Quiz 10 Geral. Caso 1 This old lady had been obstipated for many many years, and a colonoscopy was made to exclude organic disorders. She had some diverticulas.

Quiz 10

Geral

Caso 1

This old lady had been obstipated for many many years, and a colonoscopy was made to exclude organic disorders. She had some diverticulas in her sigmoid colon, and a brown discoloration of the whole colonic mucosa. This picture is from her caecum. What is this discoloration?

Answer: Melanosis (or pseudomelanosis) coli

Caso 2 This young lady had

an xray examination, showing a small tumor in her antrum on the greater curvature. This was the finding in endoscopy, the diameter of the lesion is about 8 millimeters. What is this?

Answer: Aberrant or ectopic pancreas.

Caso 3

This teenage boy had fever and diarrhea for two weeks. Colonoscopy showed this picture in his rectum and sigmoid colon. What is this?

Answer: Infectious colitis (Yersinia

Pseudotuberculosa was cultured from faeces, and the boy was cured with ciprofloxacin treatmen)

Caso 4

This middle aged man had ascites, positive mitocondrial antibodies and a finding like this in his oesophagus.What is the diagnosis?

Answer: Oesophageal varices caused by primary

biliary cirrhosis

Caso 5

This old man was examined because of chronic anaemia. In the antrum just below the angulus this little gastric ulcer was seen. Is this ulcer benign or malignant?

Answer: Malignant. The clubbing of the mucosal

folds adjacent to the ulcer is a typical finding.

Caso 6

This lady in her sixties had been troubled with a watery diarrhea six to nine times aday for a few years. Colonoscopy showed normal You see the hystological findings.. What is the diagnose?

Answer: The pink band seen in the histological

preparation is a collagen band. The diagnose is Collagenous Colitis.

Caso 7 This lady was

examined because for longstanding heartburn. In the upper part of the oesophagus, about 25 centimeters from the tooth row, this sharp border between two types of mucosa is seen. What is this finding?

Answer: Barret´s oesophagus

Caso 8 This man about 45 years

of age had suffered from diarrea and progressive stomach pain for some years, and he got some fever and high sedimentation rate. This was the finding in the sigmoideum. What is the probable diagnosis?

Answer: Morbus Crohn

Caso 9 This man in 30 - 40 years

of age came to the emergency room because of haematemesis. At time of endoscopy the following day the bleeding had already stopped. What is the name of the lesion in the distal oesophagus seen to the right in these pictures?

Mallory Weiss

Caso 10

These pictures are from the gastric body of a teenage girl, who was investigated because of severe iron deficiency anaemia.

Caso 10

A total gastrectomy was done, and the tumours (there were four of them) were found to be malignant leiomyoblastomas with metastatic changes in the regional lymph nodes. These young patients often have pulmonary chondromas and adrenal paragangliomas. What is the name of the gentleman who has given his name to this syndrome?

Answer: JA Carney. This syndrome is very rare

but has a great clinical importance. If one of it´s component, for example a malignant gastric leomyoblastoma, is found in a young girl, the other two, pulmonary chondromas and adrenal paragangliomas, should be looked for during a lifelong surveillance.