11/118. Trichobezoar: a rare cause of acute bowel obstruction.A surgically successfully treated case of (2.8 kg) Trichobezoar presenting with severe epigastric pain, vomiting, associated with anemia and dark stool of one days duration. Complicated on admission by an acute intestinal obstruction. There has been no report of such a case from saudi arabia up to the present time. The presenting symptoms and signs, and management strategies are discussed.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/118. pancreatitis of unusual origin.The anatomic pattern seen in the three patients with contiguous gastric duplications associated with pancreatic ducts evidently predisposes the patient to pancreatitis. In the previous patient reported upon from this institution, the correlation of severe bleeding episodes with attacks of pancreatitis strongly supports the concept of blood blocking the pancreatic ductal system, thereby producing pancreatitis. Passage of viscous mucoid secretions from the aberrant gastric mucosa into the pancreatic ductal system also might retard the normal flow of pancreatic juice, producing elevation of the serum amylase level and pain. Overdistention of the gastric duplication also might be considered as a source of pain, but such mechanisms can be considered only speculation at present. diagnosis is usually made after more than one exploratory laparotomy. hemorrhage may result, should the gastric duplication contain parietal cells, leading to hemoductal pancreatitis, hematemesis or melena and anemia. At least one in five patients with a gastric duplication possesses another intestinal duplication. Developmental defects commonly are associated with gastric cysts. Almost identical anatomy was present in the patients with contiguous duplications. That two such rare pancreatic disorders were documented in the same institution within two years suggests that this pattern of developmental defect is more common that had previously been expected.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
13/118. Laparoscopic resection of calcifying fibrous pseudotumor of the gastric wall. A unique case report.Calcifying fibrous pseudotumor (CFPT) is a recently described peculiar lesion characterized by the presence of abundant hyalinized collagen with psammomatous or dystrophic calcifications and a lymphoplasmacytic infiltrate. Initially, a few cases of CFPT were observed in the subcutaneous and deep soft tissues, especially at the level of the extremities, trunk, scrotum, groin, neck, and axilla; more recently, several cases have been reported in the pleura. We present a case of CFPT of the gastric wall. To our knowledge, this is the first such case to be described. A previously healthy 49-year-old woman presented with a 5-month history of epigastric pain after eating, early satiety, and weight loss. gastroscopy revealed a polypoid lesion covered by normal mucosa along the great curvature of the gastric body. The patient was submitted to surgical treatment consisting of laparoscopic wedge resection of the gastric body. Histologic examination of the specimen disclosed CFPT affecting the wall of the gastrointestinal tract. The postoperative course was uneventful, and the patient was discharged from the hospital 5 days after surgery. The patient was free of disease 6 months after excision. Herein we discuss the clinicopathological features and surgical treatment of this most unusual case.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
14/118. A fatal case of gastric mucormycosis and diabetic ketoacidosis.OBJECTIVE: To describe a case of gastric mucormycosis in conjunction with severe bleeding in a young woman, which occurred after an episode of ketoacidosis and had a fatal outcome. methods: We present a case report, including detailed clinical and pathologic findings in a woman with gastric mucormycosis associated with severe bleeding. RESULTS: A 17-year-old woman sought medical assistance for diabetic ketoacidosis and severe epigastric pain. Chest radiography showed normal findings, and blood and urine cultures were negative for bacterial growth. endoscopy disclosed an extensive ulcerated lesion involving the greater curvature and posterior wall of the stomach. biopsy specimens demonstrated the presence of invasive mucormycosis. Treatment with amphotericin b was initiated, but severe persistent gastrointestinal bleeding resulted in the patient's demise. CONCLUSION: In conjunction with diabetic ketoacidosis, severe infection by Mucor has been reported mainly in the rhino-orbital area. Although uncommon, the gastrointestinal tract can also be involved. In the case described, severe hemorrhage ensued and caused the patient's death.- - - - - - - - - - ranking = 1.0334373812923keywords = pain, area (Clic here for more details about this article) |
15/118. crack cocaine-related prepyloric perforation treated laparoscopically.Perforation, which occurs in seven to 10 patients per 100,000 population annually, complicates 5-10% of peptic ulcers. crack cocaine has been associated with many gastrointestinal disorders, including ulcer perforation. Crack-related gastroduodenal perforations, typically prepyloric, have been on the rise in the last decade. Suggested mechanisms include ischemia, motility disorders, increased air swallowing, platelet-related thrombosis, and increased ACTH and corticosterone secretion. A 28-year-old man presented with vomiting and sudden generalized abdominal pain 3 h after smoking a "rock" (a 100-mg cube of crack). physical examination revealed generalized guarding, and plain films showed free intraperitoneal air. laparoscopy confirmed the diagnosis of generalized peritonitis secondary to a 5-mm perforation of the prepyloric anterior wall of the gastric antrum. omentum-patched primary closure and thorough abdominal irrigation were undertaken. The postoperative course was uneventful. omeprazole and anti-H. pylori treatment, including erythromycin and metronidazole, were maintained for 8 weeks and 1 week, respectively. Although drug addicts are not easily compliant with long-term medical treatment, in the particular case of crack addiction, the vasoconstrictive and dismotility effects of cocaine may precipitate gastric necrosis and paralysis, respectively, in the case of vagotomy. Although distal gastrectomy was the wisest choice when open ulcer surgery was adopted, the laparoscopic treatment of perforated ulcer, with either suture or sutureless techniques, has been found to be comparable to open surgery with regard to postoperative morbidity, reoperation rates, and mortality. The potential advantages of laparoscopy include the avoidance of large incisions, less attendant pulmonary morbidity, less wound infection, and possibly fewer postoperative adhesions.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
16/118. Gastric adenocarcinoma associated with granulomatous gastritis. Case report and review of the literature.AIMS: We describe the fourth reported case of granulomatous gastritis associated with gastric adenocarcinoma, with a review of the literature and considerations about the prognostic implications of this association. RESULTS: A 48-year-old woman who had been suffering from gastritis for ten years was admitted to our institute for increasing left epigastric pain associated with vomiting. After an endoscopic biopsy had revealed an ulcerated signet ring cell carcinoma, the patient was submitted to subtotal gastrectomy with regional lymph node dissection. Pathological examination of the resected specimen revealed a superficial signet ring cell carcinoma (early cancer) associated with multiple granulomas. The granulomas, which were observed within the mucosa and the submucosa at the periphery of the carcinoma, were composed of CD68-positive, CD15-negative epithelioid and giant cells of the Langhans type, confirming their true histiocytic nature, and were also extensively found within the dissected lymph nodes. Since no ocular, skin, pulmonary or other gastrointestinal lesions were found and the granulomas were negative for acid-fast and fungal stain, a diagnosis of granulomatous gastritis was made. CONCLUSIONS: To the best of our knowledge this is the fourth example of gastric adenocarcinoma and granulomatous gastritis. These cases suggest an association between granulomatous gastritis and early gastric cancer.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
17/118. A gastric duplication cyst with an aberrant pancreatic ductal system: report of a case.We report an extremely rare case of a gastric duplication cyst together with an aberrant pancreatic ductal system, which communicated with the stomach rather than the pancreatic ductal system with no evidence of pancreatitis. A 46-year-old woman developed severe abdominal pain after a 10-year history of occasional mild abdominal pain. Upper gastrointestinal barium radiography showed a rigidity of the stomach wall, and gastroscopy revealed a fistula orifice at a greater curvature of the gastric body. Subsequent endoscopic suction of mucous secretion from within the fistula provided immediate pain relief. Abdominal computed tomography and ultrasonography showed a cystic mass contiguous with the stomach wall. Surgical exploration revealed an uncommon anomaly of a gastric duplication cyst with the aberrant pancreatic lobe. The patient made an uneventful recovery and remains well 4 years after surgery. We also herein review ten other similar cases of this uncommon congenital anomaly reported in the literature.- - - - - - - - - - ranking = 3keywords = pain (Clic here for more details about this article) |
18/118. A case of gastric duplication evaluated by gastric emptying scintigraphy.Gastric duplications are relatively rare, and communication with the gastric lumen is extremely rare. A 67-year-old man was referred to our hospital because of recurrence of epigastric pain and fullness. An upper gastrointestinal contrast study revealed a double compartment stomach, with gastric duplication starting at the esophagogastric junction outside the greater curvature. Computed tomography of the stomach with gastrografin as contrast demonstrated complete communication of the gastric duplication and primary stomach. The patient was diagnosed with complete gastric duplication. gastric emptying scintigraphy with Tc-99m diethyltriamine pentaacetic acid was performed. Test meal entered the primary stomach and duplication cyst simultaneously, and radioactivity in the primary stomach decreased linearly and gastric emptying was not delayed. In the duplication cyst, about 70% of the food that entered the cyst once was immediately evacuated from it, but the remaining 30% remained in the cyst for a long time. gastric emptying of the primary stomach was not affected by formation of the duplication cyst.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
19/118. Heterotopic pancreas in gastric antrum with macroscopic appearance of gastric polyp.Heterotopic pancreas is a relatively rare clinical diagnosis, not commonly involved in differential diagnostic considerations of GI symptoms. The authors report a case of heterotopic pancreas discovered endoscopically in the gastric antrum. A 60-year-old woman presented with epigastric pain. The patient took alendronate for osteoporosis. The endoscopic examination revealed helicobacter pylori positive antral atrophic gastropathy and a well delineated hemispherical polyp, 8 mm in diameter, in the antrum of the stomach. histology showed antral gastritis and the presence of heterotopic pancreas. After dietary measures and Helicobacter eradication, the patient was relieved of symptoms. According to the authors' opinion, the finding of heterotopic pancreas did not necessitate intervention, and was an incidental finding. The authors discuss the significance of heterotopic pancreas with the conclusion that the resection of the lesion is indicated only if consistent symptoms are present. Fig. 3, Ref. 28.)- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
20/118. Gastric volvulus and gastroduodeno-jejunal intussusception (an unusual cause of acute abdomen).An elderly man who presented with colicky abdominal pain had gastric volvulus which was reduced after barium meaL More than a year later the symptoms recurred and at laparotomy a gastroduodenojejunal intussusception was found and its apex was formed by a polypoidal gastric tumour (leiomyoma). The patient did very well without any recurrence after the resection of the tumour.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
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