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Doege-Potter syndrome by malignant solitary fibrous tumor of the liver: A case report and review of literature

World Journal of Gastrointestinal Surgery 2019年第8期11卷 348-357页

作者： Delvecchio Antonella Duda Loren Conticchio Maria Fiore Felicia Lafranceschina Stefano Riccelli Umberto Cristofano Antonella pascazio bianca Colagrande Anna Resta Leonardo Memeo Riccardo Department of Emergency and Organ Transplantation General Surgery Unit “M. Rubino” University of Bari Bari 70124 Italy Department of Pathology University of Bari Bari 70124 Italy Department of Oncology Ente Ecclesiastico Ospedale F. Miulli Acquaviva delle Fonti 70021 Italy Department of General Surgery Ospedale San Paolo Bari 70123 Italy

BACKGROUND Solitary fibrous tumor of the liver (SFTL) is a rare occurrence with a low number of cases reported in literature. SFTL is usually benign but, 10%-20% cases are reported to be malignant with a tendency to metastasize. The majority of malignant SFTL cases are associated with a paraneoplastic hypoglycaemia defined as Doege-Potter syndrome. Surgery is the best therapeutic treatment, however, long- life follow-up is recommended. CASE SUMMARY A 74-year-old man, was admitted to the emergency department after a syncopal episode with detection of hypoglycaemia resistant to medical treatment. The computed tomography revealed a solid mass measuring 15 cm of the left liver. An open left hepatectomy was performed with complete resection of tumor. Histopathological analyses confirmed a malignant SFTL. CONCLUSION Large series with long-term follow-up have not been published neither have clinical trials been undertaken. Consequently, the methodical long-term followup of surgically treated SFTLs is strongly recommended.

关键词： Solitary fibrous tumor Malignant solitary fibrous tumor of the liver Mesenchymal tumor Hepatic tumor Doege-Potter syndrome

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Iatrogenic Oesophageal Perforations in Neoplastic Lesions: Management with Covered Self-Expanding Prostheses

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Open Journal of Gastroenterology 2021年第6期11卷 89-104页

作者： Mario Anselmi Mendez Ana MarÍA Gemmato pascazio Maximiliano Figueroa Silva Julio Salgado OyarzÚN Surgery Department School of Medicine University of Concepción Concepción Chile Endoscopic Surgery Diploma Program Fellow Department of Surgery School of Medicine University of Concepción Concepción Chile

Background:Perforation of the oesophagus is a serious condition. Most of them are iatrogenic and are associated with significant morbidity and mortality, especially with late diagnosis. Aim: To prospectively analyse the results of the endoscopic management of iatrogenic perforations in oesophageal neoplasia, through the immediate insertion of a covered self-expanding prosthesis (CSES). Materials and Methods: Between 01.01.2006 and 12.30.2016, a series of 19 consecutive patients attended the Teaching Unit of Endoscopic Surgery of the Regional de Concepción Hospital, Chile, with the diagnosis of oesophageal neoplasia confirmed by biopsy were prospectively studied. All were subjected to a prior evaluation by the oncology team and subsequently referred for endoscopic palliative management of dysphagia. The average age was 77 ± 9.3 years, 8 (42.1%) were female and 11 (57.9%) were male. In 17 patients (89.5%) the stenosis compromised the oesophagus, in 2 (10.5%) the gastro-oesophageal junction, 16 had a squamous carcinoma (84.2%) and 3 an adenocarcinoma (15.8%). Results: Perforation was diagnosed during the procedure in 18 patients (94.7%) and in 1 (5.3%) 22 hours later. Follow-up was done for a minimum of 90 days or until death. The prostheses were inserted successfully in all cases. The immediate evolution was satisfactory in 12 patients (63.2%). In the rest (36.8%), 18 complications appeared. The most frequent were retrosternal pain, subcutaneous emphysema and fever. The early evolution was satisfactory in 12/19 cases (63.2%). Complication was evidenced in 7 (36.8%), the most frequent was retros

关键词： Iatrogenic Oesophageal Perforations Self-Expanding Prostheses Oesophageal Cancer

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Retroperitoneal Air after ERCP with Sphincterotomy: Frequency and Clinical Significance —Retroperitoneal Air after Sphincterotomy

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Open Journal of Gastroenterology 2016年第2期6卷 31-38页

作者： Mario Anselmi Mendez José Gerardo Acosta Mata Carlos Flores Mladineo Jaime Schwanner Carrasco Ana María Gemmato pascazio Endoscopic Surgery Teaching Care Unit Guillermo Grant Benavente Hospital Concepción Chile Department of Surgery Faculty of Medicine University of Concepción Concepción Chile

Background and Aim: After successful medical management of a patient with a clinical picture suggestive of post-sphincterotomy duodenal perforation, in which a computerized axial tomography (CAT) scan of the abdomen revealed the presence of subcutaneous emphysema and retroperitoneal air, concern arose as to the frequency of pneumoretroperitoneum following endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy (ES) and if any procedure dependent factors were associated with this problem. Aim: To assess the frequency and clinical significance of retroperitoneal air after endoscopic retrograde cholangiopancreatography with sphincterotomy. Methods: Fifty consecutive patients, who had undergone ERCP with sphincterotomy, were submitted to abdominal CT examinations within 24 hours after completion of the procedure. One patient was with a large precut, but a failed ERCP was also included. The ERCP findings were unknown to the radiologist. Results: Seven (14%) of 50 patients showed CT findings of retroperitoneal air. All of them had uneventful post-procedural recovery. No clinical or laboratory abnormality was found in this group of patients. The presence of retroperitoneal air was not associated to the variables: precut, biliopancreatic disease type, endoscopic sphincterotomy length, additional endoscopic procedure (balloon exploration, gallstone extraction, stent insertion) or procedure duration. Conclusion: After ERCP with ES, retroperitoneal air is frequently found. In the absence of physical symptoms, retroperitoneal air is not clinically relevant and does not require specific treatment.

关键词： Retroperitoneal Air ERCP Complications Duodenal Perforation

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