1/7. cyproterone acetate and ethinylestradiol-induced pill oesophagitis: a case report.Although there are many cases of oesophagitis related to pill in medical literature, there are only a few reports concerning oesophagitis related to oral contraceptives, and none about cyproterone acetate and ethinylestradiol combination (Diane-35). In this report, we describe a female patient who suffered from odynophagia and retrosternal pain after taking Diane-35 for hirsutism. The endoscopic examination revealed two well-demarcated circumferential ulcers of 1 cm diameter surrounded by relatively normal mucosa in mid-oesophagus. The patient had gone to bed immediately after taking the pill. Oral intake was stopped, and intravenous fluids and omeprazole were administered as part of treatment. The patient benefited from this approach very quickly and was discharged from hospital in 5 days. The oesophagus was completely normal in control endoscopy after 2 months. Diane-35 should be added to the list of drugs causing pill oesophagitis, and physicians should inform the patients that the pills should be taken with enough water and they should not lie down right after ingesting the pills.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Oral contraceptive-induced esophageal ulcer. Two cases and literature review.Two patients with esophageal ulcers following ingestion of oral contraceptives are presented. Without discontinuing the drug, but providing that the pills were correctly ingested, the ulcers completely healed. This new adverse side effect of oral contraceptive emphasizes once more what appears to be a never-ending problem due to the lack of awareness of the prescribing physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Vulvar hemangioma simulating child abuse.An infant with a vulvar hemangioma that had undergone extensive ulcerative changes was initially diagnosed as having a perineal burn secondary to child abuse. Although genital burns are a well-recognized manifestation of child abuse, knowledge of the natural course of untreated hemangiomas and the uncommon complication of ulceration as well as familiarity with the characteristic patterns of abusive burn injuries may allow the physician to avoid making this misdiagnosis. The confusion in diagnosis led to an extensive social service investigation that, in this case, had a positive outcome for the mother's ability to cope. There exists, however, the possibility of iatrogenic-induced emotional stress if child abuse is misdiagnosed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Idiopathic chronic ulcerative enteritis: a report of two cases.Idiopathic chronic ulcerative enteritis (ICUE) is considered by some physicians to be a variant of sprue. Two patients being treated at our hospital for nonspecific abdominal symptoms had abnormal findings from a small-bowel series; at surgery, an ulcerating process involving the jejunum was found. Clinical, radiological, and pathological findings in these cases suggest that ICUE is a distinct entity.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. cytomegalovirus enteritis causing massive bleeding in a patient with AIDS.An emergency operation was performed on a 58 year-old heterosexual male patient for massive lower gastrointestinal bleeding, which was caused by cytomegalovirus (CMV) related ulceration at the terminal ileum. Pre-operative endoscopic evaluation revealed multiple esophageal and gastric ulcerations in upper gastrointestinal tract and much fresh blood in distal colon. angiography showed vascular tufts and extravasation of contrast medium in the cecal area. angiodysplasia of cecum with massive bleeding was initially impressed. However, CMV enteritis was identified in the resected ileum, the diagnosis of acquired immunodeficiency syndrome (AIDS) was confirmed by subsequent serological tests. AIDS was unknown to treating physicians until diagnosed by pathological specimen. Massive lower gastrointestinal bleeding related to CMV ulceration in small bowel is rare, we report this unusual presentation and highlight the the suspicion of immunocompromised state of patients with unusual, multiple gastro-intestinal ulcers.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Spectrum of supraesophageal complications of gastroesophageal reflux disease.There is a growing body of clinical and research evidence to support the role of gastroesophageal reflux in the etiology of certain disorders occurring in structures located above the body of the esophagus. These supraesophageal complications have only recently been identified but substantiation of the role of gastroesophageal reflux has been difficult and sometimes impossible with the technology currently available. This introductory article to the clinical issues involved in supraesophageal complications of GERD presents several index cases and asks far more questions than it gives answers about these patients. Clinical evidence supporting the role of GERD is discussed and the results of therapy reviewed. education of the practicing physician to the role of supraesophageal complications of GERD is urged to help recognize the likelihood of such clinical conditions. There is a real need for additional clinical use and evaluation of multi site intraesophageal and pharyngeal pH probes in patients with suspected supraesophageal complications of GERD. More importantly, development of new techniques for measuring micro reflux events and sophisticated methods for determining the duration of acid exposure in tissues above the esophagus is essential. Finally, more prospective controlled outcome studies of patients with supraesophageal complications of GERD are needed utilizing specific treatment algorithms.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Genital ulcers associated with acute Epstein-Barr virus infection.To date there have been only five reported cases of females with genital ulceration associated with primary Epstein-Barr virus infection. We describe two further patients and review the clinical features of all seven cases, noting the typical features, particularly purple ulcer margins and systemic symptoms, which should alert the physician to consider this diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |