Haematogenous route is the most common route for acquiring splenic abscess (70%). Risk factors inculde polycythemia vera, malignancies, IV drugs etc. Unilocular splenic abscess has mortality rates of 15-20% and multiloculated abscess about 80%. Typical symptoms are fever, pain abdomen, pleuritic chest pain. Splenomegaly is uncommon.
Epiphrenic diverticulum is a lower esophageal diverticulum with in 10 cm of gastro esopheal junction (GEJ) Most of these diverticula are secondary and false due to associated motor disease such as Diffuse esophageal spasm (DES) or Achlasia. (Read more about Achlasia Cardia here) Unlike the middle esophageal divertula these are not traction diverticula. These are most commonly seen on the right side.
Most of these are asymptomatic and treatment is required only if they cause chest pain (due to DES) or regurgitaion or aspiration.
CEA is an oncofetal protein that is normally present during fetal life but can be present in low concentrations in healthy adults. Structurally, it is a glycoprotein with a molecular weight of 200 kDa. It is not useful as a screening test because of its low sensitivity in early-stage disease.
It can be increased in several benign diseases such as rheumatoid arthritis, cystic diseases of kidneys, COPD, cirrhosis.
It is useful as a follow up investigation after colonic resection because increasing levels correlate with the stage of the disease and similarly preop values correlate with the severity of the disease
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