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简介：Primarymalignanttumorsofthesmallintestinearerare,comprisinglessthan2%ofallgastrointestinaltumors.An85-year-oldwomanwasadmittedwithfeverof40℃andmarkedabdominaldistension.Hermedicalhistorywasunremarkable,butbloodexaminationshowedelevatedinflammatorymarkers.Abdominalcomputedtomographyshowedagianttumorwithcentralnecrosis,extendingfromtheepigastriumtothepelviccavity.Giantgastrointestinalstromaltumorofthesmallintestinecommunicatingwiththegastrointestinaltractorwithsuperimposedinfectionwassuspected.Becausenoimprovementoccurredinresponsetoantibiotics,surgerywasperformed.Laparotomyrevealedgianthemorrhagictumoradherenttothesmallintestineandoccupyingtheperitonealcavity.Thegianttumorwasasolidtumorweighing3490g,measuring24cm×17.5cm×18cmandshowingmarkednecrosis.Histologically,thetumorcomprisedspindle-shapedcellswithanaplasticlargenuclei.Immunohistochemicalstudiesshowedtumorcellspositiveforvimentin,CD31,andfactorⅧ-relatedantigen,butnegativeforc-kitandCD34.Angiosarcomawasdiagnosed.Althoughnopostoperativecomplicationsoccurred,thepatientexperiencedenlargementofmultiplemetastatictumorsintheabdominalcavityanddied42dpostoperatively.Theprognosisofsmallintestinalangiosarcomaisverypoor,evenaftervolume-reducingpalliativesurgery.

简介：Amongthevariousdiagnosticmodalitiesforsmallbowelhemangioma,videocapsuleendoscopy(VCE)anddouble-balloonenteroscopy(BE)canberecommendedaspartofthework-upinpatientswithobscuregastrointestinalbleeding(OGIB).BEissuperiortoVCEintheaccuracyofdiagnosisandtherapeuticpotential,whileinmostcasestotalenteroscopycannotbeachievedthroughonlytheantegradeorretrogradeBEprocedures.Astreatmentforsmallbowelbleeding,especiallyspoutbleeding,localizationofthelesionforthedecisionofBEinsertionfacilitatesearlytreatment,suchasendoscopichemostaticclipping,allowingpatientstoavoiduselesstransfusionandtheworseningoftheirdiseaseintolife-threateningstatus.ApplyingendoscopicIndiainkmarkingpriortolaparoscopicsurgicalresectionisaparticularlyusefultechniqueformoreminimallyinvasivetreatment.WereporttwocasesofsmallbowelhemangiomafoundinexaminationsforOGIBthatweretreatedwithcombinationoflaparoscopicandendoscopicmodalities.

简介：AIM:Toclarifythecorrelationwithphenotypicexpression,clinicopathologicalfeatures,geneticalterationandmicrosatellite-instabilitystatusinsmallintestinaladenocarcinoma(SIA).METHODS:Thecasesof47patientsdiagnosedwithprimarySIAsthatweresurgicallyresectedatourinstitutionin1975-2005werestudied.Wereviewedclinicopathologicalfindings(age,gender,tumorsize,grossappearance,histologicalmorphologictype,invasiondepth,lymphaticpermeation,venousinvasion,andlymphnodemetastasis),andtheimmunohistochemicalexpressionofMUC5AC,MUC6,MUC2,CD10,andmismatch-repair(MMR)proteins(MLH1andMSH2).WeanalyzedKRASandBRAFgenemutations,andthemicrosatelliteinstability(MSI)status.TheimmunohistochemicalstainingofCD10,MUC2,MUC5ACandMUC6wasconsideredpositivewhendistinctstainingin>5%oftheadenocarcinomacellswasrecorded.ToevaluateofMMRproteinexpression,weusedadjacentnormaltissueincludinglymphoidfollicles,inflammatorycells,andstromalcellsasaninternalpositivecontrol.SectionswithoutnuclearstaininginthetumorcellswereconsideredtohavelosttheexpressionoftherespectiveMMRprotein.RESULTS:Therewere29malesand18femalespatients(meanage59.9years,range:23-87years).Tumorswerelocatedintheduodenumin14cases(30%),thejejunumin21cases(45%),andtheileumin12cases(25%).Aphenotypicexpressionanalysisrevealed20MUC2-positivetumors(42.6%),11MUC5AC-positive(23.4%),4MUC6-positive(8.5%),and7CD10-positive(14.9%).ThetumorsizesoftheMUC2(+)tumorsweresignificantlylargerthanthoseoftheMUC2(-)tumors(mean,5.7±1.4cmvs4.7±2.1cm,P<0.05).AllthreetumorswithadenomatouscomponentwerepositiveforMUC2(P<0.05).PolypoidappearancewasseensignificantlymorefrequentlyintheCD10(+)groupthanintheCD10(-)group(P<0.05).ThetumorsizewassignificantlylargerintheCD10(+)groupthanintheCD10(-)group(mean,5.9±1.4cmvs5.0±2.1cm,P<0.05).Of34SIAswithsuccessfullyobtainedMSIdata,4wereMSI-high.O

简介：AIM:ToevaluatethecompletionrateanddiagnosticyieldofthePillCamSB2-exincomparisontothePillCamSB2.METHODS:Twohundredcasesusingthe8-hPillCamSB2wereretrospectivelycomparedto200casesusingthe12hPillCamSB2-exatatertiaryacademiccenter.Endoscopicallyplacedcapsuleswereexcludedfromthestudy.Demographicinformation,indicationsforcapsuleendoscopy,capsuletype,studylength,completionofexam,clinicallysignificantfindings,timestampofmostdistantfinding...