In this case report, a rare tumoral morphology in the gastrointestinal system is introduced. Malignant rhabdoid features are rarely observed in the gastrointestinal system but this discrimination is important due to the tumor's poor prognosis, aggressive behavior and early metastasis.
Aim
Endometriosis primarily affects women of reproductive age, and is responsible for impairing their quality of life. The presence of severe symptoms, including stenosis of the intestinal lumen, diagnostic difficulty (suspicion of malignancy) and intolerance to hormonal therapy, are indications for surgery. Despite numerous studies on endometriosis, there is still considerable controversy about its incidence, pathogenesis, diagnosis and optimal treatment.
Patients and methods
The present retrospective, observational study included 11 patients diagnosed with intestinal endometriosis between January 2009 and December 2013. Demographic data, clinical presentation, diagnostic modalities, localization of the disease and intraoperative data were collected.
Results
The median age of the patients was 43 years (34–63 years). Eight patients had intermittent abdominal pain, seven had change in bowel habits and three had rectal bleeding. Seven patients were operated on for severe stenosis of the intestinal lumen (intestinal obstruction), and three for a suspected malignancy. Postoperatively, all of the patients who underwent resection were free of pain. No patient had any disease recurrence on abdominal ultrasonography or computed tomography images.
Conclusion
Intestinal endometriosis should be considered in female patients of reproductive age presenting with constipation, rectal bleeding and abdominal pain. Repeated inadequate biopsies should also raise suspicion of intestinal endometriosis. Intestinal endometriosis is a rare disease with diagnostic difficulties, and despite medical management, treatment option is usually surgery. However, in patients diagnosed preoperatively with no intestinal obstruction, medical therapy can be tried.
SUMMARY
Objective:The aim of this study is to discuss the necessity of surgery by analysing the long term results and satisfaction of the symptomatic and asymptomatic patients who had parathyroidectomy for primary hyperparathyroidism. Method: Patients who had parathyroidectomy because of primary parathyroid pathology or during thyroid surgery as concomittant parathyroid pathology between June 1999 and September 2010 were enrolled to the present, retrospective study. A total of seventy one patient were included to the study. The Pasieka Symptom Scoring System and SF-36 questionnaire are applied to the patients. The patients were divided into two groups as symptomatic and asympyomatic. The answers to the Pasieka Symptom Scoring System's last 5 questions examining general health, surgical satisfaction and quality of life were evaluated between symptomatic and asymptomatic patients. Results: Number of the symptomatic patients were 38 (53.5%) whereas 33 patients (46.5%) were asymptomatic. Average length of follow up was 60 months. Among the operated 71 patients; 67 (94.4%) were cured, 4 (5.6%) had persistent hyperparathyroidism and 2 of these patients were operated again, the other two patients were out of follow up. Conclusions: Asymptomatic patients with primary hyperparathyroidism may have masked neurocognitive and psychiatric complaints and these patients' quality of life can be improved with surgery.
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