1/2. Double duplication in a nonrotational colon. Study of a case associated with mucinous adenoma.Duplications of gastrointestinal tract are unusual anomalies, especially in the colon. We report a case with two colonic duplications in a 20 year old woman who complained of recurrent backache associated with left lower quadrant abdominal pain. Neither physical examination nor laboratory test alterations were detected. Roentgenographic examination showed organic scolinosis, no intestinal gas and a mass with central hyperdensity and thickened wall in the descending colon area on the CT scan. laparotomy was performed in which 22 cm of ascending colon and terminal ileum sited on left side, was excised. Pathological study revealed two unrelated and cystic duplications without communication to intestinal lumen. Their epithelial lining were of colonic or gastric types and showed a mucinous adenoma; the remaining layers were normal except for eosinophilic inflammatory infiltrate with Charcot-Leyden like crystaloids. In conclusion, we present a double spherical colonic duplication type I associated to a mucinous adenoma on a non-rotational ascending colon in a patient with organic scoliosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/2. Gastrointestinal abnormalities: a significant cause of feeding difficulties and failure to thrive in Brachmann-de lange syndrome.Gastroesophageal abnormalities occur with increased frequency in patients with Brachmann-de lange syndrome (BDLS) and contribute to problems with feeding, emesis and failure to thrive. Comprehensive evaluation including longitudinal assessment of growth and development of 8 patients with BDLS was performed. Clinically significant feeding problems occurred in 6 of the 8 patients and the affected children were subsequently evaluated for gastrointestinal abnormalities. Findings in these patients included tracheal aspiration, esophageal dysmotility, gastroesophageal reflux, hiatal hernia, and esophagitis. Medical treatment was instituted where appropriate, and surgical treatment was performed if the problems did not resolve with medical treatment. Improvement in weight centiles occurred in all patients fed by nasogastric or feeding gastrostomy tube but only one patient appeared to experience increase in rate of linear growth. Careful monitoring of symptoms and growth parameters, and prompt institution of appropriate medical and surgical measures can improve the health and physical outcome of many patients with BDLS.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |