Git Case Eso Wb Ch Pancreatitis.

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Transcript of Git Case Eso Wb Ch Pancreatitis.

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26 years old girl with menorrhagia & chronic ill health for many years.She started to have dysphagia for the last 2 years.O/E: she is pale with choenychia & mild splenomegaly.Ba-swallow reported to be normal but on better interpretation an upper esophageal web was evident.She underwnt baloon dilation of the upper esophageal web without any adverse sequele.

Pale patient recovering from GA after the intervention.

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Flat-depressed finger nails: cholenychia.

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Barium swallow with upper eso web

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BA-Swallow: upper eso web

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• This middle aged female presented with gradually progressive dysphagia

1- the patient is most probably suffering from………….2- you should proceed to the following investigations:A- B-

koilonychia Atrophic GlossitisAngular Stomatitis

? PLUMMER VINSON SYNDROME.2- The following investigations needed:A- Blood Picture (Hypochromic Anemia)B- Gastric secretion (achlorohydriaC- Barium Swallow (web)

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• Plummer-Vinson or Paterson-Kelly syndrome presents as a classical triad of dysphagia, iron-deficiency anemia,

esophageal webs

Age: Middle age

Sex: 90% in females Etiology: Un-clear, may be

- iron deficiency anemia- Vitamin deficiency- or autoimmune processes

Pathology: Atrophy of :Pharyngeal

Esophageal &

Gastric mucosa

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Symptoms

GeneralPharyngeal

Weakness, fatigue, and dyspneaare Secondary to iron deficiencyanemia

SignsGeneral

Pharyngeal

Dysphagia, if present, is typically

intermittent and limited to solids.

It is usually felt in the throat

Angular stomatitis

Glossitis

Atrophic glazed mucosa of the

hypopharynx

Koilonychia

Spleenomegaly

Pallor

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Investigations

Complications

Treatment

- Stricture

- Pre-cancerous: postcricoid

carcinoma &esophageal carcinoma

Blood picture: hypochromic anemia

Gastric secretion: Achlorohydi due to atrophy of gastric mucosa

Barium swallow

Hypopharyngoscopy

Iron & vitamine supply

Repeated endoscopic dilatation

F/U for early detection of

postcricoid carcinoma &eso Ca.

Web

http://images.google.com.eg/imgres?imgurl=http://www.learningradiology.com/caseofweek/caseoftheweekpix2/cow139lg.jpg&imgrefurl=http://www.learningradiology.com/archives05/COW%20139-Esophageal%20web/esophagealwebcorrect.htm&h=635&w=727&sz=55&hl=ar&start=18&um=1&tbnid=DPgf48_sxnoZjM:&tbnh=123&tbnw=141&prev=/images?q=Plummer+vinson+Syndrome+&svnum=10&um=1&hl=ar&sa=N
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CXR: Normal. 

14 years old girl, student from Rania,Presented with epigastric pain for 8 months duration, aggravated by meals & relieved by taking antispasmotic drugs.She had anorexia, weight loss, constipation.She was admitted many times to hospital & diagnosed having multiple GSs.He had opene cholecystectomy 2 months ago.Postop still she had epigastric & RH pain.She had many imagings & proved to have chronic pancreatitis.Family H/O her young brother died of rectal cancer with liver metastasis.

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Abd U/S:

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Sobre a Sacada II - 1889

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Na Fonte - 1872

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THANKS

[email protected]


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