"Use of video capsule endoscopy in the setting of recurrent subacute small-bowel obstruction." Journal of Laparoendoscopic & Advanced Surgical Techniques.18,5. 713-716. (2008
AbstractHypothesis: Video capsule endoscopy (VCE) can be used to diagnose subacute intestinal obstruction in patients with otherwise negative imaging studies. Patients and Methods: Nine patients with symptoms consistent with intermittent small-bowel obstruction who received a VCE and ultimately required surgical intervention. Results: Patients were identified who had symptoms consistent with subacute bowel obstruction and a negative diagnostic work-up prior to VCE. All 9 patients underwent several radiologic and endoscopic examinations with no clear etiology for their symptoms. Ultimately, in every case, a stricture or mass was found to be the cause of the obstruction at either the time of VCE or exploratory laparotomy/laparoscopy. Conclusions: Patients can have a small-bowel stricture or mass that can cause symptoms of subacute smallbowel obstruction. Diagnosis of the lesion may be difficult in these patients and can often result in multiple nondiagnostic radiologic and endoscopic examinations. VCE can be helpful in finding these lesions, leading to surgical resection of the diseased bowel and a cure for the patient's signs and symptoms.
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A patient with an unusual vascular tumor, an angiosarcoma of the upper abdominal aorta, is described. The clinical, radiologic and pathologic features of this case along with 19 previously reported cases of primary aortic tumor are discussed. Primary aortic neoplasms are uncommon. They are histologically and morphologically diverse tumors in which major vascular obstruction and arterial tumor embolization dominates the clinical picture. At present, aortography combined with computerized tomography offer the best means of preoperative diagnosis.
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