Kalcificirani fibrozni tumor rektuma: prikaz slučaja

A calcifying fibrous tumor (CFT) is a benign tumor of unknown etiology. A calcifying fibrous tumor is rare in the intestinal tract. A calcifying fibrous tumor is characterized by hyalinized collagenous fibrous tissue, psammomatous or dystrophic calcification, and focal lymphoplasmacytic infiltrates on histology. Magnetic resonance imaging is the standard method for evaluating the lesions of the rectum, and CFTs should be considered in differentiating the rectal wall tumors. Herein, we report a case of a 68-year-old man with a rectal wall CFT.Kalcificirani fibrozni tumor (CFT) je benigni tumor nepoznate etiologije. CFT u crijevnom traktu je vrlo rijedak. CFT karakterizira prisutnost hijaliniziranog kolagenskog vlaknastog tkiva, psamomatoznih ili distrofičnih kalcifikacija i fokalnih limfoplazmocitnih infiltrata. Prikazujemo slučaj 68-godišnjeg muškaraca s CFT-om u stijenci rektuma. Magnetska rezonancija je korisna metoda za procjenu procesa stijenke rektuma, CFT treba uzeti u obzir u diferencijalnoj dijagnozi tumorskih procesa stijenke rektuma

HOW TO DISTINGUISH IDIOPATHIC ACHALASIA FROM PSEUDOACHALASIA?

Achalasia is a disorder characterized by insufficient relaxation of the lower esophageal sphincter and absent peristalsis. It is usually primary (idiopathic) achalasia, but it can also be secondary achalasia (pseudoachalasia). With a review of the literature, epidemiological data was gathered on achalasia in this paper, and followed up with presented etiopathogenetic mechanisms of achalasia. An optimal diagnostic algorithm along with the therapeutic possibilities in achalasia, from endoscopic to surgical methods of therapy, was analyzed. The most common causes of pseudoachalasia and the mechanisms of this disorder are reported. In patients with dysphagia and suspected achalasia, it is important to distinguish idiopathic achalasia from pseudoachalasia, since pseudoachalasia most often occurs due to tumor infiltrations of the lower esophageal sphincter. In this paper, the importance of a timely and accurate diagnosis of pseudoachalasia in relation to idiopathic achalasia was shown

HOW TO DISTINGUISH IDIOPATHIC ACHALASIA FROM PSEUDOACHALASIA?

Achalasia is a disorder characterized by insufficient relaxation of the lower esophageal sphincter and absent peristalsis. It is usually primary (idiopathic) achalasia, but it can also be secondary achalasia (pseudoachalasia). With a review of the literature, epidemiological data was gathered on achalasia in this paper, and followed up with presented etiopathogenetic mechanisms of achalasia. An optimal diagnostic algorithm along with the therapeutic possibilities in achalasia, from endoscopic to surgical methods of therapy, was analyzed. The most common causes of pseudoachalasia and the mechanisms of this disorder are reported. In patients with dysphagia and suspected achalasia, it is important to distinguish idiopathic achalasia from pseudoachalasia, since pseudoachalasia most often occurs due to tumor infiltrations of the lower esophageal sphincter. In this paper, the importance of a timely and accurate diagnosis of pseudoachalasia in relation to idiopathic achalasia was shown

Clinical and Anorectal Motility Features in Chronically Constipated Children

Constipation is a common problem in children. It can be a symptom of functional disorder in majority of cases, but sometimes a serious organic disease is a cause of constipation. Anorectal manometry plays an important role in the diagnostic procedure. It can be presumed that some values of manometric parameters could be very useful in treatment plan. The aim of this study was to confirm or exclude such limits in manometric finding, to make a plan of the therapy more accurate. Therefore the group of 81 constipated children was investigated. There were 58 patients suffering from functional constipation and 23 with organic disorders. The age of the patients was 3 to 15 years. Scoring system was applied to estimate severity of constipation and anorectal manometry was performed. Our results did not show significant correlation between clinical symptoms and signs and the values that we obtained using anorectal manometry. But, we recommend anorectal manometry because it is a safe method and contributes to clarify the diagnosis, which is very important for treatment plan

Clinical and Anorectal Motility Features in Chronically Constipated Children

Constipation is a common problem in children. It can be a symptom of functional disorder in majority of cases, but sometimes a serious organic disease is a cause of constipation. Anorectal manometry plays an important role in the diagnostic procedure. It can be presumed that some values of manometric parameters could be very useful in treatment plan. The aim of this study was to confirm or exclude such limits in manometric finding, to make a plan of the therapy more accurate. Therefore the group of 81 constipated children was investigated. There were 58 patients suffering from functional constipation and 23 with organic disorders. The age of the patients was 3 to 15 years. Scoring system was applied to estimate severity of constipation and anorectal manometry was performed. Our results did not show significant correlation between clinical symptoms and signs and the values that we obtained using anorectal manometry. But, we recommend anorectal manometry because it is a safe method and contributes to clarify the diagnosis, which is very important for treatment plan

Isolated nodular amyloidosis of the breast associated with monoclonal gamapathy (IgG) - Case report

Amiloidoza je bolest nakupljanja netopivih proteina amiloida u ekstracelularnom prostoru. Nakupljeni proteini su imunoglobulinski spojevi koje proizvode plazma stanice i B-limfociti stimulirani antigenom. Razlikujmo tri sistemska oblika amiloidoze: primarna (AL), sekundarna (AA) i obiteljska. Lokalizirana amilodoza javlja se u gušterači kod dijabetičara tipa 2, te kod bolesnika na kroničnoj dijalizi. Amiloidoza dojke je rijedak entitet i obično se javlja kod starijih žena. Pojavljuje se kao nakupljanje ili amiloidni tumor ili u sklopu sistemskih bolesti, a često se mamografski dijagnosticira kao karcinom. Prikazat ćemo slučaj 70-godišnje bolesnice s monoklonalnom IgG gamapatijom, te pridruženom hidronefrozom i akutnom bubrežnom insuficijencijom kod koje je ultrazvučni nalaz ukazivao na zloćudni tumor dojke, a mamografski nalaz prikazao je lobulirano, neoštro ograničeno područje, bez vidljivih mikrokalcifikata.Amyloidosis is an abnormal deposition of insoluble amyloid proteins in extracellular spaces. Protein deposits are components of immunoglobulins produced by plasma cells and B–lymphocytes in response to antigenic stimulation. Three different forms of systemic amyloidosis can be distinguished, those are primary (AL), secondary (AA) and family form. Localized amyloidosis occurs in the pancreas in type 2 diabetic patients and in patients on chronic hemodialysis. Amyloidosis of the breast is a rare entity, mostly involving elderly women, and may be misdiagnosed as carcinoma on mammography. A 70 years old woman presented with monoclonal IgG gamapathy, hydronephrosis, acute renal insufficiency and suspicious lesion in the breast on ultrasound. Mammography revealed a lobulated, ill demarcated area without visible microcalcifications

Contrast-induced nephropathy in patients with acute coronary syndrom after percutaneus coronary angiography and intervention

Pojedini čimbenici rizika imaju manju ili veću ulogu za razvoj kontrastom inducirane nefropatije (KIN). Svrha ovog retrospektivnog istraživanja je doprinijeti razjašnjavanju rizičnih čimbenika i štetnosti kontrastnih sredstava na bubrežnu funkciju nakon perkutane koronarne angiografije i intervencije. Istraživanje je provedeno u Klinici za unutarnje bolesti SKB Mostar, Odjel za invazivnu kardiologiju. U istraživanje je uključeno 235 bolesnika kojima je tijekom 2013. i 2014. godine učinjena perkutana koronarna angiografija i intervencija zbog akutnog koronarnog sindroma. Podaci su prikupljeni iz baze podataka informatičkog bolničkog sustava. Ustanovili samo učestalost KIN-a u 14% bolesnika nakon perkutane koronarne angiografije i intervencije. Kod ispitanika s KIN-om utvrdili smo prosječnu životnu dob od 69,3 ± 12,4 godina kao statistički značajan čimbenik (p < 0,001). Prosječna količina apliciranog kontrastnog sredstva tijekom provedbe perkutane koronarne angiografije i intervencije u ispitanika u kojih je nastao KIN iznosila je 331,8 ± 73,7 ml, što se pokazalo statistički značajno (p < 0,001). Broj bolesnika sa šećernom bolesti unutar skupine bolesnika s KIN-om iznosio je 60,6%, što je statistički značajno (p < 0,001). Ranije dokazana renalna insuficijencija unutar skupine bolesnika s KIN-om iznosila je 51,5%, što je također statistički značajno (p < 0,001). Usporedba koronarnih krvnih žila na kojima je izvršena intervencija u odnosu na pojavu KIN-a nije pokazala statistički značajnu razliku (p = 0,173). Nastanak KIN-a nakon perkutane koronarne angiografije i intervencije češća je pojava u starijih bolesnika, te u onih koji boluju od kroničnih bubrežnih bolesti i od šećerne bolesti. Također postoji povezanost količine apliciranog kontrastnog sredstva i nastanka KIN-a.Some risk factors have a smaller or greater role in developing contrast-induced nephropathy (CIN). The purpose of this retrospective study is to contribute to the clarification of the risk factors and damage of contrast agents to the renal function after percutaneous coronary angiography and intervention. The research was conducted at the University Hospital Mostar, Department of Invasive Cardiology. The study included 235 patients with percutaneous coronary angiography and intervention procedure during 2013-2014 due to acute coronary syndrome. The data was collected from the database of the IT hospital system. We found the incidence of CIN in 14% of patients after percutaneous coronary angiography and intervention. In patients with CIN an average age was 69.3 ± 12.4 years as a statistically significant factor (p < 0.001). The mean amount of applied contrast agent during percutaneous coronary angiography and intervention in subjects with CIN was 331.8 ± 73.7 ml, which was statistically significant (p < 0.001). The number of diabetic patients within the CIN group was 60.6%, which was statistically significant (p < 0.001). Previously demonstrated renal insufficiency within the CIN group was 51.5%, statistically significant (p < 0.001). Comparison of intervention on coronary blood vessels with reference to the appearance of KIN did not show a statistically significant difference (p = 0.173). The emergence of CIN after percutaneous coronary angiography and intervention is more common in older patients, those with chronic kidney disease and diabetes mellitus. There is also a correlation between the amount of applied contrast agent and the CIN after percutaneous coronary angiography and intervention