Faculty of Medicine

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Author: search.filters.author.Antonio Gligorievski

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    The Role of Contrast - Enchased Computer Tomography in the Management of Intestinal Obstruction
    (CIENT PERIODIQUE, 2021-06-10)
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    Antonio Gligorievski
    Intestinal obstruction is a condition in which intestine is obstructed because of any mechanical or non-mechanical reasons. It accounts for 20% of all surgical admissions for acute abdomen. Computed tomography (CT) is currently the exam of choice for bowel obstruction because has higher specificity in reporting the etiology, site and grade of obstruction, and the presence of bowel ischemia, affecting the surgical decision.
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    Peritoneal Carcinomatosis Present in Signet Ring Cells Gastric Carcinoma-Case Report
    (Crimson Publishers, 2020-12-10)
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    Antonio Gligorievski
    Peritoneal carcinomatosis (PC) is an important and not rare cause of morbidity and mortality among patients with gastric cancer. Younger age(less than 65 years) female gender, advanced T- and N-stage, a primary tumor of signet ring cells or linitis plastica, and primary tumors covering multiple anatomical locations of the stomach were all associated with a higher odds ratios of developing PC. PC is a frequent condition in patients presenting with gastric cancer, especially in younger patients with advanced tumor stages. In this article, we present a case of a 63 years old woman who was operatively treated for gastric cancer. Total gastrectomy was obtained and the patohistology report was signet ring cell carcinoma, stage T3N3M0. Computer tomography (CT) was done before the operative treatment and 6 months after the treatment. The CT before the treatment did not show any presents of peritoneal metastasis, there were no signs of peritoneal involvement. The next CT was done 6 months after the treatment where there was a sign of peritoneal involvement, with the diffuse spread of metastatic deposits (MS) all over the peritoneum. The present study showed a positive correlation between a more advanced T-stage and N-stage and the risk of presenting with PC. In literature, these factors were also associated with worse survival. This patient survival period was 4 months after diagnosis of peritoneal carcinomatosis with correlate with the data from the literature were median survival of patients with other metastases was 14 months, but only 4 months for patients with PC.
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    Case of Sister Mary Joseph’s Nodule Inpatient Who Underwent A Whipple Procedure
    (Crimson Publishers, 2020-12-16)
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    Antonio Gligorievski
    ;
    Ivan Nevcev
    Sister Mary Joseph’s nodule (SMJN) is a metastatic malignancy of the umbilicus which indicates advanced, metastatic disease. Sister Mary Joseph nodule or Sister Mary Joseph Sign refers to a palpable nodule bulging into the umbilicus as a result of metastasis of cancer in the abdomen or the pelvis. It is a rare occurrence, but it is a sign of abdominal cancer, most commonly an adenocarcinoma metastasis from a gastrointestinal (gastric, colonic, pancreatic cancer) or gynecologic primary malignancy. We present the case of a 61-year-old man with an acute, something less than 1cm in diameter non-tender mass located in the umbilicus, diagnostic indication of an SMJN. This patient, 4 months before was diagnosed with pancreatic carcinoma and underwent a Whipple procedure with pathophysiology result of- Adenocarcinoma capitis pancreatic pTNM= pT2 pN1 pMX. This little nodal change in the umbilicus was an indication for further investigation so a computer tomography (CT) scan was done. Our findings are discussed in the following case report.
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    Malignancy in patients with opioid use disorder: A late diagnosis in patient on maintenance treatment with Buprenorphine, with lethal effect: a case report
    (Merit Research Journals, 2016-03)
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    Antonio Gligorievski
    Heroin dependents might be at a higher risk of death from cancer than the general population. A 31-year-old male on maintenance treatment with Buprenorphine, came to our Clinic with paralysis of his legs. He also complained on spinal pains. He couldn’t walk and he was in forced position. The biochemical analysis showed high values of SE, LDH, globulins, CRP, D-dimer, Tu markers: beta HCG, CYFRA 21-1, presence of paraproteins. The other investigations showed enlarged lymph nodes in the abdomen and small pelvis, thrombosis of v.cava inf and right v. iliaca. The histological finding from the biopsy of the sacrum showed a metastatic process on the skeletal muscles. The patient was treated with buprenorphine, antibiotic therapy, Carbamazepine, anticoagulant therapy and other symtomatic therapy. Despite numerous investigations and treatment, bleeding and abscesses in the cerebrum occurred. The patient immediately underwent surgery and his recovery was well. He was discharged on his request, but his condition was deteriorated sharply at home and he died in a short time. There are few studies on malignant diseases found in heroin dependents. It is a challenge to monitor and also to compare the incidence of malignancy between heroin dependents and healthy population.