1/24. Necrotizing and giant cell granulomatous phlebitis of caecum and ascending colon.A distinctive form of necrotizing and granulomatous phlebitis of a segment of large intestine is described in a previously healthy 36-year-old woman who presented with sudden severe abdominal pain and diarrhoea. At operation the caecum and ascending colon were oedematous and inflamed and right hemicolectomy was performed. Microscopically there was striking involvement of veins in all coats of the bowel ranging from recent fibrinoid necrosis of the whole vessel wall in the case of the caecum, to more chronic giant cell granulomas in parts of the vessel wall with partial or complete occlusion of the lumen in ascending colon. Arteries and lymphatics were entirely spared of these changes. The aitiology of this condition has not been elucidated but the histological appearances and site of involvement suggest an immunological reaction to material absorbed from the bowel. No evidence of food or other allergies or of infection has been obtained. The patient remains symptom free after 18 months. This form of phlebitis does not appear to have been previously described.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/24. Embolization of the vasa recta in acute lower gastrointestinal hemorrhage: A report of five cases.PURPOSE: To present our preliminary experience in embolization of the vasa recta in acute gastrointestinal hemorrhage. methods: In four of five patients with acute gastrointestinal hemorrhage superselective embolization of the vasa recta was performed. In one patient in whom superselective catheterization of the bleeding vas rectum was technically impossible, the origin of this vessel was embolized at the level of the terminal arcade. The following embolization materials were used: microcoils and polyvinyl alcohol particles (355-500 microm), n = 2; microcoils only, n = 2; Gelfoam particles, n = 1. RESULTS: Bleeding was found in two patients in the small bowel (jejunum and ileum) and in three patients in the colon. Immediate hemostasis was achieved in all patients. No signs of ischemia or infarction were observed after intervention. CONCLUSIONS: Superselective embolization of the vasa recta proved efficient and safe in our small patient group. Advantages of this technique are reduction of the embolized area to a minimum and direct control of hemostasis.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/24. Dieulafoy-like lesions of colon and rectum in patients with chronic renal failure on long-term hemodialysis.Two rare cases with Dieulafoy-like ulcer bleeding of the colon and rectum are reported. The patients have been suffering from chronic renal failure (CRF) on long-term hemodialysis (HD), and they were brought to Saiseikai Yahata General Hospital with anal bleeding. In both patients, colonoscopy was performed, showing arterial bleeding from a protuberant vessel on the mucosa of the rectum in Case 1 and gradual arterial bleeding from the protuberant vessel on the ascending colon in Case 2. For both cases, endoscopic clipping treatment was done for hemostasis and was successful.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/24. giant cell arteritis localized to the colon associated with Crohn's disease.AIMS: Intestinal vasculitis is uncommon and usually accompanies systemic vasculitis. Although intestinal vascular changes including vasculitis have been studied intensively, and are found regularly in Crohn's disease, giant cell arteritis is distinctly unusual. We describe a case of giant cell arteritis localized to the colon of an 18-year-old girl suffering from Crohn's disease. methods and RESULTS: After three years of medical treatment, the patient underwent a proctocolectomy. The medium-sized arteries of the mesocolon demonstrated striking changes characterized by intimal fibrous thickening and an inflammatory infiltrate with giant cells, most predominant at the intima-media junction. epithelioid cells and sarcoid-like granulomas were not observed. The internal elastic lamina was fragmented. Neither clinical symptoms nor laboratory findings showed evidence of systemic vasculitis. Neither the chest CT scan nor the echo-Doppler of the temporal arteries, supra-aortic and abdominal vessels revealed any abnormality. CONCLUSIONS: This case illustrates an extremely rare feature in the spectrum of vascular lesions in Crohn's disease which have to be differentiated from temporal and Takayasu's arteritis.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
5/24. panniculitis of the descending colon caused by enterocolic phlebitis: a case report.A 73-year-old male was referred to our hospital for abdominal pain, diarrhea and general fatigue lasting for 3 weeks. physical examination of the abdomen revealed a firm mass in the left abdominal region. Computed tomography revealed a mass around the descending colon. colonoscopy and barium enema revealed poor extensibility of the lumen with edematous mucosa, and narrowing of the descending colon with rugged mucosal surface. Because of the clinical symptoms and findings, the patient was diagnosed clinically as suffering from panniculitis of the descending colon. He underwent the left hemi-colectomy with side-to-side colo-colostomy after making of a loop ileostomy. Histological analysis of the resected colon showed an infiltration of inflammatory cells, predominantly lymphocytes, into veins and venules of the submucosa, muscularis propria and fat tissue of the colonic mesentery, with an involvement of all layers of the vessel wall. Arteries were escaped from inflammatory changes. The histopathological diagnosis of enterocolic phlebitis and venulitis was made because of these findings.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
6/24. angiodysplasia of colon revisited: pathologic demonstration without the use of intravascular injection technique.The recognition of angiodysplasia either at the time of surgery or at the time of routine gross and microscopic examination has often been difficult. Until now the primary methodology used in defining the lesion has been the intravascular injection of radiopaque dyes and other compounds. This technique, however, is prohibitively time consuming and expensive, and does not encourage routine use in surgical pathology practice. We report two cases of angiodysplasia, both occurring in unlikely areas, in which the pathologic lesion was demonstrated without the use of an intravascular injection technique. One case involved 35 cm of proximal transverse colon and the other involved 23 cm of colon distal to the ileocecal valve. A simple method of demonstrating angiodysplasia by intraluminal formalin fixation (37% concentrated, unbuffered), with tying of both resected ends for 3 hours, followed by dissection of the mucosa from the muscle wall, is described. Areas of ectatic, pericryptal, thin-walled blood vessels with adjacent dilated, engorged submucosal veins are readily seen on gross direct inspection highlighted by transillumination. Histologic sections taken from these areas show early lesions of angiodysplasia characterized by ectatic, engorged submucosal veins and some dilated venules and capillaries in the mucosal lamina propria.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
7/24. A life-threatening hematochesia after transrectal ultrasound-guided prostate needle biopsy in a prostate cancer case presenting with lymphedema.A 62-year-old male presenting with lymphedema at the left lower extremity was diagnosed as prostatic carcinoma by an ultrasound-guided needle biopsy. Six days after the biopsy procedure, he developed severe hematochesia. colonoscopy revealed an oozing visible vessel at the anterior rectal wall, a few centimeters from the anus. Endoscopic hemostasis with %1 athexysclerol was applicated with success. Rebleeding with same severity as the first one occurred 48 hours after the first bleeding and endoscopic hemostasis was successful again. Follow-up was uneventful.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
8/24. nimodipine: evidence for clinically significant gastrointestinal side-effects.nimodipine, now widely used for treatment and prevention of cerebrovascular spasm, is regarded as a safe drug. Despite a preferential action on cerebral vessels, there is clinical and experimental evidence of effects on systemic vascular and intestinal smooth muscle cells. Gastro-intestinal side-effects, however, have not been reported in clinical studies dealing with treatment of vasospasm following subarachnoid haemorrhage. We report on a patient with subarachnoid haemorrhage who developed an acute life-threatening pseudo-obstruction of the colon, a variant of adynamic ileus, while being treated with intravenous nimodipine. The relationship between this complication and calcium antagonist therapy is discussed and therapeutic strategies are presented. We conclude that neurosurgeons and neurologists should be aware of calcium antagonist--related ileus in patients treated with nimodipine.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
9/24. Giant inflammatory polyps associated with idiopathic inflammatory bowel disease. An ultrastructural study of five cases.Five cases of giant inflammatory polyps associated with idiopathic inflammatory bowel disease are reported. polyps produced intestinal obstruction in three cases; consequently, surgery was performed. In a further two cases, intestinal bleeding was improved by endoscopic polypectomy. Electron microscopy showed fibroblasts, myofibroblasts, mast cells, lymphocytes, collagen fibers, capillaries, and venules. Remnants of the original mucosal epithelial cells, smooth muscle cells, and hypertrophic autonomous nerve plexuses were noted. nerve fibers were interwoven with the matrix of the polyps. mast cells were closely linked with vessels, nerves, and collagen fibers. They may have an important role in the excessive granulation, angiogenesis, and fibrotic process in giant inflammatory polyps.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
10/24. Transcatheter occlusion of inferior mesenteric arteriovenous fistula: a case report.Transcatheter embolization of the inferior mesenteric artery with steel coils was performed for the control of massive lower gastrointestinal bleeding and sepsis. The bleeding and sepsis was caused by a very large arteriovenous fistula of the inferior mesenteric vessels. This iatrogenic lesion developed and became symptomatic just 5 weeks after an anterior resection of the rectum was performed. Following embolization, the patient made a speedy recovery from the sepsis and no recurrent bleeding was noted.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
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