ABSTRACT
Pancreatitis has been occasionally associated with Crohn's disease (CD). A definite etiology of pancreatitis can be identified in most patients, but a very small proportion remain idiopathic. We report a case of idiopathic pancreatitis resolved along with the clinical improvement of CD in a 25-year-old man. He presented with abdominal pain and diarrhea for 8 years. Ileocolonoscopy and enteroclysis showed multiple, longitudinal ulcers and strictures at the ileojejunum. The laboratory findings showed elevated serum amylase (951 IU/L) and lipase (326 IU/L) without positive autoantibodies. Esophagogastroduodenoscopy, enhanced pancreatic CT, and MRCP showed no abnormalities at ampulla of Vater, pancrease, and pancreaticobiliary duct. With the treatment with antibiotics, 5-aminosalicylic acid, steroid, and azathioprine, as a whole, decreasing pattern and intermittent fine coordinated fluctuation of the levels of amylase and lipase along with the decrease of Crohn's disease activity index (CDAI) and the CRP levels were observed. Then, three months after the start of the treatment, normalization of the pancreatic enzymes was observed, and there was recurrent elevation of pancreatic engyme during 12 months maintenance therapy. This report supports the concept of an association between idiopathic pancreatitis and CD, based on a significant and close relation between the levels of serum amylase and lipase, and CDAI.
Subject(s)
Adult , Humans , Male , Aminosalicylic Acids/therapeutic use , Amylases/blood , Crohn Disease/complications , Diagnosis, Differential , Duodenoscopy , Lipase/blood , Pancreatitis/diagnosis , Tomography, X-Ray ComputedABSTRACT
Carcinoid tumors originate from the enterochromaffin cells. Rectal carcinoid tumors comprise 12.6% of all carcinoid tumors and they represent the third largest group of the gut carcinoids. However, a recent report showed that the number of reported cases has increases rapidly, which is probably due to the increased number of colonoscopic examinations. The aggressiveness of rectal carcinoid tumors is determined by the depth of invasion and the presence of metastasis. The clinical course of rectal carcinoid is benign, but these tumors may have a malignant character when the lesion is larger than 2 cm in diameter. We have experienced a case of rectal carcinoid tumor smaller than 2 cm in diameter and the patient had multiple liver metastasis.
Subject(s)
Humans , Carcinoid Tumor , Enterochromaffin Cells , Liver , Neoplasm Metastasis , RectumABSTRACT
Mallory-Weiss syndrome is a tear in the gastro-esophageal junction or its adjacent mucosa, and this occurs due to nausea or vomiting that is caused by various etiologic factors. It may occur in patients with excessive retching and struggling when undergoing upper gastrointestinal endoscopy, and its underlying factors are esophageal hiatal hernia, atrophic gastritis and old age. There are currently only rare reports about gigantic gastric mucosal rupture during performance of upper gastrointestinal endoscopy in patients with esophageal hiatal hernia. We recently experienced a 76-year-old woman who developed a gigantic gastric mucosal rupture that ranged from the gastro-esophageal junction to the gastric angle. This occurred during performance of standard upper gastrointestinal endoscopy with the patient under sedation and the patient had a concurrent esophageal hiatal hernia. The patient was treated conservatively for the rupture. Herein we report on our case along with a review of the relevant literature.
Subject(s)
Aged , Female , Humans , Conscious Sedation , Endoscopy , Endoscopy, Gastrointestinal , Gastritis, Atrophic , Hernia, Hiatal , Mallory-Weiss Syndrome , Mucous Membrane , Nausea , Rupture , VomitingABSTRACT
Thoracic aortic aneurysms are potentially life-threatening. They are caused by atherosclerosis, most commonly of the descending aorta. Clinical manifestations are due to the compression or erosion of adjacent structures, dissection, or rupture. Thoracic aortic aneurysms account for 50 to 60 percent of aortobronchopulmonary fistulas. Symptoms of aortobronchopulmonary fistulas include constant chest or back pain, cough, and dyspnea, as well as hemoptysis, which occurs in over 95 percent of cases. Recently, aortobronchial fistula, caused by thoracic aortic aneurysms, has been successfully treated with an endovascular stent graft. We report a patient with aortobronchial fistula presenting with hemoptysis, who was successfully treated with an endovascular stent graft.
Subject(s)
Humans , Aorta, Thoracic , Aortic Aneurysm, Thoracic , Atherosclerosis , Back Pain , Blood Vessel Prosthesis , Cough , Dyspnea , Fistula , Hematemesis , Hemoptysis , Rupture , Stents , ThoraxABSTRACT
Thoracic aortic aneurysms are potentially life-threatening. They are caused by atherosclerosis, most commonly of the descending aorta. Clinical manifestations are due to the compression or erosion of adjacent structures, dissection, or rupture. Thoracic aortic aneurysms account for 50 to 60 percent of aortobronchopulmonary fistulas. Symptoms of aortobronchopulmonary fistulas include constant chest or back pain, cough, and dyspnea, as well as hemoptysis, which occurs in over 95 percent of cases. Recently, aortobronchial fistula, caused by thoracic aortic aneurysms, has been successfully treated with an endovascular stent graft. We report a patient with aortobronchial fistula presenting with hemoptysis, who was successfully treated with an endovascular stent graft.