1/82. cytomegalovirus colitis in the immunocompetent host: an overview.This paper describes 2 immunocompetent patients with cytomegalovirus colitis and reviews all previously reported cases (n = 13). Affected patients were generally older (69.13 /-15.62 y-old) with probable reactivation (n = 8) or younger (43.86 /-19.73 y-old) with probable primary infection (n = 7). The onset of illness was found to be hospital-associated in 4 (50.0%) reactivation cases and 1 (14.3%) primary case. Presenting manifestations included diarrhoea (86.7%), fever (80.0%), gastrointestinal bleeding (66.7%) and abdominal pain (60.0%). endoscopy showed erosive colitis with multiple (n = 11; 73.3%) or single ulcers (n = 2, 13.3%); biopsy was diagnostic in 12/13 (92.3%) patients. Complications included massive haemorrhage (13.3%), toxic megacolon (13.3%), perforation (13.3%) and protracted inflammatory bowel disease (20.0%; exclusively in primary-infection). The mortality rate was 26.7%. Antiviral-agents were given in 8 (53.3%) cases; assessment of treatment-efficacy was not possible. In conclusion, cytomegalovirus colitis in the immunocompetent-host is a rare but potentially severe erosive disease with significant morbidity. It may occur during primary infection or reactivation; the diagnosis requires careful histopathological examination and the benefit of antiviral-therapy is unknown.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/82. colitis may be part of the antiepileptic drug hypersensitivity syndrome.PURPOSE: To show that colitis may be part of the antiepileptic hypersensitivity syndrome. methods: Description of two case histories. RESULTS: The first patient was a 47-year-old man who developed fever, lymphadenopathy, influenza-like symptoms, facial edema, skin rash and diarrhea after 3 weeks of carbamazepine (CBZ) treatment. laparotomy because of severe abdominal pain 2 weeks later showed severe colitis with perforations. The second patient was a 41-year-old woman who developed fever, diarrhea, and skin rash 4 weeks after start of CBZ treatment. A colon biopsy confirmed colitis. Stool examinations did not show pathogenic microorganisms, and there was no evidence of Crohn's disease or ulcerative colitis. Both patients had elevated liver enzymes, peripheral eosinophilia, and eosinophils in the infiltrate of the colon. CONCLUSIONS: In view of the close temporal relation between start of CBZ intake and development of colitis, the presence of fever, lymphadenopathy, and rash, and improvement after discontinuation of CBZ, we conclude that the two patients developed an AED hypersensitivity syndrome. Our case histories demonstrate that severe colitis may be part of this syndrome.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
3/82. Collagenous colitis in a Japanese patient.A case of collagenous colitis is reported. A 48 year old female who had been complaining of mild diarrhea had been under medication for a gastric ulcer. colonoscopy revealed almost normal appearance of the colonic mucosa except for one hyperplastic polyp of the cecum. Specimens of the ascending, transverse and descending colon showed a distinctively thickened collagen band beneath the surface epithelium, 10-20 microns thick, which was irregularly distributed, even within the same specimen. In some areas, the thickened collagen band was found around the upper part of the pits. periodic acid-Schiff (PAS), Azan staining and silver impregnation were positive for this thickened collagen band. Immunohistochemically, the thickened collagen band was weakly positive for collagen type iii, but negative for collagen types I and IV. plasma cells, lymphocytes and eosinophils were observed in the lamina propria in addition to intraepithelial lymphocytic infiltration. capillaries were increased in the thickened collagen band. The arrangement of surface epithelial cells was irregular. Crypts were not distorted. edema, diffuse or extensive fibrosis and congestion were not found. Through these findings the patient was diagnosed as having collagenous colitis. Many cases of this had been reported in western countries, but very few in japan. The Japanese literature was reviewed for cases of collagenous colitis and it was found that only two cases had been presented.- - - - - - - - - - ranking = 0.0008541105034737keywords = upper (Clic here for more details about this article) |
4/82. Primary epiploic appendagitis: a report of two cases.Primary epiploic appendagitis (PEA) is a rare benign self-limiting inflammatory process of the colonic epiploic appendices. patients present with acute abdominal pain, often misdiagnosed clinically as acute appendicitis or diverticulitis. Computed tomography (CT) scan findings of this condition are characteristic and can confidently suggest the diagnosis avoiding unnecessary barium enemas and colonoscopy, biopsy, or surgery.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/82. Tc-99m dextran scintigraphy in the diagnosis of protein losing enteropathy.Tc-99m dextran scintigraphy was performed on a 16-year-old male patient with protein losing enteropathy. Abnormal leakage of the radiotracer was observed in the right upper lumbar area that moved over time and excreted in the stool which was suggestive of protein loss. It is concluded that Tc-99m dextran is useful in the detection of protein losing enteropathy which is not detected by extensive radiological and endoscopic examination.- - - - - - - - - - ranking = 0.0008541105034737keywords = upper (Clic here for more details about this article) |
6/82. Acute upper gastrointestinal haemorrhage and colitis: an unusual presentation of Wegener's granulomatosis.Wegener's granulomatosis is a rare necrotizing vasculitis usually affecting the respiratory tract and kidneys. The aetiology is unknown and it usually occurs in patients over the age of 40. Involvement of the gastrointestinal tract in Wegener's granulomatosis is relatively rare and usually occurs long after the onset of initial symptoms. Acute colitis as a presenting feature of Wegener's granulomatosis is very rare with only a few reports in the literature. We describe a young woman who presented initially to hospital with gastrointestinal features and then developed a severe colitis and severe gastrointestinal haemorrhage. This preceded the development of respiratory tract features with severe pulmonary haemorrhage, haemoptysis and the development of rapidly progressive renal failure and nasal septal perforation. Following treatment with intravenous steroids and cyclophosphamide, gastrointestinal symptoms and signs improved dramatically, as did her pulmonary disease. She still remains dialysis dependent, due to end-stage renal disease secondary to glomerulonephritis.- - - - - - - - - - ranking = 0.0034164420138948keywords = upper (Clic here for more details about this article) |
7/82. Rofecoxib: a possible cause of acute colitis.Nonsteroidal antiinflammatory agents may cause relevant small bowel and colonic side effects, apart from gastroduodenal lesions. The synthesis of selective cyclooxygenase-2 (COX-2) inhibitors has been an important breakthrough in antiinflammatory therapy by decreasing the incidence of upper gastrointestinal lesions. However, there is little information available concerning their effects on gut mucosa distally to the duodenum. A case history is described of a 52-year-old woman with a temporary colostomy after resection of a sigmoid tumor and who presented with bloody diarrhea 5 days after beginning therapy with rofecoxib. The hemorrhage had its origin in the transverse colon, and the endoscopic appearance was that of actively bleeding acute hemorrhagic colitis. No other colonic lesions were detected, nor was there any evidence of related infection, bleeding diathesis, or other systemic diseases. On discontinuing rofecoxib and instituting parenteral rehydration, the bleeding and diarrhea stopped. Endoscopic follow-up revealed regenerating mucosa in the transverse colon. The time relation, the absence of other causes of hemorrhage, and the clinical evolution all strongly support the probability of a causal relation between rofecoxib and hemorrhagic colitis. This case may raise awareness concerning the possibility of colonic lesions related to the new COX-2 inhibitors, similar to what is known about nonselective antiinflammatory agents.- - - - - - - - - - ranking = 0.0008541105034737keywords = upper (Clic here for more details about this article) |
8/82. Successful cyclophosphamide therapy in recurrent eosinophilic colitis associated with hypereosinophilic syndrome.Eosinophilic colitis is a relatively rare complication of hypereosinophilic syndrome which is characterized by abdominal pain and bloody diarrhea and is usually treated with steroids and hydroxyurea. However, no standard regimen exists in cases of intractable disease despite several treatment attempts with interferon-alpha, cyclosporin, etoposide, and vincristine, etc. We here report a case of a 43-year-old woman with recurrent eosinophilic colitis as a complication of hypereosinophilic syndrome who was successfully treated with cyclophosphamide.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/82. legionellosis in a lung transplant recipient obscured by cytomegalovirus infection and clostridium difficile colitis.A 52-year-old-white male underwent double lung transplantation for severe emphysema due to alpha-1-antitrypsin deficiency and heavy tobacco use. Following a postoperative course complicated by renal insufficiency, pulmonary emboli, and clostridium difficile colitis, he was discharged in stable condition. Two months later, he was admitted to a local hospital with a fever, abdominal pain, diarrhea, nausea, and dyspnea. Computerized tomography (CT) of the chest revealed bilateral pleural effusions. sigmoidoscopy was grossly normal but biopsy demonstrated cytomegalovirus (CMV) colitis, and the patient was placed on intravenous ganciclovir. Over the next week, he became progressively hypoxemic and was transferred to the University of Pittsburgh Medical Center (post-transplant day 81) for further evaluation. His medications on transfer included: ganciclovir, prednisone, tacrolimus, dapsone, fluconazole, ondansetron, lansoprazole, digoxin, and coumadin.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
10/82. Epiploic appendagitis: an emerging diagnosis for general surgeons.The increased use of sonography and computed tomography in the assessment of lower abdominal pain has led to the greater recognition of epiploic appendagitis. Although epiploic appendagitis is increasingly described and diagnosed by radiologists it is rarely discussed in the surgical literature. We describe five recent cases of epiploic appendagitis managed at our center and review the literature regarding this clinical entity. All cases were diagnosed by computed tomography and none underwent surgery. General surgeons need to include epiploic appendagitis in their differential diagnosis for abdominal pain and be aware of the natural history of this condition when considering therapy.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
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