1. Hepatic splenosis mimicking liver metastases in a patient with history of childhood immature teratomaSara Jereb, Blaž Trotovšek, Breda Škrbinc, 2016, original scientific article Abstract: Hepatic splenosis is rare condition, preceded by splenectomy or spleen trauma, the term refers to nodular implantation of normal splenic tissue in the liver. In patients with history of malignancy in particular, it can be mistaken for metastases and can lead to unnecessary diagnostic procedures or inappropriate treatment. Case report. Twenty-two-year old male was treated for immature teratoma linked to undescended right testicle after birth. On regular follow-up examinations no signs of disease relapse or long-term consequences were observed. He was presented with incidental finding of mature cystic teratoma after elective surgery for what appeared to be left-sided inguinal hernia. The tumour was most likely a metastasis of childhood teratoma. Origin within remaining left testicle was not found. Upon further imaging diagnostics, several intrahepatic lesions were revealed. Based on radiologic appearance they were suspicious to be metastases. The patient underwent two ultrasound guided fine-needle aspiration biopsies. Cytologic diagnosis was inconclusive. Histology of laparoscopically obtained tissue disclosed presence of normal splenic tissue and led to diagnosis of hepatic splenosis. Conclusions. Though hepatic splenosis is rare, it needs to be included in differential diagnosis of nodular hepatic lesions. Accurate interpretation of those lesions is crucial for appropriate management of the patient. If diagnosis eludes after cytologic diagnostics alone, laparoscopic excision of nodular lesion is warranted before considering more extensive liver resection.
Keywords: hepatic splenosis, teratoma, metastases, laparoscopy
Published in DiRROS: 30.04.2024; Views: 50; Downloads: 5
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6. Adenocarcinoma of the small bowelMetka Šavli, Breda Jamar, 2007, professional article Abstract: Background. Adenocarcinoma of small bowel is generally a rather rare primary tumour of small bowel with a prevalence rate of 0.5-3.0/100.000 population, but the most frequent tumour of small intestine. It more often involves the duodenum and jejunum than the ileum. The aim of this paper is also to point out the value of small bowel follow through (SBFT) in the diagnosis of stenosing lesions. Case report. An 83-year old male patient suffered from abdominal pain, malaise, vomiting cachexia and diarrhoea for 3 months. The result of occult blood testing was negative. Haemoglobin level was normal. Proctoscopy, colonoscopy, upper gastrointestinal (GI) endoscopy, and ultrasonography (US) did not explain the patient's problems. Ileus of the small bowel was established with abdominal plain film. Small bowel follow through (SBFT) and computer tomography (CT) showed a stenosing tumour in the jejunum. Adenoearcinoma of the small bowel was established with histological examination after resection of the tumor. Conclusions. SBFT, with manual compression of all segments of the small bowel, can be a very accurate diagnostic investigation for evaluation of stenosing lesions in this part of the intestine.
Published in DiRROS: 22.02.2024; Views: 191; Downloads: 28
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8. Annular pancreas causing extrahepatic biliary obstructionMateja Ogulin, Breda Jamar, 2004, professional article Abstract: Izhodišča. Anularni pankreas, redka prirojena anomalija, je trak pankreatičnega tkiva, ki obkroža dvanajstnik ali izvenjetrni žolčni vod. Prikazujemo primer anularnega pankreasa, ki je povzročil izvenjetrno zaporo odtoka žolča. Prikaz primera. 46-letna ženska je prišla v urgentno ambulanto zaradi nenadnih bolečin v trebuhu, bruhanja in zlatenice. V zadnjih šestih letih je občasno opazila rumenkasto obarvanje kože, v zadnjem letu pa je občutila napetost v zgornjem delu trebuha, predvsem po mastnih obrokih. Zaključki. Dve ultrazvočni preiskavi, prva pred šestimi meseci, sta pokazali razširitev glavnega izvenjetrnega voda in jetrnih žolčnih izvodil. Vzrok za razširitev je ostal nejasen, tudi po endoskopski ultrazvočni preiskavi. Pri operaciji so našli skoraj popolno zaporo izvenjetrenega žolčnega voda, ki jo je povzročal traček pankreatičnega tkiva.
Published in DiRROS: 07.02.2024; Views: 166; Downloads: 34
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9. Dedicated small bowel follow-through - experience of Clinical institute of radiology in LjubljanaMateja Koprivnik, Breda Jamar, 2003, original scientific article Abstract: Background. Small bowell is a difficult part of the alimentary tract to examine. Radiologic modality most commonly used has been the conventional small bowel follow-through (SBFT), which has often been done in a cursory manner, without fluoroscopy and manual palpation. The purpose of our study is to present dedicated SBFT and to assess its sensibility and specificity. Patients and methods. We analysed 35 dedicated SBFT, performed from April to September 2002, in patients. Findings were evaluated according to clinical follow-up, endoscopy and surgery. Results. Our findings were consistent with clinical follow-up, endoscopy and surgery in 33 patients. In 2 patients our findings were false negative. Our results show 89.5% sensitivity and 100% specifity. Conclusions. An adequate per-oral examination remains the most reliable toll for diagnostic evaluation of the small bowel.
Published in DiRROS: 06.02.2024; Views: 131; Downloads: 30
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10. Gastroparesis in a young diabetic patientPrimož Kovačič, Breda Jamar, 2002, original scientific article Abstract: Background. Gastroparesis is defined as a delay in emptying of contents from the stomach and occurs in a variety of conditions, e.g. after vagotomy or in systemic diseases such as diabetes mellitus, scleroderma and amyloidosis. The purpose of this paper is to present the radiologic examination, a simple, reliable and noninvasive method as an alternative to other methods for the assessment of gastric emptying. Case report. A twenty-one years old female wasadmitted because of suspected autonomic neuropathy. She had insulin dependent diabetes mellitus type 1 for the last ten years. At the time of admission she was complaining of nausea, vomiting weakness and occasional dizziness. A barium study of oesophagus and stomach was performed: oesophagus was dilated and aperistaltic, remnants of food were seen in aperistaltic stomach but no obstruction, causing delayed emptying, was found. Conclusions. Scintigraphy is at the present the standard technique for the assessment of gastric emptying. Ultrasonography, magnetic resonance imaging; electrogastrography, gastroduodenal manometry and emptying of radiopaque pellets are also used for the evaluation of gastric motility in cases of delayed gastric emptying. The role of barium studies remains to be established.
Published in DiRROS: 31.01.2024; Views: 133; Downloads: 31
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