By Antonello Trecca
This atlas provides top of the range photos of medical situations of small bowel ailments, with a spotlight at the significance of terminal ileoscopy because the first step in detecting this staff of infrequent pathologies. one of the stipulations lined are celiac disorder, inflammatory bowel disorder, neoplasms, infections, and pediatric sickness. The multidisciplinary method of the presentation of medical situations, with contributions from histology, radiology, pill endoscopy, enteroscopy, and surgical procedure, guarantees that the atlas will offer a correct studying direction for novices and in addition a good replace for specialists.
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Additional info for Atlas of Ileoscopy: A Collection of Clinical Cases
20e). Case 2 A 64-year-old woman underwent a total colonoscopy as part of a routine medical evaluation. An elevated lesion, 20 mm in diameter, with a lobulated surface was detected on the ileocecal valve (Fig. 21a). NBI with magnifying colonoscopy did not evidence any remarkable capillary vessels (Fig. 21b). A. 4, © Springer-Verlag Italia 2013 47 M. Makazu et al. 48 a b d e c Fig. 20 a An elevated lesion, 30 mm in diameter, with a nodular surface was detected on the ileocecal valve in a 64year-old woman who underwent colonoscopy because of a positive fecal occult blood test.
Multiple biopsies were taken, but the histological report was negative. The patient subsequently underwent a CT scan, which revealed multiple hepatic metastases (Fig. 23). Surgical intervention consisted of a right hemicolectomy including a resection of the last 10 cm of the terminal ileum. The more superficial of the liver metastases was also biopsied. Analysis of the specimen defined a tumor stage of T2N1M1 according to the AJCC classification, with a proliferation index of 5% (Fig. 24). After an uneventful postoperative course, the patient was discharged.
2). Capsule endoscopy of the small bowel confirmed the lesions in the terminal ileum and excluded further localization of the disease. C-reactive protein and mucoprotein were both negative. , which stabilized his condition at periodic follow-up, performed every 6 months. A second lower endoscopy performed 3 years after the initial diagnosis showed complete mucosal healing in the terminal ileum. Last year, the patient came to our attention for a reappraisal of his clinical symptoms, mainly abdominal pain.