ABSTRACT
Angiodysplasia has been recognized as an important cause of lower gastrointestinal bleeding, but it is difficult to confirm the lesions. Angiodysplasia in the small bowel could be the most probable cause of bleeding particularly in the elderly patients when usual methods fail to document the focus. Small bowel angiodysplasias have been diagnosed by angiography and/or surgery at the sites where usual endoscope could not reach, and treated by medical therapy, angiographic embolization or surgery. We experienced a case of a bleeding angiodysplasia in the terminal ileum in a 51-year-old man who was taking anti-platelet agents. The lesion was diagnosed by colonoscopy, and bleeding was easily controlled with hemoclipping.
Subject(s)
Aged , Humans , Middle Aged , Angiodysplasia , Angiography , Colonoscopy , Endoscopes , Hemorrhage , IleumABSTRACT
Imigran(R) (sumatriptan), a 5-hydroxytryptamine (HT) derivative, is highly effective in aborting attacks of migraine and cluster headache. The drug is generally well tolerated. However tolerated, although up to 8% of patients consistently have demonstrate chest symptoms, including chest pressure, tightness, and pain, often mimicking angina pectoris. It has been suggested that these chest symptoms are caused by coronary vasoconstriction, and that this effect may be mediated by endothelial dysfunction. This can be reversed by the administration of glyceryl trinitrate. We report a case of vasospastic angina pectoris occurring after the administration of oral sumatriptan in a patient with migraine.
Subject(s)
Humans , Angina Pectoris , Cluster Headache , Migraine Disorders , Nitroglycerin , Serotonin , Sumatriptan , Thorax , VasoconstrictionABSTRACT
Fabry disease, angiokeratoma corporis diffusum, is a rare X-linked inborn error of glycosphingolipid metabolism due to the lack of the lysosomal enzyme, alpha-galactosidase A, resulting in a progressive deposition of specific neutral glycosphingolipids within the lysosomes of endothelial and smooth muscle cells of the cardiovascular and renal systems predominantly. We reported a case of Fabry disease, following renal biopsy for the investigation of proteinuria(Creatinine clearance 87.28 mL/min/1.73, serum creatinine 1.1 mg/dL, 24-hour urine protein 1,125 mg, 24-hour urine creatinine 1,382 mg). The patient was 46 year old male. He had experienced anterior chest pain regarded as angina pectoris for a few years. A 12- lead electrocardiogram was abnormal(T-wave inversion in II, III, AVF, and V3-V6), but echocardiography and coronary angiography revealed no abnormal. Kidney biopsy findings showed lamella inclusion bodies on electron microscopy, which are typical finding of Fabry disease. The patient is followed at O.P.D without any significant complaints for 18 months after diagnosis of Fabry disease.
Subject(s)
Humans , Male , Middle Aged , alpha-Galactosidase , Angina Pectoris , Biopsy , Chest Pain , Coronary Angiography , Creatinine , Diagnosis , Echocardiography , Electrocardiography , Fabry Disease , Inclusion Bodies , Kidney , Lysosomes , Metabolism , Microscopy, Electron , Myocytes, Smooth Muscle , Neutral Glycosphingolipids , ProteinuriaABSTRACT
Pyelocaliceal diverticula are eventrations of the upper collecting system, lying within the renal parenchyma and communicating with the main collecting system via a narrow channel. They may be detected in as many as 0.5% of excretory urograms but are usually small(<1cm in diameter) and asymptomatic. Urinary stasis may predispose patient to infection or stone formation. Rarely, transitional cell carcinoma originates within the diverticulum. Symptomatic, complicated diverticula should be treated by 5 different therapeutic alternatives which is open surgery, a percutaneous approach, shock wave lithotripsy ureterorenoscopy and retroperitoneoscopy. We report a incidentally found calculi-containing type I pyelocalyceal diverticulum patient who initially presented with epigastric pain.
Subject(s)
Humans , Carcinoma, Transitional Cell , Deception , Diverticulum , Lithotripsy , ShockABSTRACT
Pyelocaliceal diverticula are eventrations of the upper collecting system, lying within the renal parenchyma and communicating with the main collecting system via a narrow channel. They may be detected in as many as 0.5% of excretory urograms but are usually small(<1cm in diameter) and asymptomatic. Urinary stasis may predispose patient to infection or stone formation. Rarely, transitional cell carcinoma originates within the diverticulum. Symptomatic, complicated diverticula should be treated by 5 different therapeutic alternatives which is open surgery, a percutaneous approach, shock wave lithotripsy ureterorenoscopy and retroperitoneoscopy. We report a incidentally found calculi-containing type I pyelocalyceal diverticulum patient who initially presented with epigastric pain.
Subject(s)
Humans , Carcinoma, Transitional Cell , Deception , Diverticulum , Lithotripsy , ShockABSTRACT
A 54-year-old woman with diabetes mellitus was hospitalized with generalized edema and weakness. She was also found to have hypertension, hypokalemia and metabolic alkalosis. Detailed examination showed subnormal plasma renin activity and plasma aldosterone concentration. Adrenal CT scanning revealed no adrenal tumor. A successful treatment with amiloride established the diagnosis of Liddle's syndrome for the patient. Liddle's syndrome, a rare hereditary disease usually found in young patients, should be considered in the differential diagnosis of hypertension even in elderly individuals.