Here, we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation. On admission, the patient complained of severe acute abdominal pain, with ...Here, we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation. On admission, the patient complained of severe acute abdominal pain, with physical examination findings suspicious for a perforated peptic ulcer. Of note, the patient had no history of other medical conditions or recent trauma, and the initial chest radiography and laboratory findings were not specific. A subsequent abdominal computed tomography revealed intrathoracic displacement of the liver, gallbladder, transverse colon and omentum through a right diaphragmatic defect. The patient then underwent an explorative laparotomy that confirmed duodenal ulcer perforation. A primary repair of the duodenal perforation was performed, and the diaphrag-matic defect was repaired using a polytetrafluoroeth-ylene patch after the organs were reduced and the cavity irrigated. This particular case proves interesting as right-sided spontaneous diaphragmatic ruptures are very rare and difficult to diagnose. Additionally, the best treatment for such large diaphragmatic defects is still controversial, especially in cases of intrathoracic or intra-abdominal contamination.展开更多
This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical preval...This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical prevalence of duodenal ulceration is related to staple diets.Unrefined wheat and maize,soya,certain pulses and millets are associated with a low prevalence while refined wheat,maize and rice,yams,cassava and green banana with a high prevalence.Predominant foodstuffs from low prevalence areas are ulceroprotective in rat peptic ulcer models.The protective activity lies in the lipid fraction present in these foodstuffs.The lipid fraction also promotes ulcer healing,is active both orally and intramuscularly and is ulceroprotective against nonsteroidal anti-inflammatory drugs(NSAIDs).The phospholipids and phytosterols present in the lipid have been identified to be responsible for this protective activity.The combination of phospholipids and phytosterols may be of value in the prevention and treatment of duodenal ulceration and protection against the ulcerogenic effect of NSAIDs.展开更多
Congenital absence of the splenic artery is a very rare condition.To the best of our knowledge, congenital absence of the splenic artery accompanied with absence of the splenic vein has not been reported.We report a c...Congenital absence of the splenic artery is a very rare condition.To the best of our knowledge, congenital absence of the splenic artery accompanied with absence of the splenic vein has not been reported.We report a case of the absence of the splenic artery and vein in a 61-year-old woman who presented with postprandial epigastric discomfort. Upper gastrointestinal endoscopy showed a dilated, pulsatile vessel in the fundus and duodenal stenosis. An abdominal computed tomography(CT)scan revealed absence of the splenic vein with a tortuously engorged gastroepiploic vein.Three-dimensional CT demonstrated the tortuously dilated left gastric artery and the left gastroepiploic artery with non-visualization of the splenic artery.After administration of a proton pump inhibitor,abdominal symptoms resolved without any recurrence of symptoms during 6 mo of follow-up.展开更多
文摘Here, we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation. On admission, the patient complained of severe acute abdominal pain, with physical examination findings suspicious for a perforated peptic ulcer. Of note, the patient had no history of other medical conditions or recent trauma, and the initial chest radiography and laboratory findings were not specific. A subsequent abdominal computed tomography revealed intrathoracic displacement of the liver, gallbladder, transverse colon and omentum through a right diaphragmatic defect. The patient then underwent an explorative laparotomy that confirmed duodenal ulcer perforation. A primary repair of the duodenal perforation was performed, and the diaphrag-matic defect was repaired using a polytetrafluoroeth-ylene patch after the organs were reduced and the cavity irrigated. This particular case proves interesting as right-sided spontaneous diaphragmatic ruptures are very rare and difficult to diagnose. Additionally, the best treatment for such large diaphragmatic defects is still controversial, especially in cases of intrathoracic or intra-abdominal contamination.
文摘This paper pays a tribute to Dr.Frank I Tovey on his 90th birthday which happens on September 1,2011,and briefly describes the major findings in his research career and contributions as follows.The geographical prevalence of duodenal ulceration is related to staple diets.Unrefined wheat and maize,soya,certain pulses and millets are associated with a low prevalence while refined wheat,maize and rice,yams,cassava and green banana with a high prevalence.Predominant foodstuffs from low prevalence areas are ulceroprotective in rat peptic ulcer models.The protective activity lies in the lipid fraction present in these foodstuffs.The lipid fraction also promotes ulcer healing,is active both orally and intramuscularly and is ulceroprotective against nonsteroidal anti-inflammatory drugs(NSAIDs).The phospholipids and phytosterols present in the lipid have been identified to be responsible for this protective activity.The combination of phospholipids and phytosterols may be of value in the prevention and treatment of duodenal ulceration and protection against the ulcerogenic effect of NSAIDs.
文摘Congenital absence of the splenic artery is a very rare condition.To the best of our knowledge, congenital absence of the splenic artery accompanied with absence of the splenic vein has not been reported.We report a case of the absence of the splenic artery and vein in a 61-year-old woman who presented with postprandial epigastric discomfort. Upper gastrointestinal endoscopy showed a dilated, pulsatile vessel in the fundus and duodenal stenosis. An abdominal computed tomography(CT)scan revealed absence of the splenic vein with a tortuously engorged gastroepiploic vein.Three-dimensional CT demonstrated the tortuously dilated left gastric artery and the left gastroepiploic artery with non-visualization of the splenic artery.After administration of a proton pump inhibitor,abdominal symptoms resolved without any recurrence of symptoms during 6 mo of follow-up.
