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An Unusual Case of Painless Obstructive Jaundice and Cholangitis: Lemmel’s Syndrome- A Case Report 无痛性梗阻性黄疸合并胆管炎1例:Lemmel综合征1例报告

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/OGH.2018.7.2.25

Praveen S. Padasali, Vinayak Thakkannavar

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Padasali PS, Thakkannavar V. A Unusual Case of Painless Obstructive Jaundice and Cholangitis: Lemmel’s SyndromeA Case Report. OGH Reports. 2018;7(2):106-8. ABSTRACT A unusual case of periampullary duodenal diverticulum causing obstructive jaundice. Duodenal diverticula are detected in up to 27% of patients undergoing upper gastrointestinal endoscopy with periampullary diverticula (PAD) being the most common type. Although periampullary diverticula rarely cause obstructive jaundice when choledocholithiasis or tumor is not present. The periampullary duodenal diverticulum causing extrinsic compression of common bile duct and obstructive jaundice is called Lemmel’s syndrome. An 58-yr-old woman came to the emergency room with obstructive jaundice and cholangitis. Abdominal CT scan revealed PAD compressing distal CBD with CBD dilatation. PAD shows signs of inflammation in CT scan and Endoscopy. Recognition of this condition is important since misdiagnosis could lead to mismanagement and therapeutic delay. Whenever PAD is present it should always be included as one of the differential diagnosis of obstructive jaundice.

版权所有©2018phcog.net这是一篇基于知识共享署名4.0国际许可协议的开放获取文章。引用本文:Padasali PS, Thakkannavar V. 1例罕见的无痛性梗阻性黄疸和胆管炎:Lemmel综合征病例报告。卫生报告，2018;7(2):106-8。壶腹周围十二指肠憩室引起梗阻性黄疸的罕见病例。在接受上消化道内镜检查的患者中，高达27%的患者可检出十二指肠憩室，其中壶腹周围憩室(PAD)是最常见的类型。虽然壶腹周围憩室很少引起梗阻性黄疸，当胆总管结石或肿瘤不存在。壶腹周围十二指肠憩室引起胆总管外源性压迫和梗阻性黄疸称为Lemmel综合征。一名58岁妇女因梗阻性黄疸和胆管炎来到急诊室。腹部CT扫描显示PAD压迫CBD远端伴CBD扩张。PAD在CT扫描和内窥镜检查中显示炎症征象。认识到这种情况是很重要的，因为误诊可能导致管理不善和治疗延误。无论何时出现PAD，都应作为阻塞性黄疸的鉴别诊断之一。

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引用次数: 0

Metachronous Bilateral Breast Invasive Lobular Carcinoma with Metastasis to an Unusual Site 异时性双侧乳腺浸润性小叶癌伴异常部位转移

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/OGH.2018.7.2.23

Mohd Shafi Moona, A. Ismail, Zuhair Al Khair, Wael Mohamed

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Moona MS, Ismail AM, Khair ZA, Mohamed WM. Metachronous Bilateral Breast Invasive Lobular Carcinoma with Metastasis to an Unusual Site. OGH Reports. 2018;7(2):102-3. ABSTRACT Breast cancer metastasis to stomach occurs rarely and generally derives from infiltrating lobular carcinoma rather than infiltrating ductal carcinoma. We report a case of metachronous bilateral breast infiltrating lobular carcinoma metastasis to stomach in a 46-year-old female, who experienced epigastric pain, intermittent vomiting and weight loss for the duration of four months. Upper GI endoscopy done showed a gastric fundal mass and a biopsy taken. Histopathological examination of a biopsy specimen revealed metastatic lobular carcinoma.

版权所有©2018phcog.net这是一篇基于知识共享署名4.0国际许可协议的开放获取文章。本文来源:Moona MS, Ismail AM, Khair ZA, Mohamed WM。异时性双侧乳腺浸润性小叶癌伴异常部位转移。卫生报告，2018;7(2):102-3。乳腺癌胃转移罕见，且多起源于浸润性小叶癌而非浸润性导管癌。我们报告一例异时性双侧乳腺浸润性小叶癌转移至胃部的病例，患者为46岁女性，经历了四个月的胃脘痛、间歇性呕吐和体重下降。上消化道内窥镜检查显示胃底肿块，并进行了活检。组织病理学检查活检标本显示转移性小叶癌。

引用次数: 0

Squamous Cell Carcinoma Arising from Perianal Fistula in HIV Positive Patient HIV阳性患者肛周瘘并发鳞状细胞癌

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/OGH.2018.7.2.22

P. Silva, Rita Vitorino, C. Travancinha, J. Freire

引用次数: 0

Adding Low Dose Chemotherapy to Preoperative Radiotherapy in Locally Advanced Rectal Cancer: Retrospective Analysis of an Institutional Experience 局部晚期直肠癌术前放疗加低剂量化疗:回顾性机构经验分析

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/ogh.2018.7.2.19

Sanjoy Roy, D. Lahiri, D. Ray, T. Maji, Devleena, P. Chaudhuri

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Roy S, Lahiri D, Ray DK, Maji T, Devleena, Chaudhuri P. Adding Low Dose Chemotherapy to Preoperative Radiotherapy in Locally Advanced Rectal Cancer: Retrospective Analysis of an Institutional Experience. OGH Reports. 2018;7(2):86-90. ABSTRACT Objective: Analysis was done to assess the implications and effectivity of adding chemotherapy to preoperative radiotherapy in locally advanced rectal cancer. It was priority to observe any change in resectibility with combined treatment. Methods: Twenty five patients were randomized to undergo neoadjuvant chemoradiation and were compared head on with only radiation group for locally advanced rectal cancer patients in CNCI, Kolkata. Results: Of the 25 patients in the chemoradiation arm, 20 patients (80%) were potentially resectable. In the radiation only group the number was 16 (64%). [p=0.35] Curative resection with negative margins was possible in 17 patients (68%) in the combined modality arm, as opposed to 13 patients (52%) in the other arm. [p=0.39] The failure rates in the radiation group were higher. [p= 0.49] Median Overall Survival was higher in chemoradiation group (14 months vs. 11 months) as well as median Disease free survival (14 months vs. 12 months) (p = 0.99) in comparison to only radiation group. Conclusion: As a beginner’s experience, it was very encouraging to observe the positive trend of the study and effectively this study allowed us to further proceed with different dose and schedule modulation of chemotherapy and radiotherapy to build up a definitive protocol for locally advanced Rectal cancer in our institute.

版权所有©2018phcog.net这是一篇基于知识共享署名4.0国际许可协议的开放获取文章。Roy S, Lahiri D, Ray DK, Maji T, Devleena, Chaudhuri P.局部晚期直肠癌术前放疗加低剂量化疗的回顾性分析。健康报告，2018;7(2):86-90。摘要目的:分析局部晚期直肠癌术前放疗加化疗的意义及疗效。观察联合治疗后可切除性的变化是优先考虑的。方法:选取25例局部晚期直肠癌患者随机接受新辅助放化疗，与单纯放化疗组进行正面比较。结果:在放化疗组的25例患者中，20例患者(80%)是可切除的。在只接受放射治疗的组中，这一数字为16(64%)。[p=0.35]联合治疗组中有17例(68%)患者可以根治性切除阴性切缘，而另一组中有13例(52%)患者可以根治性切除。[p=0.39]放疗组的失败率较高。[p= 0.49]放化疗组的中位总生存期(14个月vs 11个月)和中位无病生存期(14个月vs 12个月)均高于单纯放化疗组(p = 0.99)。结论:作为一个初学者的经验，观察到研究的积极趋势是非常令人鼓舞的，并且有效地使我们能够进一步进行不同剂量和时间表的化疗和放疗调节，以建立我们研究所局部晚期直肠癌的最终方案。

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引用次数: 0

Unusual Metastases of Hepatocellular Carcinoma: 2 Cases 肝细胞癌异常转移2例

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/ogh.2018.7.2.26

N. A. Kader, R. Abraham, Sathi Pp

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Kader NA, Abraham RM, Sathi PP. Unusual Metastases of Hepatocellular Carcinoma: 2 Cases. OGH Reports. 2018;7(2):109-10. ABSTRACT Most common sites of metastasis from hepatocellular carcinoma (HCC) are lung, bone and lymph nodes. Metastatic tumours are associated with very poor survival. We present two cases of metastatic HCCs to very rare sites.

引用次数: 1

Prospective Evaluation of Outcome following Exploratory Laparotomy in Patients with Peritonitis due to Large Bowel Perforation 大肠穿孔所致腹膜炎剖腹探查术后预后的前瞻性评价

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/OGH.2018.7.2.20

P. Siddharth, P. Tushar, M. Sanjay, S. Hardeep, Pandey Tanica

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Siddharth P, Tushar P, Sanjay M, Hardeep S, Tanica P. Prospective Evaluation of Outcome following Exploratory Laparotomy in Patients with Peritonitis due to Large Bowel Perforation. OGH Reports. 2018;7(2):91-4. ABSTRACT Context: Large bowel perforation is mostly seen in association with colo-rectal carcinoma. Diverticulitis is a common cause for large bowel perforation in the west while it is rarely seen in India. Recent studies advocate a primary procedure in the setting of large bowel perforations. Aims: The study was done to study the etiology, management and outcome of large bowel perforations. Settings and Design: This was a prospective observational study. Materials and Methods: The study was conducted over a period of three years including 24 patients with large bowel perforations who underwent exploratory laparotomy. Surgical procedure was planned on basis of Mannheim Peritonitis Index (MPI). Outcome in terms of mortality rate during index admission was evaluated. Statistical analysis used: The Chi square test and student’s t test were used for qualitative and quantitative variables respectively. The factors found significant on Univariate analysis were assessed in a multivariate analysis. Results: Colo-rectal carcinoma was the most common aetiology present in 12 (50%) cases. Hartmann’s procedure was done in 17 (70.9%) patients. Primary anastomosis was done in 4 patients and all of them faired well post-operatively. On multivariate analysis septic shock at presentation (OR=23.3, 95% CI=1.7-2.0, p<0.001) and MPI>35 (OR=17.8, 95% CI=1.5-1.9, p=0.006) were found to be the significant factors associated with mortality. All the bacterial isolates in peritoneal fluid culture samples were extended-spectrum betalactamase (ESBL) producing species. Conclusion: A primary procedure can be safely carried out in patients of large bowel perforation with a low MPI. MPI serves as useful guide to plan surgical procedure and predict the outcome.

版权所有©2018phcog.net这是一篇基于知识共享署名4.0国际许可协议的开放获取文章。引用本文:Siddharth P, Tushar P, Sanjay M, Hardeep S, Tanica P.剖腹探查术治疗大肠穿孔所致腹膜炎的疗效评价。健康报告，2018;7(2):91-4。摘要背景:大肠穿孔多见于结直肠癌。憩室炎在西方是大肠穿孔的常见原因，而在印度却很少见。最近的研究提倡在大肠穿孔的情况下进行初级手术。目的:研究大肠穿孔的病因、治疗和预后。背景和设计:这是一项前瞻性观察性研究。材料和方法:本研究历时三年，包括24例经剖腹探查的大肠穿孔患者。根据Mannheim腹膜炎指数(MPI)计划手术。以入院时的死亡率作为评价指标。采用统计分析:定性变量采用卡方检验，定量变量采用学生t检验。在单因素分析中发现的显著因素在多因素分析中进行评估。结果:结直肠癌是最常见的病因，12例(50%)。17例(70.9%)患者行Hartmann手术。4例患者均行一期吻合，术后效果良好。在多因素分析中，脓毒性休克(OR=23.3, 95% CI=1.7-2.0, p35 (OR=17.8, 95% CI=1.5-1.9, p=0.006)被发现是与死亡率相关的重要因素。腹膜液培养样品中分离的细菌均为广谱β -内酰胺酶(ESBL)产生菌。结论:对于低MPI的大肠穿孔患者，一期手术可以安全进行。MPI可作为外科手术计划和预后预测的有用指南。

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引用次数: 1

Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and Right Atrium 肝细胞癌伴下腔静脉及右心房肿瘤血栓

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/ogh.2018.7.2.21

A. Gupta, N. Sinha, S. Mularz, M. Bernstein

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Gupta A, Sinha N, Mularz S, Bernstein M. Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and Right Atrium. OGH Reports. 2018;7(2):95-7. ABSTRACT We present a rare case of hepatocellular carcinoma with associated tumor thrombus that extends into the inferior vena cava and right atrium. Our patient presented with lower extremity edema and an elevated D-dimer. CT pulmonary angiography showed no signs of pulmonary embolism however it showed large filling defects involving the inferior vena cava, right atrium, right ventricle and superior vena cava suggestive of an extensive thrombus. On subsequent imaging studies it was identified as a tumor thrombus as opposed to a blood thrombus. A tumor thrombus is a rare complication more commonly associated with renal cell carcinoma and carries a poor prognosis. Surgical thrombectomy is considered the first line of treatment at this time, however, due to the low number of known cases to have IVC and RA involvement, there is little consensus on management. Often patients are referred for microwave ablation. Anti-coagulation is not the treatment of choice for a tumor thrombus however we speculate there may be a role for anti-coagulation.

版权所有©2018phcog.net这是一篇基于知识共享署名4.0国际许可协议的开放获取文章。引用本文:Gupta A, Sinha N, Mularz S, Bernstein M.肝细胞癌伴下腔静脉和右心房肿瘤血栓。健康报告，2018;7(2):95-7。摘要我们报告一例罕见的肝癌伴肿瘤血栓延伸至下腔静脉和右心房的病例。我们的病人表现为下肢水肿和d -二聚体升高。CT肺血管造影未见肺栓塞征象，但显示下腔静脉、右心房、右心室及上腔静脉存在较大充盈缺损，提示广泛血栓形成。在随后的影像学研究中，它被确定为肿瘤血栓而不是血栓。肿瘤血栓是一种罕见的并发症，通常与肾细胞癌相关，预后较差。手术取栓被认为是目前的一线治疗方法，然而，由于已知累及下腔静脉和类风湿性关节炎的病例很少，因此在治疗上几乎没有共识。通常患者会被转介进行微波消融术。抗凝不是肿瘤血栓的首选治疗方法，但我们推测抗凝可能有一定的作用。

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引用次数: 0

Lipoleiomyoma of Uterus-A Rare Entity 子宫脂肪肌瘤-一种罕见的实体

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-11-26 DOI: 10.5530/ogh.2018.7.2.24

Swati Patki, P. Shah

引用次数: 0

Tumor size and its Relation to Cervical Lymph Node Metastasis and its Significance as a Prognostic Indicator for Oral Squamous Cell Carcinomas (OSCCs) 口腔鳞状细胞癌肿瘤大小及其与颈部淋巴结转移的关系及其作为预后指标的意义

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-04-10 DOI: 10.5530/OGH.2018.7.1.13

A. Nayyar, K. Krishna, K. Priyadarsini, M. Ratnam, B. VenuNaidu

引用次数: 3

Clinical Study of only One Stage Esophagoplasty by using Jejunum with Esophageal Stricture 食管狭窄空肠单期食管成形术的临床研究

Oncology, Gastroenterology and Hepatology Reports

Pub Date : 2018-04-10 DOI: 10.5530/OGH.2018.7.1.18

Hw Liu, Hyon-Jong Kim, Mun Sob Won, Myong Nam Ri, Yong Liu

Copyright © 2018 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article: Liu HS, Kim HJ, Won MS, Ri MN, Liu YJ. Clinical Study of only One Stage Esophagoplasty by using Jejunum with Esophageal Stricture. OGH Reports. 2018;7(1):80-5. ABSTRACT Background: Esophagoplasty is very important in the patients who couldn’t eat normal cereal since they had organic and functional diseases in esophagus. Esophagoplasty is including multi-stage plasty and one-stage one, but most surgeon in thoracic field was concerned that one-stage plasty was reduced the duration of hospitalization, mental and physical burden, especially complications and sequelae after operations. Method: Between January 1999 and December 2015, 432 consecutive cases of cicatrical esophageal stricture were enrolled in the study at Pyongyang medical college hospital, Kim Il Sung University. The patients were randomly selected to undergo one-stage esophagoplasty (study group, 71 cases) or stepby-step esophagoplasty (control group, 361 cases). Result: One stage esophagoplasty with jejunum is associated with good postoperative result (effectiveness shortly after operation 97.2±2.7%, follow up effectiveness 98.4±2.6%) and more simplified operating method, so it is possible to introduce into the clinical practice of esophagus surgery. Conclusion: One stage esophagoplasty with jejunum is more simplified and needs less operation time compared with step by step esophagoplasty. It is also related with good postoperative result and less complication, which allows the wide introduction into the clinical practice of esophagus surgery.

版权所有©2018phcog.net这是一篇基于知识共享署名4.0国际许可协议的开放获取文章。本文引用本文:刘合生，金海军，袁美明，李美明，刘玉军。食管狭窄空肠单期食管成形术的临床研究。卫生报告，2018;7(1):80-5。背景:食管成形术对于因食道器质性和功能性疾病而不能正常食用谷物的患者非常重要。食管成形术包括多期成形术和一期成形术，但大多数胸外科医生关注的是一期成形术减少住院时间，减少精神和身体负担，尤其是术后并发症和后遗症。方法:选取金日成大学附属平壤医学院附属医院1999年1月至2015年12月连续432例瘢痕性食管狭窄患者为研究对象。随机选择患者进行一期食管成形术(研究组71例)或逐步食管成形术(对照组361例)。结果:一期空肠食管成形术术后效果好(术后短期有效率97.2±2.7%，随访有效率98.4±2.6%)，操作方法更简便，可推广到食管外科的临床实践中。结论:一期空肠食管成形术较分步食管成形术更简便，手术时间更短。术后效果好，并发症少，可广泛应用于食道手术的临床实践。

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