Browsing by Author "Alberto, S"
Now showing 1 - 10 of 20
Results Per Page
Sort Options
- Abordagem clínica da cirrose hepática: protocolos de atuaçãoPublication . Reis, J; Alves, N; Martins, A; Horta, D; Alberto, S; Santos, L; Carvalho, R; Rodrigues, C; Oliveira, A; Costa, M; Lourenço, L; Branco, J; Cardoso, M; Anapaz, V; Alexandrino, G; Figueiredo, L; Rafael, M
- Actinomycosis Causing Recurrent Perianal FistulaePublication . Cardoso, M; Carneiro, C; Lourenço, L; Rodrigues, C; Alberto, S; João, A; Rocha, R; Geraldes, V; Costa, A; Reis, J; Nunes, VActinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, Actinomyces spp. was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement. This case illustrates the importance of pursuing less common diagnoses in refractory complex perianal disease, such as actinomycosis.
- Celiac disease and upper tract Crohn's disease: a rare associationPublication . Alberto, S; Martins, A; Deus, JRThe authors present the case of a 47 years old female, with no past or familial history, hospitalized due to vomiting and significant weight loss over the last 9 months, without abdominal pain, blood loss, constipation or diarrhea. Blood tests results revealed iron deficiency anaemia, seropositivity for ASCA, anti-transglutaminase antibody and HLA-DQ2. Upper GI endoscopy showed several ulcers in duodenal mucosa and an ulcerated stricture in D3; biopsies were taken and histopathology revealed transmural inflammatory chronic infiltrate, crypt loss and some areas of villous atrophy and intraepithelial lymphocytosis. The small bowel follow through confirmed 2 main strictures in duodenum and proximal jejunum. She was started on prednisolone, azathioprine and a gluten-free diet with an initial good response although relapse was detected one month later. In this last admission, parenteral nutrition was necessary due to her deteriorated nutritional state and she also started infliximab, with subsequent significant clinical and endoscopic improvement.
- Corpo estranho no cólon como causa de hematoquéziasPublication . Alberto, S
- Critérios diagnósticos na hepatite auto-imunePublication . Alberto, S
- Dieulafoy’s lesion in Treitz’s anglePublication . Alberto, S; Oro, I; Pires, E; Alves, N; Godinho, A; Figueiredo, A; Deus, JR
- Hemangioma do osso: a propósito de um caso clínicoPublication . Alberto, S; Duarte, F; Nunes, A; Godinho, T; Dutschmann, LOs autores descrevem um caso clínico de uma mulher de 51 anos, obesa, com hipertensão arterial e cardiopatia isquémica, internada por agravamento de dor retro-esternal de grande intensidade e evolução arrastada. Após exclusão de episódio agudo de isquemia do miocárdio, o estudo desta doente revelou lesão óssea expansiva de arco costal direito (5cm x 4cm x 3.5cm), adjacente ao corpo vertebral, mal definida, com componente lítico e blástico e com aumento das partes moles adjacentes. Foi operada, tendo feito excisão, em bloco, do tumor. O exame anátomo-patológico revelou hemangioma. A Tomografia Computorizada (TC) abdominal mostrou alterações da cabeça e colo do fémur direitos, também sugestivas de hemangioma, confirmadas por radiografia e tomografia osteo-articular.
- Hematoma intramural espontáneo no traumático del intestino delgado: una complicación poco habitual de los anticoagulantesPublication . Alberto, S; Sánchez, P; Félix, J; Deus, JREl hematoma intramural del intestino delgado es una complicación poco habitual de la utilización de anticoagulantes orales. El diagnóstico sólo es posible cuando se asocian estos síntomas a una historia clínica de anticoagulación oral y pruebas radiológicas. A continuación se presenta el caso clínico de un paciente que ingreso por dolor epigástrico asociado a vómitos de retención con 48 h de evolución y antecedentes de anticoagulación oral con warfarina. La ecografía y la tomografía computarizada abdominal mostraban un asa yeyunal con espesamiento parietal difuso, indicativo de hematoma intramural. Se realizó tratamiento conservador, con regresión sintomática al segundo día y reabsorción del hematoma intramural del yeyuno. Se reintrodujo tratamiento anticoagulante, sin nueva recidiva.
- Hepatic abscess induced by foreign body: case report and literature reviewPublication . Santos, S; Alberto, S; Cruz, E; Pires, E; Figueira, T; Coimbra, E; Estevez, J; Oliveira, M; Novais, L; Deus, JRHepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon. Pre-operative diagnosis is diffi cult as patients are often unaware of the foreign body ingestion and symptoms and imagiology are usually non-specific. The authors report a case of 62-year-old woman who was admitted with fever and abdominal pain. Further investigation revealed hepatic abscess, without resolution despite antibiotic therapy. A liver abscess resulting from perforation and intra-hepatic migration of a bone coming from the pilorum was diagnosed by surgery. The literature concerning foreign body-induced perforation of the gastrointestinal tract complicated by liver abscess is reviewed.
- Hepatocellular carcinoma presenting with Budd-Chiari syndrome, right atrial thrombus and pulmonary emboliPublication . Lourenço, L; Horta, D; Alberto, S; Reis, JA 47-year-old patient presented with a two-week history of right upper quadrant pain, abdominal distention and new onset of shortness of breath. He had a history of intravenous drug abuse, no alcohol consumption and denied any known liver disease. On physical examination, he was tachypneic and had dullness in the flanks. His blood analysis at admission was as follows: hemoglobin, 12.9 g/dL; leukocyte count, 6,800/uL; platelet count, 63,000/uL; INR, 2.1; serum creatinine, 1.27 mg/dL; liver biochemistry tests were notable for marginal derangement, HBsAg was negative, anti-HCV was positive, HCV RNA was 367,498 IU/ml and alpha-fetoprotein was 992 mg/dL. Abdominal ultrasound showed a right liver lobe mass (13 cm in diameter) with inferior vena cava (IVC) thrombosis and mild peri-hepatic ascites. A 2D echocardiogram showed a presumed right atrial tumor thrombus. A multiphasic contrast-enhanced abdominal tomography (CT) confirmed a hepatocellular carcinoma (HCC) with IVC obstruction and extensive tumoral thrombus to the right atrium (14 cm long).