1/9. Bronchial granular cell tumor with osteopontin and osteonectin expression: a case report.The case of a 52-year-old Japanese man with bronchial granular cell tumors with osteopontin and osteonectin expression is reported here because there have been few investigations of their expression in benign tumors. He was admitted because of sudden hematemesis. A bronchoscopic examination revealed a lobulated polypoid tumor located in the left and right bronchi. Histologically, most tumor cells had abundant granular eosinophilic cytoplasm and were immunoreactive for S-100, neuron-specific enolase (NSE), CD68 and vimentin. Moreover, osteopontin-positive tumor cells were randomly distributed in the tumor tissue, but few stromal cells were positive. In contrast, osteonectin was mainly expressed in the peripheral tumor cells and was also distributed in the stromal cells. blood vessels at the tumor border in which osteonectin-positive tumor cells were distributed, proliferated moderately. These results suggest that osteopontin and osteonectin may play a role in the progression of granular cell tumors and in the interaction between the tumor and host or angiogenesis around the tumor, respectively.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Aortoesophageal fistula associated with tuberculous mediastinitis, mimicking esophageal Dieulafoy's disease.Aortoesophageal fistula is a rare and lethal disorder that may result from primary diseases of aorta or esophagus, aortic bypass graft, ingestion of foreign body, trauma, surgical procedure or instrumentation. Tuberculous fistula is extremely rare. We present a 27-yr-old female patient with aortoesophageal fistula associated with tuberculous mediastinitis. The patient experienced massive hematemesis and esophagoscopy revealed a small mucosal defect with exudate-coated blood vessel like Dieulafoy 's lesion on about 25 cm from the incisor teeth. Despite two sessions of endoscopic hemostatic procedures, active massive hemorrhage recurred and was controlled effectively with a prompt insertion of Sengstaken-Blakemore tube. The patient underwent open thoracotomy, which revealed aortoesophageal fistula. Numerous white-yellowish, millet seed-like tubercles were scattered in pleural and abdominal cavity. Division of fistular tract and esophageal resection with Ivor-Lewis anastomosis were performed. Histopathologic study confirmed tuberculous pleuritis and peritonitis. The patient died of postoperative pulmonary complication.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/9. Combined diagnostic and therapeutic imaging of hemosuccus pancreaticus.The justification of a request of ERCP in a patient with hematobilia, was evaluated, based on the medical history and negative endoscopy findings for gastrocolic bleeding. The diagnostic examination was performed: it confirmed the release of blood from the papilla of Vater, however the definitive diagnosis could not be established; CT, as the examination of first choice was performed. It provided additional information and the diagnosis of aneurysm of the splenic vein apparently non communicating with the main pancreatic duct, was established. angiography of the splenic artery was performed as the examination of second choice to definitely ascertain the source of bleeding. During the examination, the aneurysm embolization excluded the affected vessel from the circulation and allowed immediate benefit to the patient.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Tuberculous gastric perforation: report of a case.A 21-year-old woman presented with a 2-day history of acute abdominal pain. Contrast-enhanced computed tomography (CT) showed a perforation in the lesser curve of the stomach. The patient suffered a bout of hematemesis, following which an endoscopy showed a bleeding blood vessel at the edge of the perforation. We performed an emergency distal gastrectomy, including the ulcer site. Histopathological examination revealed tuberculous granulation tissue and acid-fast bacilli in the ulcer. The patient was given antituberculosis therapy (ATT) postoperatively, and was well when last seen 1 year 5 months after surgery. We analyzed the clinical data of five cases of tuberculous gastric perforation (TGP), reported between 1948 and 2003, including our patient. The patients ranged in age from 21 to 45 years, with a mean age of 36.8 years (SD /- 10.21), and a male to female ratio of 3 : 2. The diagnosis was confirmed by surgery or autopsy. Abdominal lymphadenopathy was present in all patients. gastrectomy was performed in four patients, and two were given ATT. All four patients in the previous reports died of their disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/9. Pancreatic cancer presenting with hematemesis from directly invading the duodenum: report of an unusual manifestation and review.Pancreatic cancer is a rare cause of gastrointestinal bleeding, and it is extremely rare for hematemesis to be the initial manifestation of invasive pancreatic cancer. We report the case of a 67-year-old man with hematemesis who was found to have invasive pancreatic cancer with a bleeding duodenal ulcer. The patient was not icteric, but repeated sudden hematemesis. An urgent pancreatoduodenectomy was performed with a favorable outcome. Microscopic examination revealed that an adenocarcinoma originating from the pancreatic head extended to the muscularis propria of the duodenum. Furthermore, an exposed vessel and narrow fistula were found. The diagnosis, pathological findings, preoperative events, and postoperative outcome in this unusual case are reviewed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/9. Massive haemorrhage from the vallecula: a diagnostic difficulty. Case report.A case is presented of massive bleeding from a vessel in the vallecula. This was confused with haemoptysis and haematemesis. The bleeding may have resulted from trauma to the vessel during intubation for emergency surgery. 25 units of blood were transfused before the site of the bleeding was identified and controlled by diathermy coagulation.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/9. Fatal aortoesophageal fistula due to double aortic arch: an unusual complication of prolonged nasogastric intubation.Fatal hematemesis occurred in a 3-month-old boy due to erosion by a nasogastric tube into the right component of an unrecognized double aortic arch. This is the youngest of six reported patients with arterioesophageal fistula in the literature. Including this patient, five of six had nasogastric tubes in place. The tube may have led to fistula formation by compression of the esophageal wall against an anomalous vessel. When a vascular ring is suspected, indwelling esophageal tubes such as nasogastric tubes should not be used.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Endoscopic injection treatment in patients with shock and gastrointestinal bleeding or stigmata of recent hemorrhage.Forty cases of upper gastrointestinal bleeding were studied. Twenty-three patients had shock and active bleeding (3 spurting, 12 oozing and 2 a clot with oozing) or stigmata of recent hemorrhage (4 with a clot and 2 with a visible vessel). Nineteen of these were submitted to endoscopic injection. In 4 cases with multiple acute hemorrhagic lesions and shock, and in 17 patients with stigmata of recent bleeding without shock, the technique was not carried out. None of the patients had a rebleed. One patient was submitted to surgery 24 hours after injection for a large acute gastric ulcer in the process of perforating, and died of pulmonary embolism 4 days later. No technique-related complications were observed. We believe endoscopic injection treatment might be the technique of choice in patients with shock and active bleeding or stigmata of recent hemorrhage of the upper gastrointestinal tract.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/9. A variety of ehlers-danlos syndrome type IV presenting with haematemesis and gastro-esophageal reflux.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.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |