ABSTRACT
Although Crohn's disease is usually found in the ileum and colon, it can be located in the whole gastrointestinal tract from the oral cavity to the anus. The frequency of gastroduodenal Crohn's disease is rare and is reported to range between 0.5% and 4.0% in Crohn's disease. And when Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel and colon. Very rarely, isolated Crohn's disease of the stomach and duodenum may occur. Definite diagnosis requires histologic confirmation, however, endoscopic biopsies often fail to reveal granuloma. Thus, if absence of definite histologic findings, combining clinical, radiologic and endoscopic findings suggest this condition. We experienced a first case of Crohn's disease confined to stomach and reported with review of the literature.
Subject(s)
Anal Canal , Biopsy , Colon , Crohn Disease , Diagnosis , Duodenum , Gastrointestinal Tract , Granuloma , Ileum , Mouth , Stomach , Upper Gastrointestinal TractABSTRACT
Gastritis cystica profunda (GCP) is a rare disease in which mature glandular epithelium extends into the muscularis mucosae or below. Mainly GCP lesions developed at gastroenterostomy stomas. We experienced two cases of GCP which were not related with any gastric surgery. The first case was 76-year-old woman who visited for epigastic pain and dyspepsia. The second case was 55-year-old woman complaining right upper quadrant pain. The polyps are found on the greater curvature of the antrum at first case, and on the lesser curvature of the antrum at second case. Each polyp was successfully removed by polypectomy.
Subject(s)
Aged , Female , Humans , Middle Aged , Dyspepsia , Epithelium , Gastritis , Gastroenterostomy , Mucous Membrane , Polyps , Rare DiseasesABSTRACT
BACKGROUND/AIMS: HBeAg-negative chronic hepatitis B (CHB) has a poor long-term prognosis. Since no precise clinically relevant HBV thresholds are known in HBeAg-negative CHB, the decision to treat is difficult. The aim of this study was to evaluate the levels of serum HBV DNA and transaminase and to investigate the correlation of these values in patients with HBeAg-negative CHB. METHODS: The study analyzed the sera from 82 patients with HBeAg-negative CHB, 61 men and 21 women. The mean age was 45 years. The patients were divided into two groups according to serum ALT levels: the patients with lower ALT level (n=52, UNL or= 2 X UNL). The level of serum HBV DNA was determined by the Cobas Amplicor HBV Monitor(TM) (Roche). RESULTS: The median serum HBV DNA level was 2.7 X 10(5) copies/mL in patients with HBeAg-negative CHB. The median serum HBV DNA level of patients with a higher ALT level (1.0 X 10(6) copies/mL) was significantly higher than that of patients with a lower ALT level (5.6 X 10(4) copies/mL)(p<0.001). The serum ALT level was correlated with serum HBV DNA levels in patients with HBeAg-negative CHB (r=0.416, p<0.001). The serum level of HBV DNA in patients with cirrhosis (median 2.0 X 10(5) copies/mL) did not differ from patients without cirrhosis (median 4.7 X 10(5) copies/mL). CONCLUSIONS: The level of serum HBV DNA was higher in patients with higher serum ALT level than it was in patients with lower serum ALT, and it was closely correlated with serum ALT levels in HBeAg-negative CHB.
Subject(s)
Female , Humans , Male , Middle Aged , Alanine Transaminase/blood , DNA, Viral/blood , English Abstract , Hepatitis B e Antigens/blood , Hepatitis B virus/genetics , Hepatitis B, Chronic/blood , Lamivudine/therapeutic useABSTRACT
Duodenal diverticula are first reported by Chomel in 1710. Duodenal diverticula are relatively common in adults with a prevalence of 23% in ERCP. The most duodenal diverticulum is asymptomatic. Complications such as obstruction, cholangitis, biliary stones, ulceration, perforation and hemorrhage can occur in approximately 10%. However, relatively few cases of bleeding from a duodenal diverticulum have been reported. The cause of bleeding from a duodenal diverticulum is uncertain and various suspected etiologies were suggested, such as ectopic gastric mucosa, stasis-induced ulceration, erosion into major vessels, aortoenteric fistulas, intradiverticular polyp, aspirin-induced erosion. We report a case of a bleeding duodenal diverticulum by a Dieulafoy-like lesion and suggest this lesion as one of possible causes of bleeding in duodenal diverticulum.