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Adnan Malik,Faisal Inayat,Muhammad Hassan Naeem Goraya,Gul Nawaz,Ahmad Mehran,Atif Aziz,Saad Saleem 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.2
A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.
Predictive factors for gangrene complication in acute calculous cholecystitis
Bader Hamza Shirah,Hamza Asaad Shirah,Muhammad Adnan Saleem,Mohammad Azam Chughtai,Mohamed Ali Elraghi,Mohamed Elsayed Shams 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.3
Backgrounds/Aims: Gallbladder gangrene is a grave complication of acute calculous cholecystitis that is difficult to detect preoperatively. Ultrasound could show a gallbladder wall that is more thickened. In addition, other clinical measures were reported to be possible predictive factors. Therefore, we aim in this study to evaluate the gallbladder wall thickness measured by ultrasound and other clinical measures as predictive factors for gangrene complication in acute calculous cholecystitis. Methods: A prospective cohort database analysis of the results of 674 patients diagnosed and treated for acute calculous cholecystitis between January 2010 and December 2014 was done. Patient’s inclusion criteria were acute calculous cholecystitis in adults who were operated within three days of onset of symptoms. Results: 117 (17.4%) patients had gangrene. Gallbladder sonographic wall thickness 5.1-6 mm, more than 6 mm, male gender, diabetes mellitus, leukocytosis ˃15,000 cells/ml, and age ≥40 years were found to be factors predisposing to gangrene complicated acute calculous cholecystitis that represented a statistically significant difference (p≤0.01). Conclusions: We conclude that gallbladder sonographic wall thickness 5.1-6 mm, more than 6 mm, male gender, diabetes mellitus, leukocytosis ˃15,000 cells/ml, and age ≥40 years were found to be factors predisposing to gangrene complicated acute calculous cholecystitis that represented a statistically significant difference. By implementing these risk factors, patients urgency for surgery can be decided in the emergency department. Other risk factors such as high alanine aminotransferase, elevated aspartate aminotransferase, and high alkaline phosphatase could be of help in the decision for early operation.