Synchronous adenocarcinoma and carcinoid tumor of the terminal ileum in a Crohn's disease patient

BACKGROUND: Several malignancies have been described in association with inflammatory bowel diseases, the most common being adenocarcinoma. Carcinoid tumor and Crohn disease has also been previously reported, however the coexistence of both neoplasms is quite rare and the clinical diagnosis is very difficult. Here we report what we believe to be the fourth case of a mixed adenocarcinoid tumor coexisting with Crohn's disease. CASE REPORT: The patient presented with clinical and radiological features of intestinal obstruction. Laparotomy showed a stricturing lesion in the last 6 cm of the terminal ileum with proximal dilation. Only the histology of the resected surgical specimen proved the presence of a mixed adenocarcinoid tumor involving the terminal ileum. CONCLUSION: Carcinoid tumor should be suspected in elderly patients with Crohn's disease presenting with intestinal obstruction and laparotomy should be considered to exclude malignancy

Confocal laser endomicroscopy for the detection of mucosal changes in ileal pouch after restorative proctocolectomy

POSTE

Effects of chronic inflammatory bowel diseases on left ventricular structure and function: a study protocol

BACKGROUND: Experimental evidences suggest an increased collagen deposition in inflammatory bowel diseases (IBD). In particular, large amounts of collagen type I, III and V have been described and correlated to the development of intestinal fibrotic lesions. No information has been available until now about the possible increased collagen deposition far from the main target organ. In the hypothesis that chronic inflammation and increased collagen metabolism are reflected also in the systemic circulation, we aimed this study to evaluate the effects on left ventricular wall structure by assessing splancnic and systemic collagen metabolism (procollagen III assay), deposition (ultrasonic tissue characterization), and cardiac function (echocardiography) in patients with different long standing history of IBD, before and after surgery. METHODS: Thirty patients affected by active IBD, 15 with Crohn and 15 with Ulcerative Colitis, submitted to surgery will be enrolled in the study in a double blind fashion. They will be studied before the surgical operation and 6, 12 months after surgery. A control group of 15 healthy age and gender-matched subjects will also be studied. At each interval blood samples will be collected in order to assess the collagen metabolism; a transthoracic echocardiogram will be recorded for the subsequent determination of cardiac function and collagen deposition. DISCUSSION: From this study protocol we expect additional information about the association between IBD and cardiovascular disorders; in particular to address the question if chronic inflammation, through the altered collagen metabolism, could affect left ventricular structure and function in a manner directly related to the estimated duration of the disease

Intervento di Delorme nel prolasso rettale completo

Tecnica chirurgica necessaria per correggere il prolasso sia per via addominale per via perineale applicando id volta in volta quella che pi\uf9 si adatta al singolo caso in relazione all'et\ue0, condizioni generali, incontinenza, stipsi, entit\ue0 del prolasso e precedenti intervent

Attualità nel trattamento della colite ulcerosa : s-pouch

L'originale disegno della S-pouch nata dagli esperimenti di Valiente e Bacon del 1955 e utilizzata e descritta poi da Parks e Nicholls (per la prima volta nel 1978), ci parve nell985, quando iniziammo a trattare gli allora sporadici casi che giungevano alla nostra osservazione, come la migliore configurazione di reservoir, pi\uf9 agevole da praticare del reservoir di Kock di cui avevamo una piccola esperienza avendolo utilizzato per eseguire un'ileostomia continente in tre casi (RCU, FAP, neovescica ileale dopo cistectomia totale) e pi\uf9 capiente della J-pouch comunque allora non ancora ben conosciuta e praticata routi.nariamente. La possibilit\ue0 d'eradicare la malattia e di preservare la funzione sfinterica ci entusiasm\uf2 cos\uec com'era successo con la chirurgia del retto neoplastico con l'uso delle suturatrici meccanich

Stricturoplastiche e morbo di Crohn

L'attuale orientamento chirurgico nel morbo di Crohn \ue8 volto al massimo risparmio del tratto gastro-enterico. L'utilizzo delle plastiche di allargamento delle stenosi \ue8 volto al risparmio di intestino, anche malato, soprattutto nei casi che presentano malattia recidiva o estes