Cases reported "Duodenitis"

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1/15. Recurrent gastrointestinal Henoch-Schonlein purpura.

    A 7-year-old boy was seen for severe abdominal pain, vomiting, and a 2.0-kg weight loss of 2 weeks duration. Stools were Hemoccult positive. Upper gastrointestinal (UGI) endoscopy showed multiple, raised red lesions in the duodenal bulb and descending duodenum. Although the patient did not have the typical cutaneous eruption, other findings such as acute onset of abdominal pain in a previously healthy boy, absence of infectious or surgical lesions, and more importantly endoscopic changes seen typically in the descending duodenum, led to the likely diagnosis of Henoch-Schonlein purpura (HSP). The patient was treated with prednisone and the duodenal lesions resolved. The diagnosis of HSP was confirmed 24 weeks after the initial symptom when he developed a palpable purpuric rash over both legs. Thirteen months following the initial symptoms and 6 months after the onset of rash, severe abdominal pain with epigastric tenderness recurred and stools were Hemoccult positive. UGI endoscopy showed multiple, raised red lesions in the descending duodenum as seen earlier. The patient was diagnosed with recurrent HSP. This presentation is atypical because of the abnormally long interval between the onset of abdominal pain and the appearance of the skin rash, and unique because of the endoscopically demonstrated recurrent gastrointestinal lesions.
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ranking = 1
keywords = abdominal pain
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2/15. Duodenojejunitis: is it idiopathic or is it Henoch-Schonlein purpura without the purpura?

    BACKGROUND: Henoch-Schonlein purpura is a small-vessel vasculitic disease that most often affects the skin. Gastrointestinal manifestations have been well described, including duodenojejunal inflammation (DJI). methods: Four children with DJI and clinical features of HSP are described, in whom the rash was either not present or appeared atypically late in the illness. RESULTS: The characteristic rash did not develop in three children, and it developed much later in one. The patients (three boys and one girl) were aged between 7 and 9 years (mean, 7.5 years). growth characteristics were normal. In all patients, pain occurred acutely with colicky abdominal pain in the spring or fall of the year, and all stools were positive for occult blood. No infectious cause was identified. Upper gastrointestinal endoscopic examinations demonstrated significant visual and histologic duodenitis in a pattern consistent with previous reports in children with known HSP. factor xiii activity was absent. immunoglobulin a levels were increased in three of four children. All children made a prompt recovery with the administration of intravenous glucocorticoids. In one child, the characteristic rash of HSP developed 18 weeks after the initial examination. CONCLUSION: Duodenojejunal inflammation may be the primary manifestation of HSP, even in the absence of the characteristic rash.
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ranking = 0.25
keywords = abdominal pain
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3/15. Diffuse duodenitis associated with ulcerative colitis.

    Backwash ileitis and postcolectomy pouchitis are well-recognized complications of ulcerative colitis (UC), whereas inflammation of the proximal small intestine is not. In contrast, small intestinal disease at any level is common in Crohn's disease (CD). Despite this well-established and accepted dogma, rare cases of histologically proven diffuse duodenitis (DD) associated with UC appear in the literature. In this study, we report our experience with similar cases exhibiting this unusual inflammatory phenomenon. Routine histologic sections from four cases of DD associated with well-documented UC were reviewed and the findings correlated with all available medical records. Multiple endoscopic biopsies showing histologic features of UC and colectomy specimens confirming severe ulcerative pancolitis were available for all cases. Varying degrees of active chronic inflammation and architectural mucosal distortion identical to UC were observed in pre- and postcolectomy duodenal biopsies of one of four and four of four cases, respectively. Similar inflammatory patterns were present postoperatively in the ileum in three of four cases and in the jejunum in one case. Endorectal pull-through (ERPT) procedures were performed in three of four patients and an end-to-end ileorectal anastomosis was done in one patient. Despite extensive upper gastrointestinal tract involvement, none of the patients developed postsurgical Crohn's-like complications during a follow-up period of 12 to 54 months. This suggests that patients with pancolitis and DD do not necessarily have CD, but rather may have UC and, most importantly, that successful ERPT procedures may be performed in these patients.
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ranking = 0.013640881686452
keywords = upper
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4/15. Acute cholecystitis and duodenitis associated with churg-strauss syndrome.

    We describe a patient with acute cholecystitis and duodenitis associated with churg-strauss syndrome. A 36-year-old male, who had been healthy, had abdominal pain following high fever. He had marked hypereosinophilia of 17,000/mm3. Radiographs of the chest disclosed a transient infiltrated lesion in the left lower lung. Ultrasonographic and gastroendoscopic examinations revealed acute cholecystitis and duodenitis, respectively. Endoscopic retrograde cholangiopancreatography demonstrated a filling defect suspecting aberrant ascariasis in the common bile duct. The patient suddenly developed distally dominant mononeuritis multiplex, especially in the upper limbs. Muscle biopsy revealed vasculitis of intramuscular arteries with infiltration of eosinophils. These findings fulfilled the diagnostic criteria of churg-strauss syndrome. Corticosteroid dramatically resolved the abdominal symptoms. cholecystectomy and removal of the foreign body were performed. Histological examinations revealed that necrosis of the gallbladder was caused by occlusion due to thrombosed arteries and that the foreign body in the common bile duct was an aggregate of necrotic epithelium of the bile duct wall surrounded by inflammatory cells. Although abdominal complaints rarely appeared as an initial symptom in the patients with churg-strauss syndrome, this syndrome should be taken into consideration for an accurate diagnosis when the patients with abdominal pain of unknown origin had eosinophilia, asthma, or allergic rhinitis.
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ranking = 0.51364088168645
keywords = abdominal pain, upper
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5/15. A patient with eosinophilia, hypoalbuminemia and abdominal pain.

    strongyloides stercoralis infections frequently present with eosinophilia and abdominal pain. Since the gastrointestinal symptoms are non-specific, only 15 percent of these patients are correctly considered to have an infectious enteritis or intestinal parasite. In fact, the initial diagnosis is peptic ulcer disease in most patients. The clinical course may be indolent, or patients may develop a sudden catastrophic illness, particularly following the administration of corticosteroids.
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ranking = 1.25
keywords = abdominal pain
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6/15. Duodenopancreatic fistula accompanying Crohn's disease of the distal duodenum.

    A 47-yr-old male with known Crohn's disease involving the third and fourth part of the duodenum and terminal ileum presented to hospital with nausea and vomiting due to duodenal obstruction. An upper gastrointestinal series revealed a clinically unsuspected fistula joining the duodenum and pancreatic duct. He subsequently underwent vagotomy and gastroenterostomy to bypass the obstructed segment of duodenum. The duodenopancreatic fistula was not disturbed. Post-operatively, his symptoms resolved, he gained 30 pounds of weight, and manifested no ill effect secondary to the fistula. A repeat upper gastrointestinal series 9 months postoperatively revealed the fistula to have closed, although marked duodenal narrowing remained.
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ranking = 0.027281763372904
keywords = upper
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7/15. Endoscopic findings in pediatric patients with Henoch-Schonlein purpura and gastrointestinal symptoms.

    We report the gastrointestinal endoscopic findings in nine patients with Henoch-Schonlein purpura. Eight patients underwent upper gastrointestinal endoscopy, which revealed erosive gastritis in one patient, hemorrhagic-erosive duodenitis in four, and both findings in one. The rectum and the sigmoid colon were examined in six patients. Aphthoid ulcers were noted in two. In one of these patients, a rectal ulcer was also noted. Severe inflammatory changes and angiitis were found in the biopsy specimens obtained from the duodenum and the colon. The vascular abnormalities in the gastrointestinal mucosa are similar histologically to those found in the skin in Henoch-Schonlein purpura.
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ranking = 0.013640881686452
keywords = upper
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8/15. Primary tuberculous granulomatous esophagogastro-duodenitis: a report of a case.

    Primary upper gastro-intestinal tuberculosis is a very rare disease. We report the case of a 25-year-old man who presented with a febrile illness and non-specific gastro-intestinal symptoms. The upper gastro-intestinal x-rays showed a normal esophagus and non-specific changes of the stomach and duodenum. endoscopy revealed diffuse esophagogastro-duodenitis of tuberculous origin. The patient recovered completely after treatment.
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ranking = 0.027281763372904
keywords = upper
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9/15. Multiple gastric tumors--Crohn's disease.

    A case of multiple, histologically in part differing gastric tumors and granulomatous inflammation in the upper gastrointestinal tract and terminal ileum in the same patient is presented. The differential diagnosis of granulomatous inflammation and a possible association between Crohn's disease and carcinoma is discussed.
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ranking = 0.013640881686452
keywords = upper
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10/15. Gastroduodenal artery aneurysm: treatment by transcatheter embolization.

    aneurysm of the gastroduodenal artery is a rare but well recognized complication of acute and chronic pancreatitis. It appears to be secondary to the proteolytic action of activated pancreatic enzymes on the arterial wall. A case is reported of massive, life-threatening hemorrhage in a patient with a gastroduodenal artery aneurysm. The aneurysm was diagnosed by angiography and treated by embolization with Gianturco coils, the first successful use of this technique. A review of the literature revealed that bleeding in the upper gastrointestinal tract is a very common clinical presentation and is frequently fatal. Arteriography followed by computerized tomography are the most specific modalities of diagnosis.
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ranking = 0.013640881686452
keywords = upper
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