139 research outputs found
Esophageal Crohn's Disease Treated “Topically” with Swallowed Aerosolized Budesonide
Proximal Crohn's disease, involving the esophagus, the stomach, the duodenum, and the proximal jejunum, is uncommon. Treatment for proximal Crohn's disease is based on data derived from case series than from controlled trials. We present a case of Crohn's colitis with concomitant proximal esophagogastroduodenal involvement treated with conventional treatment plus swallowed aerosolized budesonide as a novel adjuvant topical treatment for the esophageal disease, and we review the treatment options for proximal Crohn's disease
Total Splenectomy due to an Unexpected “Complication” after Successful Extended Laparoscopic Partial Decapsulation of a Giant Epidermoid Splenic Cyst: A Case Report
Splenic cysts are rare entities and are classified as true cysts or pseudocysts based on the presence of an epithelial lining. Congenital nonparasitic true cysts can be epidermoid, dermoid, or endodermoid, present at a young age, and are commonly located in the upper pole of the spleen. Surgical treatment is recommended for symptomatic, large (more than 5 cm), or complicated cysts. Depending on cyst number, location, relation to hilus, and the major splenic vessels, the surgical options include aspiration, marsupialization, cystectomy, partial cystectomy (decapsulation), and partial or complete splenectomy. Laparoscopic techniques have now become the standard approach for many conditions, including the splenic cysts, with emphasis on the spleen-preserving minimally invasive operations. We present the successful extended partial laparoscopic decapsulation of a giant epidermoid splenic cyst in a young female patient that, although asymptomatic, was unfortunately followed by complete splenectomy five days later due to a misinterpreted abdominal CT suggesting splenic postoperative ischemia
Endoscopic removal of a toothpick perforating the sigmoid colon and causing chronic abdominal pain: a case report
Toothpick ingestion is implicated in gut injuries which may cause severe complications, mimicking diseases causing acute abdomen. However, toothpick ingestion-related perforation may also cause mild, non-specific gastrointestinal symptoms without significant findings or major complications. We describe a young male with chronic postprandial lower abdominal pain caused by a toothpick impaction at the rectosigmoid junction after inadvertent ingestion. The foreign body was detected and successfully removed during flexible sigmoidoscopy. Perforation due to foreign body ingestion must be considered in the differential diagnosis in patients presenting with unexplained symptoms and findings, even when they do not recall any foreign body ingestion
Prevalence of Joint Hypermobility and Patterns of Articular Manifestations in Patients with Inflammatory Bowel Disease
Objective. The objective is the investigation of Joint Hypermobility (JH) and the Hypermobility Syndrome (HMS) in patients with inflammatory bowel disease (IBD).
Methods. We examined 83 patients with IBD and 67 healthy individuals for the presence of JH. Patients were excluded if they were under 18 or over 50 years of age and if they had other conditions which affect joint mobility. The x2 and the Fisher exact test were used appropriately between study groups. Odds ratios (ORs) for the risk of JH and HMS in IBD groups were calculated. Results. A total of 150 individuals (83 IBD patients and 67 healthy controls) participated in the study. 69 IBD patients, 41 with Crohn's Disease (CD) and 28 with ulcerative colitis (UC), were finally eligible. JH was detected in 29 CD patients (70.7%), in 10 UC patients (35.7%), and in 17 healthy control subjects (25.4%). Significant difference was detected on JH in CD patients as compared to UC patients (P = .0063) and controls (P < .0001). The estimated OR for JH was 7.108 (95% CI: 2.98–16.95) in CD and 1.634 (95% CI: 0.63–4.22) in UC patients. HMS was detected in 5 (12.2%) CD and in 1 (3.57%) UC patients. The OR for HMS in CD was 3.75 (95% CI: 0.41–34.007), while 7 (17.1%) CD patients had overlapping symptoms for both HMS and early spondylarthropathy. Conclusions. JH and the HMS are common in CD patients, thus articular manifestations should be carefully interpreted. This implies an involvement of collagen varieties in the pathogenesis of IBD
Laparoscopic resection of a pancreatic serous cystadenoma preserving the integrity of main pancreatic duct: a case report
Pancreatic serous cystadenomas are rare benign cystic neoplasms. Extended operations are unnecessary for serous cystadenomas and minimally invasive surgery should be performed. Laparoscopic pancreatic procedures are under evaluation. We present a case of a 79-year-old Greek woman with symptomatic cholelithiasis and a serous pancreatic cystadenoma located at the neck of the pancreas. In the occasion of a standard laparoscopic cholecystectomy the pancreatic mass was resected with a novel minimally invasive laparoscopic method preserving the integrity of the main pancreatic duct and the whole pancreas. Laparoscopic resection is a feasible, safe and effective treatment of benign pancreatic tumors, in experienced hands under proper indications
Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report
The over-the-scope-clip (OTSC; Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed method for the mechanical compression of large areas in the gastrointestinal tract. So far, indications for OTSC application are hemostasis of primary or postinterventional bleeding, closure of iatrogenic full-thickness or covered perforations. Recently closure of gastrointestinal tract fistulas using this device has been described. A 44-year-old man developed a gastrocutaneous fistula after surgical treatment for a perforated gastric ulcer. We describe the successful endoscopic closure of the fistula using the OTSC system. The patient's clinical followup was uneventful. Fistula closure was successfully implemented as it was documented by imaging and endoscopic examinations performed on the 2nd day and 6th week after the application of the clip. Endoscopic application of the OTSC device was safe and effective for the treatment of a gastrocutaneous fistula
Simultaneous occurrence of hyperthyroidism and fistulizing Crohn’s disease complicated with intra-abdominal fistulas and abscess: a case report and review of the literature
The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
Introduction. The pathogenesis of GERD is strongly
related with mixed acid and bile reflux. Benign and malignant
esophageal and gastric lesions have been associated with synergetic
activity between those parameters. Bile reflux causes reactive
gastropathy evaluated with Bile Reflux Index (BRI). The aim was to
investigate if the sequence: bile reflux-intestinal
metaplasia-GERD-esophagitis, is associated with
apoptotic/oncogenetic disturbances.
Materials/Methods. Fifteen asymptomatic subjects and
53 GERD patients underwent gastroscopy with biopsies. The
specimens examined histologically and immunohistochemically for
p53, Ki-67, Bax, and Bcl-2. Results.
Elevated BRI score detected in 47% (25/53) of patients with GERD
and in 13% (2/15) of controls (P = 0.02). Severe esophageal lesions were significantly more common
in BRI (+) patients (14/25) compared to BRI (−) ones (P = 0.0049). Immunohistochemical analysis did not show associations
between BRI score and biomarker expression.
Conclusions. Bile reflux gastropathy is
associated with GERD severity, but not with oncogene expression or
apoptotic discrepancies of the upper GI mucosa
Accidental finding of a toothpick in the porta hepatis during laparoscopic cholecystectomy: a case report
<p>Abstract</p> <p>Introduction</p> <p>Unintentional ingestion of a toothpick is not an uncommon event. Often the ingested toothpicks spontaneously pass through the gut without sequelae. However, serious complications can happen when these sharp objects migrate through the gastrointestinal wall.</p> <p>Case presentation</p> <p>In the current report, we describe the case of a 37-year-old Caucasian woman with an incidental finding of a toothpick in the porta hepatis during laparoscopic cholecystectomy for symptomatic gall stones.</p> <p>Conclusion</p> <p>Toothpick ingestion is not an uncommon event and can predispose patients to serious complications. In this particular case, the toothpick was only discovered at the time of unrelated surgery. Therefore, it was important during surgery to exclude any related or missed injury to the adjacent structures by this sharp object.</p
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