摘要:

Heterotopic gastric mucosa has been identified in all levels of the gastrointestinal tract but is a rare finding in the rectum. We describe a patient with heterotopia found during a routine evaluation of persistent symptoms, possibly due to an irritable bowel syndrome, and provide a complete review of the literature through 1992. Of the 29 reported cases, the most common presentation was painless rectal bleeding, with the heterotopia usually identified on pathologic examination of a rectal polyp. The heterotopic tissue was frequently located in the posteriolateral region of the rectum between 5 and 8 cm from the anal verge. The definitive treatment was excision, either by endoscopy or surgery, although H2may also provide symptom relief. Our patient was treated with H2with resolution of symptoms.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Two patients with tuberous sclerosis had multiple semispherical polyps in the large intestine, predominantly in the rectosigmoid colon. These were hamartomas with an excess of smooth muscle fibers in the stroma. In addition, the 21-year-old man had multiple tiny protrusions in the esophagus and oral fibroepithelial polyps. In the 31-year-old woman, who had pulmonary lymphangiomyomatosis with positive estrogen and progesterone receptors, hamartomatous gastric polyps, colonic leiomyoma, and adenomatous rectal polyps were also identified. Our findings suggest that gastrointestinal polyposis may be one of the phenotypes of tuberous sclerosis complex, possibly linking this disease with other hereditary polyposis syndromes.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We report a patient on warfarin prophylaxis who had major intraperitoneal hemorrhage 17 days following percutaneous liver biopsy (PLBx). Selective hepatic angiography revealed a pseudoaneurysm of a branch of the right hepatic artery, associated with an arterioportal venous fistula. Ultrasound with Doppler studies showed flow through the pseudoaneurysm. Embolization with platinum micro-coils resulted in cessation of flow through the pseudoaneurysm, and closure of the arterio-portal venous fistula. Anticoagulation was then resumed without recurrent bleeding. Pseudoaneurysms and arteriovenous fistulas may be mechanisms by which delayed bleeding occurs after PLBx. Doppler ultrasonography and hepatic angiography are useful in the evaluation and management of this event

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 40–year–old man developed dyspepsia, watery diarrhea, and weight loss. A clinical diagnosis of hyperthyroidism due to Graves’ disease was confirmed [free thyroxine, 87 pmol/L (normal range, 8.6–27 pmol/L)]. Bile acid malabsorption was demonstrated by a low 23– selena–25–homocholyltauric acid retention of 7.1% (normal, >15%). Antithyroid treatment (carbimazole and propranolol) was instituted, and his diarrhea subsided with the control of hyperthyroidism (free thyroxine, 15 pmol/L) along with an improvement of bile acid absorption (Se–HCAT retention, 14.7%). This case very strongly suggests the existence of bile acid malabsorption in hyperthyroidism. The temporal association suggests that the diarrhea may have been due at least in part to bile acid malabsorption, raising the possibility that the latter may be an etiological factor in thyrotoxic diarrhea. We believe this is the first such report.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Breast cancer has been reported to confer greater risk for colorectal cancer. In order to estimate the magnitude of this risk, we critically reviewed all studies evaluating the association of breast and colorectal cancer and performed a meta-analysis. The combined results from seven cohort studies demonstrated a weak association between breast cancer and the subsequent risk of colorectal cancer [pooled relative risk (RR) = 1.15; 95% confidence interval (CI) = 0.99-1.31]. Pooled results from five cohort studies showed that the risk of breast cancer after colorectal cancer was similar (pooled RR = 1.10; 95% CI = 1.03-1.17). The combined results from five crosssectional/ case-control studies revealed a positive association between breast cancer and colorectal adenomas (pooled RR = 1.74; 95% CI = 1.27-2.21). Populationbased cohort studies, the strongest research design, show essentially no increase in risk of colorectal cancer in women with previous breast cancer. Based upon this evaluation, there appears little justification for special colorectal surveillance of women with previous breast cancer.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Inflammatory diseases of the pancreas are not uncommon in the elderly; although acute and chronic pancreatitis in this age group are essentially the same diseases as in younger patients, some features are unique to the old patient. Acute pancreatitis in the elderly is more commonly of gallstone etiology; it is also more likely to have an atypical clinical presentation, making recognition more difficult. In acute necrotizing pancreatitis, the elderly patient has an increased risk of complications including multisystem failure; for this reason, such patients should be more carefully monitored and aggressively treated. Chronic pancreatitis with initial onset older than 60 years is rare in the elderly, and generally without apparent cause; much more commonly, it is seen as the advanced stage of a disease started in youth. Diffuse glandular destruction and resulting severe insufficiency are usually present; thus, rather than pain, the most frequent clinical manifestations are steatorrhea and diabetes. These complications should be adequately treated to avoid malnutrition, which may seriously affect the wellbeing and quality of life in the elderly.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Primary upper gastrointestinal lymphoma (PUGIL) is relatively common in the Middle East, and upper gastrointestinal (UGI) endoscopy is very useful for its diagnosis. Analysis of 33 patients with PUGIL revealed that ulceration, mainly superficial and/or multicentric, in 24 (73%) patients was the most frequent endoscopic feature. A granulonodular pattern was characteristic of duodenal involvement, but in contrast, infiltrative and polypoid patterns were more often seen in gastric lymphoma. Isolated involvement of the fundus was not seen in these patients. With a high index of suspicion and careful attention to mucosal details, the diagnosis of PUGIL may be made early by multiple biopsies during UGI endoscopy.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We report six cases of pseudolipoma of Glisson’s capsule. The patients ranged from 53 to 83 years old (mean 67.7 years), and all were men. Pseudolipoma of Glisson’s capsule was detected by imaging studies before operation in two cases, and noted incidentally in the remaining four. Computed tomography demonstrated a subcapsular low-density nodule with or without a highdensity spot. All but one patient had a history of abdominal operation. Grossly, the pseudolipoma was a solitary encapsulated nodule on the surface of the anterior aspect in five, and posteroinferior to the right lobe in one. The pseudolipomas ranged from 0.5 to 2 cm in diameter, were white to yellowish-white and elastic-firm. Histologically, the nodules had a dense fibrous capsule and contained necrotic mature fat tissue. In addition, three showed focal calcification. Blood vessels were rarely found within the capsule. These findings strongly suggest that history of abdominal operation, advanced age, sex, and poor blood supply to the nodule are causal to their development. Although only 18 cases have been reported previously, our six cases during but a 3-year period suggests that it may not be as rare as believed.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Divisione di Gastroenterologia, Centro per la Cura e lo Studio delle Malattie Infiammatorie Intestinali, Ospedale Nuovo Regina Margherita, Roma, Italy

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID