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Gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor and diagnosed by endoscopic ultrasound-guided tissue acquisition

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World Journal of Gastrointestinal Oncology 2017年第11期9卷 452-456页

作者： Filippo Antonini Liboria Laterza Lorenzo Fuccio Massimo Marcellini Lucia Angelelli Sonia Calcina Corrado Rubini giampiero macarri Department of Gastroenterology A. Murri Hospital Polytechnic University of Marche Endoscopy Unit AUSL Department of Medical and Surgical Sciences S. Orsola-Malpighi Hospital University of Bologna Medical Oncology Principe di Piemonte Hospital Medical Oncology Mazzoni Hospital Department of Gastroenterology San Salvatore Hospital University of L’Aquila Department of Biomedical Sciences and Public Health Pathological Anatomy and Histopathology Polytechnic University of Marche

We describe an uncommon case of a patient with a metastatic adenocarcinoma of ovarian origin presented as a gastric subepithelial tumor(SET) and that was diagnosed by endoscopic ultrasound fine-needle biopsy(EUS-FNB). Malignant gastric lesions are rarely metastatic and the primary tumor is mainly breast, lung, esophageal cancer or cutaneous melanoma. Gastric metastasis from ovarian cancer is unusual, presenting synchronously with the primary tumor but also several years later than the initial diagnosis. From an endoscopic point of view, gastric metastasis does not present specific features. They may mimic both a primary gastric tumor or, less frequently, an *** case demonstrates the importance of EUS-FNB in distinguishing SETs and how this may alter treatment and prognosis.

关键词： Metastasis Subepithelial lesion Gastric cancer Ovarian Endoscopic ultrasonography

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Small bowel diverticulitis with severe anemia and abdominal pain

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World Journal of Clinical Cases 2015年第5期3卷 462-465页

作者： Samuele De Minicis Filippo Antonini Valerio Belfiori Massimiliano Lo Cascio Barbara Marraccini Simona Piergallini Piergiorgio Mosca giampiero macarri Department of Gastroenterology Augusto Murri Hospital Polytechnic University of Marche 63900 Fermo Italy Department of Gastroenterology Ospedali Riuniti 60126 Ancona Italy

The current case report is related to a male patient with diabetes, obesity [body mass index(BMI) 33], hypertension and recurrence of anemia associated to melena and deep asthenia. M.P., a 60-year-old obese individual, was referred to our department by the primary care unit(PCU) of our hospital for severe anemia(Hemoglobin 6.5 g/d L) associated to episodes of melena and abdominal pain. In the past 5 mo the patient referred to the local hospital 3 times for episodes of melena(hemoglobin levels showed anemia 9.8 g/d L) but the main gastroenterological exams were completely negative(colonoscopy and gastroscopy). The PCU of our Hospital, after stabilization of the main parameters and blood transfusion for the low levels of hemoglobin, referred the patient to gastroenterologists: the patient was subjected to both colonoscopy and gastroscopy that were negative. Due to the condition of acute severe hemorrhage the patient, during the first 3 h from the access to the PCU, was subjected to arteriography that did not reveal any hemorrhagic foci or vascular alterations. The video capsule for the study of the small bowel showed the presence of blood beginning from the third portion of duodenum but deep gastroscopy did not reveal it. The patient was then subjected to double balloon endoscopy that revealed a severe diverticulosis of the small bowel with blood from the diverticula. The entero-tomografia computerizzata confirmed the diagnosis and revealed an extension of the diverticula for almost the entire small bowel(no diverticula in the colon). The patient was subjected to wide spectrum antibiotic therapy with resolution of the symptoms and stabilization of hemoglobin levels. The surgeon suggests no indication to surgery for the wide area involved from the disease and potential high risk of complication due to the high BMI. At home, the patient started a monthly therapy with rifaximin and probiotics associated to mesalazine. At present, after 12 mo from the last episode of hemo

关键词： Small bowel Diverticulitis Abdominal pain Anemia Intestinal bleeding

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Pancreatic disorders in inflammatory bowel disease

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World Journal of Gastrointestinal Pathophysiology 2016年第3期7卷 276-282页

作者： Filippo Antonini Raffaele Pezzilli Lucia Angelelli giampiero macarri Department of Gastroenterology A.Murri HospitalPolytechnic University of Marche Department of Digestive Diseases and Internal Medicine Sant’Orsola-Malpighi Hospital Medical Oncology Mazzoni Hospital

An increased incidence of pancreatic disorders either acute pancreatitis or chronic pancreatitis has been recorded in patients with inflammatory bowel disease (IBD) compared to the general population. Although most of the pancreatitis in patients with IBD seem to be related to biliary lithiasis or drug induced, in some cases pancreatitis were defined as idiopathic, suggesting a direct pancreatic damage in IBD. Pancreatitis and IBD may have similar presentation therefore a pancreatic disease could not be recognized in patients with Crohn’s disease and ulcerative colitis. This review will discuss the most common pancreatic diseases seen in patients with IBD.

关键词： Pancreas Pancreatitis Extraintestinal manifestations Exocrine pancreatic insufficiency Ulcerative colitis Crohn&rsquo s disease Inflammatory bowel disease

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