[Primary adenocarcinoma of the duodenum. Apropos of 18 cases].
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Primary (astronomy)
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Diverticulitis
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Objective To study the clinical characteristics and the features of fibrobronchoscopy in youth lung cancer.Methods We analyzed retrospectively the fibrobronchoscopic data of 243 young lung cancer patients.Results The male/female ratio was 1.8:1;the most symptom was cough and bloody sputum 199 cases(81.9%) ;the most frequent histologic types was small cell carcinoma(47.3%),squamous cell carcinoma(24.7%),followed by adenocarcinoma(10.7%).Conclusion Fibrobronchoscopyplays a most role on early diagnosis in youth lung cancer.
Bloody
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Although the small intestine constitutes over 75% of the length and 90% of the mucosal surface of the gastrointestinal tract, small intestine cancer is rare and accounts for only 1% of gastrointestinal malignancies. Adenocarcinoma together with carcinoid tumours are the most common histological types of primary malignant tumours of the small bowel but others, including lymphoma and leiomyosarcoma, may less frequently be encountered. Adenocarcinomas are predominantly located in the duodenum. Primary adenocarcinoma of the duodenum is a rare malignant tumor, accounting for 0.3-0.5% of all gastroenteral malignancies. The diagnosis of primary adenocarcinoma of duodenum is often delayed because its symptoms and signs are nonspecific. In this work we want to focus on the diagnostic and therapeutic problems of duodenal adenocarcinoma, reporting a case report.
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Metastatic carcinoma
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Background: Appendicitis is the most common cause of acute abdomen and appendectomy is the most frequent surgical procedure performed in the world in recent times.In the last few years the number of laparoscopic appendectomies performed around the world has dramatically increased.Objective: The aim of the work is to study the acceptance and satisfaction of the patients as regards the laparoscopic approach for management of acute appendicitis and evaluation the results.Patients and methods: It was a comparative study included 100 consecutive patients with acute appendicitis.They were given the options to accept the approach for appendectomy whether open or laparoscopic after discussion the advantages and disadvantages of each approach and the last decision were left to the patient.The study was approved by the medical ethics committee of Aswan University Hospital and a written informed consent was obtained from all patients.Results: The consecutive patients of age ranging from 15-45 years with features suggestive of acute appendicitis were divided into laparoscopic appendectomy group (LA) 70 cases and open appendectomy group (OA) 30 cases, after taking informed consent.LA was done with the help of three trocar/cannulae creating pneumoperitoneum with CO2 whereas OA was performed by McBurney incision.The operating times in OA and LA were 20-70 minutes (mean 30) and 25-95 minutes (mean 55) respectively.Increased doses of analgesics, antibiotics and antiemetics were required in OA, as compared to LA.The mean postoperative hospital stay in LA group was 1.4 days (range 1-3 days) whereas it was in OA group, it was 3.5 days (range 2-6 days).Conclusion: LA is safe and has major benefits like less postoperative pain, decreased wound infection, early hospital discharged, early return to work and a better cosmetic scar than OA.
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目的:探讨县级医院开展腹腔镜胆囊切除术(LC)的方法和经验.方法:回顾分析某医院194例胆囊结石行LC的临床资料,其中慢性胆囊炎胆囊结石168例、胆囊息肉6例、急性胆囊炎胆囊结石20例.结果:经LC治愈186例,平均住院时间5.2天.中转开腹8例,其中1例高位胆管损伤转安医大手术治愈,胆囊癌1例、胆囊床出血1例、胆囊十二指肠内漏1例、胆囊三角区粘连局部解剖不清4例经开腹手术治愈.手术并发症6例.结论:县级基层医院开展LC手术应分阶段,根据手术医生技术熟练程度严格掌握适应证,逐步扩大适应证,对于存在危险因素的患者应及时选择开腹手术,避免胆道损伤等严重并发症的发生.
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Primary adenocarcinoma of the fourth portion of the duodenum (D-IV) is reported infrequently than other parts of the duodenum. Its diagnosis is often late because of non-specific symptoms and signs. We encountered a 48-year-old male patient who was diagnosed as duodeno-duodenal intussusception, underwent segmental duodenal resection with duodenojejunal anastomosis and confirmed as adenocarcinoma of D-IV. He received adjuvant chemotherapy and is doing well at 1 year of follow-up. This report describes about the rare case of isolated adenocarcinoma of the D-IV presented as intussusception which is never reported before and successfully treated by segmental resection of the duodenum and jejunum.
Jejunum
Segmental resection
Rare disease
Adjuvant Chemotherapy
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Duodenal adenocarcinoma, a rare malignant lesion, is associated with a poor 5-year survival. Few series have addressed differences between resectable tumors of the proximal and distal duodenum. We reviewed records of 17 consecutive patients with adenocarcinoma of the duodenum who underwent resection: 10 had adenocarcinoma of the proximal duodenum, and seven had tumors of the distal duodenum. Most patients underwent pancreatoduodenectomy. Five patients with adenocarcinoma of the distal duodenum underwent segmental resection. No perioperative deaths occurred. Six of 10 patients with proximal tumors died of metastatic disease. Of the seven patients with tumors of the distal duodenum, five are alive without evidence of disease, and two died of unrelated causes. The survival of patients with adenocarcinoma of the distal duodenum is surprisingly good, and segmental resection is the procedure of choice.
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