1/91. Massive rectal bleeding due to jejunal and colonic tuberculosis.A case of massive rectal bleeding due to colonic tuberculosis in advanced pregnancy with intrauterine foetal death is reported. Patient was treated with resection of the left colon and left transverse end colostomy with closure of the rectal stump. hysterotomy for the removal of the dead foetus was performed. The patient improved in health with antitubercular treatment. The colorectal anastomosis was performed after 4 months. Massive rectal bleeding in intestinal tuberculosis, though rare should be kept in mind.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
2/91. Iliopsoas haemophiliac pseudotumours with bowel fistulation.Two cases of iliopsoas haemophilic pseudotumours are presented. In one patient a fistula developed between a pseudotumour and the large bowel. This resulted in an abscess involving the pseudotumour and adjacent tissues. It resolved after 5 years of therapy involving percutaneous drainage and closure of the fistula. The second patient had a massive pseudotumour that had obstructed both ureters. Later he suffered a fatal mixed Gram negative septicaemia probably related to erosion into the colon.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
3/91. Diagnostic and therapeutic considerations for fecal impaction.During an 18-month period, 18 patients were admitted to the Beth israel Hospital because of fecal impaction or its complications. The records of the 18 patients were reviewed to determine the presenting signs and symptoms, radiologic findings, course and etiology of fecal impaction. Prior use of drugs that slow gastrointestinal motility was found in seven cases, and seven of the 18 patients had severe neuropsychiatric illness. The presenting signs and symptoms in almost all instances were consistent with a diagnosis of intestinal obstruction. The difficulty in differentiating intestinal obstruction caused by fecal impaction from obstruction resulting from other lesions is discussed. The diagnosis of fecal impaction should be entertained only after other causes of intestinal obstruction have been excluded.- - - - - - - - - - ranking = 0.43218242428487keywords = drug (Clic here for more details about this article) |
4/91. Unusual negative side effects of non-steroidal anti-inflammatory drugs in the proximal colon.Two cases of uncommon side effects of non-steroidal anti-inflammatory drugs (NSAID) are presented which show that in special cases NSAID lesions can be located predominantly in the proximal colon, that NSAID-caused lesions may present themselves as diaphragm-like strictures and that alterations by NSAID in this part of the bowel may bring enormous problems for the differential diagnosis.- - - - - - - - - - ranking = 2.1609121214244keywords = drug (Clic here for more details about this article) |
5/91. Colonic perforation associated with slow-release diclofenac sodium.upper gastrointestinal tract complications due to non-steroidal anti-inflammatory drugs are well recognised. However, adverse effects on large intestinal mucosa are less common and less well recognised, even though they carry a significant morbidity and mortality. Here we report a case of colonic perforation in a healthy woman without any underlying colonic pathology associated with ingestion of slow release diclofenac sodium.- - - - - - - - - - ranking = 0.43218242428487keywords = drug (Clic here for more details about this article) |
6/91. Iatrogenic lesions of the colon and rectum.Our ability to document a number of examples of iatrogenic lesions of the colon and rectum in three general hospitals confirms the multiplicity of these lesions as presented in the literature. It appears that the careful surgeon and his associates would well heed the old admonition known as Murphy's law, that "Anything that can go wrong will go wrong." In the daily practice of the general surgeon and proctologist, it is apparent that gentleness in approaching any anal-rectal examination for either diagnostic or therapeutic purposes is mandatory. The insertion of any foreign object, be it an examining finger, a thermometer, enema tip, or proctoscope, may subject the patient to an inadvertent injury of significant proportion. The dangers inherent in the evaluation and treatment of patients with recognized disease processes is significantly greater than that associated with routine and screening examinations. morbidity and mortality have been shown to be associated with the barium enema as well as with the barium enema as well as with some of the newer radiologic procedures such as mesenteric angiography. The use of tap water for enemas has produced morbidity both from thermal injuries and from electrolyte depletion. Antibiotics and chemotherapeutic drugs frequently result in colon and rectal disease, and therapeutic procedures directed at organs adjacent to the colon and rectum have resulted in a number of iatrogenic lesions. This reviews confirms reports of others that iatrogenic lesions of the colon and rectum are not solely due to the physician's inexperience, as significant numbers of these lesions were the result of the diagnostic or therapeutic efforts of men of considerable experience and skill. Advanced age of the patient and diseases leading to changes in the character of the bowel wall frequently were factors in the production of these lesions. A poorly prepared bowel has led to increased morbidity and mortality associated with iatrogenic perforations. The early recognition of these lesions and prompt medical and surgical management diminishes both the morbidity and mortality associated with such injuries.- - - - - - - - - - ranking = 0.43218242428487keywords = drug (Clic here for more details about this article) |
7/91. Treatment of pseudotumors with nonsteroidal antiinflammatory drugs.Large inflammatory pseudotumors (IPT) traditionally are managed with extensive surgical resection. This approach, which often is associated with significant morbidity, has been deemed necessary because of the uncertainty of diagnosis, symptomatology, and involvement of vital structures. Also, there is a lack of other reliable therapy for this clinically aggressive yet histologically benign disease characterized by an overreactive inflammatory response. The authors treated 2 cases of abdominal IPT with nonsteroidal antiinflammatory drug (NSAID) with successful results. After a diagnosis of IPT on tumor biopsy, an NSAID trial can confirm the diagnosis and treat the disease by causing tumor shrinkage and eventual resolution. Excision remains indicated in easily resectable tumors and in nonresponders to NSAID therapy.- - - - - - - - - - ranking = 2.1609121214244keywords = drug (Clic here for more details about this article) |
8/91. Nonsteroidal anti-inflammatory drug-induced strictures of the colon: report of a case and review of the literature.The phenomenon of strictures of the colon induced by nonsteroidal anti-inflammatory drugs is a newly recognized pathologic entity that has gained little exposure in the surgical literature to date. A further case is reported and the clinical features of this entity are discussed. Most patients present with symptoms suggestive of malignancy, namely anemia, obstructive symptoms, or weight loss. Pathologic changes are characterized by diaphragm-like strictures with submucosal fibrosis. Surgical resection to exclude malignancy and treat symptoms along with cessation of the nonsteroidal anti-inflammatory drug is the treatment of choice.- - - - - - - - - - ranking = 2.5930945457092keywords = drug (Clic here for more details about this article) |
9/91. Multiple colonic ulcers caused by churg-strauss syndrome in a 15-year-old girl.churg-strauss syndrome (CSS), or allergic granulomatous angiitis, is an uncommon vasculitic syndrome that is found mainly in middle-aged adults. We describe a 15-year-old girl with CSS, diagnosed by histological findings and characteristic clinical features. The patient experienced two episodes of catastrophic gastrointestinal vasculitis, resulting in resection of 150 cm of small intestine and right hemicolectomy. Colonoscopic examination showed multiple colonic ulcers with active bleeding. The clinical course of the patient was grave and refractory to the therapy of steroid and cytotoxic drugs. In the world literature only two patients with multiple colonic ulcers caused by CSS have been reported, and very rare cases of childhood-onset CSS have been published. We reviewed CSS in children and found that the prognosis was poorer than that in adults.- - - - - - - - - - ranking = 0.43218242428487keywords = drug (Clic here for more details about this article) |
10/91. Colonic wall necrosis due to tuberculosis in hiv-seropositive patient.We report a 40-year-old man with sloughing off of the colonic due to tuberculous associated with hiv infection. He presented with lump in the abdomen, distention and vomiting suggestive of intestinal obstruction. Proximal loop ileostomy with closure of colonic perforation was performed, with good recovery. This was followed by antitubercular chemotherapy.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
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