Gastrenterologia
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- Tumores do Peritoneu: a propósito de dois casos de pseudomixoma peritonealPublication . Sofia, A; Donato, A; Espírito-Santo, V; Freitas, D; Martins, MI; Leitão, M; Romãozinho, JM; Domingos, J; Urbano, M; Gouveia-Monteiro, J
- Hemorragias digestivas altas: cinco anos de experiência do Serviço de Gastrenterologia dos Hospitais da Universidade de CoimbraPublication . Sofia, C; Donato, A; Leitão, M; Gouveia, H; Oliveira, MG; Pimenta, I; Romãozinho, JM; Cantante, J; Chaves, A; Dias, A; Pinto, G; Baptista, E; Ganho, E; Júlio, M; Teixeira, V; Domingos, J; Moules, J; Bilhau, J; Arruda, F; Barbosa, J; Freitas, D; Gouveia-Monteiro, J
- Cirroses menos frequentes: a cirrose biliar primária e a cirrose da hemocromatose idiopáticaPublication . Henriques, PP; Donato, A; Porto, A
- Meios auxiliares do dignóstico da cirrose hepáticaPublication . Donato, A
- Endoscopic Nd-YAG laser therapy as palliative treatment for esophageal and cardial cancerPublication . Freitas, D; Gouveia, H; Sofia, C; Pina-Cabral, JE; Donato, ABACKGROUND/AIM: Progressive dysphagia is the most important symptom in inoperable cases of carcinoma of the esophagus and cardia. Treatment for the relief of dysphagia is chosen based on the lowest mortality and morbidity. This paper describes alpha consecutive series of patients with esophageal or cardial cancer, without a documented tracheoesophageal fistula, who were referred for palliative laser therapy. Alternative palliative treatments are discussed, as well as factors involved in successful laser treatment. MATERIAL AND METHODS: Over a five year period, 104 patients were treated endoscopically with the Nd-YAG laser for symptomatic improvement dysphagia caused by malignant tumors of the esophagus or cardia. RESULTS: After the initial laser therapy, good improvement was achieved in 78 patients (75%) and fair improvement in 17 patients (16%). Eighty-three patients with significant improvement were followed until death. In 42 of these 83 patients, the initial laser therapy was the only treatment given; the remaining 41 patients required either additional laser treatment or other palliative therapy. CONCLUSION: Laser treatment for palliation in esophageal and cardial cancer is promising. Given the proper circumstances, it may lay the framework for many other important treatment modalities.
- Gastric ascariasis: a rare cause of upper gastrointestinal bleedingPublication . Pontes, JM; Leitão, M; Portela, F; Andrade, P; Lopes, H; Vasconcelos, H; Romão, Z; Pimenta, J; Donato, A; Freitas, D
- Mesenteric arteriovenous fistula causing portal hypertension and bleeding duodenal varicesPublication . Baranda, J; Pontes, JM; Portela, F; Silveira, L; Amaro, P; Ministro, P; Rosa, A; Pimenta, I; Andrade, P; Bernardes, A; Pereira, J; Leitão, M; Donato, A; Freitas, DWe report a case of portal hypertension associated with a non-traumatic arteriovenous fistula, presenting with bleeding duodenal varices. The patient was admitted for melaena. Emergency endoscopy showed oesophageal varices with no signs of recent bleeding and with no blood in the upper gastrointestinal tract. Arteriography of the coeliac axis and superior mesenteric artery failed to detect any bleeding source. Endoscopy was repeated because of persistent bleeding and revealed active bleeding from varices in the distal duodenum. The patient underwent surgery and a large paraduodenal varicose vein associated with an arteriovenous fistula was found. Resection of the paramural varix and surgical occlusion of the arteriovenous fistula were effective in the control of bleeding. Liver biopsy revealed mild portal fibrosis without cirrhosis. Three years after surgery the patient still has oesophageal varices but has not had recurrent bleeding. There was regression of intraduodenal varices.
- An unusual endoscopic procedure to remove a toothbrush from the stomachPublication . Bastos, I; Gomes, D; Cotrim, I; Gouveia, H; Donato, A; Freitas, D
- Apolipoproteína A1 e litíase biliar na cirrose hepáticaPublication . Baranda, J; Ministro, P; Amaro, P; Rosa, A; Pimenta, I; Donato, A; Freitas, DA prospective study was performed in 67 male patients with cirrhosis, admitted in our Department during one year. Biliary lithiasis was found in 37% of patients. The occurrence of lithiasis was not related to age, weight or severity of liver disease. Seric total bilirubin was higher in lithiasic patients (p < 0.05). Apolipoprotein A1 levels were lower in those ones with lithiasis (p < 0.005). Apolipoprotein A1 was the only factor associated independently with the finding of lithiasis.
- Oesophageal lichen planusPublication . Souto, P; Sofia, C; Pina-Cabral, JE; Castanheira, A; Saraiva, S; Tellechea, O; Donato, A; Freitas, DLichen planus is a common skin and mucosal disease, with very rare symptomatic oesophageal involvement. We report a case of painful dysphagia due to oesophageal lichen planus in a 60-year-old woman who also had oral, cutaneous and genital lichen planus lesions. Steroid treatment produced considerable improvement of all lesions and a rapid symptomatic remission.