Intramural pseudodiverticulosis of the esophagus. A case report and review of the literature

Oesophageal intramural pseudodiverticulosis is a very rare cause of dysphasia. This work reports the observation of a 42 year-man who presented with dysphasia; Diagnosis was established by baryum meal. The patient underwent an oesophagectomy because of failure of endoscopic dilatation. Pathologic examination revealed characteristic lesions of esophageal pseudodiverticulosis, with fissures between the lumen and sero-mucosal glands located in the oesophageal wall and containing Candida spores. By means of a review of the relevant literature, etiopathogenesis, diagnosis and treatment of oesophageal intramural pseudodiverticulosis are discussed.     

Thoracic intramedullary haematoma as a complication of warfarin: case report and literature review

Spontaneous intraspinal haematomas due to anticoagulants are uncommon, and usually extradural or subdural. Intramedullary haematomas are particularly rare, and only two case reports were found in the literature. We report a case of a thoracic intramedullary haemorrhage in a 61 year old man who had been commenced on warfarin 1 month previously, following aortic valve replacement. The literature is reviewed and reversal of warfarin effects, imaging and recommendations for treatment are discussed.     

Villous tumor of the duodenum: report of a case and review of the literature

Villous tumors of the duodenum are rare tumors which have been infrequently reported in the literature. Surgical treatment options include wide local excision and radical pancreaticoduodenectomy. A case of duodenal villous adenoma presenting with bilious vomiting is presented here. Received: April 25, 2000 / Accepted: November 20, 2000     

Spontaneous haematoma of the iliac psoas muscle: a case report and review of the literature

Spontaneous haematomas of the iliac psoas muscle are rare lesions seen in patients receiving anticoagulant agents or suffering from clotting disorders. We report the rare case of a spontaneous iliac psoas haematoma causing femoral neuropathy in a patient not undergoing anticoagulant treatment or suffering from a coagulopathy. After conservative treatment the patient was entirely asymptomatic, and magnetic resonance imaging demonstrated complete dissolution of the haematoma. Spontaneous iliac psoas haematomas should be considered in the differential diagnosis of leg pain in otherwise healthy patients.     

Widespread post-traumatic acute spinal subdural haematoma: case report and review of the literature

STUDY DESIGN: A case report of acute post-traumatic spinal subdural haematoma (ASSH). OBJECTIVE: To report a rare post-traumatic problem. SETTING: Dicle University Hospital, Diyarbakir, Turkey. METHOD: A 3-year-old boy was admitted to our clinic with paraplegia 24 h after falling from a height of about 5 meters. Investigation revealed an acute spinal subdural haematoma. RESULTS: Following surgery there was marked improvement. The rehabilitation of the patient continues. CONCLUSION: MRI is the most valuable diagnostic method. In each case diagnosed as ASSH, prompt evacuation should be performed before irreversible neurological damage occurs.     

Villous adenoma of the duodenum: A case report and review of the literature

A case of villous adenoma of the duodenum, with focal in situ carcinomatous changes, has been described with a review of forty-two other case reports from the world literature. Occult bleeding, resulting in anemia, and vague obstructive symptoms appear to be the most common presenting findings. The average age was 56.4 years, which was seven years younger than the average age for villous tumors of the colon. Adequate radiologic studies should establish the diagnosis preoperatively. These tumors obtain relatively large size before causing significant symptoms. Approximately one third showed carcinomatous changes, and approximately one half of these were in situ changes. Local segmental resection for duodenal villous tumors is desirable when possible. However, in areas where this is not feasible, local mucosal excision is acceptable for benign tumors and for those with in situ carcinoma. If invasive carcinoma is found in the excised specimen, pancreatoduodenectomy is recommended. Insufficient evidence is available to adequately evaluate survival for malignant villous tumors of the duodenum, but the available data suggest that the survival after treatment of malignant villous tumors is comparable to other malignant lesions originating in the duodenum.     

食管、十二指肠异时性双原发癌1例

多原发癌又称重复癌（multiple primary carcinoma，MPC）是指同一器官或系统不同部位，同时或先后发生两个或两个以上原发癌病灶。其中，又以其出现的时间间隔分为同时性多原发癌（synchronous carcinoma，SC）和异时性多原发癌（metachronous carcinoma，MC）。原发性十二指肠癌发病率较低，仅为0．035％，占消化道恶性肿瘤的0．3％，十二指肠作为第二原发癌的多原发癌则更为少见。本院近期收治1例食管、十二指肠异时性双原发癌，现报告如下。     

Intramural pseudocyst of the duodenum caused by pancreatic head cancer: report of a case

An intramural pseudocyst in the alimentary tract develops as a rare complication of acute pancreatitis or trauma. A 60-year-old woman with pancreatic head cancer underwent preoperative radiological examinations, which revealed a 45-mm cystic mass around the second portion of the duodenum. Endoscopic ultrasonography confirmed a cystic lesion in the submucosal layer of the duodenum and fine needle aspiration cytology of the cystic contents suggested adenocarcinoma. The cystic fluid was amylase-rich, at 17040 U/l. We performed pancreaticoduodenectomy for the pancreatic head cancer. Pancreatography of the resected specimen showed a communication between the main pancreatic duct and the cystic lesion. The cut surface of the resected specimen revealed a cystic lesion, which surrounded the duodenum. Pathologically, the cystic lesion was diagnosed as a pseudocyst, located between the dissociated smooth muscle layers of the duodenum.