Upper gastro-intestinal fibre-optic endoscopy

A study of 3 000 upper gastro-intestinal fibre-optic endoscopies over a 3-year period is reported. The majority of patients were endoscoped after barium meals and in 69% of the cases the endoscopic findings correlated well with the radiological findings. In 28% of the cases the endoscopic findings differed from the radiological findings. Endoscopy is more accurate than radiology in the examination of the postgastrectomy stomach, in acute gastro-intestinal haemorrhage, in the radiologically distorted gastric antrum and in the follow-up of gastric ulcer healing. The localisation, healing rate and incidence of recurrence in gastric ulcers and the accuracy of endoscopic biopsy and cytology are reported. The value of endoscopic examination of the stomach and duodenum is shown, but it is stressed that endoscopy is complementary to and not exclusive of radiology.S. Afr. Med. J., 48, 857 (1974)

The value of estimating urinary indican

Urinary indican, a metabolic product of bacterial action on tryptophan in the small bowel, has been estimated in the urine as an indirect indication of small bowel bacterial contamination, in 50 normal controls, 18 patients with small bowel disease, 22 patients with calcific pancreaitis and group of 20 children with kwashiorkor and 10 control children of a similar age-group.Elevated urinary indican excretion 2SD above the mean normal of 49 mg/24 hours was found in a variety of small bowel conditions. Patients with calcific pancreatitis had a mean indican level of 48 mg/24 hours, suggesting that there is no excess bacterial proliferation in the small bowel in this disease.Urinary indican levels were extremely low in both control children and kwashiorkor patients. An insignificant increase occurred after the kwashiorkor was treated. The value of estimating the indicanuria level in each group is evaluated

The value of estimating urinary indican

Urinary indican, a metabolic product of bacterial action on tryptophan in the small  bowel, has been estimated in the urine as an indirect indication of small bowel bacterial contamination, in 50 normal controls, 18 patients with small bowel disease, 22  patients with calcific pancrea~itis and group of 20 children with kwashiorkor and 10 control children of a similar age-group. Elevated urinary indican excretion 2SD above the mean normal of ";9 mg/24 hours was found in a variety of small bowel  conditions. Patients  wi~h calcific pancreatitis had a mean indican level of 48 mg/24 hours, suggesting that there is no excess bacterial proliferation in the small bowel in this disease. Urinary indican levels were extremely low in both control children and kwashiorkor patients. An insignificant increase occurred after the kwashiorkor was treated. The value of estimating the  indicanuria level in each group is evaluated

Cathartic colon with unusual histological features

A case report of a patient with a long history of constipation, surreptitious and overt purgative abuse, is preseated. The radiological appearances were characteristic of cathartic colon. Macroscopic examination of the colon showed the lesions to be situated mainly in the caecum and ascending colon. The histology showed atypical features, with discrete linear ulceration and eosinophil infiltration, but not melanosis coli. It is suggested that a variety of histological changes, some simulating localised ulcerative colitis, may occur in cathartic colon. The pharmacological and pathophysiological effects of irritant purgatives are discussed.S. Afr. Med. J. 48, 216 (1974)

Alpha 1 antitrypsin phenotypes and alcoholic pancreatitis.

Altered frequencies of alpha 1 antitrypsin phenotypes have been reported in patients with chronic pancreatitis, suggesting a possible genetic basis for individual susceptibility to this disease. Alpha 1 antitrypsin phenotypes, with particular regard to alcoholic pancreatitis, were studied. Patients with alcoholic pancreatitis were compared with alcoholic control subjects with no history of pancreatic disease. Serum alpha 1 antitrypsin concentrations were raised in pancreatitis patients sampled within one month of an acute attack of pancreatitis, but otherwise values were similar to those of control subjects. There were no significant differences in alpha 1 antitrypsin phenotypes between alcoholics with pancreatitis and alcoholic control subjects. This study of alpha 1 antitrypsin phenotypes provides no evidence of an inherited susceptibility to alcoholic pancreatitis