1/39. Intestinal ulceration, obstruction, and haemorrhage in congenital syphilis.intestinal obstruction and bleeding are uncommon complications of congenital syphilis (CS). A VDRL-positive infant developed incomplete intestinal obstruction and rectal bleeding. Despite conservative management, his symptoms continued. At laparotomy, terminal ileal inflammation and stenosis were demonstrated. He underwent ileal resection and primary end-to-end anastomosis with resolution of his symptoms. Histopathological examination demonstrated heavy plasmacytic infiltration of the lamina propria and submucosa with ulceration of the mucosa, consistent with syphilitic ileitis. This report documents for the first time bleeding from ileal ulcers associated with intestinal obstruction in CS and highlights an unusual presentation of the disease.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/39. Systemic lupus erythematosus with a giant rectal ulcer and perforation.A 41-year-old man with systemic lupus erythematosus (SLE) who developed pelvic inflammation due to perforation of a giant rectal ulcer is described. The patient presented with persistent diarrhea, abdominal pain and fever without development of disease activity of SLE. Endoscopic and radiological examinations revealed a perforated giant ulcer on the posterior wall at the rectum below the peritoneal evagination. The ulcerated area was decreased after a colostomy was performed at the transverse colon to preserve anal function. The patient is currently being monitored on an outpatient basis. It should be noted that life-threatening complications such as perforated ulcer of the intestinal tract could occur without SLE disease activity.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
3/39. Solitary rectal ulcer syndrome: two case reports.Owing to its rarity, solitary rectal ulcer syndrome (SRUS) is often misdiagnosed as malignant ulcer, or ulcer in association with inflammatory bowel disease. We present two adult females with anorectal symptoms (i.e. pain, tenesmus and bowel habit changes). Both had normal levels of serum carcinoembryonic antigen. barium enema revealed irregular mucosa with stricture of the lower rectum. An ulcer, 2.7 cm in diameter, was found in one patient but not the other. Rectal biopsy under sigmoidoscopy demonstrated non-specific inflammation, without evidence of malignancy. Because of the intractable symptoms and the inability to discriminate between malignant and benign conditions, exploratory laparotomy was performed, followed by low anterior resection of the rectum. Histological examination of both specimens showed submucosal rectal fibrosis with a non-specific ulceration in one. These findings were compatible with SRUS. The patients' symptoms improved dramatically after the resection and they remain well, five months and one year after surgery. awareness of this rare anorectal condition is necessary for appropriate management particularly to avoid unnecessary abdomino-perineal resection.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/39. Crohn's disease of the esophagus: report of a case.We report herein the case of a 27-year-old man with Crohn's disease of the esophagus. The patient presented with large ulcers in the esophagus for which treatment based on a diagnosis of reflux esophagitis was commenced. Although his symptoms were initially resolved, the ulcers did not improve and he was readmitted to hospital 3 months later for progressive heartburn. An esophagoscopy revealed large ulcers in the esophagus, and a colonoscopy revealed a longitudinal ulcer in the terminal ileum. Histological examination of specimens from the terminal ileum showed severe inflammation without granuloma formation, which led to a diagnosis of Crohn's disease. The oral administration of prednisolone and salazosulfapyridine controlled his symptoms and the esophageal ulcers were observed to be healing 2 weeks after this treatment was initiated. A review of the English literature revealed only 77 cases of this disease. Isolated esophageal lesions were reported in ten patients (13.0%), none of which were able to be diagnosed as Crohn's disease preoperatively. Ileocolic lesions developed after esophageal lesions in only five patients (6.5%) including ours. In the remaining 62 patients (80.5%), ileocolic lesions had existed synchronous with or prior to the esophageal lesions. This suggests that ileocolic lesions may often coexist in Crohn's patients with esophageal lesions, and that examination of the terminal ileum must be performed to confirm a diagnosis of Crohn's disease of the esophagus.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/39. nasal septal perforation: a rare extraintestinal manifestation of Crohn's disease.Nasal manifestations of Crohn's disease are quite rare. They are typified by chronic mucosal inflammation, obstruction, bleeding, and occasionally septal perforation--signs and symptoms that are common to many disease states of the nose. Nasal findings, much like oral lesions, can precede the more typical gastroenterologic manifestations of Crohn's disease. Otolaryngologists should be aware of such an association and consider the diagnosis of Crohn's disease in atypical cases of nasal disease. We report the case of a 12-year-old boy who had severe Crohn's disease and a nasal septal perforation, and we discuss this complication in the context of its otolaryngologic manifestations.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/39. One-month-old infant with multiple ulcers of stomach, small bowel, large bowel, and protein-losing enteropathy: case report.Multiple inflammatory ulcers of the gastrointestinal tract are rare in young infants. Most cases are caused by infectious organisms, vasculitis, or an autoimmune process. We report a 1-month-old infant who was healthy until he presented with an inflammatory mesenteric cyst, and multiple ulcers of the stomach, duodenum, jejunum, ileum, and colon. Histologically, the ulcerations were sharply demarcated, full thickness, and filled with macrophages. He had a low serum albumin and IgG due to protein-losing enteropathy. He was treated with supportive care and immunomodulating drugs. The gastrointestinal inflammation resolved by 3 and 1/2 years of age. The medications were withdrawn at 5 and 1/2 years of age he had no relapse of clinical symptoms. He continues to have asymptomatic mild hypoalbuminemia and low serum IgG. We could not find a report of a similar clinical presentation and outcome.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
7/39. A case of penetrating aortic atherosclerotic ulcer with hemoptysis.A 69-year old Japanese woman with hypertension was admitted because of continuous back pain and recurrent hemoptysis. Radiographic findings showed an enhanced irregular mass, at the aortic arch fed by the tracheal artery, which implied both a penetrating aortic atherosclerotic ulcer and lung cancer. Diagnostic surgery revealed no evidence of cancer but did reveal a rupture of the intima at the distal part of the aortic arch. It is assumed that the transmural oozing occurred after development of the penetrating aortic ulcer, which formed an extra-aortic hematoma and caused surrounding inflammation, and led to tracheal artery feeding. The intramural hematoma might have weakened vascular wall tension from the aorta, and formed an oozing extra-aortic hematoma instead of an acute rupture.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
8/39. Reversible axial myopia following infectious scleral ulceration--a case report.adult-onset axial myopia is uncommon in comparison with the lenticular myopia. When we dealt with a case of the infectious scleral ulceration, the progressive myopic shift was not only due to the dense nuclear sclerosis but also due to the longer axial length. The elongating axis became shortened after 3-months follow up. Then the patient underwent uneventful cataract surgery. However, the reversal process persisted even after the operation. Although the pathogenesis is not well known, we concluded that the cataract surgery in dealt with the complicated cataract should be delayed in the cases with any inflammation or the axial changes.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
9/39. Ileal perforation in diffuse intestinal Behcet disease: report of a case.Intestinal ulcers in Behcet disease tend to cause perforation, and postoperative recurrence is common with a high mortality rate. The optimal therapeutic strategy has yet to be elucidated, particularly in cases of diffuse intestinal involvement. We herein present a case of diffuse intestinal Behcet disease with ileal perforation. A 57-year-old Japanese woman was referred to our institution with complaints of intractable oral ulcers and abdominal pain. The patient underwent an emergency laparotomy for perforated peritonitis in spite of the intravenous administration of prednisolone (1.5 mg/kg) under total parenteral nutrition. Macroscopically, an inflamed ileum measuring 1.6 m in length was resected, including a 1-cm perforated ulceration. Innumerable small and deep ulcers were also observed, consisting of nonspecific inflammation. The patient has been free from any recurrence of intestinal ulcers while being treated with prednisolone, colchicine, and a low-residue diet for 1.5 years.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
10/39. Conjunctival ulceration in recurrent wegener granulomatosis.PURPOSE: To describe a patient with wegener granulomatosis (WG) previously in remission who developed conjunctival ulceration as the first sign of disease recurrence. methods: Case report and review of the literature. RESULTS: Twenty-one years after WG was originally diagnosed and with the disease thought to be in remission, a 52-year-old man with complaints of ocular irritation for the previous year was found to have multiple palpebral conjunctival ulcerations of the left eye. Incisional biopsy revealed mixed inflammation consistent with WG. Within 3 months of recognition of his conjunctival ulcers, newly recurrent pulmonary inflammation developed and serologies for cytoplasmic-pattern antineutrophil cytoplasmic antibodies (C-ANCA) became positive. CONCLUSION: Conjunctival ulceration is a rare manifestation of WG but may presage more widespread disease. Mucosal ulceration in a patient with a previous diagnosis of WG should stimulate an aggressive search for renewed systemic disease activity.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
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