Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result i...Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result in gastrointestinal bleeding. We describe a case of a 74-year old male with GIST of the stomach accompanied with a giant abscess that penetrated the gastric lumen. The patient experienced undiagnosed fever for two months prior to hospitalization. Gastrointestinal endoscopy, X-ray series and computed tomography of the patient’s abdomen revealed a gastric submucosal tumor in the fornix, with a fistula to the gastric lumen that was inundated with a great deal of pus. The mass was diagnosed as a GIST from biopsy specimens. The patient was treated by endoscopic drainage of the abscess and intravenous administration of antibiotics. Eventually, a partial gastrectomy was performed. He was also administered Imanitib mesylate as adjuvant therapy. He was followed up for 2 years and no metastasis or recurrence was recognized at the follow- up examinations. This is the first report of a patient with clearly diagnosed GIST with endoscopic evidence of an abscess penetrating into the gastric lumen.展开更多
Perforation of the gallbladder with cholecystohepatic communication is a rare cause of liver abscess. Because it is a rare entity, the treatment modality has not been fully established. We report for the first time a ...Perforation of the gallbladder with cholecystohepatic communication is a rare cause of liver abscess. Because it is a rare entity, the treatment modality has not been fully established. We report for the first time a patient with an intrahepatic abscess due to gallbladder perforation successfully treated by endoscopic stent placement into the gallbladder who had a poor response to continuous percutaneous drainage.展开更多
Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon. Pre-operative diagnosis is difficult as patients are often unaware of the foreign body ingestion and symp...Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon. Pre-operative diagnosis is difficult as patients are often unaware of the foreign body ingestion and symptoms and imagiology are usually non-specific. The authors report a case of 62-year-old woman who was admitted with fever and abdominal pain. Further investigation revealed hepatic abscess, without resolution despite antibiotic therapy. A liver abscess resulting from perforation and intra-hepatic migration of a bone coming from the pilorum was diagnosed by surgery. The literature concerning foreign body-induced perforation of the gastrointestinal tract complicated by liver abscess is reviewed.展开更多
Isolated pancreatic tuberculosis is an extremely rare condition, more so in an immunocompetent individual. Its presentation as pancreatic abscesses with colonic perforation has not been reported so far. This condition...Isolated pancreatic tuberculosis is an extremely rare condition, more so in an immunocompetent individual. Its presentation as pancreatic abscesses with colonic perforation has not been reported so far. This condition poses difficulties in clinical diagnoses. Herein we report a case who was operated in another hospital for pancreatic abscesses, and referred to our institution later when he developed fecal peritonitis due to colonic perforation. Re-laparotomy, resection and exteriorisation of the colon were done. Acid fast bacilli was seen in the histopathological examination of the resected colon. The patient responded remarkably to anti-tuberculous therapy and two sittings of debridement. Post procedure the patient developed pancreatic fistula, which was managed successfully with stenting. Pancreatic tuberculosis should be considered as a differential diagnosis when pancreatitis is atypical.展开更多
Splenic abscess is a rare entity normally associated with underlying diseases.We report a case of splenic abscess with large gas formation in a non-diabetic and non-immunosuppressed patient after surgery for colon per...Splenic abscess is a rare entity normally associated with underlying diseases.We report a case of splenic abscess with large gas formation in a non-diabetic and non-immunosuppressed patient after surgery for colon perforation.The most frequent cause of splenic abscess is septic embolism arising from bacterial endocarditis.Splenic abscess has a high rate of mortality when it is diagnosed late.Computed tomography resolved any diagnostic doubt,and subsequent surgery confirmed the diagnosis.展开更多
The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver,where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum,then migrating to t...The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver,where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum,then migrating to the liver,complicated by hepatic abscess and Staphylococcus aureus sepsis is reported. A 59-year-old man without a history of foreign body ingestion was admitted to our hospital because of sepsis and epigastralgia,which had progressively worsened. No foreign body was identified at preoperative imaging,but a rosemary twig was discovered during laparotomy. The liver abscess and sepsis were controlled successfully with surgery and antibiotics. This unusual condition should be kept in mind when dealing with cases of hepatic abscess,or even sepsis of unknown origin. Despite the improvement of non-surgical techniques such as percutaneous drainage and interventional endoscopy,surgery still remains important in the treatment of hepatic abscess caused by an ingested foreign body.展开更多
Colorectal cancer usually present with known symptoms while there are less common manifestation including abscess formation which can be intra or extra peritoneal. A 60-year-old Caucasian male with a history of RLQ ab...Colorectal cancer usually present with known symptoms while there are less common manifestation including abscess formation which can be intra or extra peritoneal. A 60-year-old Caucasian male with a history of RLQ abdominal pain, nausea, vomiting and anorexia from 15 days ago referred to surgery ward. Ultrasound showed a hypoachoic lesion with diameters 50 mm x 70 mm in RLQ of abdomen and a round echogenic area in right lobe of liver with diameter 15 mm. The findings were revealed an abscess located in right lilac fossa then local drainage of abscess was performed. Four days later the patient was re-admitted because of severe abdominal distention and lack of bowel movement. Laparoscopy was performed before proceeding with further examinations, due to the poor general condition of the patient. The sigmoid was adherent into the abdominal wall and mild intestinal loop distention and apple-core view was observed during operation. Can- cer of sigmoid complicated by a right lilac fossa abscess was diagnosed and Hartman colestomy was undertaken. At the last follow-up examination 3 months after operation, the patient was in good health with no clinical evidence of recurrence.展开更多
文摘Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result in gastrointestinal bleeding. We describe a case of a 74-year old male with GIST of the stomach accompanied with a giant abscess that penetrated the gastric lumen. The patient experienced undiagnosed fever for two months prior to hospitalization. Gastrointestinal endoscopy, X-ray series and computed tomography of the patient’s abdomen revealed a gastric submucosal tumor in the fornix, with a fistula to the gastric lumen that was inundated with a great deal of pus. The mass was diagnosed as a GIST from biopsy specimens. The patient was treated by endoscopic drainage of the abscess and intravenous administration of antibiotics. Eventually, a partial gastrectomy was performed. He was also administered Imanitib mesylate as adjuvant therapy. He was followed up for 2 years and no metastasis or recurrence was recognized at the follow- up examinations. This is the first report of a patient with clearly diagnosed GIST with endoscopic evidence of an abscess penetrating into the gastric lumen.
文摘Perforation of the gallbladder with cholecystohepatic communication is a rare cause of liver abscess. Because it is a rare entity, the treatment modality has not been fully established. We report for the first time a patient with an intrahepatic abscess due to gallbladder perforation successfully treated by endoscopic stent placement into the gallbladder who had a poor response to continuous percutaneous drainage.
文摘Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon. Pre-operative diagnosis is difficult as patients are often unaware of the foreign body ingestion and symptoms and imagiology are usually non-specific. The authors report a case of 62-year-old woman who was admitted with fever and abdominal pain. Further investigation revealed hepatic abscess, without resolution despite antibiotic therapy. A liver abscess resulting from perforation and intra-hepatic migration of a bone coming from the pilorum was diagnosed by surgery. The literature concerning foreign body-induced perforation of the gastrointestinal tract complicated by liver abscess is reviewed.
文摘Isolated pancreatic tuberculosis is an extremely rare condition, more so in an immunocompetent individual. Its presentation as pancreatic abscesses with colonic perforation has not been reported so far. This condition poses difficulties in clinical diagnoses. Herein we report a case who was operated in another hospital for pancreatic abscesses, and referred to our institution later when he developed fecal peritonitis due to colonic perforation. Re-laparotomy, resection and exteriorisation of the colon were done. Acid fast bacilli was seen in the histopathological examination of the resected colon. The patient responded remarkably to anti-tuberculous therapy and two sittings of debridement. Post procedure the patient developed pancreatic fistula, which was managed successfully with stenting. Pancreatic tuberculosis should be considered as a differential diagnosis when pancreatitis is atypical.
文摘Splenic abscess is a rare entity normally associated with underlying diseases.We report a case of splenic abscess with large gas formation in a non-diabetic and non-immunosuppressed patient after surgery for colon perforation.The most frequent cause of splenic abscess is septic embolism arising from bacterial endocarditis.Splenic abscess has a high rate of mortality when it is diagnosed late.Computed tomography resolved any diagnostic doubt,and subsequent surgery confirmed the diagnosis.
文摘The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver,where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum,then migrating to the liver,complicated by hepatic abscess and Staphylococcus aureus sepsis is reported. A 59-year-old man without a history of foreign body ingestion was admitted to our hospital because of sepsis and epigastralgia,which had progressively worsened. No foreign body was identified at preoperative imaging,but a rosemary twig was discovered during laparotomy. The liver abscess and sepsis were controlled successfully with surgery and antibiotics. This unusual condition should be kept in mind when dealing with cases of hepatic abscess,or even sepsis of unknown origin. Despite the improvement of non-surgical techniques such as percutaneous drainage and interventional endoscopy,surgery still remains important in the treatment of hepatic abscess caused by an ingested foreign body.
文摘Colorectal cancer usually present with known symptoms while there are less common manifestation including abscess formation which can be intra or extra peritoneal. A 60-year-old Caucasian male with a history of RLQ abdominal pain, nausea, vomiting and anorexia from 15 days ago referred to surgery ward. Ultrasound showed a hypoachoic lesion with diameters 50 mm x 70 mm in RLQ of abdomen and a round echogenic area in right lobe of liver with diameter 15 mm. The findings were revealed an abscess located in right lilac fossa then local drainage of abscess was performed. Four days later the patient was re-admitted because of severe abdominal distention and lack of bowel movement. Laparoscopy was performed before proceeding with further examinations, due to the poor general condition of the patient. The sigmoid was adherent into the abdominal wall and mild intestinal loop distention and apple-core view was observed during operation. Can- cer of sigmoid complicated by a right lilac fossa abscess was diagnosed and Hartman colestomy was undertaken. At the last follow-up examination 3 months after operation, the patient was in good health with no clinical evidence of recurrence.
