Adenocarcinoma of the third portion of the duodenum in a man with CREST syndrome

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Esophagopericardial fistula as a rare complication after total gastrectomy for cancer

<p>Abstract</p> <p>Background</p> <p>Esophagopericardial fistula is a rare but life-threatening complication of benign, malignant or traumatic esophageal disease. It is most commonly associated with benign etiology and carries a high mortality rate which increases with delay in diagnosis.</p> <p>Case presentation</p> <p>We present a case of an esophagopericardial fistula as a rare complication in a 53-year-old male patient, 7 months after total gastrectomy for an adenocarcinoma of the esophagogastric junction.</p> <p>Conclusion</p> <p>The prognosis of esophagopericardial fistula is poor, especially when it is associated with malignancy.</p

Seronegative cat-scratch disease diagnosed by PCR detection of Bartonella henselae DNA in lymph node samples

AbstractCat scratch disease (CSD), the typical clinical manifestation of Bartonella infections usually follows a typical benign self-limited course. Nevertheless, a variety of unusual clinical manifestations and confusing imaging features can lead to misinterpretations and render the disease a diagnostic dispute. Routine laboratory tests exhibit varying reported sensitivity and are usually unhelpful in diagnosis, as serology fails in terms of specificity and/or sensitivity. Herein we report a case of seronegative Bartonella infection presenting as symptomatic suppurative lymphadenitis with abscess formation, which was surgically drained. Diagnosis was established by PCR analysis from lymph nodes samples obtained during the procedure. PCR detection of specific DNA fragments from lymph node biopsy provides a sensitive detection of disease. The technique should be considered for patients with suspected CSD and negative serology, since serological assays exhibit low sensitivity. In ambiguous cases, surgical exploration may provide tissue for diagnosis; it is well tolerated and affords improved recovery

THE CORRELATION BETWEEN SERUM GASTRIC LEVELS AND HISTOPATHOLOGY OF THE STOMACH DURING THE ANHEPATIC PHASE OF THE EXPERIMENTAL LIVER TRANSPLANTATION

THE AIM OF THIS STUDY IS TO INVESTIGATE THE SITE OF THE GASTRIN METABOLISM THROUGH THE CORRELATION BETWEEN THE SERUM GASTRIN LEVELS AND THE HISTOLOGICAL FINDINGS OF THE GASTRIC BIOPSIES DURING THE ANHEPATIC PHASE OF EXPERIMENTAL ORTHOTOPIC LIVER TRANSPLANTATION (O.L.T.). FOURTY ANIMALS (PIGS) WITH BODY WEIGHT20-25 KGR WERE USED IN 20 EXPERIMENTAL OLT WITH V-V BY-PASS (20 AS DONORS, 20AS RECIPIENTS). DURING THE RECIPIENT OPERATION BLOOD SAMPLES WERE COLLECTED AND GASTRIC BIOPSIES (FULL THICKNESS) WERE TAKEN. THE SERUM GASTRIN BASE VALUE WAS 33,7 +- 6,26 PG /ML. THERE WAS A STATISTICAL SIGNIFICANT (P < 0,05) INCREASE OF THE MEAN GASTRIC LEVEL (68,8 +- 18,3 PG/ML) DURING THE ANHEPATIC PHASE. THE HISTOLOGICAL FINDINGS IN 7 RECIPIENTS (35%) WERE ULCERATION OF GASTRIC MUCOSA. THE HIGH GASTRIN LEVELS, AS A RESULT OF THE ANHEPATIC PHASE, WAS ASSOCIATED TO ULCERATION OF THE GASTRIC MUCOSA, BY THE HYPOTHESIS OF GASTRIC MUCOSA, BY THE HYPOTHESIS OF GASTRIC HYPERSECRETION. THE GASTRIN LEVEL DECREASE AFTER THE REPERFUSION OF THE GRAFT WAS RELATED TO THE GASTRIN METABOLISM BY THE LIVER.ΣΚΟΠΟΣ ΤΗΣ ΜΕΛΕΤΗΣ ΕΙΝΑΙ Η ΑΝΑΛΥΣΗ ΚΑΙ Η ΣΥΣΧΕΤΙΣΗ ΤΩΝ ΔΙΑΚΥΜΑΝΣΕΩΝ ΤΗΣ ΓΑΣΤΡΙΝΗΣ ΤΟΥ ΟΡΟΥ ΚΑΙ ΤΩΝ ΤΟΙΧΩΜΑΤΙΚΩΝ ΑΛΛΟΙΩΣΕΩΝ ΤΟΥ ΣΤΟΜΑΧΟΥ ΚΑΤΑ ΤΗ ΔΙΑΡΚΕΙΑ ΤΗΣ ΑΝΗΠΑΤΙΚΗΣ ΦΑΣΗΣ ΣΤΗΝ ΠΕΙΡΑΜΑΤΙΚΗ ΜΕΤΑΜΟΣΧΕΥΣΗ ΗΠΑΤΟΣ. ΧΡΗΣΙΜΟΠΟΙΗΘΗΚΑΝ 40 ΠΕΙΡΑΜΑΤΟΖΩΑ ΧΟΙΡΟΙ (20 ΩΣ ΔΟΤΕΣ, 20 ΩΣ ΛΗΠΤΕΣ), ΒΑΡΟΥΣ ΣΩΜΑΤΟΣ 20-25 KGR, ΚΑΤΑΤΗ ΔΙΑΡΚΕΙΑ 20 ΟΡΘΟΤΟΠΙΚΩΝ ΠΕΙΡΑΜΑΤΙΚΩΝ ΜΕΤΑΜΟΣΧΕΥΣΕΩΝ ΗΠΑΤΟΣ (Ο.Μ.Η.) ΜΕ ΧΡΗΣΗ ΕΞΩΣΩΜΑΤΙΚΗΣ ΦΛΕΒΟΦΛΕΒΙΚΗΣ ΠΑΡΑΚΑΜΨΗΣ. ΚΑΤΑ ΤΗ ΔΙΑΡΚΕΙΑ ΤΗΣ ΜΕΤΑΜΟΣΧΕΥΣΗΣ ΕΛΑΜΒΑΝΟΝΤΟ ΔΕΙΓΜΑΤΑ ΑΙΜΑΤΟΣ ΤΟΥ ΛΗΠΤΗ ΓΙΑ ΤΗ ΜΕΤΡΗΣΗ ΤΗΣ ΓΑΣΤΡΙΝΗΣ, ΚΑΘΩΣ ΚΑΙΒΙΟΨΙΕΣ ΣΤΟΜΑΧΟΥ (ΟΛΙΚΟΥ ΠΑΧΟΥΣ). Η ΜΕΣΗ ΤΙΜΗ ΤΗΣ ΓΑΣΤΡΙΝΗΣ ΠΟΥ ΕΛΗΦΘΗ ΩΣ ΤΙΜΗ ΑΝΑΦΟΡΑΣ ΗΤΑΝ 33,7+-6,26 PG/ML. ΑΠΟ ΤΑ ΕΡΓΑΣΤΗΡΙΑΚΑ ΚΑΙ ΠΑΘΟΛΟΓΙΚΑ ΕΥΡΗΜΑΤΑΤΗΣ ΠΕΙΡΑΜΑΤΙΚΗΣ ΜΕΛΕΤΗΣ, ΠΑΡΑΤΗΡΕΙΤΑΙ Η ΣΤΑΤΙΣΤΙΚΑ ΣΗΜΑΝΤΙΚΗ (P < 0,05) ΑΥΞΗΣΗ ΤΗΣ ΓΑΣΤΡΙΝΗΣ ΤΟΥ ΟΡΟΥ ΚΑΤΑ ΤΗΝ ΑΝΗΠΑΤΙΚΗ ΦΑΣΗ ΤΗΣ ΟΡΘΟΤΟΠΙΚΗΣ ΜΕΤΑΜΟΣΧΕΥΣΗΣ ΗΠΑΤΟΣ (68,8 +- 18,3 PG/ML), ΠΟΥ ΠΙΘΑΝΩΣ ΣΥΝΕΒΑΛΕ ΣΤΗΝ ΥΠΕΡΕΚΚΡΙΣΗ ΤΟΥ ΣΤΟΜΑΧΟΥ, ΜΕ ΑΠΟΤΕΛΕΣΜΑ ΤΗΝ ΕΜΦΑΝΙΣΗ ΔΙΑΒΡΩΣΕΩΝ ΣΤΟ ΓΑΣΤΡΙΚΟ ΒΛΕΝΝΟΓΟΝΟ ΣΕ ΠΟΣΟΣΤΟ 35% ΤΩΝ ΛΗΠΤΩΝ

Management of a ruptured bile duct cyst

A case of a ruptured bile duct cyst in a 25-year-old male patient is presented. The initial management of the clinical presentation of acute abdomen consisted of an exploratory laparotomy and a T-tube cystostomy of a choledochal cyst. Two months later, he was admitted to our surgical department. Preoperative evaluation showed a type IV-A choledochal cyst. The patient underwent excision of the choledochal cyst, cholecystectomy, and the construction of a Roux-en-Y end-to-side hepaticojejunostomy

Seronegative cat-scratch disease diagnosed by PCR detection of Bartonella henselae DNA in lymph node samples

Cat scratch disease (CSD), the typical clinical manifestation of Bartonella infections usually follows a typical benign self-limited course. Nevertheless, a variety of unusual clinical manifestations and confusing imaging features can lead to misinterpretations and render the disease a diagnostic dispute. Routine laboratory tests exhibit varying reported sensitivity and are usually unhelpful in diagnosis, as serology fails in terms of specificity and/or sensitivity. Herein we report a case of seronegative Bartonella infection presenting as symptomatic suppurative lymphadenitis with abscess formation, which was surgically drained. Diagnosis was established by PCR analysis from lymph nodes samples obtained during the procedure. PCR detection of specific DNA fragments from lymph node biopsy provides a sensitive detection of disease. The technique should be considered for patients with suspected CSD and negative serology, since serological assays exhibit low sensitivity. In ambiguous cases, surgical exploration may provide tissue for diagnosis; it is well tolerated and affords improved recovery