In this case report, we present a case of autoimmune pancreatitis (AIP) diagnosis in a patient after a 7-year history of suspicious pancreatic cancer. Kim’s and Japanese criteria were used to diagnose AIP. Our case avoided undesirable invasive procedures and recovered thanks to the proper diagnosis and timely treatment with prednisone. Early and accurate diagnosis of AIP, in this case, had a significant impact on the treatment and prognosis process.
Mirizzi syndrome is an unusual presentation of prolonged cholelithiasis. This study aimed to analyze the diagnostic methods, operative strategies, and outcome of the surgical treatment of patients with Mirizzi syndrome.We retrospectively evaluated the patients with Mirizzi syndrome treated in our General Surgery Clinic. The data collected included demographic variables, clinical presentation, diagnostic methods, surgical procedures, and postoperative complications.The study included 13 male and 21 female patients, with a mean age of 67.2 years. The incidence of Mirizzi syndrome was determined as 0.6% (34/5632), and type II was more frequently observed (52.9%); no patient was determined as type IV. The incidences of types I and III were 35.2% and 11.7%, respectively. Among the preoperative diagnostic evaluations, ultrasonography was the initial imaging study that was performed in all patients. Computerized tomography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography were the other radiological studies. Surgical procedures included cholecystectomy for 83% of the patients with type I. The remaining cases and 14 of the type II patients (77.7%) underwent choledochotomy and T-tube insertion following cholecystectomy. Four of the patients with type II variety and all of the type III patients underwent cholecystectomy and roux-en-Y hepaticojejunostomy. All of the patients had complete recovery, with a morbidity rate of 5.8%, and there was no hospital mortality.The essential part of the management of patients with Mirizzi syndrome is to determine the best surgical procedure in the preoperative period. In type I patients, simple cholecystectomy is generally enough, but sometimes T-tube insertion may be required, while the cases with types II-IV require more complex surgical approach, such as cholecystectomy and bilioenteric anastomosis. Roux-en-Y hepaticojejunostomy is an appropriate procedure with good outcome.
Esophageal tuberculosis is rare. In some cases, the clinical presentation of this infection may mimic esophageal carcinoma. Differential diagnosis may be difficult and may result in an unnecessary surgical therapy such as esophagectomy. In this report we document the endoscopical, radiological, histological and bacteriological features of esophageal tuberculosis in a 62-year-old woman. She was admitted to our hospital complaining of dysphagia and odynophagia. Upper gastrointestinal endoscopy revealed an ulcerovegetant lesion in the right wall of the esophagus suggesting esophageal carcinoma. Further investigation resulted in a diagnosis of esophageal tuberculosis. She was successfully treated by antituberculous chemotherapy. We suggest that esophageal tuberculosis has to be kept in mind in the differential diagnosis of esophageal ulcerovegetant lesions.
Ince barsakta infeksiyona neden olup, karin agrisi, barsak bosaltiminda sorunlara ve kilo kaybina sebep olabilir. Ger- ci sunulan hastada akut pankreatit ve semptomlarin sebebi safra kesesi ve yollarindaki taslar, ama cok nadiren T. sa- ginata’nin koledok ve safra kesesine girdigi, biliyer sikayetlere, akalkuloz kolesistite ve hatta kese perforasyonuna ne- den oldugu bildirilmistir. Ulkemizde safra yollari ile iliskili en sik gordugumuz parazitler Fasciola hepatica, Echinococ turleri ve Ascaris lumbricoides olmakla birlikte parazit hastaliklari yonunden endemik olan ulkemizde endoskopi veya ERCP yaparken tenya ile de karsilasirsak sasirmamak gerekir
Brush cytology and forceps biopsy are the most commonly used techniques to allow a diagnosis to be reached in patients found with suspected proximal biliary malignancies during endoscopic retrograde cholangiography. However, the sensitivity of brush cytology for diagnosis of malignant biliary strictures ranges only from 30 % to 60 % [1], while in the case of the biopsy forceps it may in some cases be impossible to advance the forceps to the level of the stricture. Recently, we had experience of three cases of proximal biliary stricture in which cholangiocarcinoma was strongly suspected. In all three it proved possible to obtain sufficient biopsy samples for a diagnosis using a novel method.
In developing countries the prevalence of duodenal ulceration is related to the staple diet and not to the prevalence of Helicobacter pylori. Experiments using animal peptic ulcer models show that the lipid fraction in foods from the staple diets of low prevalence areas gives protection against ulceration, including ulceration due to non-steroidal anti-inflammatory drugs (NSAIDs), and also promotes healing of ulceration. The lipid from the pulse Dolichos biflorus (Horse gram) was highly active and used for further investigations. Further experiments showed the phospholipids, sterol esters and sterols present in Horse gram lipid were gastroprotective. Dietary phospholipids are known to be protective, but the nature of protective sterols in staple diets is not known. The present research investigates the nature of the protective phytosterols.Sterol fractions were extracted from the lipid in Dolichos biflorus and tested for gastroprotection using the rat ethanol model. The fractions showing protective activity were isolated and identification of the components was investigated by Gas Chromatography-Mass Spectrometry (GC-MS).The protective phytosterol fraction was shown to consist of stigmasterol, β-sitosterol and a third as yet unidentified sterol, isomeric with β-sitosterol.Dietary changes, affecting the intake of protective phospholipids and phytosterols, may reduce the prevalence of duodenal ulceration in areas of high prevalence and may reduce the incidence of recurrent duodenal ulceration after healing and elimination of Helicobacter pylori infection. A combination of phospholipids and phytosterols, such as found in the lipid fraction of ulceroprotecive foods, may be of value in giving protection against the ulcerogenic effect of NSAIDs.
