摘要:

Mushroom poisoning, mycetismus, is a well-recognized cause of fulminant hepatic failure in Western Europe and is increasingly seen in the United States. We present a case of fulminant hepatic failure secondary to mushroom poisoning treated successfully with an orthotopic liver transplant.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Hepatitis C virus (HCV) antibodies detected by radioimmunoassay (RIA) and immunoblot assay were determined in 139 patients with alcoholic liver disease (ALD). Risk factors for exposure to HCV were recorded. Anti-HCV was detected by RIA in 38 (27%), but only 18 (13%) were confirmed with an immunoblot assay. One hundred seven (77%) had risk factors. Of these 107, anti-HCV was detected in 36 by RIA and in 17 by immunoblot assay. Only 2 of 32 patients without risk factors had anti-HCV detected by RIA (1 was reactive with immunoblot, p < 0.05 vs. patients with risk factors). Parenteral drug use and multiple anti-HCV. Age, sex, duration of alcoholism, race, and birthplace did not correlate with detectable HCV antibodies.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The exact pathophysiological mechanism of halitosis is not clear, and in many patients the etiology is an enigma. We followed three couples in which one member or both had halitosis. All the subjects had evidence ofHelicobacter pyloriinfection. All received a treatment course of colloidal bismuth subcitrate four times a day and 250 mg metronidazole three times a day. There was impressive improvement in their symptoms, the halitosis disappearing along with eradication of the organism. We call the attention of physicians to the possible connection between halitosis,H. Pyloriinfection, and familial occurrence. Further studies to confirm this surprising association are in order.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Acute acalculous cholecystitis is an uncommon but very serious illness, that, if undiagnosed, may lead to gallbladder perforation and death. The condition has numerous causes that result in bile stasis and ischemia leading to inflammation and infection in the gallbladder wall. The bedside diagnosis may be difficult, especially in critically ill patients. Current imaging techniques including ultrasonography, computer tomography, and radionuclide cholescintigraphy are very helfful. Depending on the clinical situation, the gallbladder should either be drained by a surgical or percutaneous cholecystostomy under local anesthesia or removed.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Percutaneous endoscopic gastrostomy provides a nonsurgical alternative to enteral feeding. The tube may deteriorate or be expelled accidentally from the stomach and require replacement. We report a patient in whom the replacement Foley catheter migrated into the jejunum, resulting in impaction of the hub into the abdominal wall with resultant localized infection and impaction at the stoma site. We review this problem and suggest a simple technique to prevent the complication.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Splenic complications of acute pancreatitis are rare. We describe a spontaneous subcapsular splenic laceration during an episode of acute pancreatitis, without any evidence of one of the currently reported predisposing factors. Its spontaneous resolution suggests that conservative therapy can be proposed in such complications.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Hypoxia in the setting of liver disease is often multifactorial. Obstructive or restrictive lung disease, pleural effusions, and tense ascites are common underlying disorders. Less often observed and frequently unrecognized is hypoxia related to diffuse intrapulmonary shunting—the hepatopulmonary syndrome. Its etiology is unknown but may result from disordered gut peptide metabolism. Symptoms may be ameliorated by somatostatin and reversed by successful live transplantation. Here we report a patient with severe hepatopulmonary syndrome who failed somatostatin therapy and declined liver transplantation. On her own the patient took large daily doses of powdered garlic (Allium sativum). She has experienced partial palliation of her symptoms and some objective signs of improvement over 18 months of continuous self-medication. The possible effects of garlic's main physiologically active compound, allicin, on gut peptide metabolism and pulmonary vasculature are unknown. This innocuos compound may deserve further investigation given the limited therapeutic options for this disorder.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We report a young male IVDA with CAH caused by HBV who was infected with HIV and who contracted listeriosis in the form of acute hepatitis and bacteremia, with epithelioid granulomas in the liver. Treatment with ampicillin and a aminoglycoside for 3 weeks was followed by rapid and maintained improvement. Involvement of the liver is unusual in listeriosis and, as far as we are aware, it has not been described previously in patients with HIV infection.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The watermelon stomach is an uncommon but treatable cause of chronic gastrointestinal bleeding. We report our experience with the clinical and endoscopic features of 45 consecutive patients treated by endoscopic Nd:YAG laser coagulation. The prototypic patient was a woman (71%) with an average age of 73 years (range of 53–89 years) who presented with occult (89%) tranfusion-dependent (62%) gastrointestinal bleeding over a median period of 2 years (range of 1 month to > 20 years). Autoimmune connective tissue disorders were present in 28 patients (62%), especially Raynaud's phenomena (31%) and sclerodactyly (20%). Atrophic gastritis occurred in 19 of 19 (100%) patients, with hypergastrinemia in 25 (76%) of 33 patients tested. Antral endoscopic appearances included raised or flat stripes of ectatic vascular tissue (89%) or diffusely scattered lesions (11%). Proximal gastric involvement was present in 12 patients (27%), typically in the presence of a diaphragmatic hernia. Endoscopic laser therapy after a median of one treatment (range of 1–4) resulted in complete resolution of visible disease in four patients (13%) and resolution of > 90% in 24 patients (80%). Hemoglobin levels normalized in 87% of patients over a median follow-up period of 2 years (range of 1 month to 6 years) with no major complications. Blood transfusions were not necessary after laser therapy in 86% of 28 initially transfusion-dependent patients. The characteristic clinical, laboratory, and endoscopic features allow for a confident diagnosis that can lead to successful endoscopic treatment.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID