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Marcelo Averbach

Publications and source records attributed to Marcelo Averbach.

11 recordsLinked to original sources
PubMed2006

Deeply infiltrating endometriosis affecting the rectum and lymph nodes.

OBJECTIVE: To analyze morphologic aspects of bowel endometriosis. DESIGN: Prospective study of 35 consecutive cases of bowel endometriosis. SETTING: Multidisciplinary group practice and teaching hospital. PATIENT(S): Thirty-five patients with bowel endometriosis were assessed between September 2003 and June 2005. INTERVENTION(S): Histologic analysis of 35 tissue samples removed at laparoscopic rectosigmoidectomy. MAIN OUTCOME MEASURE(S): We performed an evaluation of lesion size, number of lesions present in the bowel, intestinal wall layers affected by the endometriotic lesion, circumference of the intestinal loop affected by the endometriotic lesion, and presence of lymph nodes with foci of endometriosis. RESULT(S): Analysis of the surgical samples revealed lymph nodes in the pericolic adipose tissue of 19 (54%), cases and in 5 of these cases (26.3%), endometriosis had affected the lymph nodes. When the thickness of the endometriotic lesion reached 1.75 cm, lymph nodes of all patients were affected, and all patients in whom more than 80% of the circumference of the intestinal loop was affected by endometriosis presented with positive lymph nodes. CONCLUSION(S): This study raises doubts about whether this form of the disease can still be considered a clinically benign disease.

Adult↗
PubMed2006

Bowel endometriosis and schistosomiasis: a rare but possible association.

OBJECTIVE: To report the case of a patient submitted to laparoscopic bowel resection in whom histology revealed endometriosis and schistosomiasis. DESIGN: Case report. SETTING: Multidisciplinary group practice and teaching hospital. PATIENT(S): A 31-year-old patient with pelvic pain. INTERVENTION(S): Laparoscopic bowel resection. MAIN OUTCOME MEASURE(S): Laparoscopic treatment of endometriosis affecting the sigmoid. RESULT(S): Histology performed on tissue removed at surgery revealed epithelioid granulomas with birefringent and partially calcified eggs characteristic of Schistosoma mansoni within an endometriotic lesion affecting the entire width of the sigmoid. CONCLUSION(S): Endometriosis and schistosomiasis may be present simultaneously in patients with bowel symptoms and pelvic pain.

Adult↗
PubMed2005

Use of a homemade nylon loop for the prevention of postpolypectomy bleeding of large pedunculated polyps.

To avoid bleeding after colonoscopic polypectomy, several procedures are being used. We describe a new method that consists of a homemade nylon loop that is applied and tied to the stalk of the pedunculated polyp and after which a conventional polypectomy is done. We have used this method in 15 patients and no complication was observed. The procedure is simple; the loop may be opened to large diameters to make it easier to use for large polyps. It has a low cost and seems to be safe and effective to prevent bleeding after endoscopic polypectomy.

Adult↗
PubMed2004

[Rectovaginal septum endometriosis: a disease with specific diagnosis and treatment].

BACKGROUND: The involvement of the rectovaginal septum, of rectum and sigmoid by endometriosis leads to intense symptoms as dysmenorrhea, pelvic pain, deep dyspareunia, tenesmus and hematochezia in young and middle aged women during periods. The diagnosis can be made by tipycal history and vaginal examination, rectal examination, barium enema, proctoscopy and so on. The indications of operation include severe clinic symptoms and failed conservative therapy. The treatment of choice for this type of endometriosis is the surgical resection of affected tissue, in order to relieve patient symptoms, and avoid disease progression. The correct assessment as to the presence and extension of the endometriosis-affected sites such as the rectum, uterosacral ligaments and rectovaginal septum is extremely important to provide better results with the surgical treatment of endometriosis. AIM: To describe the main aspects related to rectovaginal septum endometriosis and offer the general surgeon some information about this enigmatic disease. CONCLUSION: Rectovaginal septum endometriosis is a frequent disease, with specific diagnosis and treatment.

Endometriosis↗
PubMed2004

[High resolution chromoendoscopy in the differential diagnosis of neoplastic and non-neoplastic polyps].

BACKGROUND: Magnifying colonoscopy brought the possibility of precise histologic diagnosis of colorectal lesions through their surface appearance. Despite the high accuracy of magnifying colonoscopy it is a specialized and expensive equipment not available in most medical centers. Due to these reasons the use of conventional colonoscopy with chromoscopy has been raised because this produce can reproduce most of the information previously obtained by magnifying colonoscopy. AIM: To determine the role of high resolution colonoscopy and indigo carmine chromoscopy for differential diagnosis between neoplastic and non-neoplastic colorectal lesions through measurements of accuracy, sensitivity, specificity, positive and negative predictive values. PATIENTS / METHODS: It was performed a prospective study. Seventy-four colorectal polyps were evaluated in 54 patients. A high resolution Olympus Exera CFQ 160L colonoscope was used. After the identification of the lesions, they were dyed with indigo carmine 0,2% and classified according to Kudo's classification by a single observer. After resection, the polyps were submitted to histopathological examination. RESULTS: The endoscopic findings were compared to histopathologic results. The accuracy of the method was 79,7%, sensibility of 88,8%, specificity of 55%, positive predictive value of 84,2% and a negative predictive value of 64,7%. CONCLUSION: We can conclude that we must be careful to apply high resolution colonoscopy and chromoscopy because adenomatous lesions can be misdiagnosed as non-neoplastic.

Adenomatous Polyps↗
PubMed2004

Rectal endoscopic ultrasound with a radial probe in the assessment of rectovaginal endometriosis.

STUDY OBJECTIVE: To evaluate the accuracy of rectal endoscopic ultrasound and to evaluate endometriosis in the rectovaginal septum, rectum, and sigmoid walls. DESIGN: Validation of diagnostic test (Canadian Task Force classification II-1). SETTING: Tertiary care hospital. PATIENTS: Thirty-two consecutive women clinically suspected of having rectovaginal septum endometriosis without previous surgical treatment. INTERVENTION: Colonoscopy, transrectal ultrasound, and rectal endoscopic ultrasound, followed by laparoscopy or laparotomy. MEASUREMENTS AND MAIN RESULTS: The disease was classified according to 1996 standards of the American Society of Reproductive Medicine. Images obtained by colonoscopy, endoscopic ultrasound, and surgery and histologic findings were compared. In 6 patients endometriosis infiltrated bowel muscularis wall, in 20 it infiltrated rectovaginal septum, and in the remaining 6 there was no evidence of lesions. In all women in whom infiltration of the intestinal wall was suspected, rectal endoscopic ultrasound and colonoscopy confirmed the lesions (sensitivity 100%, specificity 67%). CONCLUSION: Endoscopic ultrasound was useful in preoperative assessment of women with endometriosis.

Adult↗
PubMed2003

Laparoscopic treatment of intestinal intussusception in the Peutz-Jeghers syndrome: case report and review of the literature.

The hamartomatous polyps of Peutz-Jeghers Syndrome (PJS) can cause repeated episodes of rectal bleeding and intestinal subocclusion. Laparoscopic treatment of intussusception is rarely reported and must be considered for this clinical condition. We described a 35-year-old male with PJS who presented with rectal bleeding and abdominal pain. One duodenal polyp and two others in the jejunum, which caused intussusception, were visualized on preoperative investigation. Polyps were identified by laparoscopy and removed extracorporeally through enterotomies. All lesions were hamartomas. The patient was discharged on the third postoperative day and has been asymptomatic for more than 2 years. Laparoscopy allows an adequate access to explore and treat small bowel polyps and avoid the classic laparotomy.

Adult↗