While jejunoileal diverticula are rare and often asymptomatic, they may lead to chronic non-specific or acute symptoms. The large majority of complications present with an acute abdomen similar to appendicitis, cholec...While jejunoileal diverticula are rare and often asymptomatic, they may lead to chronic non-specific or acute symptoms. The large majority of complications present with an acute abdomen similar to appendicitis, cholecystitis or colonic diverticulitis but they also may appear with atypical symptoms. As a result, diagnosis of complicated jejunoileal diverticulosis can be quite difficult, and may solely depend on the result of surgical exploration. In the absence of contra-indications, diagnostic laparoscopy has the benefit of thorough examination of the abdominal contents and helps to reach an absolute diagnosis. Surgical resection of the involved small-bowel segment with primary anastomosis is the preferred treatment in patients with symptomatic complicated jejunoileal diverticular disease. An atypical presentation of complicated jejunal diverticulitis in conjunction with sigmoid diverticulitis diagnosed with laparoscopy and treated with surgical resection is presented.展开更多
We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde c...We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde cholangiopancreatography showed a tuberous filling defect in the middle and superior parts of the common bile duct,and mild stenosis in the inferior duct.Computed tomography(CT) showed a well enhanced mass in the middle and superior parts of the common bile duct.A single cancer of the middle and superior bile duct was suspected and extra-hepatic bile duct resection was performed.CT eleven months after surgery revealed enhanced inferior bile duct wall and a slightly enhanced tumor within it.Retrospective review of the CT images taken before first surgery showed enhanced inferior bile duct wall without intrabiliary tumor only on the delayed phase.The inferior bile duct tumor was suspected to have originally co-existed with the middle and superior bile duct tumor.Pancreaticoduodenectomy was performed subsequently.Histopathological examination revealed that the middle and superior bile duct tumor was a moderately differentiated tubular adenocarcinoma while the inferior bile duct tumor was a papillary adenocarcinoma.The two tumors were separated and had different histological findings and growth patterns,further suggesting that they were two primary cancers.展开更多
Multicentric gliomas are considered to be well recognized but uncommon; often scatter widely in different lobes or hemispheres; and cannot be attributed to a definite pathwayEll. A patient diagnosed as multicentric gl...Multicentric gliomas are considered to be well recognized but uncommon; often scatter widely in different lobes or hemispheres; and cannot be attributed to a definite pathwayEll. A patient diagnosed as multicentric gliomas is presented in this paper. He was firstly misdiagnosed as cerebral metastatic tumors, but later the histopathological examination revealed them to be glioblastoma （WHO grade IV）. Additionally, the aim of the paper was to describe the case history of the patient and the problems encountered in the pathogenesis, pathophysiology, diagnosis and treatment.展开更多
文摘While jejunoileal diverticula are rare and often asymptomatic, they may lead to chronic non-specific or acute symptoms. The large majority of complications present with an acute abdomen similar to appendicitis, cholecystitis or colonic diverticulitis but they also may appear with atypical symptoms. As a result, diagnosis of complicated jejunoileal diverticulosis can be quite difficult, and may solely depend on the result of surgical exploration. In the absence of contra-indications, diagnostic laparoscopy has the benefit of thorough examination of the abdominal contents and helps to reach an absolute diagnosis. Surgical resection of the involved small-bowel segment with primary anastomosis is the preferred treatment in patients with symptomatic complicated jejunoileal diverticular disease. An atypical presentation of complicated jejunal diverticulitis in conjunction with sigmoid diverticulitis diagnosed with laparoscopy and treated with surgical resection is presented.
文摘We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde cholangiopancreatography showed a tuberous filling defect in the middle and superior parts of the common bile duct,and mild stenosis in the inferior duct.Computed tomography(CT) showed a well enhanced mass in the middle and superior parts of the common bile duct.A single cancer of the middle and superior bile duct was suspected and extra-hepatic bile duct resection was performed.CT eleven months after surgery revealed enhanced inferior bile duct wall and a slightly enhanced tumor within it.Retrospective review of the CT images taken before first surgery showed enhanced inferior bile duct wall without intrabiliary tumor only on the delayed phase.The inferior bile duct tumor was suspected to have originally co-existed with the middle and superior bile duct tumor.Pancreaticoduodenectomy was performed subsequently.Histopathological examination revealed that the middle and superior bile duct tumor was a moderately differentiated tubular adenocarcinoma while the inferior bile duct tumor was a papillary adenocarcinoma.The two tumors were separated and had different histological findings and growth patterns,further suggesting that they were two primary cancers.
文摘Multicentric gliomas are considered to be well recognized but uncommon; often scatter widely in different lobes or hemispheres; and cannot be attributed to a definite pathwayEll. A patient diagnosed as multicentric gliomas is presented in this paper. He was firstly misdiagnosed as cerebral metastatic tumors, but later the histopathological examination revealed them to be glioblastoma （WHO grade IV）. Additionally, the aim of the paper was to describe the case history of the patient and the problems encountered in the pathogenesis, pathophysiology, diagnosis and treatment.
