ABSTRACT
Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. As the clinical manifestations are very diverse and associated with nonspecific symptoms, research seeking to identify organic causes to rule out IBS and to enable differential diagnosis is required. A 24-year-old man was referred to our hospital for specialized management of IBS. He had a 7-month history of intermittent epigastric and lower abdominal pain. On the basis of clinical examination, he was diagnosed with IBS and administered medication at a primary clinic. However, his symptoms did not improve after treatment. We performed capsule endoscopy at our hospital and identified a parasite (Ancylostoma duodenale) in the proximal jejunum. We therefore report a case of parasitic infection found by additional examination while evaluating symptoms associated with a previous diagnosis of refractory IBS.
Subject(s)
Humans , Young Adult , Abdominal Pain , Ancylostoma , Ancylostomatoidea , Capsule Endoscopy , Diagnosis , Diagnosis, Differential , Irritable Bowel Syndrome , Jejunum , ParasitesABSTRACT
Toothbrush swallowing is a rare event. Because no cases of spontaneous passage have been reported, prompt removal is recommended to prevent the development of complications. Most swallowed toothbrushes have been found in the esophagus or the stomach of affected patients, and there has been no previously reported case of a toothbrush in the colon. Here, we report a case of a swallowed toothbrush found in the ascending colon that caused a fistula between the right colon and the liver, with a complicating small hepatic abscess. This patient was successfully managed using exploratory laparotomy. To our knowledge, this is the first documented case of a swallowed toothbrush found in the colon.
Subject(s)
Adult , Humans , Male , Colon/injuries , Colonic Diseases/diagnosis , Deglutition , Fistula/diagnosis , Foreign-Body Migration/surgery , Laparotomy , Toothbrushing/instrumentationABSTRACT
A Sengstaken-Blakemore (S-B) tube has been widely used to treatment of bleeding esophageal varices. It controls bleeding in 50~92% of cases and provide more time to plan future management. However, there are a number of complications with its use, some of which are lethal. We recently observed a very unusual complication of a S-B tube, namely an impaction of the gastric balloon at the gastroesophageal junction, which could not be deflated by removing the clamps and suctioning the air with a syringe. The gastric balloon was punctured endoscopically with needle knife and deflated. The S-B tube was then be easily removed.