Browsing by Author "Cardoso, M"
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- 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.
- Acute-on-chronic liver failurePublication . Cardoso, M
- Anemia por deficiência de ferro: a abordagem do GastrenterologistaPublication . Anapaz, V; Cardoso, M
- A Complex Case of Cholestasis in a Patient with ABCB4 and ABCB11 MutationsPublication . Cardoso, M; Branco, J; Anapaz, V; Rodrigues, C; Carvalho, R; Horta, D; Martins, A; Reis, JThe low-phospholipid-associated cholelithiasis (LPAC) syndrome is a form of symptomatic cholelithiasis occurring in young adults, characterized by recurrence of symptoms after cholecystectomy and presence of hepatolithiasis. The case refers to a healthy 39-year-old Caucasian male who presented with abdominal pain and jaundice. His blood tests showed conjugated hyperbilirubinemia and elevated liver enzymes (total bilirubin 6.65 mg/dL, γ-glutamyltransferase 699 IU/L) and abdominal computed tomography revealed dilation of common bile duct and left intrahepatic ducts. Magnetic resonance cholangiopancreatography identified choledocholithiasis, retrieved by endoscopic retrograde cholangiopancreatography, after which there was a worsening of jaundice (total bilirubin 23 mg/dL), which persisted for several weeks, possibly due to ciprofloxacin toxicity. After an extensive workup including liver biopsy, the identification of two foci of hepatolithiasis on reevaluation abdominal ultrasound raised the hypothesis of LPAC syndrome and the patient was started on ursodeoxycholic acid, with remarkable improvement. Genetic testing identified the mutation c.1954A>G (p.Arg652Gly) in ABCB4 gene (homozygous) and c.1331T>C (p.Val444Ala) in ABCB11 gene (heterozygous). In conclusion, we describe the unique case of an adult male with choledocholithiasis, hepatolithiasis, and persistent conjugated hyperbilirubinemia after retrieval of stones, fulfilling the criteria for LPAC syndrome and with possible superimposed drug-induced liver injury, in whom ABCB4 and ABCB11 mutations were found, both of which had not been previously described in association with LPAC.
- Diagnóstico diferencial de ascite em doente AgHBs positivo: caso clínicoPublication . Alexandrino, G; Cardoso, M; Oliveira, AM; Carvalho, R; Reis, J
- Gastric gastrointestinal stromal tumor presenting with an intraluminal draining abscess and left pleural effusion.Publication . Cardoso, M; Lourenço, L; Oliveira, AM; Boléo-Tomé, JP; Reis, J
- Pericardite constritivaPublication . Ornelas, E; Cardoso, M; Paixão, P
- Quisto de Klestadt: Relato de caso clínicoPublication . Melo, M; Rito, J; Orfão, J; Cardoso, M; Freire, FRelata-se o caso de uma mulher de 68 anos, com história de tumefação nasolabial direita, com 5 anos de evolução e com intercorrências infeciosas associadas. Ao exame objetivo apresentava uma lesão com cerca de 2,5cm, regular, móvel, não aderente aos planos profundos, com procidência e obstrução do vestíbulo nasal, elevação da cartilagem alar nasal e do lábio superior homolaterais. A tomografia computadorizada caracterizou uma lesão de densidade de tecidos moles que causava moldagem óssea subjacente e abaulamento interno da asa do nariz, com redução do vestíbulo nasal direito. Foi realizada enucleação quística por via intraoral. O exame anatomopatológico confirmou o diagnóstico de quisto de Klestadt. O pós-operatório decorreu sem intercorrências e sem evidência de recidiva a 1 ano. Revisão bibliográfica sobre o tema.
- A Rare Cause of Abdominal Pain in a Patient with Acute Necrotizing Pancreatitis.Publication . Branco, C; Cardoso, M; Lourenço, C; Santos, L; Horta, V; Coimbra, E; Reis, JINTRODUCTION: Walled-off necrosis (WON) is a potentially lethal late complication of acute pancreatitis (AP) and occurs in less than 10% of AP cases. It can be located in or outside the pancreas. When infected, the mortality rate increases and can reach 100% if the collection is not drained. Its treatment is complex and includes, at the beginning, intravenous antibiotics, which permit sepsis control and a delay in the therapeutic intervention, like drainage. Nowadays, a minimally invasive approach is advised. Depending on the location of the collection, computed tomography (CT)-guided drainage or endoscopic necrosectomy are the primary options, then complemented by surgical necrosectomy if needed. Infected WON of the abdominal wall has been rarely described in the literature and there is no report of any infection with Citrobacter freundii. CASE: We present the case of a 61-year-old man with necrotizing AP complicated by WON of the left abdominal wall, infected with Citrobacter freundii that was successfully treated with CT-guided percutaneous drainage and intravenous antibiotics. CONCLUSION: Infected WON accounts for considerable mortality and its location in the abdominal wall is rare; it can be treated with antibiotics and CT-guided drainage with no need for further intervention.