11/177. Gastric pseudotumor.The authors present a case report of a pseudotumor of the stomach and a brief discussion about this very unusual entity. A 75-year-old female patient was admitted with melena and a large epigastric tumor; she underwent upper gastrointestinal endoscopy, abdominal ultrasound, magnetic resonance imaging, guided needle aspiration and angiography. Preoperative diagnostic hypothesis included a partially thrombosed aneurysm of the splenic artery, pancreatic cystic neoplasm with gastric invasion and pancreatic pseudocyst complicated with hemorrhage. laparotomy revealed a gastric tumor and the patient was submitted to a radical subtotal Billroth II gastrectomy. Only the pathologic examination revealed the unexpected definitive diagnosis of an organized intramural gastric hematoma. There were no postoperative complications and she remains asymptomatic 10 months after surgery.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/177. Recurrent upper gastrointestinal bleeding due to the Dieulafoy's lesion.Dieulafoy's lesion of the gastrointestinal tract, an abnormally dilated artery that penetrates through the mucosa, has been diagnosed more frequently in recent years. Bleeding occurs when the vessel ruptures. Despite widespread awareness of this entity, it remains a diagnostic challenge for gastroenterologists because of its small size and hidden location. Several different diagnostic methods and treatments have been introduced throughout the years. endoscopy plays a major role in diagnosis and therapy. In this case report, the patient was successfully treated endoscopically using epinephrine injection and heater probe thermoco-agulation. The characteristics of the Dieulafoy's lesion, its current diagnosis, treatment, and complications are discussed.- - - - - - - - - - ranking = 4keywords = upper (Clic here for more details about this article) |
13/177. Double pylorus: case report and review of the literature.Double pylorus is an unusual condition in which a double communication between the gastric antrum and the duodenal bulb occurs. It may be congenital, or it may be acquired complication of peptic ulcer disease. We present a case of double pylorus in a gentleman with epigastric pain and previous history of peptic ulcer disease. The relationship between helicobacter pylori and this disease was assessed. A review of the literature, the role of associated diseases and the role of H. pylori are discussed.- - - - - - - - - - ranking = 1.4757615050958keywords = pain (Clic here for more details about this article) |
14/177. Near-fatal hemorrhage following gastrografin studies.The use of upper gastrointestinal studies followed by gastric drainage and observation is recommended for the evaluation and treatment of stomal dysfunction due to edema or gastric atony. Gastrografin though, may be precipitated out and can cause gastrointestinal bleeding if left in the gastric remenant. This agent should be used with proper precautions in the evaluation of postoperative gastric retention.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
15/177. Haematemesis and Melaena: surgical management.A prospective study of the surgical management of 100 consecutive patients with benign, non-variceal upper gastrointestinal bleeding is presented. The manner of presentation, precipitating factors, investigations and associated medical problems are discussed. Chronic duodenal ulceration was the most common cause of haemorrhage. vagotomy and drainage with oversewing or excision of the bleeding ulcer was the surgical procedure performed in 71 of the patients in the series. The incidence of recurrent bleeding was 7%; no patient in this category required further operation. The mortality rate was 6%, and there were no deaths recorded in the patients who underwent vagotomy and drainage. The reasons for the relatively low surgical mortality are discussed.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
16/177. Gastric duplication cyst.BACKGROUND/AIM: The aim of this study is to evaluate the diagnostic and therapeutic difficulties of gastric duplication cysts. methods: A 38-year-old female patient presented with dyspepsia and repeated episodes of epigastric pain. She was operated with the diagnosis of pancreatic pseudocyst according to her US and CT scans, and found to have a gastric duplication cyst. A cyst about 80x80 mm, localized on the posterior wall of the corpus of the stomach close to the fundus, was dissected from the surrounding tissues and partially from the gastric wall. The cyst did not have muscle layer on the common wall with the stomach, so the cystic mucosa was stripped away from the gastric muscle layer. The gastric lumen was not entered. RESULTS: Although gastric duplication cysts do not have specific symptoms and signs, CT, MR and endoscopic ultrasonography may help the preoperative diagnosis, but the diagnosis is usually confirmed at laparotomy. Needle aspiration may cause complications. CONCLUSION: Because of the complications that may occur after needle aspiration and malignant potential of the tissue, the treatment of these cysts is surgical.- - - - - - - - - - ranking = 1.4757615050958keywords = pain (Clic here for more details about this article) |
17/177. ultrasonography of gastric volvulus: "peanut sign".We report a case of chronic gastric volvulus in which ultrasonography (US) was useful. An 81-year-old woman was hospitalized due to vomiting, and upper gastroduodenoscopy revealed that the stomach was spirally twisted and constricted. An upper gastrointestinal barium study demonstrated an organoaxial-mesenteroaxial combined type gastric volvulus. US showed constriction between the dilated upper stomach body and the lower stomach body similar to a "peanut". Thereafter, the patient's vomiting stopped and follow-up US demonstrated that the constriction of the stomach was loosened. Therefore, we believe that this characteristic US sign paralleled the symptoms of the patient.- - - - - - - - - - ranking = 3keywords = upper (Clic here for more details about this article) |
18/177. Acute jejunogastric intussusception: report of five cases.The purpose of this study was to investigate the clinical manifestations and diagnosis of patients with acute jejunogastric intussusception. From May 1986 to June 1999, a total of 5 men (54-76 years old) were collected. Their initial presentations included epigastralgia (4), coffee-ground vomitus (3), frank hematemesis (1), and tarry stool (1). All patients had gastric surgeries 10-30 years previously. Radiograph of the abdomen showed a soft tissue density at the left upper quadrant in one patient. Panendoscopies were done in 4 patients. An obstructed efferent loop with a distended hyperemic small bowel protruding into the remnant of stomach was found in 3 cases, gangrenous change of the bowel wall in one of them. Stump cancer was diagnosed initially in the other patient. barium study (3/5) showed efferent loop obstruction with "coil spring sing" and a central defect in the stomach. All 5 patients underwent segmental resection and end-to-end anastomosis between the 2nd to 6th hospital day. Operative findings were type II jejunogastric intussusception with retrograde invagination of a segment of efferent loop (30-100 cm in length) into the stomach. In conclusion, acute jejunogastric intussusception is an emergent condition. Early and accurate diagnosis is important. A high susception must be kept in mind in patients having a history of gastrojejunostomy with severe abdominal pain or upper gastrointestinal bleeding.- - - - - - - - - - ranking = 10.648816529457keywords = abdominal pain, pain, upper (Clic here for more details about this article) |
19/177. Concomitant diagnosis of primary sjogren's syndrome and systemic AL amyloidosis.A 48 year old woman was referred to hospital for buccal discomfort. physical examination showed a macroglossia and features of xerostomia. She was diagnosed as having primary sjogren's syndrome according to the criteria proposed by the European Community study group in 1993. Furthermore, a lower lip salivary gland biopsy showed amyloid deposits that were also seen in the stomach and in the bone marrow. echocardiography was consistent with cardiac amyloidosis. serum immunofixation identified a monoclonal IgGlambda. As far as is known, this is the first report of systemic primary amyloidosis associated with sjogren's syndrome. The relation between these two disorders is discussed.- - - - - - - - - - ranking = 5.063134299138keywords = discomfort (Clic here for more details about this article) |
20/177. Dieulafoy lesions: a review of 6 years of experience at a tertiary referral center.Dieulafoy lesions are uncommon sources of GI hemorrhage and predominantly occur in the proximal stomach. At one time a pathological diagnosis made postoperatively, Dieulafoy lesions are now routinely diagnosed and treated endoscopically. Their true incidence is unclear as quiescent Dieulafoy lesions are easily overlooked on endoscopy and bleeding lesions are occasionally misidentified. Over 6 yr (June 1993-November 1999), 40 Dieulafoy lesions were identified on upper endoscopy at our institution, of which seven were located in the duodenum and one in the right colon. Forty-seven percent of patients were hospitalized for other causes before onset of bleeding, and 17 of 40 were found to have other abnormal findings at endoscopy. In 90% of the cases, endoscopic treatment was successful. Seven patients died, but none as a result of hemorrhage. In 24 endoscopically-treated patients in whom follow-up data are available, Dieulafoy bleeding recurred in one patient. Dieulafoy lesions are rare and often difficult to diagnose, but must be considered in the evaluation of upper and lower GI tract hemorrhage, as they can usually be managed endoscopically.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
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