The mesenteric levels of the tumor markers CEA and cytokeratins were higher than the peripheral levels in these colorectal adenocarcinoma patients. Higher levels of these biologic tumor markers are associated with an advanced state of cancerous dissemination.
INTRODUCTIONColorectal cancer is an important cause of death. Most cases of colon and rectal cancer arise from a preexisting adenomatous polyp. However, if colorectal polyps are very large or not accessible for endoscopic ablation, or if they cannot be removed without an increased risk of perforation, surgical procedures are required.PRESENTATION OF CASEThe case of a patient with a giant villous adenoma of the rectum is described. The patient had diarrhea for 2 years associated with asthenia. Colonoscopy revealed a sessile lesion in the rectum measuring 14 cm in the largest diameter. Rectal eversion technique was used, resecting the lesion under direct visibility and an external coloanal anastomosis was performed. Surgery was satisfactory and the resection margins were free.DISCUSSIONRemoval of these polyps should be performed aiming to reduce the incidence of colorectal cancer, as well as to control local and systemic symptoms, such as diarrhea and fluid and electrolyte disorders, mainly in villous adenomas. Various surgical techniques are proposed, but in extensive circumferential lesions of the rectum they are difficult to apply. The rectal stump eversion technique was described by Maunsell (1892), for rectal cancer.CONCLUSIONEversion of the rectal stump and external coloanal anastomosis may be a good surgical alternative for resecting giant rectal adenomas.
Introdução: Os primeiros casos da COVID-19, causada pela infecção do novo coronavírus (SARS-CoV-2), surgiram na China, em dezembro de 2019. Apesar da porta de entrada mais comum do agente etiológico ser pelo trato respiratório, evidências demonstram que a doença pode apresentar sintomas extrapulmonares, como os do trato gastrointestinal. Objetivo: Descrever as desordens gastrointestinais associadas à infecção pelo coronavírus. Método: Estudo de caráter exploratório, baseado no método de revisão
Objetivo: relatar um caso de um paciente com acalásia idiopática grau II, de acordo com a Classificação de Chicago, que foi submetido a uma cardiomiotomia a heller-pinotti. Relato de caso: paciente de 17 anos, masculino, com história de disfagia, com dificuldade na deglutição de alimentos sólidos e pastosos em progressão. Realizados exames subsidiários como esofagograma baritado e manometria esofágica de alta resolução para confirmação do diagnóstico. Considerações finais: casos de acalásias são pouco frequentes, porém o diagnóstico precoce e condutas adequadas ajudam na boa evolução do paciente. Um dos métodos aplicados na correção com excelentes resultados é a técnica de Heller-Pinotti por videolaparoscopia.
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