Gastroduodenal bleeding may complicate a variety of diseases of the esophagus, stomach, duodenum and hepatopancreatobiliary system. Patient's life ultimatley depends on how well a clinician is informed in modern diagnosis methods and how capable he/she is of making an adequate treatment choice [1].
The authors describe a case of Whipple's disease (WD) in a 56-year-old male patient followed up for 2 years. The diagnosis was established on the evidence that there was a low-density retroperitoneal or mesenteric infiltrate at computed tomography and PAS-positive macrophages in the biopsy specimens of the duodenal retrobulbar mucosa. Arthropathy had developed within 10 years before the occurrence of intestinal symptoms, subsided with their progression, and recurred after their regression. On the basis of this observation and the data available in the literature, the authors discuss the relationships of arthropathy to the abdominal manifestations of WD.
The authors describe a case of Whipple's disease (WD) in a 56-year-old male patient followed up for 2 years. The diagnosis was established on the evidence that there was a low-density retroperitoneal or mesenteric infiltrate at computed tomography and PAS-positive macrophages in the biopsy specimens of the duodenal retrobulbar mucosa. Arthropathy had developed within 10 years before the occurrence of intestinal symptoms, subsided with their progression, and recurred after their regression. On the basis of this observation and the data available in the literature, the authors discuss the relationships of arthropathy to the abdominal manifestations of WD.
Patients with gastric and duodenal ulcer, in who never had the typical complaints, and anamnestic data about pathology of biliary system were examined. More than one third of the biliary sludge was found. Finding dates demonatrate an appearence of hypokinetic biliary dysfunction in patients with gastric and duodenal ulcer. The received results indicate the for necessity of obligatory ultrasonic research for the purpose of revealing biliary dysfunctions in patients with gastric ulcer; subsequent dynamic supervision and preservation of pathological changes to prevente cholelithiasis.
In spite of the general affection of the greater curvature of the stomach, there were no dyspeptic manifestations, pains in the upper half of the stomach were not related to meals, 'and the stool remained unchanged. The main characteristic of the clinical picture was the distribution of the tumor process to the diaphragm, which was a reason explaining the complaints about acute pains in the right flank enhancing in the course of movements or deep breaths. No data about any metastatic affection of the skeleton bones, lungs or pleura were received. This case shows the need in the close examination of the diaphragm in the case of the pain syndrome in the right hypochondrium in patients with generalized tumor diseases.
