• Title/Summary/Keyword: Pancreatic lesion

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A Case of Intussusception Caused by Meckel's Diverticulum with Heterotopic Pancreatic and Gastric Tissues (이소성 췌장과 위점막을 가진 멕켈 게실에 의한 장중첩증 1예)

  • Kim, Mi Jin;Kim, Jae Young;Sul, Ji Young;Kang, Dae Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.75-79
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    • 2006
  • Intussusception is a frequent cause of intestinal obstruction in early childhood and most are idiopathic in origin. In a minority of cases a definite pathological lead point is identified by imaging studying or during surgery. As the pathologic lead point of intussusception, Meckel's diverticulum is the most common lesion. In symptomatic patients, 40~60% of Meckel's diverticulum contain ectopic tissue, with gastric mucosa being far the most common type. A few Meckel's diverticulum contain pancreatic tissue. Combined heterotopic pancreatic and gastric tissues in the Meckel's diverticulum especially causing intussusception is extremely rare. We report the case of 5-year-old girl with an intussusception caused by Meckel's diverticulum containing both heterotopic gastric and pancreatic tissues.

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The roles of endoscopic ultrasound in the diagnosis of pancreatobiliary cancer (췌·담도암 진단에 있어서 내시경초음파의 역할)

  • Kim, Kook Hyun
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.77-84
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    • 2016
  • Pancreatic cancer, the 4th leading cause of cancer-related death in the United States, has a very poor prognosis. Cholangiocarcinoma originates from either intrahepatic or extrahepatic bile duct, and its incidence is gradually increasing worldwide. Endoscopic retrograde cholangiopancreatography with brush cytology has a high false-negative rate for the diagnosis of biliary malignancy. Recently, endoscopic ultrasonography (EUS) has emerged as the potential modality to detect pancreatic cancer. EUS-guided fine needle aspiration for cytologic analysis made it possible to overcome the obstacle in differentiating between benign and malignant lesions in the pancreatobiliary lesion, and it has been well established as a safe and effective procedure. Herein, the clinical application of EUS in the diagnosis of pancreatobiliary cancer was reviewed.

A Rare Case of Primary Squamous Cell Carcinoma of the Stomach and a Review of the 56 Cases Reported in Japan

  • Wakabayashi, Hideyuki;Matsutani, Takeshi;Fujita, Itsurou;Kanazawa, Yoshikazu;Nomura, Tsutomu;Hagiwara, Nobutoshi;Hosone, Masaru;Katayama, Hironori;Uchida, Eiji
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.58-62
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    • 2014
  • We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy, and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristics of 56 cases of gastric squamous cell carcinoma reported in Japan.

Littoral cell angiomas: Benign lesion with a penchant for visceral malignancies

  • Snigdha Gulati;Hoonbae Jeon;Adarsh Vijay
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.1
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    • pp.1-5
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    • 2023
  • Littoral cell angiomas are rare vascular tumors of the spleen. Because of their rarity, unclear etiopathogenesis, and association with other malignancies, these tumors can pose diagnostic and therapeutic challenges. Due to paucity of published literature on this entity often limited to case reports, relevant data on this topic were procured and synthesized with the aid of a comprehensive Medline search in addition to oncologic, pathologic, radiologic, and surgical literature review on littoral cell angiomas. This article provides an in-depth review into postulated etiopathogenesis, pathology, clinical manifestations, associated malignancies, and prognostic features of littoral cell angiomas.

Solid pseudopapillary epithelial neoplasm of pancreas in pregnancy: A case report and review of literature

  • R K Hanumantha Naik;Anbalagan Amudhan;ArunKumar Ashokkumar;Anbarasu Inbasekaran;Selvaraj Thangasamy;Jeswanth Sathyanesan
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.92-98
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    • 2024
  • The solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is an uncommon tumor that accounts for approximately 1%-2% of exocrine pancreatic neoplasms. It predominantly affects female in their second and third decades of life. In this case report, we present a clinical scenario of a 21-year-old pregnant woman who incidentally discovered a solid cystic lesion in her pancreas, exhibiting features suggestive of SPEN. The patient underwent surgery during the second trimester. Management of pregnant females with SPEN poses challenges due to the absence of definitive treatment guidelines, particularly in determining the ideal timing for surgical intervention. Notably, during pregnancy, the presence of a small SPEN does not necessarily require immediate resection. However, if the tumor is of significant size, it can give rise to complications such as tumor rupture, multivisceral resection, recurrence, spontaneous abortion, intrauterine growth restriction, or premature delivery if not addressed. In the existing literature, a common finding is that approximately two-thirds of pregnant females with SPEN underwent surgery in the second trimester, often without complications for the mother or fetus. All these tumors were larger than 8 cm. The decision to operate before or after birth can be individualized based on team discussion. However, delay in surgery may lead to larger tumors and higher risks like bleeding, rupture, multivisceral resection, and recurrence. Therefore, second-trimester surgery seems safer, and lessens dangers, emergency surgery, and tumor recurrence.

TROGLITAZONE, A NOVEL ANTIDIABETIC DRUG -NEW AVENUE FOR TREATING INSULIN RESISTANCE-

  • Horikoshi, Hiroyoshi
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1998.05a
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    • pp.1-4
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    • 1998
  • Impaired insulin action in Type 2 diabetes is thought to lead to hyperglycemia, with both environmental and complex genetic factors playing key roles. Although the primary lesion in Type 2 diabetes is unknown, a number of studies suggest that metabolic defects in the liver, skeletal muscle and fat, and pancreatic ${\beta}$-cells contribute to the disease. These metabolic abnormalities are characterized by the overproduction of hepatic glucose, impaired insulin secretion, and peripheral insulin resistance. In current pharmacological treatment of Type 2 diabetes, sulfonylurea (SU) drugs have mainly been used as oral hypoglycemic drugs to stimulate endogenous insulin secretion from ${\beta}$ cells. SU drugs, however, sometimes aggravate the disease by causing fatigue of the pancreatic ${\beta}$ cells, which leads to reduced drug efficacy after long-term treatment. This class of drugs also leads to enhanced obesity arising from the stimulation of endogenous insulin secretion in obese Type 2 diabetic patients, plus an increased incidence of SU-induced hypoglycemia. Since 1980, a major challenge has been made by us to develop a potential pharmacological therapy for the treatment of insulin resistance in peripheral tissues and/or suppression of abnormal hepatic glucose production in Type 2 diabetic patients. Such a drug would be expected to have fewer side effects and retain long-term efficacy.

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Clinicopathological observations on the experimental pancreatitis Induced by ligation of pancreatic ducts (췌관 결찰에 의한 실험적 췌장염의 임상병리학적 관찰)

  • Sung, Eun-jue;Lee, Hyun-beom
    • Korean Journal of Veterinary Research
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    • v.34 no.2
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    • pp.407-415
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    • 1994
  • Present experiments were undertaken in order to find out the most available diagnostic method for acute pancreatitis. Experimental dogs were divided into experimental group and control group. The experimental dogs were laparotomized and their pancreatic ducts were ligated for the induction of pancreatitis. The control dogs were laparotomized only for comparison. In addition to the complete blood count, serum amylase and lipase activities, serum glucose, total protein and albumin contents were measured daily for 11 days after the operation. Fecal fat droplet count by Sudan III staining and fecal trypsin activity examination by x-ray film digetion test were also undertaken daily. The results obtained were summarized as follows; 1. Serum amylase activities of the experimental group increased to peak on the third day and returned to the preoperative values on the eighth day. 2. Serum lipase activities of the experimental group increased to peak on the first day and returned to the preopertive values within six to eight days. 3. Serum glucose contents of the experimental group showed significant increse only on the first day. 4. Serum albumin contents of the experimental group decreased significantly during the experimental period. Whereas those of the control group significantly decreased only on the first day. 5. The experimental group showed marked leukocytosis, neutrophilia, and lymphopenia for the first 5 or 8 days. Whereas the control group showed only neutrophilia for the first 3 days. 6. The results of fecal fat droplet count showed some diagnostic value on the third and fourth day in only one experimental dog(No 1). No significant changes in the fecal trypsin activity were noticed in all dogs. 7. Histopathologically. all dogs of experimental group showed changes of pancreatitis. However the degree of the pancreatic lesion was not pararell to the degree of the serum amylase or lipase activity changes.

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Management Strategy and Surveillance of Intraductal Papillary Mucinous Neoplasm-Gastroenterologist's Viewpoint (췌관 내 유두상 점액종양의 치료 전략과 추적 관찰-소화기내과의 관점)

  • Kim, Tae Hyeon;Chon, Hyung Ku
    • Journal of Digestive Cancer Research
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    • v.9 no.1
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    • pp.1-7
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    • 2021
  • The length, the frequency, and the methods of surveillance for intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debating. According to the recent guidelines, IPMN is stratified into "high-risk stigmata" or absolute indication and "worrisome features" or relative indication as a guide in managing these patients, either those with resection of the lesion or those under surveillance. The risk of malignant transformation was quite low for branch duct-IPMNs without worrisome features or high risk stigmata. However, because the incidence rate of pancreatic cancer in these patients increase linearly with time, continued long-term surveillance is therefore important for patients with low-risk, as well as higher-risk, IPMN. Considering the high prevalence of malignancy, main duct-IPMN should be treated by surgical resection. Among patients with these type IPMNs, segmental dilatation of the main pancreatic duct without any mural nodules and larger than 10 mm of main pancreatic duct might not be immediately resected and need very careful examination and observation. The risk related to a major pancreatic resection must balance the risk of surveillance in patients with IPMN of the pancreas who have co-morbidity and are elderly.

Intralobar Pulmonary Sequestration Showing Increased Serum CA19-9

  • Ahn, Yong-Hwan;Song, Mi-Jin;Park, Sang-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.507-510
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    • 2012
  • Carbohydrate antigen 19-9 (CA19-9) is a specific tumor marker of the biliary, pancreatic and gastrointestinal tracts. CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis. Intralobar pulmonary sequestration is an uncommon congenital lung anomaly. It is dissociated from the normal tracheobronchial tree and is supplied by an anomalous systemic artery. There have been some reports of elevation of CA19-9 in this lesion. We report a case of intralobar pulmonary sequestration with elevated serum CA19-9 in a 29-year-old man who was diagnosed with bronchiectasia of left lower lung field on general check up. He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts. Elevated serum CA19-9 level might be encountered with benign pulmonary disease such as pulmonary sequestration.

Endoscopic Management of Ampullary Tumors (십이지장 팽대부 종양의 내시경적 치료)

  • Hwehoon Chung;Jae Keun Park
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.93-98
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    • 2023
  • Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.