A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Sharma, Brij
- A Case of Young Colon Cancer Presenting as Neck Mass
Authors
1 Department of Gastroenterology IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 73, No 6 (2020), Pagination: 50-52Abstract
Colorectal adenocarcinoma, the third most diagnosed cancer in males and the second most diagnosed in females, commonly presents with changes in bowel habits, rectal bleeding, weight loss, fatigue, and abdominal pain. While non-regional lymphatic the involvement in colon primary is an uncommon finding, metastatic mediastinal and su-praclavicular lymph node without the involvement of major intermediary organs like liver or lungs is extremely rare. We report the case of a 25-year-old male with colorectal cancer who had an unusual initial presentation as a progres-sively increasing left-sided neck mass. Early age of onset of colorectal malignancy without any bowel symptoms and presentation as metastasis to left supraclavicular node (Virchow’s node) without solid end-organ involvement makes this case novel.Keywords
Colorectal Carcinoma, Contrast Enhanced Computed Tomography, FNAC, Carcinoembryonic Antigen.References
- Lindsey A., et al.“Global Cancer Statistics, 2012”. Ca: A Cancer Journal for Clinicians 65.2 (2015): 87-108.
- K. M. Mohandas and D. C. Desai, “Epidemiology of digestive tract cancers in India. V. Large and small bowel,”Indian Journal of Gastroenterology, vol. 18, pp. 118–121, 1999.
- Speights VO, Johnson MW, Stoltenberg PH, Rappaport ES, Helbert B, Riggs M. Colorectal cancer: current trends in initial clinical manifestations. South Med J. 1991May; 84(5):575-578.
- El-Halabi MM, Chaaban SA, Meouchy J, Page S, Salyers WJ. Colon cancer metastasis to mediastinal lymph nodes without liver or lung involvement: a case report. Oncol Lett. 2014;8(5):2221–2224.
- Reddy RR, Das P, Rukmangadha N, Manilal B, Kalawat TC. Colonic carcinoma presenting with axillary lymphadenopathy-a very rare clinical entity. IJSR. 2017; 6(8):2015–2017.
- Venugopal, A., Stoffel, E.M. Colorectal Cancer in Young Adults. Curr Treat Options Gastro17, 89–98 (2019).
- Prachi S. Patil 1 & Avanish Saklani et al. Colorectal Cancer in India: An Audit from a Tertiary Center in a Low Prevalence Area. Indian J Surg Oncol (December 2017)8(4):484–490.
- Achmad H, Hanifa R. Supraclavicular lymphnodes: unusual manifestation of metastases adenocarcinoma colon. Acta Med Indones. 2015;47(4):333–339.
- Sundriyal D, Kumar N, Dubey SK, Walia M. Virchow’s node. Case Reports. 2013;2013(1):bcr2013200749–bcr2013200749.
- Aksel B, Dogan L, Karaman N, Demirci S. Cervical lymphadenopathy as the first presentation of sigmoid colon cancer. Middle East J Cancer. 2013;4(4):185–188.
- A Case of Dual Primary Gastric and Colonic Malignancy
Authors
1 Professor, Department of Gastroenterology IGMC- Shimla, IN
2 Assistant Professor, Department of Gastroenterology, IGMC - Shimla, IN
3 Associate Professor, Department of Gastroenterology, IGMC- Shimla, IN
4 Senior Resident, Department of Gastroenterology, IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 73, No 8 (2020), Pagination: 43-45Abstract
Incidence of multiple primary malignant neoplasm increases with age, mainly because of an improvement in diagnostic techniques and prolonged survival of patients treated for malignancy. Multiple tumors may develop synchronously or metachronously. If the time interval between the appearances of the two neoplasms is less than 6 months, they are defined as synchronous, and if the time interval is longer than 6 months, they are classified as metachronous. Gastric cancer associated with synchronous colon cancer is very rare. We report a case of 56 year old male who was presented with dyspepsia with associated alarm feature and during evaluation was found to have synchronous primary gastric and colonic cancer.Keywords
Esophagogastorduodenoscopy, Gastric Cancer, Double Primary Gastric and Colorectal Cancer, Histopathological Examination.References
- Watanabe S et al. Multiple primary cancers in 5,456 autopsy cases in the National Cancer Center of Japan. J Natl Cancer Inst 1984; 72(5): 1021−7.
- Billroth T. Die allgemeine chirurgische pathologie und therapie. In: Reimer G. (ed.) 14 Aufl. Berlin 1889; 908
- Warren S, Gates O. Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer. 1932; 16:1358–1414.
- Ha TK, An JY, Youn HG, et al. Surgical outcome of synchronous second primary cancer in patients with gastric cancer. Yonsei Med J 2007; 48: 981-987.
- Yano K, Yamashita T, Chishiki M, Osaki T, Sugio K, Yasumoto K. Two cases of synchronous superficial double cancers in the esophagus and stomach. J UOEH 2002. 24: 225-232.
- Onoue S, Katoh T, Chigira H, et al. Synchronous multiple primary cancers of the stomach and duodenum in aged patients: report of two cases. Sur Today 2000; 30: 735-738.
- Dinis-RM, Lomba VH, Silva R, Moreira L, Lomba VR. Associated primary tumours in patients with gastric cancer. J Clin Gastroenterol 2002; 34: 533-535.
- Mitsugu Kochi, Masashi Fujii, Noriaki Kanamori, Yoshiaki Mihara, Tomoya Funada, Hidenori Tamegai, Megumu Watanabe, Yuriko, Takayama, Hiroshi Suda, Tadatoshi Takayama. Metachronous Double Primary Gastric and Colorectal Cancer: Is Prognosis Better with Gastric or Colorectal Cancer Occurring First? Journal of Cancer Therapy, 2013, 4, 720-725
- Green PH, O’Toole KM, Weinberg LM, Goldfarb JP. Early gastric cancer. Gastroenterology. 1981; 81:247–256.
- Ikeguchi M, Ohfuji S, Oka A, Tsujitani S, Maeda M, Kaibara N. Synchronous and metachronous primary malignancies in organs other than the stomach in patients with early gastric cancer. Hepatogastroenterology. 1995;42:672–676
- Bozzetti F, Bonfanti G, Mariani L, Miceli R, Andreola S. Early gastric cancer: unrecognized indicator of multiple malignancies. World J Surg. 2000; 24:583–587.
- Ikeda Y, Saku M, Kawanaka H, Nonaka M, Yoshida K. Features of second primary cancer in patients with gastric cancer. Oncology. 2003; 65:113–117.
- Knekt P et al. Risk of colorectal and other gastro-intestinal cancers after exposure to nitrate, nitrite and N-nitroso compounds: a follow-up study. Int J Cancer. 1999; 80:852-6.
- Evaluation of the Gastrointestinal Tract in a Young Patient with Iron Deficiency Anemia – A Case Report
Authors
1 Assistant Professor, Department of Gastroenterology, IGMC- Shimla, IN
2 Professor, Department of Gastroenterology IGMC- Shimla, IN
3 Associate Professor, Department of Gastroenterology IGMC- Shimla, IN
4 Senior Resident, Department of Gastroenterology IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 73, No 8 (2020), Pagination: 46-48Abstract
Iron deficiency anemia is not a disease in itself, but may be a manifestation of a serious underlying disease such as malignancy. The incidence of colorectal and gastric cancer in younger individuals is low. Therefore, the yield of upper and lower gastrointestinal tract examinations in young men with IDA to evaluate for the presence of GI pathology may also be lower than that in older men. So evidence for the necessity of endoscopy in young men with IDA is significantly lacking. Here we present a case of chronic iron deficiency anemia in a young 25 year old male patient, who on evaluation was found to have sporadic stage IV colonic carcinoma.Keywords
Iron Deficiency Anemia, Esophagogastroduodenoscopy, Contrast Enhanced Tomography, PET, Gastrointestinal, FNAC.References
- Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician 2013; 87:98–104.
- Johnson-Wimbley TD, Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol 2011; 4:177–184.
- Goddard AF, James MW, McIntyre AS, Scott BB, British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut 2011;60:1309–1316
- Kim NH, Park JH, Park DI, et al. Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy? Korean J Intern Med. 2018 Jan 5.
- Rockey DC, Cello JP. Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med 1993; 329:1691–1695.
- Ioannou GN, Rockey DC, Bryson CL, Weiss NS. Iron deficiency and gastrointestinal malignancy: a population- based cohort study. Am J Med 2002; 113:276–280.
- Inra JA, Syngal S. Colorectal cancer in young adults. Dig Dis Sci 2015; 60:722–733.
- Karimi P, Islami F, Anandasabapathy S, Freedman ND, Kamangar F. Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev 2014; 23:700–713.
- Venugopal, A., Stoffel, E.M. Colorectal Cancer in Young Adults. Curr Treat Options Gastro 17, 89–98 (2019).
- Dysphagia as a Presenting Complaint in Carcinoma Lung: A Case Report
Authors
1 Department of Gastroenterology, IGMC- Shimla, IN
2 Department of Gastroenterology ,IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 73, No 9 (2020), Pagination: 38-40Abstract
Carcinoma lung classically present with symptoms of cough, hemoptysis, chest pain and weight loss. Lung cancer presenting with sole manifestation of difficulty swallowing as the initial presenting complaint is very uncommon. Literature reports 1-2 % patients with lung cancer had dysphagia at presentation. We report a case of 45 years male, who is initially evaluated for the complaints of difficulty swallowing and eventually diagnosed to have carcinoma lung with mediastinal lyphadenopathy as the cause of his symptoms.Keywords
Lymphadenopathy, Extrinsic Compression, Carcinoma.References
- Zannini G, Coseri A. Dysphagia in lung cancer. Riforma Med. 706 (1962) 708.
- Le Roux BT. The presentation of bronchial carcinoma. Scott Med J. 1968; 13: 31-7.
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- Maguire PD, Sibley GS, Zhou S-M, et al. Clinical and dosimetric predictors of radiation-induced oesophageal toxicity.Int J Rad Onc Biol Phys. 1999; 45: 97-103.
- Stankey RM, Roshe J, Sogocio RM. Carcinoma of the lung and dysphagia. Dis Chest. 1969; 55: 13-17.
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- Fleishner F.C. The esophagus and mediastinal lymphadenopathy in bronchial carcinoma. Radiology. 58(1952) 48.
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- Hassan WA, Darwish K, Shalan IM, Elbaki LA, Elmohsen EA, Sayed WH. Aetiologic mechanisms of dysphagia in lung cancer: A case series. Egyptian Journal of Chest Diseases and Tuberculosis. 2014; 63(2): 435–442.
- Camidge D.R. The cause of dysphagia in carcinoma of the lung. J R Soc Med. 2001; 94:567-572.
- ‘Downhill’ Varices as a Surrogate Marker for Mediastinal or Lung Pathology: A Case Report
Authors
1 Department of Gastroenterology ,IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 73, No 10 (2020), Pagination: 26-28Abstract
‘Downhill’ varices are dilated veins resulting from SVC obstruction whose blood flow is directed caudally towards azygous vein or inferior vena cava. Their etiology differs from that of the usual “uphill” varices secondary to portal hypertension. We report a case of 63 year old male that was suspected to have mediastinal / lung pathology based on finding of downhill varix on diagnostic esophagogastroduodenoscopy despite normal chest X- ray. Subsequently, the lung pathology was confirmed on contrast enhanced tomography of chest and on bronchoscopy. So findings of ‘downhill’varices on endoscopy can suggest lung/medistinal pathology which needs to be confirmed on subsequent testing.Keywords
Esophagogastroduodenoscopy, Red color sign, Contrast Enhanced Computed Tomography, Endoscopic Band Ligation.References
- Felson B, Lessure AP. “Downhill” varices of the esophagus. Dis Chest. 1964; 46:740-46.
- Rosenblatt ML, Rabinowitz M. Downhill esophageal varices (EV) secondary to fibrosingmediastinitis. (FM) AJG. 2000; 95:2602-03.
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- Tavakkoli H, Asadi M, Haghighi M, Esmaeili A. Therapeutic approach to downhill esophageal varices bleeding due to superior vena cava syndrome in Behcet’s disease: a case report. BMC Gastroenterol. 2006 ; 6: 43.
- Areia M, Romãozinho JM, Ferreira M, Amaro P, Freitas D. Unidadede Cuidados Intensivos de Gastrenterologia – 13 anos de vida. GE-J Port Gastrenterol. 2005; 12(3): 62.
- Vorlop E, Zaidman J, Moss SF. Clinical challenges and images in GI. Downhill esophageal varices secondary to superior vena cava occlusion. Gastroenterology.2008; 135(6): 1863, 2158.
- Management of Post-ERCP Air Leak: A Case Report
Authors
1 Department of Gastroenterology, IGMC - Shimla, IN
2 Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, IN
Source
The Indian Practitioner, Vol 73, No 11 (2020), Pagination: 37-38Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is associated with retroperitoneal perforation in approximately 2.1% patients, but not infrequently, retroperitoneal air, pneumoperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema are also reported which may or may not be associated with retroperitoneal perforation. We report the case of a female patient with post-ERCP air leak into different compartments without iatrogenic gastrointestinal perforation and which was managed conservatively.Keywords
Endoscopic Retrograde Cholangiopancreatography, Contrast Enhanced Computed Tomography, Side Viewing Esophagogastroduodenoscope.References
- Ferrara F, Luigiano C, Billi P, Jovine E, Cinquantini F, D’Imperio N. Pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema after ERCP. Gastrointest Endosc 2009; 69:1398-401.
- Seymann GB, Savides T, Richman KM. Massive subcutaneous emphysema after endoscopic retrograde cholangiopancreatography. Am J Med 2010; 123:e15-6.
- Kaul S, Koul S, Singh H, Kachroo SL, Chrungoo RK. Post ERCP Surgical Emphysema. J K Science 2008; 10:18990.
- Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg 2000; 232:191-8.
- Jaiswal SK, Sreevastava DK, Datta R, Lamba NS. Unusual occurrence of massive subcutaneous emphysema during ERCP under general anaesthesia. Indian J Anaesth 2013; 57:615-7.
- Seymann GB, Savides T, Richman KM. Massive subcutaneous emphysema after endoscopic retrograde cholangiopancreatography. Am J Med. 2010; 123:e15–6.
- Kaul S, Koul S, Singh H, Kachroo SL, Chrungoo RK. Post ERCP Surgical Emphysema. J K Science. 2008; 10:18990.
- Extranodal Histiocytic Sarcoma Rectum: A Case Report
Authors
1 Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, IN
2 Department of Surgery, IGMC - Shimla, IN
Source
The Indian Practitioner, Vol 73, No 11 (2020), Pagination: 39-41Abstract
Histiocytic sarcoma (HS) is an exceedingly rare but aggressive hematopoietic tumor, showing morphologic and immunophenotypic features of mature tissue histiocytes. Diagnosis of HS is based on histological and immunohistochemical evidence of histiocytic differentiation supported by an extensive immunophenotypic analysis that excludes other large cell malignancies in the differential diagnosis. Search of world literature revealed only three previous reports of extranodal histiocytic sarcoma (ENHS) involving rectum specifically. We report a case of ENHS of rectum in a 65 year old man presenting with hematochezia. Radiological findings were indicative of polypoidal soft tissue mass lesion in rectum. Histopathology and immunohistochemical studies of the resected specimen confirmed the uncommon diagnosis ENHS.Keywords
Histiocytic Sarcoma, Extranodal Histiocytic Sarcoma, Magnetic Resonance Imaging.References
- Takahashi E, Nakamura S. Histiocytic Sarcoma : An Updated Literature Review Based on the 2008 WHO Classification. J Clin Exp Hematop. 2013; 53(1): 1-8.
- Skala S L, Lucas D R, Dewar R. Histiocytic Sarcoma: Review, Discussion of Transformation From B-Cell Lymphoma, and Differential Diagnosis. Arch Pathol Lab Med. 2018;142:1322– 1329
- Hornick JL, Jaffe ES, Fletcher CD. Extranodal histiocytic sarcoma: Clinicopathologic analysis of 14 cases of a rare epithelioid malignancy. Am J Surg Pathol 2004; 28:1133 44.
- Vos JA, Abbondanzo SL, Barekman CL, Andriko JW, Miettinen M, Aguilera NS. Histiocytic sarcoma: A study of five cases including the histiocyte marker CD163. Mod Pathol 2005; 18:693 704.
- Park MI, Song KS, Kang DY. Histiocytic sarcoma of rectum – A case report. Korean J Pathol 2006; 40:156 9.
- Jiang QM, Zhou WW, Song R, Ye XZ, Li J. [Histiocytic sarcoma: A clinicopathologic study of 4 cases]. Zhonghua Xue Ye Xue Za Zhi 2012; 33:751 5.
- Mitra S, Jhunjhunwala A, Mukherjee P. Extranodal histiocytic sarcoma mimicking colorectal lymphoma: Case report and review of literature. Indian J Pathol Microbiol 2019; 62:467-9.
- Swerdlow SH, Campo E, Harris NL, et al. (eds). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Revised 4th ed. Lyon, France: International Agency for Research on Cancer; 2017.
- Retrospective Study of Sociodemographic, Endoscopic, and Histopathologic Features of Esophageal Cancer at a Tertiary Care Hospital of Himachal Pradesh, India
Authors
1 Department of Gastroenterology, IGMC-Shimla, IN
2 Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, IN
Source
The Indian Practitioner, Vol 73, No 12 (2020), Pagination: 30-34Abstract
Background: Esophageal Cancer (EC) is one of the least responsive tumors to cancer therapy with overall poor prognosis. Published data from different regions in India have indicated their observations on the local risk factors. Presently, as there seems little prospect of early detection and effective management of this cancer, understanding the etiology of EC may suggest opportunities for its primary prevention.
Material & Methods: A retrospective hospital record-based study was carried out for the period of five years (2014-2019) in Department of Gastroenterology of Indira Gandhi Medical College Shimla- a tertiary care hospital located in Sub – Himalyan ranges of North India in Himachal Pradesh.
Results: A total of 363 patients were diagnosed to have EC, 58.68% were male and 41.32% were female with male to female ratio of 1.42:1. Most patients come from rural areas (82.09%) and belonged to low socioeconomic status (38.01%). Most patients were illiterate (41.87%) and were involved in farming works (52.06%). Majority (76.03%) had a history of smoking bidi followed by alcohol consumption (29.20%). The most common primary location of the malignancy was middle third of the esophagus in 44.63% followed by lower third 35.54% and upper third 19.83%. Squamous cell histology was identified in 70.24% patients, while 29.75% patients had adenocarcinoma.
Conclusion: EC is one of the important cancers in northern Indian state of Himachal Pradesh. Squamous cell carcinoma is the most common type followed by adenocarcinoma. The most common primary location of the malignancy was middle third of the esophagus followed by lower and upper third. The major risk factors associated with EC included tobacco and alcohol consumption besides low socioeconomic status, illiteracy, rural background and occupation of farming.
Keywords
Esophageal Cancer, Human Development Index, Adenocarcinoma, Squamous Cell Carcinoma, World Health Organization.References
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- Endoscopic Removal of an Ingested Mercury Glass Thermometer: A Case Report
Authors
1 Associate Professor, Department of Gastroenterology, IGMC- Shimla, IN
2 Professor, Department of Gastroenterology IGMC- Shimla, IN
3 Senior Resident, Department of Gastroenterology IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 74, No 6 (2021), Pagination: 54-56Abstract
Foreign body ingestion is a potentially lethal condition and the wide variety of ingested foreign bodies poses a challenge in the management of these patients. Endoscopic removal is the first-line treatment for ingested foreign bodies that need to be removed either due to their harmful potential or because they will most likely fail to pass per anus. We report the retrieval of an ingested thermometer from the stomach of a young schizophrenic male by endoscopic means.Keywords
Foreign body, thermometer, endoscopy, esophagusReferences
- Sugawa C, Ono H, Taleb M, Lucas CE. Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review. World J Gastrointest Endosc. 2014; 6:475 81.
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- Hong KH, Kim YJ, Kim JH, Chun SW, Kim HM, Cho JH. Risk factors for complications associated with upper gastrointestinal foreign bodies. World J Gastroenterol 2015; 21:8125 31.
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- Dokas S, Koliouskas D, Masmanidou M, Ziakas G. Endoscopic removal of an ingested thermometer. Case Rep Clin Pract Rev. 2003; 4(3): 193-195
- Feldman M, Friedman LS, Brandt LJ, Chung RT, Rubin DT. Wilcox CM. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th edition. Philadelphia, PA: Elsevier, 2021.
- Bredfeld JE, Moeller DD. Systemic mercury intoxication following rupture of a Miller-Abbott tube. Am J Gastroenterol. 1978; 69: 478-80
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- Benign Esophageal Perforation – Non-Surgical Management
Authors
1 Department of Gastroenterology, IGMC-Shimla, IN
2 Department of Gastroenterology, IGMC-Shimla, H.P., IN
Source
The Indian Practitioner, Vol 74, No 8 (2021), Pagination: 43-45Abstract
Surgery is usually considered a treatment for acquired benign esophageal perforation but in sick patients’ surgery is not possible. We report a case of mid esophageal perforation, detected during side-viewing endoscopy. As the surgery was difficult considering her age and comorbidities, a fully covered, a self-expandable metallic stent (FC-SEMS) was placed over perforation, which was tied by plastic wire from the proximal end of FC-SEMS and anchored to the tooth (canines) to prevent inward migration. FC-SEMS was removed after three months and complete closure of esophageal perforation was achieved. This is probably the first case report in which one end of the plastic thread was tied to FC-SEMS (proximal end) endoscopically and another end of plastic thread tied to teeth to prevent inward migration after stent deployment.Keywords
Fully Covered Self-Expandable Metallic Stent (FC-SEMS), Esophageal Perforation, Non-Surgical Management.References
- Biancari F, D’Andrea V, Paone R, Di Marco C, Savino G, Koivukangas V, Saarnio J, Lucenteforte E. Current treatment and outcome of esophageal perforations in adults: systematic review and meta-analysis of 75 studies. World J Surg. 2013 May;37(5):1051-9.
- Romero RV, Goh KL. Esophageal perforation: Continuing challenge to treatment. Gastrointestinal Intervention 2013 2(1), 1–6.
- Chirica M, Champault A, Dray X, Sulpice L, Munoz-Bongrand N, Sarfati E, Cattan P. Esophageal perforations. J Visc Surg. 2010 Jun;147(3): e117-28.
- Thornblade LW, Cheng AM, Wood DE, Mulligan MS, Saunders MD, He H, Oelschlager BK, Flum DR, Farjah F. A Nationwide Rise in the Use of Stents for Benign Esophageal Perforation. Ann Thorac Surg. 2017 Jul;104(1):227-233.
- Aloreidi K, Patel B, Ridgway T, Yeager T, Atiq M. Non-surgical management of Boerhaave’s syndrome: a case series study and review of the literature. Endosc Int Open. 2018 Jan;6(1): E92-E97.
- Malignant Colo-Duodenal Fistula: A Rare Complication of Carcinoma Colon
Authors
1 Professor, Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, IN
2 Associate Professor, Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, IN
Source
The Indian Practitioner, Vol 75, No 5 (2022), Pagination: 32-34Abstract
Colo-duodenal fistula is a very infrequent complication of colon cancer that presents not only with severe clinical symptoms, but a poor prognosis due to locally advanced disease. It consists in a pathological communication between the lumen of the colon and duodenum. Presentation is generally sub-acute with majority of the patients presenting with non-specific abdominal pain, diarrhea, nausea and vomiting. The contact of duodenal bile salts with colonic mucosa frequently leads to diarrhea, so also duodenal colonization with colonic pathogens frequently leads to malabsorption, foul eructation and feculent vomiting. The diagnosis is established either by gastrointestinal contrast studies or contrast enhanced CT scan. Gastro-duodenoscopy and colonoscopy can demonstrate the fistulous communication and it can also be helpful in obtaining
a histological diagnosis. We report a case of a 38-year-old male patient who presented to our gastroenterology clinic with complaints of diarrhea and abdominal pain and was diagnosed to have carcinoma colon with colo-duodenal fistula.
Keywords
carcinoma colon, colo-duodenal fistula, endoscopy, colonoscopyReferences
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- Carcinoma as a Complication of Esophageal Epiphrenic Diverticulum: a Case Report
Authors
1 Professor, Department of Gastroenterology, IN
2 Associate Professor, Department of Gastroenterology, IN
3 Assistant Professor, Department of Anatomy, IGMC- Shimla, IN
Source
The Indian Practitioner, Vol 75, No 6 (2022), Pagination: 38-39Abstract
Esophageal diverticula are rare and the association of cancer in a diverticulum is even more rare. Esophageal diverticula are classified by location- phrenoesophageal (Zenker’s diverticulum-70%), thoracic and mediastinal (10%), and epiphrenic (20%). [3] Incidence of cancer in a diverticulum is 0.3%–7%, 1.8%, and 0.6% for pharyngoesophageal, midesophageal, and epiphrenic diverticula, respectively. We report a case of epiphrenic esophageal diverticulum complicated by malignancy within the diverticulum.
Keywords
CECT, contrast enhanced computed tomography, EGD, esophagogastroduodenoscopyReferences
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