiology, more frequently seen in young adults in close relationship with Chronic Ulcerative Colitis. We report the case of a 30 year old woman, coming from the peruvian amazon with PSC associated with Sjögren Syndrome, Chronic Pancreatitis and Retroperitoneal Fibrosis, without colonic involvement. She was treated with external biliary drainage and controlled for 12 months. In this paper, clinical, biochemical, radiological, histological and therapeutic features are reviewed as well as its possible immunologie autoimmune origin.