Congenital Portal Vein Aneurysm Associated with Peliosis Hepatis and Intestinal Lymphangiectasia

Portal vein aneurisym (PVA), peliosis hepatis (PH) and intestinal lymphangiectasia (IL) all are very uncommon entities. Herein, we presented a unique patient with these three rare entities who was admitted to our hospital because of portal hypertensive ascites rich in protein and lymphocyte. PVA was extrahepatic and associated with coronary vein aneurysm. Peliosis hepatis was of microscopic form. Lymphangiectasia was present in peritoneum and small intestine. Diagnoses of these rare entities were made by imaging techniques and histopathological findings. Patient also had hydronephrosis caused by ureteropelvic junction narrowing. Best of our knowledge, there is no such a case reported previously with the association of PVA, PH and IL. Therefore, we propose PVAPHIL syndrome to define this novel association

Mucosa-associated lymphoid tissue lymphoma of the duodenum together with multiple intra-abdominal thromboses and hepatitis C virus infection: a case report

Mucosa associated lymphoid tissue MALT lymphoma is a low grade malignancy that arises most commonly from the gastric mucosa. Small intestinal involvement is very rare. The causative relationship between Helicobacter pylori and the gastric MALT lymphoma is a well known issue, but recently there are several data suggesting the role of hepatitis C virus (HCV) infection in the pathogenesis of lymphoma including MALT lymphoma. Herein we present a rare case of duodenal MALT lymphoma with multiple intra-abdominal thromboses together with HCV infection that was confirmed by real-time polymerase chain reaction detecting HCV-RNA within the peripheral blood mononuclear cells

Eosinophilic esophagitis: Case report

Eosinophilic esophagitis is an inflammatory condition of the esophagus characterized by eosinophilic infiltration. It is a condition mainly affecting children; the adult form has only recently gained recognition as a distinct entity. The major symptom among adults with eosinophilic esophagitis is dysphagia. It is often misdiagnosed as gastroesophageal reflux disease because of the similarity in symptoms. An endoscopic biopsy is required to distinguish between the conditions. The cause of eosinophilic esophagitis is poorly understood, but food allergy has been implicated. Topical steroids are the most effective and convenient method for the treatment of eosinophilic esophagitis in adults. The long-term prognosis of eosinophilic esophagitis is uncertain; however, data suggests a benign course. We herein present two eosinophilic esophagitis cases that were the first to be diagnosed in our clinic

A case of Aeromonas hydrophila enteritis in the course of ulcerative colitis

A 24-year-old man with a previous diagnosis of ulcerative pancolitis presented with severe malabsorption with watery diarrhea, malaise, and weight loss. Physical examination revealed paleness, hypotension, tachycardia, edema, ascites, and left-sided pleural effusion. Laboratory analysis revealed hypoalbuminemia and hypocalcemia. Further examination revealed that malabsorption was related to Aeromanas hydrophila infection. Clinical improvement was observed upon oral ciprofloxacin treatment. No clinical or laboratory activation of ulcerative colitis was detected during this infection. (C) 2007 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved

Postprandial platelet-poor plasma 5-hydroxytryptamine concentrations during diarrhea and constipation periods of alternatingtype irritable bowel syndrome patients

Background/aims: Our aim was to measure concentrations of platelet-poor plasma 5-hydroxytryptamine and to assess any relationship with gastrointestinal symptomatology under fasting and fed conditions in alternating-type irritable bowel syndrome during both constipation and diarrhea periods separately. Results of the two periods were compared with each other as well as with the results of the controls. Methods: Nine patients with alternating diarrhea and constipation symptoms and 9 controls were enrolled. Serial plasma 5-hydroxytryptamine was measured for 1 hour under fasting and for 3 hour after a standard carbohydrate meal. Patients underwent the same measurements during constipation and diarrhea periods separately. Serum 5-hydroxytryptamine concentrations were determined by high-performance liquid chromatography. Symptomatology was assessed throughout the study. Results: Patients exhibited higher concentrations of platelet-poor plasma 5-hydroxytryptamine under fed conditions during diarrhea, especially at postprandial 30 minutes (p<0.05) compared with concentrations during constipation. Increases in postprandial plasma 5-hydroxytryptamine concentrations relative to fasting concentrations were also significantly higher during the diarrhea period than during constipation and in controls (p<0.05). Although there was no significant correlation between plasma 5-hydroxytryptamine concentrations and symptom scores, patients had worse postprandial symptomatology during diarrhea compared with controls (p<0.05). Conclusions: Platelet-poor plasma 5-hydroxytryptamine concentrations after meal ingestion differ between constipation and diarrhea periods in alternating-type irritable bowel syndrome. Postprandial symptomatology is also more prominent during diarrhea. These results suggest that differences in plasma levels of serotonin between diarrhea and constipation may underlie the pathogenesis of alternating-type irritable bowel syndrome and could be involved in some aspects of symptomatology