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Hepatectomía derecha extendida por colangiocarcinoma intrahepático en un paciente con síndrome de Dubin-Johnson Hepatectomy for cholangiocarcinoma in one patient with Dubin Johnson syndrome  [cached]
CRISTIAN GAMBOA C,RICARDO Yá?EZ M,JORGE MARTíNEZ C,MARCO ARRESE J
Revista Chilena de Cirugía , 2009,
Abstract: El síndrome de Dubin-Johnson (SDJ) es una patología benigna, familiar, con carácter autosómico recesivo y de aparición poco frecuente. Consiste en un defecto en la excreción hepática de la bilirrubina conjugada que permite su entrada al canalículo biliar, manifestando un cuadro clínico de ictericia silente. La asociación de esta enfermedad con colangiocarcinoma intrahepático es excepcional, siendo difícil la sospecha precoz de este diagnóstico y también el manejo de la ictericia postoperatoria. El objetivo de este trabajo es describir un caso clínico con estas características y revisión de la literatura existente. Se presenta a un paciente de sexo masculino de 71 a os de edad, con antecedente de síndrome de Dubin-Johnson diagnosticado a los 40 a os. Asintomático, en exámenes de rutina se encuentra un tumor hepático en la ecotomografía abdominal, que luego se corrobora en la TAC y RNM, mide aproximadamente 10 cm de diámetro, de ubicación central y derecho. Resto de estudio no muestra diseminación. Se realiza laparoscopia diagnóstica y ecografía intraoperatoria confirmando lo visto por imágenes, y se decide convertir a laparotomía para efectuar hepatectomía derecha extendida. Biopsia rápida y diferida informan colangiocarcinoma. Evoluciona favorablemente en el postoperatorio, con hiperbilirrubinemia sostenida de lenta resolución. La asociación de hepatectomía con síndrome de Dubin-Johnson es de muy baja frecuencia, existiendo poca literatura al respecto. Se ha descrito que la hiperbilirrubinemia en el postoperatorio es de difícil manejo, sin embargo, en este caso el paciente evolucionó favorablemente sin necesidad de alguna terapia específica. Dubin-Johnson syndrome (SDJ) is a rare benign autosomal recessive congenital disease that causes jaundice. We report a 71 years old male with a Dubin Jonson syndrome diagnosed at the age of 40. On a ultrasound examination and magnetic resonance imaging, a liver tumor was found, that was excised. The pathology report showed a cholangiocarcinoma. During the postoperative period, the patient had a hyperbilirubinemia that subsided slowly. There are reports of hyperbilirubinemia of difficult management after hepatectomy in patients with Dubin-Johnson syndrome.
Corrección quirúrgica de infarto de intestino delgado en un equino mediante yeyunocecostomía con grapadora quirúrgica mecánica Surgical management of small intestine infarction by stapled jejunocecostomy in a horse
Diego L Duque B,Elizabeth Coral D,José Bran
Revista Colombiana de Ciencias Pecuarias , 2007,
Abstract: Un equino macho, entero, criollo colombiano de siete a os de edad, fue remitido a la clínica de grandes animales del centro de veterinaria y zootecnia CES debido a síndrome abdominal agudo. Al ser evaluado clínicamente presentó depresión, ruidos abdominales disminuidos, deshidratación (6%), frecuencia cardiaca y respiratoria en 40 lpm y 28 rpm, respectivamente, temperatura en 37.1 °C y distensión marcada de intestino delgado evidente mediante palpación rectal y ultrasonografía transabdominal. No hubo respuesta a los analgésicos por parte del equino; los parámetros en líquido peritoneal estuvieron alterados. Se sospechó lesión estrangulante en intestino delgado. La laparotomía exploratoria reveló infarto idiopático de siete metros de yeyuno y la porción proximal del íleon. Fue practicada una yeyunocecostomía latero lateral con grapadora quirúrgica mecánica (GIA 80). El animal permaneció hospitalizado 10 días y la recuperación postquirúrgica fue exitosa. Este caso es el primer reporte en el país de esta cirugía. A 7- years-old criollo colombiano stallion was referred to the Large Animal Hospital Centro de Veterinaria y Zootecnia CES (Envigado, Colombia) because of an acute abdominal syndrome that had persisted for seven hours despite medical treatment. On physical examination the stallion was depressed, dehydrated (6%), borborygmi were diminished, rectal temperature was 37.1 °C, hearth and respiration rates were 40 beats/min and 28 breaths/min, respectively. On rectal examination and abdominal ultrasonography small intestine was distended. Peritoneal fluid analysis was altered. Signs of pain were nonresponsive to analgesics. The diagnosis by exploratory laparotomy was infarction of small intestine (seven meters of the jejunum and proximal portion of the ileum) of unknown etiology. A jejunocecostomy was done using a GIA 80 surgical stapler (United Surgical). Postsurgical recuperation was successful. This case becomes the first report of a jejunocecostomy in a horse in Colombia
Colangiocarcinoma: Actualización, diagnóstico y terapia Cholangiocarcinoma
Luis Burgos San Juan
Revista médica de Chile , 2008,
Abstract: Cholangiocarcinoma is a malignant lesion of the bile duct epithelium. Its incidence and prevalence are low. It appears from the sixth decade of life and there is slight male predominance. It is most frequently found in the confluence of the hepatic ducts, where it is called hilar cholangiocarcinoma or Klatskin tumor. Its etiology is unknown but there are predisposing conditions and environmental risk factors such as primary sclerosing cholangitis, Caroli's disease, bile duct malformations, industrial toxins and parasitic infections. The classic presentation of cholangiocarcinoma includes jaundice, weight loss and right upper quadrant pain. These, in addition to laboratory exams, endoscopical and imaging procedures, lead to the diagnosis. Hilar cholangiocarcinoma must be distinguished from other malignant or benign causes of biliary obstruction. Cholangiocarcinoma of the distal common bile duct must be differentiated from other periampullary tumors and intrahepatic cholangiocarcinoma can be confused with a hepatocellular carcinoma. Two classifications are used for clinical staging: TNM and Bismuth-Corlette. The best treatment is the complete surgical excision with negative histological margins, although the resectability index is low. The type and size of surgery depends on the location and extent of the tumor. Patients with unresectable tumors can be subjected to palliative procedures such as biliary-enteric bypass, endoscopic or pecutaneous stent placement. Chemotherapy is not effective. Recently, endoscopic phototherapy has emerged as a better alternative for palliative care
Gemcitabina en 4 pacientes con colangiocarcinoma: Report of four cases Gemcitabine in the treatment of cholangiocarcinoma.  [cached]
Jorge Gallardo E,Elsa Cabrera A,Betzabé Rubio L,Carolina González V
Revista médica de Chile , 2001,
Abstract: Cholangiocarcinoma is a biliary tree cancer of unknown etiology, whose symptoms are unspecific and is usually detected in advanced stages. Surgery continues to be the only curative therapy. Median survival in patients with inoperable tumors ranges between 5 and 8 months. There are few studies on the effects of chemotherapy, with a very small response. We report four patients with advanced cholangiocarcinoma, treated with gemcitabine 1000 mg/m2, weekly for 3 weeks every 28 days. There was a stabilization of tumor size and symptoms were alleviated. Toxicity was low and there was a probable prolongation of survival (Rev Méd Chile 2001; 911-6).
Colangiocarcinoma primario asociado a enfermedad de Caroli Primary cholangiocarcinoma asociated with Caroli disease  [cached]
Gaspar Faría O,Xabier de Aretxabala U,Armando Sierralta Z,Plácido Flores O
Revista médica de Chile , 2001,
Abstract: A 68 years old male presented with right hypochondrium abdominal pain and jaundice with no other clinical finding. CAT Scan and Ultrasonography showed right lobe bile duct dilatation. Magnetic Resonance Cholangiopancreatography gave an outstanding vision of a restricted right lobe bile duct dilatation associated to choledocholithiasis. A right hepatectomy and bile duct exploration were performed. The histopathological study disclosed a Caroli disease associated to a primary cholangiocarcinoma. Caroli disease is a congenital disorder characterized by intrahepatic cystic bile duct dilatation with a high risk association with cholangiocarcinoma (Rev Méd Chile 2001; 129: 1433-8)
Colangiocarcinoma infectado
Ridruejo Sáez,R.; Jiménez Bartolomé,B.;
Anales de Medicina Interna , 2006, DOI: 10.4321/S0212-71992006000700009
Abstract: cholangiocarcinomas are malignancies of the biliary duct system. they are encountered in 3 geographic regions: intrahepatic, proximal extrahepatic, and distal extrahepatic. the etiology of most bile duct cancers remains undetermined but some risk factors, like gallstone, have been suggested to play a role by inducing malignant transformation. the prognosis and clinical manifestations depend on the anatomical location and clinical presentation may be confuses or by means of complications like sepsis. we present a case of cholangiocarcinoma which made debut with cholestasis and sepsis in a cholecystectomiced pacient, who had a long standing lithiasic cholecystitis.
Colangiocarcinoma hepático en un felino y hallazgos anatomopatólogicos, y clínicos compatibles con peritonitis infecciosa felina
Julieta Ochoa A.,AI Roque,JA Daza H.
Revista MVZ Córdoba , 2012,
Abstract: Se presentan los hallazgos patomorfológicos de colangiocarcinoma hepático (CGC) con efusión peritoneal en un gato doméstico geronte y se relaciona con la sintomatología clínica y los hallazgos anatomopatológicos compatibles con la peritonitis infecciosa felina (PIF). Se atendió en la clínica veterinaria de la Universidad de los Llanos un paciente felino de 8 a os de edad, criollo, con aumento de la silueta abdominal y depresión. Clínicamente se encontró deshidratación del 7%, hipotermia (37.2oC), mucosas pálidas, disnea y hepatomegalia. Mediante abdominocentesis se obtuvo un exudado no séptico y un cuadro citológico compatible con CGC con células columnares bajas dispuestas en panal de abeja, presentando anisocariosis, hipercromacia moderada, citoplasmas claros y vacuolados acompa ados de un fondo sucio inflamatorio y hemorrágico con detritos celulares. En el análisis radiográfico se observó hepatomegalia con un patrón de punteado característico de formación neoplásica y ascitis. A la necropsia se presentó hemotórax e hidropericardio, ascitis y nódulos neoplásicos blancos duros al corte en el 45% del parénquima hepático y un patrón nodular sobre la superficie visceral del estomago, intestinos delgado, grueso y mesenterio. Las muestras se fijaron en formalina buferada al 10%, se procesaron mediante métodos rutinarios para microscopía óptica. Por histopatología se diagnosticó CGC moderadamente diferenciado con intensa desmoplasia. Citológica e histopatológicamente se evidenció un CGC hepático con efusión peritoneal que se relacionó con la sintomatología clínica y los hallazgos anatomopatológicos compatibles con la PIF.
Muerte súbita asociada a descarga eléctrica en un equino: reporte de un caso
Morales B,Abelardo; García,Francisco; L,Júlio De Jesús; Villoria L,Diana;
CES Medicina Veterinaria y Zootecnia , 2012,
Abstract: the aim of this study was to describe a case of sudden death in a horse associated with electric shock. refer a thoroughbred horse race, sex male, 7 years old. with a history of sudden collapse and death. he practiced the technique described for equine necropsy. samples were collected from all organs for histology. additionally, blood samples for complete blood count and blood chemistry. the room where the fish was was assessed with a power detector. necropsy results were cyanotic mucous membranes, marked rigor mortis. bleeding ecchymotic epicardium and endocardium. liver hemorrhage, adrenal and kidney bruise. the histological sections showed in muscle: marked hypereosinophilia, retains the basic profile of the muscle myofibril, acute coagulation necrosis. heart: coagulation necrosis, degeneration of muscle myofibrils with hyalinization and swelling. hematological tests evidenced acute hemolysis. environmental assessment with the power detector revealed a discharge of electricity with an amperage ≥250 ma. in conclusion we report a case of sudden death in a horse associated with electric shock.
Hepatectomía derecha extendida por colangiocarcinoma intrahepático en un paciente con síndrome de Dubin-Johnson
GAMBOA C,CRISTIAN; Yá?EZ M,RICARDO; MARTíNEZ C,JORGE; ARRESE J,MARCO; NERVI N,BRUNO; BORGHERO E,YERKO; TORRES M,JAVIERA; JARUFE C,NICOLáS;
Revista chilena de cirugía , 2009, DOI: 10.4067/S0718-40262009000300011
Abstract: dubin-johnson syndrome (sdj) is a rare benign autosomal recessive congenital disease that causes jaundice. we report a 71 years old male with a dubin jonson syndrome diagnosed at the age of 40. on a ultrasound examination and magnetic resonance imaging, a liver tumor was found, that was excised. the pathology report showed a cholangiocarcinoma. during the postoperative period, the patient had a hyperbilirubinemia that subsided slowly. there are reports of hyperbilirubinemia of difficult management after hepatectomy in patients with dubin-johnson syndrome.
Endoscopic ultrasound for cholangiocarcinoma re-evaluation after Wallstent placement Ecografía endoscópica en la reevaluación de un colangiocarcinoma tras la colocación de una prótesis Wallstent  [cached]
J. Iglesias-García,J. Lari?o-Noia,S. Seijo-Ríos,J. E. Domínguez-Mu?oz
Revista Espa?ola de Enfermedades Digestivas , 2008,
Abstract:
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