git case of the week4212
TRANSCRIPT
![Page 1: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/1.jpg)
Case of the week:GOO
Dr. Mohamed Shekhani.
![Page 2: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/2.jpg)
History:
• 43 years old Arabic woman presented with dyspesia, vomiting & weight loss for the last month.
• O/E: evident weight loss, no pallor or jaundice, no LAD, No clubbing, normal chest & heart & abdomen soft with no organomegaly.
![Page 3: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/3.jpg)
![Page 4: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/4.jpg)
![Page 5: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/5.jpg)
![Page 6: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/6.jpg)
![Page 7: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/7.jpg)
![Page 8: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/8.jpg)
![Page 9: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/9.jpg)
![Page 10: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/10.jpg)
![Page 11: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/11.jpg)
![Page 12: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/12.jpg)
![Page 13: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/13.jpg)
![Page 14: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/14.jpg)
![Page 15: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/15.jpg)
Diagnosis:
• Pancreatic head cancer.• Sent to surgeon for bypass surgery &
histological diagnosis.
![Page 16: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/16.jpg)
Lessons:
• Dyspepsia with alarm features as anorexia,weight loss,anemia, H/M, >45 is indication for endoscopy.
• If you don’t find a clear upper GIT pathology explaining the symptoms we should think of pancreatobiliary pathology& send for appropriate imaging.
![Page 17: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/17.jpg)
Another case:
• Elderly woman with epigastric pain,anorexia,weight loss.
• OGD normal.
![Page 18: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/18.jpg)
EUS:
![Page 19: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/19.jpg)
Encroaching (to advance beyond proper or former limits: desert encroaching upon grassland) on the portal vein making
it inoperable:
![Page 20: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/20.jpg)
60 years old female with DM,presented with dyspepsia,anorexia, weight loss
![Page 21: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/21.jpg)
![Page 22: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/22.jpg)
EMR done: ulcer after the EMR
![Page 23: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/23.jpg)
![Page 24: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/24.jpg)
After ulcer healing: remnant lesion
![Page 25: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/25.jpg)
After ulcer healing: remnant lesion
![Page 26: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/26.jpg)
After ulcer healing: remnant lesion
![Page 27: Git case of the week4212](https://reader036.vdocuments.mx/reader036/viewer/2022062503/58ea9a201a28abe5728b4cbb/html5/thumbnails/27.jpg)
After ulcer healing: remnant lesionnew biopsies taken; further actions?