1/24. Neovascular glaucoma as a complication of retinal vasculitis in crohn disease.PURPOSE: To report a case of neovascular glaucoma as a complication of retinal vasculitis in crohn disease. methods: Case report with fluorescein angiogram. RESULTS: A 62-year-old man with biopsy-proven crohn disease presented with bilateral uveitis, bilateral iris new vessels, and neovascular glaucoma in the left eye. fluorescein angiography revealed signs of retinal vasculitis and capillary nonperfusion in both eyes. CONCLUSION: crohn disease may be associated with retinal vasculitis and, thus, neovascular glaucoma. A satisfactory result can be achieved by using corticosteroids to control the retinal vascular inflammation, by applying panretinal photocoagulation and by controlling the increased intraocular pressure surgically.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/24. Granulomatous osteonecrosis in Crohn's disease.A 25-year-old white woman was diagnosed with Crohn's disease involving the small and large intestines. She had a complex clinical course that required treatment with multiple pharmacological agents, including intravenous, oral and rectal corticosteroids. She also received parenteral nutrition with lipid emulsions. Finally, repeated intestinal resections and drainage of perianal abscesses were required. Her disease was complicated by gallstones, urolithiasis and hip pain. After osteonecrosis was diagnosed, joint replacements were performed. review of the pathological sections from the resected hip, however, resulted in detection of granulomatous inflammation with multinucleated giant cells - the histological 'footprint' of Crohn's disease in the gastrointestinal tract. Because prior specialized perfusion fixation pathological studies of the intestine in Crohn's disease have shown that granulomas are located in the walls of blood vessels, a possible mechanism for the pathogenesis of osteonecrosis in Crohn's disease is chronic microvascular ischemia of bone.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/24. 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 = 1keywords = vessel (Clic here for more details about this article) |
4/24. Newly-formed lymph nodes in the submucosa in chronic inflammatory bowel disease.BACKGROUND AND AIMS: Routine diagnostic work revealed cell aggregates reminiscent of lymph nodes in the bowel submucosa in occasional cases of chronic inflammatory bowel disease. We therefore investigated whether they fulfill criteria for classification as lymph nodes. methods: Colon with terminal ileum from a patient with florid Crohn's disease and a colectomy specimen from a patient with ulcerative colitis were investigated. Sections were immunostained with antibodies that recognize endothelial and sinus-lining cells, immune-accessory cells, and lymphoid cells. RESULTS: Circumscribed collections of cells that fulfill all the major criteria for classification as lymph nodes were found in the large and small bowel. They had marginal and intermediate sinuses (positive for BMA 120, CD34, CD31, X-11, and von Willebrand's factor), afferent lymph vessels, T- and B-regions, and a capsule. Small collections composed predominantly of B cells that had only a marginal sinus were also occasionally observed. CONCLUSION: Secondary mucosa-associated lymphoid tissue, typically seen as follicular lymphoid hyperplasia, also appears to occur as secondary submucosal lymph nodes. This phenomenon seems inconsistent with the notion that lymph nodes do not develop after birth. We have also noted secondary development of lymph nodes in lymphangioma and lymphangioleiomyomatosis. It is possible that local lymph vessel proliferation, possibly with chronic lymphedema of the tissue involved, is an important prerequisite for lymph node neogenesis.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/24. Combined use of preoperative provocative angiography and highly selective methylene blue injection to localize an occult small-bowel bleeding site in a patient with Crohn's disease: report of a case.PURPOSE: Gastrointestinal bleeding in patients with Crohn's disease presents both a diagnostic and therapeutic challenge. The bleeding site may be difficult to localize preoperatively and multiple segments of gross disease can lead to uncertainty as to the precise source at the time of laparotomy. methods: We describe a patient with Crohn's disease and recurrent gastrointestinal bleeding in whom the combined use of provocative angiography and highly selective methylene blue injection was used preoperatively to accurately identify the site of hemorrhage and direct bowel resection. RESULTS: Provocative angiography identified the bleeding point in the jejunum. methylene blue, which had been injected distally into the bleeding vessel during angiography, stained the bowel wall at the bleeding site. Segmental bowel resection was subsequently performed and no further bleeding occurred during the 18-month follow-up period. CONCLUSIONS: The combined use of provocative angiography and highly selective methylene blue injection may aid in the preoperative and intraoperative localization of occult bleeding sites in patients with Crohn's disease. This allows the bleeding lesion to be removed with a limited resection, thus preserving bowel length.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/24. Vascular compromise prior to intestinal manifestations of Crohn's disease in a 14-year-old girl.Vascular manifestations as extraintestinal symptoms of Crohn's disease are rare and only occasionally reported in children. A 14-year-old girl with vascular compromise prior to intestinal manifestations of Crohn's disease is described. The vascular symptoms were due to segmental narrowing of several major arteries as shown by angiography. This kind of vascular involvement in our patient is different from the pattern described in Crohn's disease and resembles Takayasu's disease. Recently, it has been suggested that Crohn's disease could be mediated by multifocal gastrointestinal infarction due to chronic focal mesenteric arteritis at the level of the muscularis propria of the gut. In Takayasu's disease, a granulomatous inflammation of the vasa vasorum of affected vessels is frequently found. An intramural arteritis, granulomatous in nature, could be the common pathway in both Crohn's and Takayasu's diseases. Until the etiologies of both diseases are uncovered, the interrelation between them will remain subject to speculation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/24. magnetic resonance angiography in a patient with Crohn's disease associated cerebral vasculitis.Vasculitits of the central nervous system (CNS) is a known complication of chronic inflammatory bowel diseases. We report the case of a female patient with Crohn's disease, developing vasculitis of the CNS with evidence of pathological vessel depiction on magnetic resonance angiography. To our knowledge this is the first case report regarding MRA documentation of vessel changes typical for angiitis in a patient with Crohn-associated vasculitis of the CNS.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
8/24. A case report of acute febril neutrophilic dermatosis (Sweet's syndrome) and Crohn's disease.A case of Crohn's disease complicated by Sweet's syndrome is presented. The main ultrastructural findings were the multiplication of basal lamina surrounding the venulea, interendothelial gaps and in perivascular locations mixed infiltrates of neutrophiles and erythrocytes. The changes indicate that the initial site of the reaction was the walls of the dermal vessels.- - - - - - - - - - ranking = 1keywords = 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 = 1keywords = vessel (Clic here for more details about this article) |
10/24. Polyneuropathy: an unusual extraintestinal manifestation of Crohn's disease.Among the extraintestinal complications of Crohn's disease, neuropathy seems to be rare, and is only exceptionally reported in the literature. The authors present the report of a patient followed over a 12-year period who developed polyneuropathy with a parallel course to Crohn's disease. There was no evidence of any other underlying condition. On one occasion, the patient developed a cutaneous vasculitis with fibrinoid deposits in the vessels. The search for circulating immune complexes was positive. The authors demonstrated increased intestinal permeability using the 51chromium-labeled ethylenediaminetetra-acetate (51Cr-EDTA) test. Ultrastructural study of a biopsy of the superficial peroneal nerve disclosed a marked denervation process. Therapeutic plasmapheresis were performed, improving the neurologic symptoms. Vasculitis with circulating immune complexes is suggested as a possible mechanism in view of the occurrence of cutaneous vasculitis, increased intestinal permeability, and plasma exchange efficiency.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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