BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively hig...BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma,melanoma,lung cancer,and breast cancer,whereas reports of esophageal cancer with cardiac metastasis are rare.CASE SUMMARY The case of a 60-year-old man who complained of dysphagia is presented.Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis.Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor,multiple liver and lung metastases,and a left pleural effusion.Pathological examination of a biopsy speci-men from the esophageal tumor showed spindle-shaped cells,raising suspicion of esophageal sarcoma.The disease progressed rapidly,and systemic chemotherapy was deemed necessary,however,due to his poor general condition,adminis-tration of cytotoxic agents was considered difficult.Given his high Combined Positive Score,nivolumab was administered,however,the patient soon died from the disease.The autopsy confirmed spindle cell carcinoma(SCC)of the esophagus and cardiac metastasis with similar histological features.Cancer stem cell markers,ZEB1 and TWIST,were positive in both the primary tumor and the cardiac metastasis.CONCLUSION To the best of our knowledge,there have been no prior reports of cardiac metastasis of esophageal SCC.This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease,with the autopsy examination showing cardiac metastasis.展开更多
Intussusception is relatively rare in adults but common in children.[1,2]An untreated intussusception often causes intestinal obstruction,intestinal perforation,peritonitis,and shock.[3]Diabetic ketoacidosis(DKA)is th...Intussusception is relatively rare in adults but common in children.[1,2]An untreated intussusception often causes intestinal obstruction,intestinal perforation,peritonitis,and shock.[3]Diabetic ketoacidosis(DKA)is the most common acute hyperglycemic emergency in uncontrolled type 1 diabetes(T1DM).[4]More than 60%of DKA patients experience gastrointestinal symptoms such as nausea,vomiting,and abdominal pain,[5,6]which sometimes lead to the neglect of other serious underlying conditions.Although delayed gastric emptying,intestinal obstruction,electrolyte imbalance,and metabolic acidosis are associated with DKA,the underlying mechanism has not been fully elucidated.[7]This study aimed to report a DKA patient complicated with intussusception.展开更多
BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastro...BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.展开更多
BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased r...BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased recurrence risk.AIM To explore the current research status and emerging hotspots of PJS.METHODS Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection.Additionally,a case of PJS-induced intestinal intussusception,successfully treated with endoscopic methods despite three laparotomies,was highlighted.Comprehensive bibliometric and visual analysis were conducted with VOSviewer,R and CiteSpace.RESULTS Altogether 1760 studies were identified,indicating a steady increase in the publication number.The United States had the highest influence,whereas the University of Helsinki emerged as the leading institution,and Aaltonen LA from the University of Helsinki was the most prolific author.Cancer Research,Oncogene and Endoscopy were the top three journals based on H-index.Keyword burst direction analysis revealed that"cancer risk","management","surveillance"and"familial pancreatic cancer"were the potential hotspots for investigation.Additionally,"early detection","capsule endoscopy","clinical management","double-balloon endoscopy","familial pancreatic cancer"and"molecular genetic basis"were identified as the key clusters of co-cited references.Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.CONCLUSION In the last three decades,global publications related to PJS show a steadily increasing trend in number.Endoscopic management is currently a research hotspot.展开更多
目的探究不同镇静剂在盐水灌肠治疗小儿肠套叠中的应用效果。方法选取包头市第四医院2021年3月至2022年5月收治的60例行超声监测下温生理盐水灌肠复位术的患儿作为研究对象,按随机数表法分为水合氯醛组和鲁米那组,各30例。水合氯醛组给...目的探究不同镇静剂在盐水灌肠治疗小儿肠套叠中的应用效果。方法选取包头市第四医院2021年3月至2022年5月收治的60例行超声监测下温生理盐水灌肠复位术的患儿作为研究对象,按随机数表法分为水合氯醛组和鲁米那组,各30例。水合氯醛组给予水合氯醛进行术前镇静,鲁米那组给予鲁米那进行术前镇静。比较两组患儿:(1)催眠时间;(2)术前、术后24 h的白细胞(WBC)及C-反应蛋白(CRP);(3)灌肠治疗后复位成功情况;(4)复套情况(超声检查);(5)患儿家长满意度。结果水合氯醛组与鲁米那组组内术后24 h WBC均低于术前WBC,差异具有统计学意义(P<0.05);水合氯醛组镇静催眠时间及镇静效果均优于鲁米那组,且水合氯醛组家长满意度比鲁米那组高,差异均有统计学意义(P<0.05);结论水合氯醛在盐水灌肠治疗小儿肠套叠中的应用价值高,镇静时间迅速,能够提高患儿家长满意度。展开更多
BACKGROUND Ectopic pancreas may be unfamiliar to many people because it is rare and difficult to diagnose.However,this disease is highly susceptible to misdiagnosis and missed diagnosis.In this article,we report two c...BACKGROUND Ectopic pancreas may be unfamiliar to many people because it is rare and difficult to diagnose.However,this disease is highly susceptible to misdiagnosis and missed diagnosis.In this article,we report two cases of pancreatic heterotopia in the gastric sinus and small intestine,respectively,both of which were confirmed by histopathological examination.CASE SUMMARY The first patient was a 43-year-old female which reported abdominal distension for 2 mo.The second was a 67-year-old female who experienced intermittent epigastric discomfort for 15 d.In both cases,there was no confirmed preoperative examination,and the postoperative pathology indicated the presence of ectopic pancreas.CONCLUSION The diagnosis of ectopic pancreas is difficult,and is often prone to misdiagnosis and the possibility of being overlooked.Various laboratory tests and imaging tests should be carefully evaluated before surgery to achieve early detection,early diagnosis and early treatment.展开更多
文摘BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma,melanoma,lung cancer,and breast cancer,whereas reports of esophageal cancer with cardiac metastasis are rare.CASE SUMMARY The case of a 60-year-old man who complained of dysphagia is presented.Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis.Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor,multiple liver and lung metastases,and a left pleural effusion.Pathological examination of a biopsy speci-men from the esophageal tumor showed spindle-shaped cells,raising suspicion of esophageal sarcoma.The disease progressed rapidly,and systemic chemotherapy was deemed necessary,however,due to his poor general condition,adminis-tration of cytotoxic agents was considered difficult.Given his high Combined Positive Score,nivolumab was administered,however,the patient soon died from the disease.The autopsy confirmed spindle cell carcinoma(SCC)of the esophagus and cardiac metastasis with similar histological features.Cancer stem cell markers,ZEB1 and TWIST,were positive in both the primary tumor and the cardiac metastasis.CONCLUSION To the best of our knowledge,there have been no prior reports of cardiac metastasis of esophageal SCC.This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease,with the autopsy examination showing cardiac metastasis.
文摘Intussusception is relatively rare in adults but common in children.[1,2]An untreated intussusception often causes intestinal obstruction,intestinal perforation,peritonitis,and shock.[3]Diabetic ketoacidosis(DKA)is the most common acute hyperglycemic emergency in uncontrolled type 1 diabetes(T1DM).[4]More than 60%of DKA patients experience gastrointestinal symptoms such as nausea,vomiting,and abdominal pain,[5,6]which sometimes lead to the neglect of other serious underlying conditions.Although delayed gastric emptying,intestinal obstruction,electrolyte imbalance,and metabolic acidosis are associated with DKA,the underlying mechanism has not been fully elucidated.[7]This study aimed to report a DKA patient complicated with intussusception.
文摘BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.
基金Capital Health Development Research Special Project,No.2020-4-5123.
文摘BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased recurrence risk.AIM To explore the current research status and emerging hotspots of PJS.METHODS Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection.Additionally,a case of PJS-induced intestinal intussusception,successfully treated with endoscopic methods despite three laparotomies,was highlighted.Comprehensive bibliometric and visual analysis were conducted with VOSviewer,R and CiteSpace.RESULTS Altogether 1760 studies were identified,indicating a steady increase in the publication number.The United States had the highest influence,whereas the University of Helsinki emerged as the leading institution,and Aaltonen LA from the University of Helsinki was the most prolific author.Cancer Research,Oncogene and Endoscopy were the top three journals based on H-index.Keyword burst direction analysis revealed that"cancer risk","management","surveillance"and"familial pancreatic cancer"were the potential hotspots for investigation.Additionally,"early detection","capsule endoscopy","clinical management","double-balloon endoscopy","familial pancreatic cancer"and"molecular genetic basis"were identified as the key clusters of co-cited references.Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.CONCLUSION In the last three decades,global publications related to PJS show a steadily increasing trend in number.Endoscopic management is currently a research hotspot.
文摘目的探究不同镇静剂在盐水灌肠治疗小儿肠套叠中的应用效果。方法选取包头市第四医院2021年3月至2022年5月收治的60例行超声监测下温生理盐水灌肠复位术的患儿作为研究对象,按随机数表法分为水合氯醛组和鲁米那组,各30例。水合氯醛组给予水合氯醛进行术前镇静,鲁米那组给予鲁米那进行术前镇静。比较两组患儿:(1)催眠时间;(2)术前、术后24 h的白细胞(WBC)及C-反应蛋白(CRP);(3)灌肠治疗后复位成功情况;(4)复套情况(超声检查);(5)患儿家长满意度。结果水合氯醛组与鲁米那组组内术后24 h WBC均低于术前WBC,差异具有统计学意义(P<0.05);水合氯醛组镇静催眠时间及镇静效果均优于鲁米那组,且水合氯醛组家长满意度比鲁米那组高,差异均有统计学意义(P<0.05);结论水合氯醛在盐水灌肠治疗小儿肠套叠中的应用价值高,镇静时间迅速,能够提高患儿家长满意度。
文摘BACKGROUND Ectopic pancreas may be unfamiliar to many people because it is rare and difficult to diagnose.However,this disease is highly susceptible to misdiagnosis and missed diagnosis.In this article,we report two cases of pancreatic heterotopia in the gastric sinus and small intestine,respectively,both of which were confirmed by histopathological examination.CASE SUMMARY The first patient was a 43-year-old female which reported abdominal distension for 2 mo.The second was a 67-year-old female who experienced intermittent epigastric discomfort for 15 d.In both cases,there was no confirmed preoperative examination,and the postoperative pathology indicated the presence of ectopic pancreas.CONCLUSION The diagnosis of ectopic pancreas is difficult,and is often prone to misdiagnosis and the possibility of being overlooked.Various laboratory tests and imaging tests should be carefully evaluated before surgery to achieve early detection,early diagnosis and early treatment.
