Page 50 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

abdominal pain mainly related to and augmented by meals is essential, which is combined with the initiation of immuno-
and resistant to conservative treatment, and also with chemotherapy. PET/CT can play a role in assessing
indigestion and gradual significant weight loss, what she was remission and in detecting secondary solid tumors. Close
experiencing for four years. She had hypertension, coronary cooperation between the gastroenterologist and the
artery disease, COPD, thoracotomy for benign mediastinal hematologist, in the diagnosis and after follow-up is
mass, spondylosis and osteoporosis in her medical history. important.
Laboratory tests, echocardiography, exercise ECG testing,
chest CT and bronchoscopy did not reveal any pathological 42. MANAGEMENT OF A GIANT COLORECTAL POLYP –
abnormality and her COPD was well-controlled. Neither THE COLLABORATION OF PRIVATE AND STATE
repeated abdominal ultrasound nor gastroscopy and HEALTHCARE SERVICE
colonoscopy could explore the etiology of the complaints. As Gelley A. , Hritz I.
1
2
abdominal MRI showed atrophy of the pancreas substitution 1. Kelen Private Hospital, Budapest, Hungary; 2. Center for
treatment was started but it did not lead to persistent Therapeutic Endoscopy, 1st Dept. of Surgery, Semmelweis
improvement. Subsequently abdominal CT-angiography was University, Budapest, Hungary
performed which revealed significant stenosis of the celiac
trunk, therefore vascular surgeon and interventional Introduction: The interdependence of private and public
radiologist planned percutaneous visceral intervention. healthcare is obvious in Hungary. Private healthcare offers
However digital subtraction angiography performed before more time and attention to the patient, however challenging
the intervention showed a 40-65% short, respiratory- cases, particularly advanced interventions are matters of
dependent stenosis on the initial segment of the celiac trunk. state health competence.
The recognised MALS was treated by laparoscopic Case report: A 44-year-old female patient who earlier
decompression, ganglion blockade and anti-reflux surgery by underwent a left adnexectomy due to endometriosis had
an experienced surgeon (it was video-documented). been treated for years with abdominal complaints (eg. reflux
Conclusion: Despite the negative results of the usual disease).
diagnostic tests we should think about MALS in patients with We performed transabdominal ultrasound which delineated
persistent complaints. The diagnosis and treatment of MALS a 5x2x4.5 cm solid lesion of the right colon with a vascular jet
needs an interdisciplinary approach. In the light of our case from the edge to the center. The tumor appeared to be
we are analyzing a large multicentric trial conducted between intraluminal.
2000-2017 which reports the postoperative outcome of 373 CT scan couldn't reveal the origin of the lesion; localized it
patients, and among those a small number of patients were between gallbladder and colon. Both, colonoscopy and
already treated with robot-assisted laparoscopic surgery. gastroscopy under propofol sedation were performed in a
Private Hospital. Colonoscopy revealed a large
41. GASTRIC MALT AND DLBCL - DIAGNOSIS AND erythematous polyp with a long thick stalk in the hepatic
TREATMENT - 3 CASE REPORTS flexure. The gastroscopy was negative.
1
2
Gelley A. , Horváth L. The polyp was removed in a tertiary gastroenterology center
1. Department of Gastroenterology Buda Hospital of the as follows: first, an Olympus hemoclip was placed on the
Hospitaller Order of Saint John of God, Budapest, Hungary; stalk of the polyp, then the polyp was removed using an
2. 3rd Dept. of Internal Medicine of Semmelweis University, Endoflex 35mm oval snare (ERBE VIO3, Endocut mode).
Budapest, Hungary The removed polyp corresponded to a tubular adenoma with
low-grade dysplasia (R0 resection). A short video of the
Introduction: 68% to 75% of extranodal gastrointestinal polypectomy will be presented.
non-Hodgkin's lymphoma occurs in the stomach. The most Conclusion: Appropriate and detailed abdominal ultrasound
important predisposing factor is Helicobacter pylori infection. examination of all organs is essential in both, private and
Histologically, the vast majority are extranodal marginal zone public healthcare. The collaboration between private and
lymphoma (MALT) or diffuse large B-cell lymphoma public healthcare system as well as monitoring levels of
(DLBCL). The former is a low-grade lymphoma, while the competence are essential for providing the most targeted
latter is a high-grade aggressive lymphoma. However, MALT care and maintaining patient confidence.
can transform into DLBCL. All three forms of the disease are
presented in our patients. 43. RITKA VÉRZÉSFORRÁSOK - AZ ECTOPIÁS VARIX
Case reports: 83-year-old female: DLBCL. Received 6 VÉRZÉS DIAGNOSZTIKÁJÁNAK ÉS TERÁPIÁJÁNAK
cycles of R-CVP (Rituximab-Cyclophosphamide-Vincristin- NEHÉZSÉGEI
1
1
1
1
2
Medrol). After the fourth cycle, interim PET/CT was negative Gellért B. , Lázár I. , Kristóf T. , Sümegi J. , Lombay B.
for lymphoma but showed hypermetabolic areas in the colon. 1. Borsod-Abaúj-Zemplén Megyei Központi Kórház és
A second tumor was confirmed by the abdominal US and CT. Egyetemi Oktató Kórház, II. Belgyógyászati Osztály; 2.
Laparoscopic resection occurred, colon adenocarcinoma Borsod-Abaúj-Zemplén Megyei Központi Kórház és
was confirmed. She has been in remission for 4 years. Egyetemi Oktató Kórház, Intervenciós Radiológiai Osztály
59-year-old female: DLBCL ABC (activated B cell) phenotype
transformed from MALT, which means worse prognosis. Introduction: Az ectopias varixok az összes tápcsatornai
Received 6 cycles of R2-CHOP (Revlimid-Rituximab- varicositasok 1-5%-t alkotják és a varix vérzések 2-5%-ért
Cyclophosphamide-Doxorubicin-Vindcristin-Medrol). After felelősek. Az ectopiás varixok közül a duodenalis
the fourth cycle interim PET / CT was negative. She's been lokalizációjú a leggyakoribb (~17%), ezekből származik az
in remission for a year. ectopiás varix vérzések 25-33%-a.
59-year-old female: marginal zone MALT. Received 8 cycles Aims: Ezen vérzések diagnosztikája és terápiája komoly
of R-CVP. Closing PET / CT was negative. 7 years in kihívást jelent, speciális megközelítést igényel. Ezt kívánjuk
remission. All patients were Hp positive and received a bemutatni két esetünk kapcsán.
successful eradication. Case description: 1. Sz. B. 52 éves férfibeteg
Conclusion: Gastric lymphomas are well curable anamnézisében pseudocysta képződéssel, majd duodenum
hematological malignancies. Helicobacter pylori eradication szűkülettel szövődő, recidiváló, toxikus etiológiájú krónikus
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48 Central European Journal of Gastroenterology and Hepatology
Volume 6, Supplementum 2 / November 2020