Guest guest Posted June 1, 2003 Report Share Posted June 1, 2003 Results from Belgrade – KBC Serbia ABDOMEN ECHO AND DOPPLER OF PORTAL SYSTEM: Date: 09.01.2002. LIVER: augmented, 17 cm right lobus, diffusely nonhomogeneous, v.portae 16.4 mm, flow 13 cm/sec, size is getting wider in the main stem up to 26 mm, without tromb. SPLEEN: augmented, homogeneous, 22x8 cm, vein lienalis in hilus is enormousley dilate, 37 mm, with turbulent flow, without tromb. In the hilus of the spleen, and around the tail of pancreas there is a massive grapelike braid of highly dilate collaterale veins with turbulent flows, in epigastrium spiral serpentlike dilate vein collaterale up to 2.5 cm can be seen, presumably in constitution with recanalisation of umbilicale vein, with fast flows. The flow in hepatic artery in hepatoduodenal ligament sufficiant rythmic around 50 cm/sec. Holecyst without calculus, gall lines (pathways) are not dilate. In the left bottom quadrant of the abdomen, under the anterior abdominal wall, a longitudinal dilate vein (collaterala) with fast flow can be seen. The ascites is not visable. Right kidney in hidronefrosis with 6 mm stone, in the central part in pielon a stone sized 9 mm is visable. Left kidney o.k.In the spleen there are several spleniculuses. Bladder and prostate o.k. Prof Dr Mijrana Perisic ABDOMEN ECHO Date: 19.12.2001. Liver is slightly larger, hyperechogenous, nonhomogenous without focal changes floats in ascites. Holecyst edematous wall with no sing of calculouses v.portae is clearly wider just as v.lienalis around 20 mm with tortuous capillary tubes in spleen hilus where aneurysm is visable. V.lienalis size 40x35mm dif. Dg possibly incapsulate ascites. Plenty ascites. Pancreas looks normal. Spleen is large 180x100 mm. Kidneys without macromorphologic changes. Prof Dr Jesic Rada ENDOVIDEOEZOFAGOGASTRODUODENSCOPIA WITH PROXIMAL JEJUNOSCOPIA Date: 18.01.2002. Indication: suspition on malabsorption syndrome Gullet is passed across its whole size, macroscopically in the distal half are visable varices I up to II degree, with no sign of bleeding. There is no foreign content in the belly. There are clearly sings of portal gastropathia diffusely across the belly. Pylorus is easily passed, bulbous is not deform, postbulboural and proximal jejunum look unchanged. Several biopsies are taken from proximal jejunum, bleeding is a bit expressed but not significantly. CONCLUSION: Varices oesophagi gr. I-II. Gastropathia portalis (To give plasma, observe KS and stool) Dr S. Djuranovic RECTOSIGMOIDOSCOPIA /FLEX.INSTR./ Indication: Chronically diffused illness of the liver, preparation for transplatation. Suspicion on ulcerous colitis. Inspection and rectal tuse: B.o. Rectum, sigma, distal descedens have been explored - up to the level of 50 cm from anus. There are no changes in mucilage (slime) in all inspected parts of colon. Biopsies are taken (microscopic colitis?) Dg: Colitis microscopians??? Prof Dr Tomica Milosavljevic Date: 22.01.2002. Method: HE, Series x, Giemsa. MI: Inspected serial sections from three samples of colon mucosa with diffuse heterogeneous inflammation in the whole thickness of lamina propria, which presents with enhanced lincocyte, plasmacyte, eozinophil, histocyte and other undifferentiated inflammen cells. Locally presence of lymphoid folicular agregate at the borderline with submucosa. Minimal focal cryptitis(+), but with no enhanced number of IEL cells. CONCLUSION: Unspecified inflammation of colon mucosa(+), there are no sign for active IBD or any other distinctive colitis. Described changes also doesn't comply criteria for either microscopic, lymphocyte or collagen cryptitis. Dr Marjan Micev, Patalog FLEXIBLE RECTOSIGMOIDOSCOPIA Date: 27.12.2001. Indication: Liver cirrhosis, preparation for transplatation, previously ostensible ulcerous colitis, huge pv.30%. Inspectio et RT N.o. Rectum and sigma explored, filmed on video. Mucilage diffusely strewn with locally cockles and hyperemia zones, between is visable locally normal submucosa vascular sara. Biopsies are not taken. Interior piles discreet. CONCLUSION: Colitis chronica (colopatia portalis??) Dr S.Djuranovic RTG SCOPIA AND GRAPHIA OF GASTRODUENUM AND SMALL INTESTINE PASSAGE Gullet has regular flow and is lumen wide, mucilage relief is marked with lines and peristalsis is appropriate as well as passage contrast. Belly has regular position and tonus, mucilage relief is appropriate, with adequate peristalsis and passage contrast. Nothing is noticable. Bulbous duodenal proper formed and positioned, with regular relief and adequate peristalsis and passage contrast. Duodenal frame (ram) is regular. Barium contrast passes by all parts of small intestine unmolested and shows no signs of neither contractred places nor stops (stopovi). There is an impression that primordial part of jujunum has a little wider lumen. Mucilage relief is purely adequate. Cecum and terminal ileum are fulfilling and in morphological sense imponiji regularly. Peristalsis is alive and plentiful, somewhere with the presence of antiperistalsis waves. Passage is unmolested. Incidental find massive calcareous shadow in the projection of the left kidney and several smaller in the projection of the right kidney. INSTITUTE OF CARDIOVASCULAR DISEASES DEDINJE BELGRADE, M.TEPICA 1 ROENTGEN SECTION, Stosic Goran 29791 CELIACOGRAPHIA AND INDIRECT PORTOGRAPHIA Spleen is racily magnified. Lienal artery elengired with big aneurysm (5x4cm) with calcific wall. Lienal and portal vein dilated. Recanalized umbilical vein (diameter about 1 cm). Retrograde flow is occurring also through coronar vein, varces (varksi-digest/weld?) in gullet Gr.III. During the procedure significant allergic reaction occurred, bump on the face, lid, rash on the skin. Synopen and adrenalin were given. Inspection was aborted. Kavografija of hepatic vein hasn't been done. Doc dr D.Sagic Date: 15.01.2002. ERCP: After duodenoscopia papilla was kanulirana (cannular?) and contrast was injected which impregnate pancreatic and galls ways. Pancreaticus gracinalholedohus as well, and only claws are being observed. Intrahepatic lops and holecista are not shown. Dr Krstic and Dr Korneti PATIENT PREPARATION FOR TRANSPLANTATION Patient had hepatitis,… He has fatigue, water in stomach, his legs are distilling. In 1993. his heartbeat was hasten. Blood pressure is not raised. Objectively: concious, eupnoic(?), without cyanosis, colour of the skin is primrose. Pulmo: normal respiratory sound. Cor: action rythmic, tones are clear, slightly systole sound over the top. Ta: 105/60mmHg EKG: sinus rhythm, fr. 70/min, trhere is no change in St and TE. TH§ symptomatic DG. Cirrhosis hepatis Heart EHO should be done. EHO abdomen with a. abdominalis. Dr.M.Nidzovic IMMUNOALLERGOLOGY ANALYSES ANA negative AMA negative ASMA +++ ANCA +1:16 MrSciMed Sladjana Andrejevic Spec - Interne medicine BLOOD TESTS Konstituent 18.12. 2001. 14.01. 2002. Referentne vrednosti Jedinice RBC 2.91 2.70 WBC 4.1 2.2 Hemoglobin 99 90 Hematocrit 0.306 0.271 PLT 49 41 140 - 440 NCV 105.0 100.1 SE 8 mm/1h HCO3 20 22 Gama 30 Protr. time 35% 31% S-glukoza 3.7 4.7 3.9-6.1 mmol/L S-urea 4.9 4.1 2.5-7.5 mmol/L S-kreatinin 6.4 55 53-124 (m) 53-106 (z) mmol/L S-bilirubin- whole 38 53 <20.5 mmol/L S-bilirubin- direct <7 mmol/L S-ukupni proteins 4.9 64 62-81 g/L P-fibrinogen 1.18 1.28 2-4 g/L S-holesterol 1.7 1.8 3.1-6.5 mmol/L S-trigliceridi 0.53 0.41 <2.83 mmol/L S-hlorid 107 109 98-106 mmol/L S-kalijum (K) 4.1 3.8 3.5-5.1 mmol/L S-natrijum 141 141 135-148 mmol/L S-kalcijum (Ca) 2.10-2.70 mmol/L S-iron 23.8 20.7 8.8-32.4 (m) 6.6-30.4 (z) mmol/L S-bikrabonati 20 22 24-32 mmol/L S-AST(GOT) 68 33 <34 U/L S-ALT (GPT) 54 27 <38 U/L S-alkalna fosfataza 96 64 30-78 U/L S-gama-GT 30 34 <61 U/L S-alfa-amilaza 36 49 20-78 U/L Albumins 14 36 g/L Proteins 49 64 B4 43 69 mmol/L BC 0 0 mmol/L DBiC -5 -16 mmol/L Goran Stosic 31.01.2003. TEST NAME RESULTS UNITS NORML RANGE SE 6 0 - 10 L 2.2 LOW 4.1 - 10.9 ER 2.68 LOW 3.8 - 5.8 TR 69 LOW 140 - 440 HB 88 LOW 120 - 180 GLUKOZA 4.2 MMOL/L 3.9 - 6.4 UREA 2.8 MMOL/L 1.70 - 8.30 UKUPNI BILIRUBIN 45.7 HIGH UMOL/L 3.4 - 20.0 DIREKTNI BILRUBIN 14.7 HIGH UMOL/L 0.0 - 6.0 KREATININ 34.6 UMOL/L 44.0 - 120.0 AST 50 HIGH U/L 0. - 37. ASL 24 HIGH U/L 0. - 40. ALK. FOSFATAZA 147 U/L 36. - 140 AMILAZA 43 U/L 0. - 90 LDH 449 U/L 230 - 450 CK 126 U/L 0 - 190 HOLESTEROL MMOL/L 3.50 - 6.50 TRIGLICERIDI MMOL/L 0.40 - 1.80 UKUPNI PROTEINI 51 LOW G/L 63.0 - 83.0 ALBUMIN 26.8 G/L 35 - 50 FOSFOR MMOL/L 0.80 - 1.60 GVOZFJE UMOL/L 7.3 - 23.6 MOKTACNA KISELINA 133 UMOL/L 140 - 420 GAMA-GT FIBRINOGEN HcO3 24-35 Cl2 98-105 K 4.1-5.6 Na 130-147 Radiologic find of Magnetic Resonance Inspection was done in T1 and FSE T2 sequence in sagittal and axial projection without and with injection of contrast, from level Th2 to Th10. Inspection of thoracis spine shows emphatic kyphosis with base in Th5 where there is somewhat more expressed disk-arthrotic changes. There is also a presence of schmorlov hernia in Th10. In vertebral canal from level Th3 to Th5 of vertebral body there is significant emphatic flow void of epidural vein vessels, but neither affection of medulla in that level can not be excluded - AP diameter of medulla has uneven contours with dimension under 10 mm (millimetre). Postcontrastingly there is no significant changes in signal magnitude on parenhima medulla. L-S spine shows rectified physical Lordosis with degenerative changes in height iv disk L5.There are no other changes. Quote Link to comment Share on other sites More sharing options...
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