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Secondary CBD Stone due to Curry Leaf Stems: A Case Report and Review of Literature 咖喱叶茎继发CBD结石一例报告及文献综述
A. Teja, A. Pujahari
1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. World Health Organization classification of tumours of soft tissue and bone. Fourth Edition. Vol 5. Lyon: IARC Press; 2013. pp. 230–231 2. Hornick JL, Fletcher CD. PEComa: What do we know so far? Histopathology. 2006;48:75–82 3. Folpe AL, Goodman ZD, Ishak KG, Paulino AF, Taboada EM, Meehan SA, et al. Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults. Am J Surg Pathol. 2000;24:1239–1246 4. Tsui WM, Colombari R, Portmann BC, Bonetti F, Thung SN, Ferrell LD, Nakanuma Y, Snover DC, Bioulac-Sage P, Dhillon AP. Hepatic angiomyolipoma: A clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol. 1999;23:34–48 5. Ooi SM, Vivian JB, Cohen RJ. The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma. Int Urol Nephrol. 2009;41:559– 565. 6. Martignoni G, Pea M, Reghellin D, Zamboni G, Bonetti F. PEComas: The past, the present and the future. Virchows Arch. 2008;452:119–132. doi: 10.1007/s00428-007-0509-1 7. Brimo F, Robinson B, Guo C, Zhou M, Latour M, Epstein JI. Renal epithelioid angiomyolipoma with atypia: a series of 40 cases with emphasis on clinicopathologic prognostic indicators of malignancy. Am J Surg Pathol. 2010;34:715– 722. 8. Deng YF, Lin Q, Zhang SH, Ling YM, He JK, Chen XF. Malignant angiomyolipoma in the liver: a case report with pathological and molecular analysis. Pathol Res Pract. 2008;204:911–918 9. Xu H, Wang H, Zhang X, Li G. [Hepatic epithelioid angiomyolipoma: a clinicopathologic analysis of 25 cases] Zhonghua Bing Li Xue Zazhi. 2014;43:685–689.
1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F.世界卫生组织软组织和骨骼肿瘤分类。第四版。卷5。里昂:IARC出版社;2013. 第230-231页佩科马:到目前为止我们知道些什么?中华病理学杂志。2006;48:75-82Folpe AL, Goodman ZD, Ishak KG, Paulino AF, Taboada EM, Meehan SA,等。镰状韧带/圆韧带透明细胞肌黑素细胞肿瘤:血管周围上皮样透明细胞肿瘤家族的新成员,易发生于儿童和年轻人。[J]中华外科杂志,2000;24:1239-1246。徐文m, Colombari R, Portmann BC, Bonetti F, Thung SN, Ferrell LD, Nakanuma Y, Snover DC, Bioulac-Sage P, Dhillon AP.肝脏血管平滑肌脂肪瘤:30例临床病理研究及异常形态变异描述。[J]中华外科杂志,1999;23:34-48。黄晓明,吴文杰,孔瑞杰。Ki-67标志物在肾血管平滑肌脂肪瘤上皮样变的病理诊断中的应用。中华医学杂志,2009;41(1):559 - 565。6. 马提尼·G,皮亚·M,瑞格林·D,赞博尼·G,博内蒂·F.佩科玛斯:过去、现在和未来。中国生物医学工程学报,2008;42(2):119 - 132。Doi: 10.1007/s00428-007-0509-1刘建军,刘建军,刘建军,刘建军。肾上皮样血管平滑肌脂肪瘤伴非典型性:附40例报告,重点讨论恶性肿瘤的临床病理预后指标。中华外科杂志,2010;34(4):715 - 722。8. 邓云峰,林强,张生,凌彦明,何建军,陈晓峰。肝脏恶性血管平滑肌脂肪瘤1例病理及分子分析。中华疾病杂志,2008;04:911 - 918。王许H, H,张X,李g(肝上皮样血管肌脂肪瘤:25例的临床病理的分析]中华Bing李雪以。2014;43:685 - 689。
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引用次数: 0
Acute Severe Pancreatitis and Bilateral Renal Cortical Necrosis 急性重症胰腺炎和双侧肾皮质坏死
R. Yadav, S. Gamanagatti, Atin Kumar, Subodh Kumar
Corresponding Author: Dr Shivanand Gamanagatti Email: shiv223@gmail.com Acute Severe Pancreatitis and Bilateral Renal Cortical Necrosis The diagnosis can be challenging since it may not be possible to distinguish AFNAC from ulcerative colitis or Crohns’ disease since they can have a similar presentation.1-3 Clinical symptoms and signs, laboratory investigations, and radiology remain inconclusive in distinguishing between them. The presence of trophozoites, especially if showing erythrophagocytosis (ingested red blood cells in the cytoplasm) in fresh stool samples of symptomatic patients, was typically considered diagnostic; recently, erythrophagocytosis has been reported in non-pathogenic trophozoites too. Serological tests for amoebiasis are of doubtful value in endemic areas as they cannot distinguish between prior and present infection; antigen detection in stool and molecular techniques using polymerase chain reaction are highly sensitive, but not easily accessible. In the absence of these tests, the only means of definitely establishing the diagnosis may be a demonstration of trophozoites of E. histolytica on histopathology.4 Surgery should be expedited in AFNAC.1-3 Bowel involvement dictates the extent of the colonic resection; primary anastomosis is usually precluded since the colon is very friable, and it is safer to resect and exteriorize the proximal and distal bowel to be restored at a later date.1-3,5 Amoebicidal therapy (metronidazole followed by luminal agents such as diloxanide furoate) should be given in suspected cases, and continued if the diagnosis is confirmed.
通讯作者:Shivanand Gamanagatti博士电子邮件:shiv223@gmail.com急性重症胰腺炎和双侧肾皮质坏死的诊断可能具有挑战性,因为可能无法将AFNAC与溃疡性结肠炎或克罗恩病区分开来,因为它们具有相似的表现。临床症状和体征、实验室检查和放射学在区分它们方面仍然没有定论。滋养体的存在,特别是在有症状患者的新鲜粪便样本中显示红细胞吞噬(摄取细胞质中的红细胞),通常被认为是诊断;最近,在非致病性滋养体中也有红细胞吞噬的报道。阿米巴病血清学检测在流行地区的价值值得怀疑,因为它们不能区分既往感染和当前感染;粪便抗原检测和利用聚合酶链反应的分子技术是高度敏感的,但不容易获得。在没有这些检查的情况下,确定诊断的唯一方法可能是在组织病理学上显示溶组织芽胞杆菌的滋养体afnac患者应加快手术。1-3肠受累程度决定结肠切除的程度;由于结肠非常脆弱,通常不进行一期吻合,切除并取出近端和远端肠以在以后恢复更为安全。疑似病例应给予阿米巴杀菌剂治疗(甲硝唑加氟乙酸二氧胺等药物),确诊后继续治疗。
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引用次数: 0
Hepatic Epithelioid Angiomyoli-poma of the Liver: A Diagnostic Dilemma 肝上皮样血管平滑肌脂肪瘤:诊断困境
B. Nalini, V. Vij, Arif Ali, Praveen Kumar
1. Anandan AK, Balachandran P, Chowksey A, Sankaranarayanan G, Samuel U. Bilateral renal cortical necrosis following acute pancreatitis A rare complication of a common disease. Saudi J Kidney Dis Transpl 2018; 29:1211-5. 2. Petejova N, Martinek A. Acute kidney injury following acute pancreatitis: A review. Biomed Pap Med FacUnivPalacky Olomouc Czech Repub. 2013 Jun;157(2):105-13. 3. Krishna GS, Kishore KC, Sriram NP, Sainaresh VV, Lakshmi AY, Siva Kumar V. Bilateral renal cortical necrosis in acute pancreatitis. Indian J Nephrol. 2009 Jul;19(3):125. 4. Thuysbaert T, Standaert C, De Visschere P. Reverse Rim Sign. J Belg Soc Radiol. 2018 Feb 14;102(1):27. 5. Dyer RB, Chen MY, Zagoria RJ. Classic signs in uroradiology. Radiographics. 2004 Oct;24 Suppl 1:S24780. Review. 6. Badiola-Varela CM. Acute renal cortical necrosis: contrastenhanced CT and pathologic correlation. UrolRadiol. 1992;14(3):159-60 7. Goergen TG, Lindstrom RR, Tan H, Lilley JJ. CT appearance of acute renal cortical necrosis. AJR Am J Roentgenol. 1981 Jul;137(1):176-7. 8. Chugh KS, Jha V, Sakhuja V, Joshi K. Acute renal cortical necrosis – A study of 113 patients. Ren Fail 1994;16:37-47. Bansal Nalini1 Vivek Vij2 Arif Ali2 Praveen Kumar3
1. Anandan AK, Balachandran P, Chowksey A, Sankaranarayanan G, Samuel u。急性胰腺炎后双侧肾皮质坏死是一种罕见的常见并发症。沙特肾脏病杂志2018;29:1211-5。2. 李建平,李建平。急性胰腺炎并发急性肾损伤的研究进展。中华生物医学杂志,2013,31(2):105-13。3.Krishna GS, Kishore KC, Sriram NP, Sainaresh VV, Lakshmi AY, Siva Kumar V.急性胰腺炎双侧肾皮质坏死。中国生物医学工程学报。2009;19(3):125。4. 李建军,李建军,李建军,等。中国生物医学工程学报,2018,32(1):444 - 444。5. 陈建军,陈建军,陈建军。放射学的典型征象。放射学。2004 Oct;24增刊1:S24780。审查。6。Badiola-Varela厘米。急性肾皮质坏死:增强CT与病理对比。UrolRadiol。60 1992; 14(3): 159 - 7。高根TG,林德龙RR,谭宏,李俊杰。急性肾皮质坏死的CT表现。张建军,张建军,张建军,等。生物医学工程学报,2011,30(1):379 - 379。8. Chugh KS, Jha V, Sakhuja V, Joshi K.急性肾皮质坏死- 113例患者的研究。任失败1994;16:37-47。Bansal Nalini1 Vivek Vij2 Arif Ali2 Praveen Kumar3
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引用次数: 0
Successful Closure of Penetrating Rectal Injury Using Flexible Endoscopic Over-the-Scope-Clip (OTSC) 应用柔性内镜镜内夹(OTSC)成功闭合穿透性直肠损伤
A. Jain, Sudesh Sharda, A. Joshi, Suchita Jain
Penetrating rectal injuries in civilian surgical practice are mostly due to gun-shot injuries or stab injuries in buttock area1. Treatment algorithm of these penetrating injuries depends upon whether its a gun-shot or stab wound. Irrespective, the management of these injuries is challenging and depends upon associated internal injuries. Fundamental management principles of rectal injury secondary to stab wound include direct primary closure, fecal diversion, presacral drainage or distal rectal washout.2 We report a case of stab injury to the natal cleft region with the rectal injury which was successfully managed endoscopically by using over-the-scope-clip (OTSC).
在民用外科实践中,直肠穿透伤多由臀部的枪伤或刀伤引起。这些穿透伤的治疗方法取决于它是枪伤还是刺伤。无论如何,这些损伤的管理是具有挑战性的,并取决于相关的内伤。刀伤继发直肠损伤的基本处理原则包括直接初级闭合、粪便分流、骶前引流或直肠远端冲洗我们报告的情况下,刺伤出生裂区直肠损伤成功地管理内窥镜下使用过镜夹(OTSC)。
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引用次数: 0
Hydatid Cyst of the Pancreas: A Diagnostic Dilemma 胰腺包虫囊肿:诊断困境
A. Javed, G. Agarwal, Aravinda Ps, J. Manipadam, S. Puri, A. Agarwal
Background : Hydatid cyst of the pancreas is rare and differentiating from more common cystic lesions of the pancreas is difficult preoperatively. Patients and Methods : Retrospective analysis of consecutive patients with intra-abdominal hydatid disease in our center from January 2000 to December 2017. We identified six patients with pancreatic hydatid cyst during the study period, which made our study group. Results: Of 310 patients with intra-abdominal hydatid cysts, only 6 (1.9%) patients had pancreatic hydatid cysts. The age ranged from 14 to 48 years, and all six were female. Pain was the predominant symptom in all patients, associated with abdominal mass in four patients, nausea in 2 patients, and fever in 1 patient. Intracystic bleeding complicated one patient. Cysts were isolated to the pancreas in all cases, being located in the head of the pancreas in one patient, body in one patient, tail in two patients, body and tail of the pancreas in two patients. The average size of the cyst was 8.8 cm (range: 5 to 14 cm). Hydatid serology was positive in three patients; therefore, accurate preoperative diagnosis was established in only three patients (50%). Besides albendazole therapy, four patients underwent open surgery, and two underwent laparoscopic surgery. Surgical procedures included emergency distal pancreatico-splenectomy, cysto-pericystectomy, deroofing with and without Roux-en-Y cysto-jejunostomy, and distal pancreatectomy. The patients did well with a mean follow-up of 41.5 months, without recurrence. Conclusion : Primary pancreatic hydatid cysts are rare, difficult to diagnose, and timely intervention avoids life-threatening complications. Cyst-enteric anastomosis in patients undergoing deroofing may prevent pancreatic fistula, and laparoscopic surgery is feasible and safe.
背景:胰腺包虫囊肿是罕见的,术前很难与更常见的胰腺囊性病变鉴别。患者与方法:回顾性分析我院2000年1月至2017年12月连续收治的腹内包虫病患者。我们在研究期间确定了6例胰腺包虫囊肿患者,使我们的研究组。结果:310例腹内包虫囊肿患者中,只有6例(1.9%)患者有胰腺包虫囊肿。年龄14 ~ 48岁,6例均为女性。所有患者的主要症状为疼痛,4例伴有腹部肿块,2例伴有恶心,1例伴有发热。1例患者并发囊内出血。所有病例的囊肿均分离到胰腺,1例位于胰腺头部,1例位于胰腺体,2例位于胰腺尾,2例位于胰腺体和胰腺尾。囊肿平均大小为8.8 cm(范围:5 ~ 14 cm)。3例包虫血清学阳性;因此,只有3例(50%)患者的术前诊断是准确的。除阿苯达唑治疗外,4例患者行开放手术,2例患者行腹腔镜手术。外科手术包括急诊远端胰脾切除术、膀胱包皮切除术、伴或不伴Roux-en-Y膀胱空肠吻合术和远端胰腺切除术。患者的平均随访时间为41.5个月,无复发。结论:原发性胰腺包虫病罕见,诊断困难,及时干预可避免危及生命的并发症。膀胱肠吻合术可预防胰瘘,腹腔镜手术可行且安全。
{"title":"Hydatid Cyst of the Pancreas: A Diagnostic Dilemma","authors":"A. Javed, G. Agarwal, Aravinda Ps, J. Manipadam, S. Puri, A. Agarwal","doi":"10.7869/TG.582","DOIUrl":"https://doi.org/10.7869/TG.582","url":null,"abstract":"Background : Hydatid cyst of the pancreas is rare and differentiating from more common cystic lesions of the pancreas is difficult preoperatively. Patients and Methods : Retrospective analysis of consecutive patients with intra-abdominal hydatid disease in our center from January 2000 to December 2017. We identified six patients with pancreatic hydatid cyst during the study period, which made our study group. Results: Of 310 patients with intra-abdominal hydatid cysts, only 6 (1.9%) patients had pancreatic hydatid cysts. The age ranged from 14 to 48 years, and all six were female. Pain was the predominant symptom in all patients, associated with abdominal mass in four patients, nausea in 2 patients, and fever in 1 patient. Intracystic bleeding complicated one patient. Cysts were isolated to the pancreas in all cases, being located in the head of the pancreas in one patient, body in one patient, tail in two patients, body and tail of the pancreas in two patients. The average size of the cyst was 8.8 cm (range: 5 to 14 cm). Hydatid serology was positive in three patients; therefore, accurate preoperative diagnosis was established in only three patients (50%). Besides albendazole therapy, four patients underwent open surgery, and two underwent laparoscopic surgery. Surgical procedures included emergency distal pancreatico-splenectomy, cysto-pericystectomy, deroofing with and without Roux-en-Y cysto-jejunostomy, and distal pancreatectomy. The patients did well with a mean follow-up of 41.5 months, without recurrence. Conclusion : Primary pancreatic hydatid cysts are rare, difficult to diagnose, and timely intervention avoids life-threatening complications. Cyst-enteric anastomosis in patients undergoing deroofing may prevent pancreatic fistula, and laparoscopic surgery is feasible and safe.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90758736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Liver Transplantation Program in India: The Core-Satellites Model 印度肝移植项目:核心-卫星模型
Magnus Mansard, R. Siddachari, Goutham Kumar, N. Subramanian, A. Olithselvan
Background : Liver transplants in India are mostly done in a few large volume centers. There are many small volume centers which use the expertise and support from these large volume centers to carry out liver transplantations. The effectiveness of this model where a core large volume center supports the smaller volume satellite centers has not been evaluated before. Aim : To assess the outcomes of patients transplanted atsatellite centres and monitored remotely and compare them with those transplanted in the core center and managed by an in-house team. Results : The recipients in the satellite centers were younger than those in the core hospital. The other parameters were comparable. The donors were younger in the satellite hospitals than those in the core hospital.The incidence of early graft dysfunction was lesser in the peripheral hospitals than in the core hospital (5 [10.20%] vs 11 [35.48%],p = 0.009). The length of postoperative hospital stay was also lesser among patients operated in the satellite centers (15.96 ± 6.75 vs 20.59 ± 10.14, p = 0.018). Conclusion : This core-satellites model has been shown to be an effective model in the performance of liver transplantations at multiple centers with equivalent outcomes.
背景:印度的肝移植大多是在几个大容量的中心进行的。有许多小容量中心利用这些大容量中心的专业知识和支持来进行肝移植。该模型的有效性,其中一个核心大体积中心支持较小体积的卫星中心,以前没有评估。目的:评估在卫星中心移植并远程监测的患者的预后,并将其与在核心中心移植并由内部团队管理的患者进行比较。结果:卫星中心的受赠者比核心医院的受赠者年轻。其他参数具有可比性。卫星医院的献血者比核心医院的献血者年轻。外围医院早期移植物功能障碍发生率低于核心医院(5例[10.20%]vs 11例[35.48%],p = 0.009)。在卫星中心手术的患者术后住院时间也较短(15.96±6.75 vs 20.59±10.14,p = 0.018)。结论:该核心-卫星模型已被证明是一种有效的多中心肝移植模型,具有等效的结果。
{"title":"Liver Transplantation Program in India: The Core-Satellites Model","authors":"Magnus Mansard, R. Siddachari, Goutham Kumar, N. Subramanian, A. Olithselvan","doi":"10.7869/TG.579","DOIUrl":"https://doi.org/10.7869/TG.579","url":null,"abstract":"Background : Liver transplants in India are mostly done in a few large volume centers. There are many small volume centers which use the expertise and support from these large volume centers to carry out liver transplantations. The effectiveness of this model where a core large volume center supports the smaller volume satellite centers has not been evaluated before. Aim : To assess the outcomes of patients transplanted atsatellite centres and monitored remotely and compare them with those transplanted in the core center and managed by an in-house team. Results : The recipients in the satellite centers were younger than those in the core hospital. The other parameters were comparable. The donors were younger in the satellite hospitals than those in the core hospital.The incidence of early graft dysfunction was lesser in the peripheral hospitals than in the core hospital (5 [10.20%] vs 11 [35.48%],p = 0.009). The length of postoperative hospital stay was also lesser among patients operated in the satellite centers (15.96 ± 6.75 vs 20.59 ± 10.14, p = 0.018). Conclusion : This core-satellites model has been shown to be an effective model in the performance of liver transplantations at multiple centers with equivalent outcomes.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84394132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Laparoscopic Lateral Pancreatico-jejunostomy: An Experience from a Tertiary Care Center 腹腔镜外侧胰空肠吻合术:来自三级护理中心的经验
A. Javed, Shashi Kiran Bd, Aravinda Ps, M. Saravanan, A. Agarwal
Background: Surgical options for patients of chronic pancreatitis with refractory pain include drainage and/or resectional procedures. Lateral pancreatojejunostomy (LPJ), the commonly performed drainage operation has traditionally been done as open procedure. Laparoscopic LPJ is a technically demanding procedures and is presently gaining acceptance in many centers. Patients and methods: Retrospective analysis of prospectively maintained patient database of chronic pancreatitis at our center from January 2007 to April 2018. Results: During the study period, 41 patients underwent laparoscopic LPJ and constituted the study group. Of the 41 patients, 26 were male.Their mean age was 30.7 (7-51) years. Pain was the main indication of surgery. Nine patients had diabetes and 6 had steatorrhea. The mean MPD diameter was 13.6 (8-25) mm. The mean duration of surgery was 180 (140-340) min and blood loss was 110 ml. There was no mortality. Postoperative hospital stay was 5 (3-9) days and satisfactory pain relief was seen in 91% on at least 3 months follow-up. Follow-up period ranged from 1 to 109 months (average-43.6 months). Conclusions: Laparoscopic LPJ is feasible and safe with good short and long-term outcomes in selected groups of patients.However, it is a technically demanding procedure and should be done by a surgeon well versed with laparoscopic skills including suturing and knotting..
背景:慢性胰腺炎难治性疼痛患者的手术选择包括引流和/或切除手术。外侧胰空肠吻合术(LPJ)是一种常用的引流手术,传统上是开放的。腹腔镜下LPJ是一项技术要求很高的手术,目前在许多中心得到认可。患者与方法:回顾性分析本中心2007年1月至2018年4月前瞻性维护的慢性胰腺炎患者数据库。结果:研究期间,41例患者行腹腔镜下LPJ,构成研究组。41例患者中,26例为男性。平均年龄30.7岁(7-51岁)。疼痛是手术的主要指征。9例有糖尿病,6例有脂肪漏。平均MPD直径为13.6 (8-25)mm,平均手术时间为180 (140-340)min,出血量为110 ml,无死亡。术后住院时间为5(3-9)天,在至少3个月的随访中,91%的患者疼痛缓解满意。随访1 ~ 109个月,平均43.6个月。结论:在选定的患者组中,腹腔镜LPJ是可行且安全的,具有良好的短期和长期预后。然而,这是一个技术要求很高的程序,应该由精通腹腔镜技术的外科医生来完成,包括缝合和打结。
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引用次数: 2
Acute Fulminant Necrotising Amoebic Colitis 急性暴发性坏死性阿米巴结肠炎
R. Kaushik, Simrandeep Singh, R. Punia
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引用次数: 1
Idiopathic Chronic Pancreatitis in Bihar: A Perspective from Eastern India 比哈尔邦的特发性慢性胰腺炎:来自印度东部的视角
U. Anand, Ramesh Kumar, R. Priyadarshi, B. Kumar, Sanjay Kumar, K. Parasar
Background: There is a lack of data describing the clinical profile, complications, and treatment outcome of patients with idiopathic chronic pancreatitis (ICP) from Eastern India. The current study aimed to present data on these aspects from a tertiary care centre of Bihar a part of Eastern India. Methods: Prospective data were collected with regard to clinic-epidemiological profile, complication, and treatment outcome from each patient of ICP (n=129). The median follow-up period was 3.8 (01 06) years. Results: ICP constituted the most common (64.1%, 129/201) cause of chronic pancreatitis. The mean age ± SD of ICP patients was 31.5 ± 11.2 years, and 71 (55%) were male. Diabetes and symptomatic steatorrhea were found in 25% (n=33) and 6.2% (n=08) patients. Pancreatic head mass was found in 43 (33%) patients, of which 17 (39.5%) was malignant. When patients were categorized into early-onset (= 30 years) and late-onset (>30 years) groups, no significant difference was found with regard to the proportion of patients with diabetes, head mass, and malignancy. The majority (69.7%) of patients required surgery (Frey’s procedure) due to failed medical therapy. Seventy-four (82%) patients had significant pain relief during a median follow-up of 3.8 years after surgery. Conclusions: ICP is the most common cause of chronic pancreatitis in Bihar. The majority of such patients are young, with slight male preponderance. They have a significant risk of developing diabetes and pancreatic malignancy. They are poorly responsive to medical therapy, and the outcome of surgical therapy is good.
背景:缺乏描述印度东部特发性慢性胰腺炎(ICP)患者的临床特征、并发症和治疗结果的数据。目前的研究旨在从印度东部比哈尔邦的一个三级保健中心提供这些方面的数据。方法:收集每例ICP患者(n=129)的临床流行病学资料、并发症及治疗结果等前瞻性资料。中位随访时间为3.8(01 - 06)年。结果:ICP是最常见的慢性胰腺炎病因(64.1%,129/201)。ICP患者的平均年龄±SD为31.5±11.2岁,男性71例(55%)。25% (n=33)和6.2% (n=08)的患者出现糖尿病和症状性脂肪漏。43例(33%)患者发现胰腺头肿块,其中17例(39.5%)为恶性。将患者分为早发型组(= 30岁)和晚发型组(bbb30岁),两组患者合并糖尿病、头部肿块和恶性肿瘤的比例无显著差异。由于药物治疗失败,大多数(69.7%)患者需要手术(Frey手术)。术后中位随访3.8年,74例(82%)患者疼痛明显缓解。结论:ICP是比哈尔邦慢性胰腺炎最常见的病因。这类患者多为年轻人,男性略占优势。他们患糖尿病和胰腺恶性肿瘤的风险很大。他们对药物治疗反应较差,手术治疗效果良好。
{"title":"Idiopathic Chronic Pancreatitis in Bihar: A Perspective from Eastern India","authors":"U. Anand, Ramesh Kumar, R. Priyadarshi, B. Kumar, Sanjay Kumar, K. Parasar","doi":"10.7869/TG.580","DOIUrl":"https://doi.org/10.7869/TG.580","url":null,"abstract":"Background: There is a lack of data describing the clinical profile, complications, and treatment outcome of patients with idiopathic chronic pancreatitis (ICP) from Eastern India. The current study aimed to present data on these aspects from a tertiary care centre of Bihar a part of Eastern India. Methods: Prospective data were collected with regard to clinic-epidemiological profile, complication, and treatment outcome from each patient of ICP (n=129). The median follow-up period was 3.8 (01 06) years. Results: ICP constituted the most common (64.1%, 129/201) cause of chronic pancreatitis. The mean age ± SD of ICP patients was 31.5 ± 11.2 years, and 71 (55%) were male. Diabetes and symptomatic steatorrhea were found in 25% (n=33) and 6.2% (n=08) patients. Pancreatic head mass was found in 43 (33%) patients, of which 17 (39.5%) was malignant. When patients were categorized into early-onset (= 30 years) and late-onset (>30 years) groups, no significant difference was found with regard to the proportion of patients with diabetes, head mass, and malignancy. The majority (69.7%) of patients required surgery (Frey’s procedure) due to failed medical therapy. Seventy-four (82%) patients had significant pain relief during a median follow-up of 3.8 years after surgery. Conclusions: ICP is the most common cause of chronic pancreatitis in Bihar. The majority of such patients are young, with slight male preponderance. They have a significant risk of developing diabetes and pancreatic malignancy. They are poorly responsive to medical therapy, and the outcome of surgical therapy is good.","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85245498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Appointments: They give, I take 预约:他们给,我接受
Vyom Aggarwal
{"title":"Appointments: They give, I take","authors":"Vyom Aggarwal","doi":"10.7869/TG.583","DOIUrl":"https://doi.org/10.7869/TG.583","url":null,"abstract":"","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91354116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Tropical gastroenterology : official journal of the Digestive Diseases Foundation
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