摘要:

Surgicalrohn's disease (CD) and multiple sclerosis (MS) share familial occurrence and similar epidemiological traits. Apart from one report of both diseases occurring among consanguineous relatives, only three cases of CD and MS in the same patient have thus far been described. We describe here a 29-year-old woman in whom MS developed in 1983 and CD in 1989. The MS may have been the result of a strongly HLA-associated genetic pre-disposition, while the additional development of CD may have been due either to genetic factors or perhaps simply to chance. Viewing this case in the context of epidemiological data, however, we suggest that the development of CD and MS is based on one or more common genetic factors acting in conjuction with other presumably exogenous factors and triggering HLA antigens to lead to one disease or the other.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgical 44-year-old man with acute jejonoileitis of unknown etiology developed small bowel obstruction. Intermittent abdominal pain, bloody diarrhea, ascitses, and leukocytosis were prominent features. All stool cultures were negative. On steroid treatment, symptoms and radiographic features completely resolved. We suggest, in agreement with an earlier report, that acute jejunoileitis may be regarded as a distinct clinical entity.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgical 66-year-old man with squamous cell carcinoma of the tongue and vallecula had massive lower gastrointestinal hemorrhage. Colonoscopy examination results were normal, but angiography revealed a 3 X 6-cm hypervascular mass in the right lower quadrant. Persistent bleeding required resection of a large ileal ulcer, which proved to be an isolated ulcer containing cells with cytomegalovirus (CMV) inclusion bodies. Massive gastrointestinal hemorrhage due to an isolated CMV ileal ulcer in adults without acquired immunodeficiency syndrome has not been previously reported. This case illustrated that hemorrhage due to CMV infection of the ileum may occur in the absence of endoscopic evidence of colonic involvement.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalypothyroidism may lead to secondary pseudoobstruction. We report a patient with intestinal symptoms, from hypothyroidism in which previous conventional examinations were negative. Gastrointestinal manometry disclosed features of pseudoobstruction, and we discuss the importance of performing functional studies in selected cases, in as much as symptoms seemed to resolve on replacement therapy.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgical patient who presented with chronic inflammation of the colon, and initially also the terminal ileum, accompanied by marked diarrhea, is described. Repeated high-dose steroid therapy was only temporarily successful, and symptoms recurred upon dose reduction. During the further course of the disease, a marked elevation of alkaline phosphatase and transaminases, as well as soft tissues swelling occurred. Clinically, the diagnosis of inflammatory bowel disease with primary sclerosing cholangitis was made. Irregularities in the walls of the common bile duct and the intrahepatic ducts seen at endoscopic retrograde cholangiopancreatography were consistent with the latter diagnosis. However, extreme eosinophilia of peripheral blood, bone marrow and bowel mucosa was present, and liver histology showed eosinophilic cholangiohepatitis. Under the diagnosis of hypereosinophilic syndrome with involvement of bowel, liver and biliary system, therapy with hydroxyurea was initiated. The patient's condition improved promptly. Eosinophil count and liver enzymes have remained normal under long-term medication with 1.0 g per day of this drug.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicale describe a 29-year-old atient who developed acutte colitis limited to the sigmoid and left colon with features mimicking ischemic injury after a prolonged administration of trifluoroperazine and levomepromazine, two phenothiazines in association with haloperidol, another neuroleptic, and biperidene, an anticholinergic compound. The discontinuation of these drugs was followed by a prompt and complete recovery, and no other cause of acute colitis was found. The subsequent administration of sultopride, a neuroleptic from the benzamide family and then the readministration of haloperidol were well tolerated. No colonic disorder occurred for the following months. This case strongly supports the view that neuroleptic agents, in particular phenothiazines, may induce acute colitis and that haloperidol, a butyrophenone derivative, or sultopride, a benzamide-related neuroleptic, can be administered thereafter without recurrence of the disease.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalediastinal pseudocysts of internal pancreatic fistulas are rare as a cause of bilateral pleural effusions even in relapsing pancreatitis. We describe a 38-year-old man with recurrent bilateral pleural effusion as a complication of a pancreatic pseudocyst. Extension of a pancreatic pseudocyst. into the posterior mediastinum was clearly identified by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan of the abdomen and chest, and the complication was successfully treated by surgical management. We stress the importance of definite assessment of the communication of pancreatic pseudocyst with mediastinum in patients with pancreatitis who develop recurrent pleural effusions.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicale describe a 40-year-old black North American woman with isolated hepatic tuberculosis and an incidentally elevated alkaline phosphatase. Imaging studies of the liver showed a lesion suggesting primary or metastatic disease, which turned out to be the so-called pseudotumoral form of hepatic tuberculosis. We believe this is the first case recorded in the English language literature of isolated hepatic tuberculosis manifesting first as an incidentally elevated alkaline phosphatase. It seems to be the third documented case in the English literature of a patient with this rare form of tuberculous involvement without systemic manifestations. The patient responded to antituberculous therapy and is healthy 4 years after treatment.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgical patient with disseminated gastrointestinal sarcoidosis and non-Hodgkin's malignant lymphoma developed diarrhea and polyadenopathy. Laboratory analysis revealed the presence of protein-losing enteropathy without biological signs of malabsorption. Gastrointestinal biopsy specimens showed numerous sarcoidosis nodules without neoplastic proliferation in the stomach, small intestine, and rectum. The patient's course was favorable after treatment with prednisone and chlorambucil. Disseminated gastrointestinal sarcoidosis may be a previously unidentified cause of protein-losing enteropathy.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalo determine the density of mucosal lymphoid follicles in 10 histologically normal rectums, including the anorectal junction, we counted the follicles macroscopically after the specimens were fixed in 10% acetic acid. The mean density in the rectum was 25.6/cm2. The mean density at the anorectal junction was slightly but not significantly higher, at 29.2/cm2. We found no significant change in follicle density with increasing age in specimens from people between the ages of 17 and 90 years.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID