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Biomedical subjects

P A LoPresti

Publications and source records attributed to P A LoPresti.

12 recordsLinked to original sources

Resected sigmoid carcinoma with 13-year metastasis-free interval. Sternal recurrence detected by immunoscintigraphy.

Colorectal cancers rarely present with bone metastases. Regular postoperative monitoring after resection by conventional imaging techniques and carcinoembryonic antigen levels aids physicians in identifying such tumor recurrences. However, some recurrences might elude detection by bone scan, computed tomography, and magnetic resonance imaging, and newer tests such as immunoscintigraphy using radioimmune-tagged monoclonal antibodies may be more diagnostic. Here we report a case, presenting with delayed recurrence at a rare bony site, in which application of immunoscintigraphy helped in the definitive detection of the tumor recurrence.

Adenocarcinoma↗

Adult foregut duplication.

We report a gastric duplication in a 23-year-old man. The case is unique because the stomach is the rarest location for enteric duplication, the duplication almost never occurs in adults, and the duplication consisted exclusively of pancreatic tissue. This extreme example illustrates the close embryologic and anatomic association between stomach and pancreas. A case is made for the use of the general term of foregut duplication to avoid confusing nomenclature.

Adult↗

Congenital duodenal stenosis. The duodenal cervix sign.

A case of congenital duodenal stenosis is reported complicated by recurrent pancreatitis. The diagnosis was not initially entertained because of the pancreatitis. The radiographic appearance on gastrointestinal series was unusual for pancreatitis. The finding of an anomalous celiac axis on arteriography suggested the possibility of other congenital anomalies. The diagnosis of congenital duodenal stenosis was confirmed at laparotomy. The obstruction was relieved with a duodenojejunostomy. Two year follow-up reveals the patient to be asymptomatic without recurrence of pancreatitis. This is the first endoscopic report of this lesion and the presence of the duodenal cervix sign should suggest the diagnosis of congenital duodenal stenosis.

Adult↗

Hypoglycemia secondary to metastases to the liver. A case report and review of the literature.

A 76-year-old man presented with hypoglycemic coma associated with metastatic liver disease. Serum immunoreactive insulin excluded insulinoma as a cause of hypoglycemia. Negative glucose responses to glucagon and epinephrine testing indicated failure of compensatory glycogenolysis. The patient's increased glucose requirements of 500 g per 24 hr were reduced to normal only after shrinkage of the liver tumor bulk was accomplished with chemotherapy. Hepatic hypoglycemia is discussed and the literature is reviewed.

Aged↗

Uncommon presentation of pancreatic pseudocyst.

Five cases of pancreatic pseudocyst are presented with unusual manifestations. Clinical features of each entity are discussed to enable one to diagnose the rare manifestations and complications of pancreatic pseudocyst. Reasonable understanding of such cases enables accurate diagnostic work-up for confirmation and early surgical intervention.

Adult↗

Pancreatic ascites: diagnostic importance of ascitic lipase.

10 cases of pancreatic ascites are presented. Ascitic fluid lipase is complementary to the determination of ascitic amylase in the diagnosis of pancreatic ascites and may be a more reliable diagnostic indicator of pancreatic ascites on a random ascitic fluid sample. Conservative management, consisting of abdominal paracentesis with or without diurectics, proved to be the treatment of choice in 3 of our patients who failed to reveal an associated pseudocyst.

Adenocarcinoma↗