ABSTRACT
Scrub typhus is an acute febrile illness that results from the destruction of endothelial cells by Orientia tsutsugamushi and subsequent systemic vasculitis. It manifests as fever, headache, myalgia, eschar formation, and lymphadenopathy. Some authors have reported that such vasculitis involves the gastrointestinal tract and that hyperemia, erosion, ulceration, and active bleeding of the gastric mucosa subsequently develop. However, no case of ulcer perforation in a patient with scrub typhus has been reported to date. Here, we report the case of a perforated duodenal ulcer in a 70-year-old female patient with scrub typhus.
Subject(s)
Aged , Female , Humans , Duodenal Ulcer , Endothelial Cells , Fever , Gastric Mucosa , Gastrointestinal Tract , Headache , Hemorrhage , Hyperemia , Lymphatic Diseases , Orientia tsutsugamushi , Scrub Typhus , Systemic Vasculitis , Ulcer , VasculitisABSTRACT
Meningeal carcinomatosis in patients with prostate cancer is very rare. Recently, we experienced a case of meningeal carcinomatosis in a patient with prostate cancer. He had undergone a radical prostatectomy 11 years before presentation and had undergone chemotherapy 4 years before presentation due to bone metastases. This time, he visited the emergency department because of a seizure. Although cerebrospinal fluid (CSF) examinations did not reveal malignant cells, we diagnosed meningeal carcinomatosis based on positive CSF prostate-specific antigen and magnetic resonance imaging (MRI) findings. The diagnosis was confirmed pathologically. We treated the patient with whole brain radiotherapy and intrathecal chemotherapy. We report a case of prostate cancer with meningeal carcinomatosis with a literature review.
Subject(s)
Humans , Brain , Emergencies , Magnetic Resonance Imaging , Meningeal Carcinomatosis , Neoplasm Metastasis , Prostate , Prostate-Specific Antigen , Prostatectomy , Prostatic Neoplasms , SeizuresABSTRACT
The clinical presentation of snake bites varies greatly. Symptoms range from only bite marks to muscle spasms, paralysis, altered mental status, and muscle weakness. In severe cases, symptoms may include life threatening coagulopathy or gastrointestinal bleeding owing to increased vascular permeability. In this report, the patient presented with massive gastrointestinal bleeding after a snake bite and recovered with conservative treatment.
Subject(s)
Humans , Bites and Stings , Capillary Permeability , Disseminated Intravascular Coagulation , Gastrointestinal Hemorrhage , Hemorrhage , Muscle Weakness , Paralysis , Snake Bites , Snakes , SpasmABSTRACT
BACKGROUND/AIMS: Stercoral colitis is an inflammatory condition related to increased intraluminal pressure, itself caused by impacted fecal material. Stercoral colitis is a rare condition and has a generally poor prognosis. The aims of this study were to investigate the clinical characteristics and outcomes of stercoral colitis according to management strategy. METHODS: From January 2004 to August 2009, 11 patients were diagnosed with stercoral colitis at our center. The medical records of these individuals were reviewed retrospectively with regard to the clinical characteristics, management strategy, and clinical outcomes. We defined severe stercoral colitis as stercoral colitis complicated by systemic inflammatory response syndrome, sepsis, or septic shock. RESULTS: Eleven patients (three men and eight women) with a mean age of 70+/-8 years were included. Ten patients were elderly with constipation as a predisposing factor. Nine patients had severe stercoral colitis according to out criteria. Of these, five patients underwent surgery, and the other four were treated with a conservative management strategy. One patient (20%) in the surgical group and all patients in the conservative management group (n=4) died. CONCLUSIONS: Stercoral colitis should be considered in elderly patients with predisposing factors and presents as fecal impaction with colonic wall thickening or pericolic fat stranding on CT scan. In patients with severe stercoral colitis, early surgery may be effective in reducing mortality.
Subject(s)
Aged , Humans , Male , Colitis , Colon , Constipation , Fecal Impaction , Intestinal Perforation , Medical Records , Prognosis , Retrospective Studies , Sepsis , Systemic Inflammatory Response SyndromeABSTRACT
Melanosis means the accumulation of brown or black pigment in an organ. Melanosis can be observed in virtually all parts of the gastrointestinal tract. However, it most frequently affects the colon. It is said that melanosis in small intestine is very rare, and no case has been reported in which melanosis was simultaneously noted in duodenum and ileum without involving the colonic mucosa. Here we report a case of melanosis duodeni and melanosis ilei which were found simultaneously in a 56-year-old female patient with chronic renal failure and heart failure who had been taking oral ferrous sulfate for 3 years.
Subject(s)
Female , Humans , Middle Aged , Colon , Duodenum , Ferrous Compounds , Gastrointestinal Tract , Heart Failure , Ileum , Intestine, Small , Iron , Kidney Failure, Chronic , Melanosis , Mucous MembraneABSTRACT
Ischemic colitis is the most common form of ischemia in the gastrointestinal tract. It results from inadequate blood flow in the colon that leads to inflammation of the colon. Though this disease frequently affects the elderly with risk factors of ischemia, younger patients may be affected too. Several conditions such as major vascular occlusion, small vessel disease, shock, some medications, colonic obstructions and hematologic disorders can predispose individuals to ischemic colitis. Ischemic colitis following colonoscopy is rare. Here we report 2 cases of ischemic colitis which developed after colonoscopic procedures in patients without risk factors of ischemia.