Browsing by Author "Gomes, D"
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- Adenoma seroso oligoquístico do pâncreas: a propósito de um caso clínicoPublication . Almeida, N; Alves, S; Borges, I; Gregório, C; Gomes, D; Portela, F; Sérgio, M; Rui, M; Urbano, M; Gouveia, H; Martinho, F; Freitas, D
- An unusual foreign body in the rectum.Publication . Bastos, I; Gomes, D; Gregório, C; Baranda, J; Gouveia, H; Donato, A; Freitas, DThis is the report of an unusual foreign body in the rectum which was a complication of the migration of an esophageal Celestin's prosthesis.
- O balão intragástrico nas formas graves de obesidadePublication . Almeida, N; Gomes, D; Gonçalves, C; Gregório, C; Brito, D; Campos, JC; Gouveia, H; Freitas, DIntroduction: In patients with morbid obesity the intragastric balloon (IGB) can be a “bridge” to surgery or a temporary treatment in patients who are not candidates for surgery. Objective: Evaluate IGB efficacy in morbidly obese patients. Patients and Methods: In 2003/2004 seventeen IGB Bioenterics ® filled with normal saline and methylene blue were placed in 17 patients [11 women, median age was 49.2 (27-69 years); median body mass index was 55.6 (40.2-74.2 Kg/m2)], followed by nutritionists and/or endocrinologists. They had previously tried dietetic and/or pharmacological measures with limited results. Co-morbidities were present in 13 (76.5%). Results: Eight (47%) patients presented nausea/vomiting in the first 24-72h that persisted in 4 (23.5%) leading to dehydration and pre-renal insufficiency and forcing premature removal of the balloon (0.5 to 4 months). In the other patients, the device was removed at 6 months treatment (in 1 patient at 10 months). All patients suffered weight loss (5-70 Kg); median loss-19.6 Kg (p<0.001). No cases of spontaneous deflation/displacement occurred. Six (35.3%) underwent bariatric surgery. Conclusions: The IGB is a useful method for weight loss in morbidly obese patients. Nausea and vomiting are the most common complications. Although desirable, subsequent surgery is not always performed.
- Um caso de síndrome de compressão do tronco celiaco com eventual componente iatrogénicoPublication . Almeida, N; Amaro, P; Gonçalves, C; Gregório, C; Gomes, D; Otero, M; Gouveia, H; Freitas, DApresenta-se o caso de um doente de 64 anos com epigastralgias, náuseas e vómitos recorrentes, associados a astenia, anorexia e emagrecimento significativo nos últimos meses. Estas queixas estavam presentes desde 1998 mas agravaram-se em 2002 após cirurgia para correcção de acalásia. Perante a avaliação efectuada colocaram-se como hipóteses diagnósticas uma pancreatite aguda idiopática recorrente ou uma isquémia mesentérica. A realização de arteriografia abdominal evidenciou uma estenose significativa do tronco celíaco, compatível com síndrome de compressão do tronco celíaco. A revisão do processo radiológico sugeriu eventual sequela de lobectomia superior esquerda realizada em 1994.
- Derrame Pleural Recidivante por FÍstula Pancreático-PleuralPublication . Ribeiro, B; Gomes, D; Rosa, A; Amaro, P; Tomé, L; Leitão, M; Freitas, D
- Epigastralgias por osso espetado na parede gástricaPublication . Freire, P; Gomes, D; Sousa, H; Portela, F; Andrade, P; Lopes, S; Alves, S; Gouveia, H; Leitão, M
- Groove Pancreatitis with Biliary and Duodenal Stricture: An Unusual Cause of Obstructive JaundicePublication . Gravito-Soares, M; Gravito-Soares, E; Alves, A; Gomes, D; Almeida, N; Tralhão, G; Sofia, CINTRODUCTION: Groove pancreatitis is an uncommon cause of chronic pancreatitis that affects the groove anatomical area between the head of the pancreas, duodenum, and common bile duct. CLINICAL CASE: A 67-year-old man with frequent biliary colic and an alcohol consumption of 30-40 g/day was admitted to the hospital complaining of jaundice and pruritus. Laboratory analysis revealed cholestasis and the ultrasound scan showed intra-hepatic biliary ducts dilatation, middle third cystic dilatation of common bile duct, enlarged Wirsung and pancreatic atrophy. The magnetic resonance cholangiopancreatography showed imaging findings compatible with groove pancreatitis. An esophagogastroduodenoscopy later excluded duodenal neoplasia. He was submitted to a Roux-en-Y cholangiojejunostomy because of common bile duct stricture. Five months later a gastrojejunostomy was performed due to a duodenal stricture. The patient remains asymptomatic during follow-up. DISCUSSION: Groove pancreatitis is a benign cause of obstructive jaundice, whose main differential diagnosis is duodenal or pancreatic neoplasia. When this condition causes duodenal or biliary stricture, surgical treatment can be necessary.
- Injecção intralesional de betametasona nas estenoses benignas do esófagoPublication . Gonçalves, C; Almeida, N; Gomes, D; Gregório, C; Cotrim, I; Gouveia, H; Freitas, DIntralesional steroid injection has been used in benign oesophageal strictures to improve the results of dilatation. Most studies use triamcinolone, only a few have reported using betamethasone. Objectives: To evaluate the efficacy and safety of the combination of dilatation and intralesional betamethasone injection in benign oesophageal strictures. Methods: Cases of benign oesophageal strictures treated with dilatation and betamethasone injection between January 1st 1998 and December 31st 2004 were retrospectively analysed. Thirty-one patients (21 males, 10 females) were identified, with a mean age of 58.8 years. The most frequent aetiologies of the stenosis were post-surgical (16 patients), peptic (11 cases) and caustic (5 cases). Results: The periodic dilatation index significantly decreased (p=0.002), although there was no statistically significant variation between medium luminal diameter pre and post-treatment. There were no adverse events. Conclusion: Intralesional betamethasone injection is a safe technique which increases efficacy of endoscopic dilatation. However, no conclusions can be drawn from our study due to the small population studied.
- Meningitis in a patient with previously undiagnosed Crohn's diseasePublication . Almeida, N; Portela, F; Oliveira, P; Duarte, A; Gregório, C; Gomes, D; Gouveia, H; Leitão, M
- Síndrome de MirizziPublication . Lérias, C; Souto, P; Pina-Cabral, JE; Saraiva, S; Gomes, D; Durão, A; Moreira, A; Sofia, C; Leitão, M; Donato, A; Freitas, D