4 research outputs found
Giant esophageal fibrovascular polyp with clinical behaviour of inflammatory pseudotumor: A case report and the literature review
Introduction. Esophageal fibrovascular polyps are rare, benign, intraluminal, submucosal tumor-like lesions, characterized by pedunculated masses which can demonstrate enormous growth. The most frequent symptoms are dysphagia, vomiting and weight loss. Fibrovascular polyps with long stalks can regurgitate into the airways and cause asphyxia. Esophageal inflammatory pseudotumor is extremely rare lesion accompanied with various systemic manifestations as fever, anemia and thrombocytosis. Case report. We presented a 29-year-old man complaining of a long-lasting fever and dysphagia. He was found to have huge pedunculated submucosal tumor of esophagus, surgically completely resected. Histopathological examination showed that this giant tumor, 24 x 9 x 6 cm, was a fibrovascular polyp. The postoperative course was uneventful. The preoperative fever, anemia and thrombocytosis disappeared and did not recur in the postoperative course. Conclusion. We reported a patient with giant esophageal pedunculated tumor with clinical manifestations of inflammatory pseudotumor and histopathological picture of fibrovascular polyp, that we have not found described in the literature before
Giant esophageal fibrovascular polyp with clinical behaviour of inflammatory pseudotumor: A case report and the literature review
Introduction. Esophageal fibrovascular polyps are rare, benign, intraluminal,
submucosal tumor-like lesions, characterized by pedunculated masses which can
demonstrate enormous growth. The most frequent symptoms are dysphagia,
vomiting and weight loss. Fibrovascular polyps with long stalks can
regurgitate into the airways and cause asphyxia. Esophageal inflammatory
pseudotumor is extremely rare lesion accompanied with various systemic
manifestations as fever, anemia and thrombocytosis. Case report. We presented
a 29-year-old man complaining of a long-lasting fever and dysphagia. He was
found to have huge pedunculated submucosal tumor of esophagus, surgically
completely resected. Histopathological examination showed that this giant
tumor, 24 x 9 x 6 cm, was a fibrovascular polyp. The postoperative course was
uneventful. The preoperative fever, anemia and thrombocytosis disappeared and
did not recur in the postoperative course. Conclusion. We reported a patient
with giant esophageal pedunculated tumor with clinical manifestations of
inflammatory pseudotumor and histopathological picture of fibrovascular
polyp, that we have not found described in the literature before
C-reactive protein in drainage fluid as a predictor of anastomotic leakage after elective colorectal resection
Background/Aim. C-reactive protein (CRP) is considered to be an indicator of
postoperative complications in abdominal surgery. The aim of this study was
to determine the significance of serial measurement of CRP in drainage fluid
in the detection of anastomotic leakage (AL) in patients with colorectal
resection. Methods. CRP values in serum and drainage fluid, respectively,
were measured on the first, third, fifth, and seventh postoperative day (POD)
in 150 patients with colorectal resection and primary anastomosis. The values
obtained were compared between the group of patient without complications of
surgical treatment and those with AL. Results. Clinically evident AL was
observed in 15 patients - in two (4.2%) patients with left colonic surgery,
and 13 (12.6%) patients with colorectal anastomosis. Mean values of CRP were
higher in the patients with AL than in the patients without complications,
both in serum and drainage fluid, with the most significant differences
recorded on the PODs 5 and 7 (p < 0.001). Correlation analysis showed a
positive correlation between serum and drainage fluid CRP levels in both
groups of patients. Serum and drainage fluid CRP values on the PODs 5 and 7
are most important in the detection of AL. In 80% of patients with CRP values
in the drainage fluid of 53 mg/L for the POD 5 and 42 mg/L for the POD 7 AL
was observed. The method specificity was 77% for the POD 5, and 83% for the
POD 7. All the patients with CRP values in drainage fluid above 108 mg/L on
the POD 5 and 93 mg/L on the POD 7 had AL. Conclusion. Serial measurement of
CRP in drainage fluid can reliably be used in the detection of AL in patients
with colorectal resection. The most significant values obtained on the PODs 5
and 7 were positively correlated with the values registered in serum
Diagnostic value of serial measurement of c-reactive protein in serum and matrix metalloproteinase-9 in drainage fluid in the detection of infectious complications and anastomotic leakage in patients with colorectal resection
Background/Aim. Postoperative infectious complications are one of the most
important problems in surgical treatment of colorectal cancer (CRC), being
present in up to 40% of patients. The aim of this paper was to establish the
significance of serial measurement of C-reactive protein (CRP) in serum and
matrix metalloproteinase-9 (MMP-9) in drainage fluid for the detection of
infectious complications and anastomotic leakage (AL) in patients with
colorectal resection. Methods. CRP and MMP-9 values in serum and drainage
fluid, respectively, were measured on the first, third, fifth, and seventh
postoperative day (POD) in 150 patients with colorectal resection and primary
anastomosis. The values obtained were compared between the patients without
complications and those with surgical site and remote infections and AL.
Results. Surgical site infections (SSIs) were observed in 41 (27.3%), and
remote infections in 10 (6.7%) patients. Clinically evident AL was observed
in 15 (10%) patients. In 82% of the patients with SSIs, serum CRP value on
POD 5 exceeded 82 mg/L, with 81% specificity. AL was reported in 85% and 92%
of the patients on PODs 5 and 7, respectively, with CRP values of 77 mg/L and
90 mg/L, respectively. The specificity was 77% for POD 5 and 88% for POD 7.
All the patients with CRP values exceeding 139 mg/L on POD 5 had some of SSIs
and/or AL. The mean values of MMP-9 were not statistically different between
the group without complications (n = 99) and the group with AL (n = 15).
Conclusion. Serial measurement of CRP is recommended for screening of
infectious complications of colorectal resection. Patients with CRP values
above 139 mg/L on POD 5 cannot be discharged from hospital, and require an
intensive search for infectious complications, particularly AL. MMP-9
measurement in drainage fluid is not relevant in the detection of AL in
patients with colorectal resection