Gastric lipoma excision.
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Biomedical subjects
Publications and source records attributed to H Kaymakcalan.
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A patient who, eight years prior, had a Heller operation for achalasia developed hypertrophic osteoarthropathy possibly secondary to a leiomyoma of the esophagus with sarcomatous changes. No local invasion or metastases were found. Total esophagectomy completely cured the esophageal symptoms and relieved the swelling and pain of her knees and other joints. This case illustrates the hypertrophic osteoarthropathy syndrome, its marked diagnostic significance and its occurrence secondary to an esophageal leiomyoma and leiomyosarcoma.
In this patient with long-standing cardiomyopathy and congestive heart failure the syndrome of fulminant hepatic failure developed on two occasions; he recovered both times. There was no evidence of viral or toxic hepatitis as a cause of his liver failure. We conclude that in this case, aggravation of long-standing congestive heart failure may have led to severe hepatocellular necrosis with signs of encephalopathy not commonly observed.
The presence of submassive hepatic necrosis in acute liver injury of viral or toxic etiology in liver biopsy specimens is of great diagnostic and prognostic significance. Liver biopsy, however, cannot be performed in some of these patients due to an abnormal coagulation profile. Hence, other noninvasive methods for diagnosis of submassive hepatic necrosis would be helpful. We compared the serum immunoglobulin-G levels in 15 patients with typical acute viral hepatitis and 19 patients with severe acute viral hepatitis with submassive hepatic necrosis. The difference of the Ig-G levels in both groups was statistically significant. By using discriminant analysis we found that it was possible to make the correct diagnosis of submassive hepatic necrosis in 89.5% of patients with acute viral hepatitis when only Ig-G levels were utilized.
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