[Congestive gastropathy in liver cirrhosis].
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Biomedical subjects
Publications and source records attributed to B Lurie.
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A case of malabsorption due to a stagnant loop which occurred in a huge ventral hernia is presented. The clinical course was relatively indolent with symptoms of malabsorption and occasional abdominal pain. Although rare, abdominal hernia can lead to malabsorption due to bacterial overgrowth as a result of stagnant loop.
A combined histopathologic, histochemical, and immunohistochemical study of benign colorectal adenomas is presented. Specimens of 39 adenomas were studied by hematoxylin and eosin (HE) stain, alcian blue-periodic acid Schiff (AB-PAS), and high-iron-diamine-alcian blue (HID-AB). Carcinoembryonic antigen (CEA) was demonstrated by peroxidase-antiperoxidase (PAP) technique. Variable amounts of neutral mucin and decreased sulfated acid mucin content, as well as increased CEA content, were found in the dysplastic epithelium of benign colonic adenomas. These changes were not seen in normal colonic mucosa. It is suggested that the above-mentioned methods may represent an aid in the evaluation of malignant potential of benign polyps.
A 43-year-old woman developed recurrent attacks of intermittent obstructive jaundice 5 years after cholecystectomy. After 6 years of recurrent attacks, an obstructive lesion was finally demonstrated, and was diagnosed at surgery as an amputation (traumatic) neuroma of the midcommon bile duct (CBD). Symptoms disappeared following surgical removal of the lesion. We review the clinical picture of this relatively rare problem, along with its diagnosis, pathogenesis, and treatment.
Hemorrhage from esophageal varices during pregnancy in women with cirrhosis is a rare occurrence with a high mortality rate. Two such women, previously treated surgically for bleeding varices, one with additional sclerotherapy, had massive hemorrhages at 35 weeks necessitating cesarean section for fetal distress. Both neonates were healthy. One woman died one week postpartum. Pregnancy does not appear detrimental to the maternal prognosis despite the theoretical probability of raised portal pressure. About 70% of those with demonstrable varices will bleed during pregnancy; the overall mortality rate is 20%. Endoscopy and sclerotherapy before and in early pregnancy may help reduce the mortality rate. An awareness of the possibility of unpredictable bleeding and of the available treatments in a pregnant woman with esophageal varices is essential.
The element content of clipped nails of 13 patients with liver cirrhosis was examined by X-ray microanalysis, and compared with that of 50 healthy subjects. The results showed a statistically significant increase in the percentage of Na, Mg and P and a slight, but statistically significant decrease in S and Cl. The percentage of K, Ca, Fe, Cu and Zn did not show any difference from that of the controls. The findings indicate that X-ray microanalysis may be a valuable tool for the simultaneous examination of a large number of elements in the fingernails.
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Caroli's disease was complicated by a Budd-Chiari-like syndrome as a result of enlarged lymph nodes that compressed the vena cava. Histologically the picture was compatible with "sinus histiocytosis with massive lymphadenopathy." We discuss the combination of these two rare disorders.
Specimens of fifteen surgically resected stomachs with early gastric cancer were histologically and histochemically examined using Alcian blue-periodic acid-Schiff and high iron diamine--Alcian blue stains. Samples were taken from the tumor, from the gastric mucosa 3 cm from the edge, and from the resected margins. In all 15 stomachs colonic intestinal metaplastic changes were present in the tumor tissue, as well as in the adjacent 3 cm mucosa and in the distant resected margins. In all cases neutral mucin content was reduced, whereas acid nonsulfated mucin was increased as demonstrated by Alcian blue-periodic-acid Schiff staining. Furthermore, acid sulfated mucin was demonstrated by high iron diamine-Alcian blue staining in the superficial layer of the metaplastic mucosa adjacent to the cancerous lesion and in the tumor itself. Sparse foci were also found in the surgical margins. We suggest that the increased content of acid sulfated mucin and its distribution might serve as an early indicator of malignant potential of the metaplastic gastric mucosa.
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