1/4. stomach phytobezoars in two uremic anorexic patients.Conglomerates of food and mucus or phytobezoars composed of vegetable matter are sometimes found in the stomach in the general population. Reports of phytobezoars in uremic patients are, however, scarce. Here we describe 2 uremic patients in which esophagogastroduodenoscopy was performed due to dyspepsia associated with weight loss and in which stomach phytobezoars were discovered. Theoretically, uremic patients should be at risk for producing bezoars. In fact, these patients frequently present predisposing conditions such as autonomic neuropathy, diabetes mellitus and delayed gastric emptying. Gastric bezoars cause anorexia. Anorexia is a frequent symptom in dialysis patients and is associated with malnutrition. In these patients, malnutrition is strongly associated with mortality and is quite difficult to reverse. Similarly, phytobezoars cause chronic anorexia. We suggest that clinicians working in dialysis units should consider the possibility of a gastric bezoar when evaluating anorexic uremic patients.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
2/4. Recurrent acute pancreatitis in anorexia and bulimia.CONTEXT: Mild pancreatitis has been reported as a consequence of anorexia nervosa, bulimia nervosa, or what has been termed the "dietary chaos syndrome". Either chronic malnutrition, or refeeding after periods of malnutrition, may precipitate acute pancreatitis through several pathogenetic mechanisms. CASE REPORT: A 26-year-old woman with a ten-year history of anorexia and bulimia presented with a third episode of acute pancreatitis in three months. The patient had been abstinent from alcohol for many years. Imaging studies during all three admissions failed to identify any biliary disease, including gallstones or biliary sludge. A cholecystectomy was performed, with a normal intraoperative cholangiogram, and no abnormalities on pathologic examination of the gallbladder and bile. The patient was discharged on hospital day 10 with no pain, and she has begun to return to regular eating habits. pancreatitis has not recurred after 6 months of follow up. We have identified 14 cases in the literature of acute pancreatitis associated with anorexia or bulimia. CONCLUSION: In the absence of evidence for gallstone, alcohol or metabolic etiologies, eating disorders may contribute to the pathophysiology of some idiopathic cases of pancreatitis.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
3/4. Reversible anorexia and rapid weight loss associated with neuroleptic administration in Alzheimer's disease.weight loss and malnutrition despite adequate dietary intake has been reported to be part of the clinical course in advanced dementia of the Alzheimer type. We present a case of reversible weight loss associated with neuroleptic use in a patient with Alzheimer's disease and discuss a possible pathophysiological basis for the weight loss.- - - - - - - - - - ranking = 0.5keywords = malnutrition (Clic here for more details about this article) |
4/4. Factitious illness by proxy presenting as anorexia and polydipsia by proxy.Factitious illness by proxy is a highly pathological form of parent-child relationship. To our knowledge no former case of polydipsia by proxy has been published. The case of a 2-y-old boy suffering from malnutrition due to displacement of maternal anorexia and polydipsia is presented. child psychiatric evaluation found cognitive delay and psycho-social impairment in the child, as well as a severe mother-child relationship disturbance. Psychological assessment showed a personality disorder with depressive and paranoid features in the mother. The father was described as a schizoid personality. The possible mechanisms of displacement are hypothesized.- - - - - - - - - - ranking = 0.5keywords = malnutrition (Clic here for more details about this article) |