1/10. Chronic intestinal lymphocytic microphlebitis.The authors report two cases of a peculiar microphlebitis of the intestines, similar to that described by Saraga and Costa quite recently [5]. The patients had undergone hemicolectomy because of evolving ileus caused by cecal polyps or lipohyperplasia, respectively. Pseudomembranous-ulcerative inflammation of the cecum and variously intense lymphocytic infiltrates of numerous small submucosal veins and venules of the intestines were found in both cases. thrombosis occurred very rarely in the affected vessels, although sometimes it was found in deeper and larger veins. Arteries, lymphatics, mesenterial veins and lymph nodes were normal. Parts of the distal ileum and ascending colon displayed the phlebitic changes without mucosal alterations. The authors hypothesize that it was not the abnormal local circulation, but some hitherto not fully clarified immunological disorder that resulted in the disease. In contrast to the claim of Saraga and Costa [5], it is suggested that thrombosis of the small veins does not have a significant role in the development of the lesions, but a complex process that includes the entry of antigens via the altered mucosa followed by an immunogenic inflammatory response of the small veins is responsible for the pathogenesis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/10. Necrotizing enterocolitis following intrauterine blood transfusion.Intravascular intrauterine transfusion allows a more sophisticated and exact approach to the management of severe Rh hemolytic disease. This technique involves direct manipulation of the fetal umbilical vessels; its hazards include umbilical cord trauma and thrombosis or emboli. The consequences of such events in utero are largely unknown. In this case necrotizing enterocolitis occurred in a full-term infant after three intrauterine intravascular transfusions.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/10. pheochromocytoma and ischemic enterocolitis.In the nine year period, 1978-1987, two patients with pheochromocytoma presented to Sacred heart Hospital, Yankton, south dakota. Both cases were complicated pre-operatively by ischemic enterocolitis--a rarely reported, usually fatal complication of pheochromocytoma. It is thought that catecholamine-induced vasoconstriction of the mesenteric vessels resulted in the wide-spread hemorrhagic necrosis of the gut. Both patients survived not only the initial ischemic mesenteric insult, but also excision of the tumor.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/10. Pseudomembranous colitis in a patient of paraquat intoxication.A 49 year-old man drank paraquat 7-8 fold of human fatal dose, and died of severe respiratory failure in 24 days in spite of intensive therapy. The autopsy revealed diffuse pulmonary fibrosis caused by prolonged intoxication of paraquat. An interesting finding was many raised plaques from 1 mm to 10 mm in diameter, observed in whole colon. Histologically, these plaques were composed of necrotic mucosa ("pseudomembrane"), disrupted crypts and edematous submucosa with fibrin education, intervening in normal colon tissue with sharp margins, and diagnosed as non-antibiotic-induced pseudomembranous colitis. Since the edematous submucosa of the raised plaque had a stratified fibrin education around a dilated capillary, it was speculated that the vessel injury by paraquat might play a role in the pathogenesis of pseudomembranous colitis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/10. Total parenteral nutrition using peripheral veins in surgical neonates.A new program of total parenteral nutrition (TPN) for surgical neonates has been described an investigated. The program is based on the use of fat emulsion as the major source of calories and infusion of large volumes of the solution via peripheral veins. This program has three main advantages over conventional hyperalimentation using a central venous catheter: (1) it avoids complications such as septicemia, thrombosis of large vessels, and metabolic complications such as hyperglycemia or osmotic diuresis; (2) it provides physiological nutritive elements containing a normal composition of glucose, protein, and fat; and (3) it is easy to start and manage the TPN using a peripheral vein. Thirty-four neonatal surgical patients with life-threatening gastrointestinal anomalies have been placed on this TPN program. Infusion of fat emulsion and large volumes of fluid were well tolerated and all patients gained weight during the period of observation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/10. Massive mural edema in severe pseudomembranous colitis.Three patients had severe acute pseudomembranous colitis due to clostridium difficile toxin and required surgical resection. In addition to the characteristic mucosal lesions, the colonic specimens showed a marked degree of diffuse mural edema that extended into the muscularis propia and involved areas of the colon with and without pseudomembranes. To our knowledge, such extreme edema has not been previously noted in pathologic descriptions of this disorder; it may possibly result from a toxic effect on the vessels combined with a large parenteral fluid replacement. Lesser degrees may be seen in other forms of acute colitis, but it would appear that the presence of massive and diffuse mural edema is most typical of Clostridia-associated colitis. The detection of such edema in a case of acute colitis should prompt an investigation for antibiotic usage and C difficile toxins.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/10. Systemic absorption of oral cholestyramine.A patient with clostridium difficile -toxin colitis was treated with oral cholestyramine, but died of other causes 15 days later. At autopsy, the colitis had resolved, but cholestyramine particles were found within the vessels of most body tissues, most prominently in his ulcerated distal esophagus. Clusters of bacteria were found adjacent to some of the cholestyramine particles, suggesting a common portal of entry.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/10. Toxic megacolon due to ischemic enterocolitis associated with retroperitoneal fibrosis.A 46-yr-old man, in whom retroperitoneal fibrosis had been found 4 yr previously, presented with abdominal pain, fever, diarrhea, and marked dilation of the transverse colon with superficial ulceration. The megacolon was unresponsive to nasogastric suction, corticosteroids, antibiotics, and total parenteral nutrition. Arteriograms revealed total occlusion of the celiac axis and superior and inferior mesenteric arteries. laparotomy showed encasement of the retroperitoneal vessels by dense fibrous tissue. A vascular bypass graft was performed, connecting the distal superior mesenteric artery to the right external iliac artery. This led to complete and lasting resolution of gastrointestinal complaints.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/10. Ischaemic colitis (necrotizing colitis, pseudomembranous colitis) in acute schistosomiasis mansoni: report of two cases.Two cases of ischaemic necrosis of the sigmoid colon (necrotizing colitis) are reported in 2 brothers aged 7 and 4 years, diagnosed within a 10 d interval. The children had bathed in streams suspected to be contaminated by schistosoma mansoni about 50-60 d before the onset of acute disease. Both patients had been previously exposed to schistosome-infected streams without showing signs or symptoms of infection. Before admission, S. mansoni eggs had not been found in the stool. Both patients presented with an apparently identical, relatively symptomatic clinical course with rapid evolution to an acute abdomen. laparotomy disclosed, in both patients, extensive necrosis (ischaemic necrotizing colitis of schistosomal aetiology) of about 20 cm in the first child and 8 cm in the second, extending from part of the descending colon to the sigmoid. The patients were successfully operated upon (hemicolectomy plus colostomy). The histopathological findings were similar in both patients. Ischaemic necrosis with complete destruction of the mucosa and part of the submucosa was detected in the first case; in the necrotic areas a few eggs of S. mansoni were seen, with no granulomatous reaction, but surrounded by cell shadows, pycnotic nuclei and amorphous material. necrosis extended to the muscular layer and serosa, in which schistosome granulomas in the necrotic-exudative phase were seen, as well as diffuse granulocytic exudate and fibrin. Sections of tissue from both patients contained numerous eggs and granulomas all in the same exudative phase in regional lymph nodes and near the thrombotic vessels. After surgery, the 2 patients progressed similarly. About 10 d after hospital discharge, the patients received anti-schistosomal treatment with oxamniquine. No further sign of infection was detected at subsequent recall visits.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/10. Increased substance p receptor expression by blood vessels and lymphoid aggregates in clostridium difficile-induced pseudomembranous colitis.Pseudomembranous colitis is most often caused by toxins secreted by clostridium difficile following bowel flora overgrowth after antibiotic use. The secretory and inflammatory effects observed in C. difficile toxin A-induced enterocolitis in the rat ileum are inhibited by CP-96,345, a substance p (SP) receptor antagonist. To determine if SP plays a role in the pathogenesis of human pseudomembranous colitis, SP receptor distribution was examined in a toxin A-positive specimen of bowel. Quantitative receptor autoradiography was used to examine SP receptors in tissue from a patient who tested positive for C. Difficile toxin. SP receptors were massively increased in small blood vessels and lymphoid aggregates in the pseudomembranous colitis bowel in comparison to control specimens. The SP binding was saturable and exhibited similar affinities for SP and CP-96,345. SP may contribute to the inflammatory response in pseudomembranous colitis via a massive increase in SP receptor antagonists may offer a novel therapeutic intervention for pseudomembranous colitis.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
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