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21. |
Invited editorial |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 115-116
Paul,
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PDF (186KB)
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ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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22. |
Misdiagnosis of specific cytomegalovirus infection of the ileoanal pouch as refractory idiopathic chronic pouchitisReport of two cases |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 117-120
Manuel,
Muñoz‐Juarez John,
Pemberton William,
Sandborn William,
Tremaine Roger,
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摘要:
PURPOSE:Chronic nonspecific reservoir ileitis (pouchitis) occurs in 5 to 10 percent of patients who undergo ileal pouch‐anal anastomosis for ulcerative colitis. Specific infection of the ileal pouch‐anal anastomosis with cytomegalovirus has not been reported.AIM:We report two patients with specific cytomegalovirus infection of the ileal pouchanal anastomosis, initially misdiagnosed as idiopathic chronic pouchitis.CASE SERIES:Patient 1 had ileal pouchanal anastomosis for ulcerative colitis. Three years later she had diarrhea, fever, pelvic pain, and pouch inflammation at endoscopy consistent with pouchitis. She had no response to medical therapy. Repeat endoscopy showed persistent inflammation and biopsies showed cytomegalovirus. She had symptomatic improvement after treatment with intravenous ganciclovir, 10 mg/kg/day for ten days (stopped for rash). Repeat pouch biopsies were negative for cytomegalovirus. Patient 2 had ileal pouch‐anal anastomosis for ulcerative colitis. Nine years later she had resection of obstructing stricture at previous loop ileostomy site. She underwent reoperation with ileostomy and pouch defunctionalization for peritonitis. Four weeks later she had fever and bloody discharge from the diverted pouch. Pouch endoscopy with biopsy showed inflammation consistent with pouchitis. She had no response to medical therapy. Re‐examination of pouch biopsies with a specific monoclonal immunofluorescent stain showed cytomegalovirus. She had symptomatic improvement after treatment with intravenous ganciclovir, 10 mg/kg/day for 21 days. Repeat pouch biopsies were negative for cytomegalovirus.CONCLUSIONS:Specific cytomegalovirus infection of the ileal pouch‐anal anastomosis may be misdiagnosed as idiopathic refractory chronic pouchitis. Cytomegalovirus must be excluded before immune modifier therapy or pouch excision in these patients.
ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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23. |
Self‐assessment quiz |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 121-121
Judith,
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PDF (92KB)
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ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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24. |
Selected abstracts |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 122-129
&NA;,
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PDF (901KB)
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ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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25. |
Self‐assessment quizAnswers, critiques, and references |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 130-130
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PDF (125KB)
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ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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26. |
Announcements |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 131-131
&NA;,
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PDF (133KB)
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ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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27. |
Notice to candidates for certification |
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Diseases of the Colon & Rectum,
Volume 42,
Issue 1,
1999,
Page 132-132
&NA;,
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PDF (123KB)
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ISSN:0012-3706
出版商:OVID
年代:1999
数据来源: OVID
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