Heterotopický pankreas (HP) je vrozená anomálie charakterizovaná přítomností pankreatické tkáně, která je anatomicky oddělena od hlavní pankreatické žlázy bez kontinuity vývodného systému a vaskularity. Nejčastější místa pro tento posun jsou v horní části gastrointestinálního traktu, zejména v žaludku, duodenu a proximálním jejunu. Mezi další méně obvyklá místa patří jícen, ileum, Meckelův divertikl, žlučový strom, mezenterium a slezina. Nekomplikovaný heterotopický pankreas obvykle nevykazuje příznaky a léze je často objevena náhodně během nesouvisejících operací, zobrazovacích vyšetření nebo pitvy. Tato zpráva popisuje 35letého muže s anamnézou požití žíraviny, který vykazoval dysfagii. Během chirurgického výkonu byla přibližně 40 cm od DJ flexury v jejunu pozorována tkáň o rozměrech 0,7 × 0,5 cm. Identifikovaná tkáň byla vyříznuta a odeslána na histopatologické vyšetření (HPE). Závěrem doporučujeme excizi ektopické tkáně a doporučujeme HPE, protože diagnózu HP nelze potvrdit bez důkladného histopatologického vyšetření. I přes svou vzácnost by měl být heterotopický pankreas zahrnut do diferenciální diagnózy při hodnocení gastrointestinálních stromálních tumorů.
Heterotopic pancreas (HP) is a congenital anomaly characterized by the presence of pancreatic tissue that is anatomically separate from the main pancreatic gland without continuity of the duct system and vascularity. The most frequent locations for this displacement are within the upper gastrointestinal tract, particularly in the stomach, duodenum, and proximal jejunum. Other less common sites include the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Typically, uncomplicated heterotopic pancreas does not exhibit symptoms, and the lesion is often discovered incidentally during unrelated surgeries, imaging examinations, or autopsy. This report describes a 35-year-old male with a history of corrosive ingestion who presented with dysphagia. During surgical exploration, a tissue measuring 0.7 × 0.5 cm was observed approximately 40 cm from the DJ flexure in the jejunum. The identified tissue was excised and sent in for histopathological examination (HPE). In conclusion, we advise the excision of the ectopic tissue and recommend HPE because the diagnosis of HP cannot be confirmed without a thorough histopathological examination. Despite its rarity, heterotopic pancreas should be included in the differential diagnosis when evaluating gastrointestinal stromal tumors.
- Keywords
- heterotopický pankreas,
- MeSH
- Choristoma surgery diagnosis complications MeSH
- Pancreatitis, Chronic * MeSH
- Adult MeSH
- Endoscopy, Digestive System MeSH
- Jejunum abnormalities surgery MeSH
- Caustics poisoning MeSH
- Humans MeSH
- Pancreas abnormalities anatomy & histology MeSH
- Deglutition Disorders * surgery etiology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0 - 18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) have been dealt with in other Guidelines and are therefore not mentioned in this Guideline. Training and ongoing skill maintenance will be addressed in an imminent sister publication.
- MeSH
- Burns, Chemical etiology therapy MeSH
- Cholangiopancreatography, Endoscopic Retrograde standards MeSH
- Foreign Bodies therapy MeSH
- Child MeSH
- Endosonography standards MeSH
- Endoscopy, Gastrointestinal methods standards MeSH
- Gastrointestinal Tract injuries MeSH
- Caustics toxicity MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Digestive System Diseases therapy MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Publication type
- Journal Article MeSH
- Practice Guideline MeSH
This guideline refers to infants, children, and adolescents ages 0 to 18 years. The areas covered include indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography; and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease has been dealt with in other guidelines and are therefore not mentioned in this guideline. Training and ongoing skill maintenance are to be dealt with in an imminent sister publication to this.
- MeSH
- Cholangiopancreatography, Endoscopic Retrograde MeSH
- Foreign Bodies MeSH
- Child MeSH
- Endoscopy, Digestive System MeSH
- Endosonography MeSH
- Gastroenterology MeSH
- Endoscopy, Gastrointestinal standards MeSH
- Gastrointestinal Hemorrhage MeSH
- Gastrointestinal Diseases diagnosis therapy MeSH
- Caustics MeSH
- Infant MeSH
- Colonoscopy MeSH
- Humans MeSH
- Adolescent MeSH
- Infant, Newborn MeSH
- Pediatrics MeSH
- Child, Preschool MeSH
- Societies MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Practice Guideline MeSH
- Geographicals
- Europe MeSH
The aim of this study was to examine whether nanofiber scaffolds seeded with rabbit bone marrow mesenchymal stem cells (MSCs nanofibers) transferred onto the damaged corneal surface and covered with cyclosporine A (CsA)-loaded nanofiber scaffolds (CsA nanofibers) enable healing of the rabbit cornea injured with 1N NaOH. The healing of damaged corneas was examined morphologically, immunohistochemically and biochemically on day 24 after the injury. Compared to untreated injured corneas, where corneal ulceration or large corneal thinning or even perforation were developed, injured corneas treated with drug free nanofibers healed without profound disturbances in a majority of cases, although with fibrosis and scar formation. In injured corneas treated with CsA nanofibers or MSCs nanofibers, the development of scar formation was reduced. Best healing results were obtained with a combination of MSCs and CsA nanofibers (MSCs-CsA nanofibers). Corneas healed with highly restored transparency. Neovascularization highly expressed in untreated injured corneas and reduced in corneas treated with CsA nanofibers or MSCs nanofibers, was suppressed in corneas treated with MSCs-CsA nanofibers. The levels of matrix metalloproteinase 9, inducible nitric oxide synthase, interleukin 6, α-smooth muscle actin, tumor growth factor β and vascular endothelial growth factor were significantly decreased in these corneas as compared to untreated corneas, where the levels of the above mentioned markers were high. In conclusion, MSCs-CsA nanofibers were effective in the treatment of severe alkali-induced corneal injury.
- MeSH
- Cyclosporine administration & dosage MeSH
- Wound Healing drug effects MeSH
- Sodium Hydroxide toxicity MeSH
- Immunosuppressive Agents administration & dosage MeSH
- Cicatrix prevention & control MeSH
- Caustics toxicity MeSH
- Rabbits MeSH
- Drug Delivery Systems methods MeSH
- Disease Models, Animal MeSH
- Nanofibers MeSH
- Corneal Neovascularization prevention & control MeSH
- Drug Carriers MeSH
- Corneal Injuries therapy MeSH
- Tissue Scaffolds MeSH
- Mesenchymal Stem Cell Transplantation methods MeSH
- Animals MeSH
- Check Tag
- Rabbits MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Nehody s prostředky na udržování hygieny v domácnosti a s kosmetickými přípravky tvoří hned po intoxikacích léky druhou nejčastější příčinu konzultací dětských otrav s Toxikologickým informačním střediskem (TIS) v Praze (1677 nehod v roce 2012). Tyto otravy bývají náhodné, spadající zejména do období batolecího věku dítěte. Z valné části je konzultováno s TIS požití cizorodé látky, zřídka polití nebo vniknutí nežádoucí substance do oka. Typická je pro dětské nehody expozice malému množství čisticího nebo pracího přípravku. Dítě není ohroženo celkovými příznaky, ale možností poškození zažívacího traktu. Míra rizika je daná podílem dráždivých či korozivních látek, které přípravek obsahuje. U pěnivých přípravků s obsahem saponátů hrozí aspirace pěny při zvracení. Po požití kosmetických přípravků s obsahem alkoholu může dojít k celkovým příznakům v závislosti na jeho podílu v daném produktu, na požitém množství přípravku, na hmotnosti a věku postiženého dítěte. V praxi jsou tyto situace výjimečné. Nehody s kosmetickými přípravky bez alkoholu se obvykle obejdou bez následků, zažívací problémy po větším požitém množství (zvracení, průjem, bolesti břicha) nejsou vyloučeny. Ochutnání přípravků s rozpouštědly (laky na nehty a odlakovače) obvykle nevyžaduje léčbu kvůli velmi malým požitým dávkám.
Accidents involving household maintenance products and cosmetic products are only second to medication poisoning as the most common reason for consultations on child poisoning provided by the Toxicological Information Center (TIS) in Prague (1,677 accidents in the year 2012). These intoxications tend to be accidental and are particularly associated with the period of toddlerhood. The majority of consultations with the TIS are for ingestion of a foreign substance, rarely for spills or chemical splash in the eye. Child accidents typically involve exposure to a small amount of a cleaning or washing product. The child is not at risk of systemic symptoms, but of developing damage to the gastrointestinal mucosa. The risk level is determined by the proportion of irritants or corrosives contained in the product. In the case of foamy products containing surface active agents, there is a risk of foam aspiration during vomiting. Ingestion of cosmetic products containing alcohol may result in systemic effects depending on the proportion of alcohol in the particular product, the amount of the product ingested, and the weight and age of the child affected. These situations are uncommon in the practice. Accidents with alcohol-free cosmetic products usually go without consequences; however, digestive problems after ingesting larger quantities (vomiting, diarrhea, abdominal pain) cannot be excluded. Ingestion of products with solvents (nail polish and nail polish remover) does not generally require treatment, given the very small amounts ingested.
- MeSH
- Detergents * poisoning adverse effects MeSH
- Disinfectants poisoning adverse effects MeSH
- Child MeSH
- Irritants poisoning adverse effects MeSH
- Caustics poisoning adverse effects MeSH
- Cosmetics * poisoning adverse effects MeSH
- Humans MeSH
- First Aid * methods nursing MeSH
- Accidents, Home MeSH
- Emergency Medical Services MeSH
- Check Tag
- Child MeSH
- Humans MeSH
Chromium is widely used in various industries including construction sector. Skin contact with cement has been associated with allergic or irritant contact dermatitis. Contact dermatitis is one of the most frequently reported health problems among construction workers. Irritant contact dermatitis from cement ranges from cement burns to cumulative irritant contact dermatitis. Cement burns are rarely reported and are considered a severe form of acute irritant contact dermatitis. They are associated with amateur user working in a short ready-mix time-frame with poor protective measures. They usually result in significant morbidity and initially are associated with minimal discomfort. We report a typical case.
- MeSH
- Burns, Chemical etiology MeSH
- Dermatitis, Occupational etiology MeSH
- Dermatitis, Irritant etiology MeSH
- Caustics toxicity MeSH
- Construction Materials toxicity MeSH
- Skin Ulcer chemically induced MeSH
- Middle Aged MeSH
- Humans MeSH
- Leg Injuries chemically induced MeSH
- Accidents, Occupational MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
Virové bradavice patří mezi nejčastější virová onemocnění kůže dětí a mladistvých. Vznikají na podkladě infekce lidskými papilomaviry (HPV), které se řadí mezi DNA viry. Jsou přísně specifické ke svému hostiteli. Inkubační doba je 1–12 měsíců. Incidence celosvětově vzrůstá. Četnost bradavic není známa, odhaduje se výskyt u 7–12 % obyvatelstva. Dvakrát častěji se vyskytují u bílé rasy, postižení mužů a žen je 1:1. Někdy dochází ke spontánní regresi onemocnění, ale infekce v buňkách může perzistovat a léčba je obtížná.
Viral verrucas are one of the most common viral skin diseases in children and adolescents. They are caused by a human papiloma virus infection (HPV); it belongs to the family of DNA viruses. The viruses are strictly specific towards their hosts. Their incubation period is 1–12 months. Their incidence keeps rising worldwide. The frequency is unknown; it is estimated to affect 7–12% of population. They are twice more frequent in Caucasians, they affect men and women in 1:1 ratio. A spontaneous regression is occasionally possible, but the infection in cells may persist and the treatment is difficult.
Principem chemických metod je plošný a ohraničený účinek látek označovaných jako kaustika. Používáním těchto látek, převážně alfahydroxykyselin – ovocných kyselin, fenolu, kyseliny trichloroctové, vede k navození regeneračních procesů v kůži. Mechanické obrušování pleti pomocí speciálních krémů a past s abrazivními přísadami se nazývá mechanický peeling.
The principle of chemical methods is surface circumscribed effect of substances described as caustics. The use of these substances, mainly alpha-hydroxy-acid-fruit acids, phenol, and trichloracetic acid, leads to stimulation of regeneration processes in skin. Mechanic abrasion of skin with use of special creams and pastes with abrasive substances is called mechanical peeling.
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
Přeruš. str. : il., tab. ; 30 cm
Analýza výsledků náhrady jícnu transpozicí žaludku do hrudníku u dětí operovaných touto technikou na našem pracoviští v letech 1993 - 2003 pro atrézii jícnu nebo poleptání jícnu. Zhodnocení výskytu časných a pozdních komplikací, doby do dosažení plné perorální výživy, délky hospitalizace, výskytu a způsobu řešení striktur v anastomóze a počtu rehospitalizací. Vzájemné srovnání skupin dětí s atrézií esofagu (AE) a poleptáním. Sledování růstu a vývoje, problémů s příjmem potravy, výskytu gastrointestinálních a respiračních poblémů, stavu výživy. Určení vztahu urychlené evakuace žaludku k těmto problémům. Snaha o nutriční intervenci u pacientů s neprospíváním. Optimalizace předoperační přípravy a pooperační péče, event. modifikace postupu zajišťujícího urychlenou evakuaci žaludku. Využití výsledků studie k prevenci některých problémů. Zlepšení dlouhodobé péče o děti s TŽ.; Analysis of outcome of gastric transposition (GT) for esophageal replacement in children operated in author s institution between 1992 and 2003 foŕ esophageal atresia (EA) or caustic injury (CI). Comparison of incidence of early and late complications, time to full peroral feedings, number of readmissions in chldren with GT for EA and CI. Follow up of development, feeding problems, overall morbidity, gastrointestinal and respiratory symptoms a nutritional status. Assessment of influence of gastric evacuation on above-mentioned problems and parameters. Modification of management of children with planned or performed GT according to results of the study.
- MeSH
- Anastomosis, Surgical MeSH
- Esophageal Atresia MeSH
- Esophagus transplantation MeSH
- Caustics MeSH
- Quality of Life MeSH
- Nutritional Status MeSH
- Postoperative Care MeSH
- Preoperative Care MeSH
- Gastric Emptying MeSH
- Conspectus
- Pediatrie
- NML Fields
- gastroenterologie
- transplantologie
- pediatrie
- NML Publication type
- závěrečné zprávy o řešení grantu IGA MZ ČR
OBJECTIVE: This study examined a cohort of pediatric patients treated for suspected corrosive injury of the oesophagus in the ENT department between 1994 and 2003. METHODS: During the study period we examined 337 patients. All patients were treated according to an individual diagnostico-therapeutic protocol that included: foremost, early rigid oesophagoscopy; intensive medical therapy; nasogastric tube placement; and/or surgical intervention. RESULTS: Our proposed system of grading on a scale from 0 to 4 was used to classify the findings upon oesophagoscopy. One hundred eighty eight patients (55.7%) had a negative exam; 1st degree corrosive injury was present in 58 patients (17.4%); 2nd and 3rd degree injury in 81 patients (24%); and 4th degree was found in 10 patients (3%). CONCLUSIONS: Because the endoscopic findings were positive in 44% of patients with suspected corrosive injury, early rigid oesophagoscopy is indicated in all patients suspected of having corrosive injury even in the absence of clinical symptoms.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Burns, Chemical etiology classification therapy MeSH
- Esophagoscopy MeSH
- Esophagus injuries MeSH
- Intubation, Gastrointestinal MeSH
- Glucocorticoids therapeutic use MeSH
- Hospitalization MeSH
- Enzyme Inhibitors therapeutic use MeSH
- Proton Pump Inhibitors MeSH
- Catheterization MeSH
- Caustics toxicity MeSH
- Cohort Studies MeSH
- Infant MeSH
- Humans MeSH
- Critical Care MeSH
- Child, Preschool MeSH
- Proton Pumps MeSH
- Retrospective Studies MeSH
- Injury Severity Score MeSH
- Esophageal Stenosis chemically induced surgery MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Child, Preschool MeSH
