Eosinophilic gastroenteritis in a child with gastric outlet obstruction mimicking superior mesenteric artery syndrome

Eosinophilic gastroenteritis (EGE) is known to have a low incidence among the pediatric population, but it can result in serious complications, such as gastric outlet obstruction. In previously published EGE cases with the obstruction in adults, surgeries were often performed. In this report, we present a 14-year-old girl who came to our facility with severe abdominal pain and vomiting. On the initial abdominal physical examination, diffuse tenderness and severe epigastric pain were noted. Computed tomography scan of the abdomen showed the findings of superior mesenteric artery (SMA) syndrome. However, she had no history of recent weight loss, and the medical history was inconsistent with SMA syndrome. We planned upper gastrointestinal series with barium, and then verified gastric outlet obstruction. We performed esophagogastroduodenoscopy and obtained a final diagnosis of EGE through mucosal biopsy specimen. Corticosteroids and anti-inflammatory medications were administered. Dietary modification and education were done as well. The symptoms resolved, and the follow-up esophagogastroduodenoscopy and ultrasonography showed improvements in the obstruction. Our case emphasizes that gastric outlet obstruction due to EGE must be carefully differentiated from SMA syndrome because of their similarities in clinical features and radiologic images. In doing so, we can avoid surgical intervention and perform medical/dietary treatment for gastric outlet obstruction.

Antihypertensive effect of ethanol extracts of Aralia elata in spontaneously hypertensive rats

Antihypertensive effects of ethanol extracts of Aralia elata (Miq.) Seem. (AE) were investigated in spontaneously hypertensive rats (SHR). SHR aged 14 weeks were treated for 8 weeks with AE (10 or 50 mg/kg/day) or amlodipine besylate (Am; 10 mg/kg/day) orally. Hypertension results in injury to several organs and can produce a significant increase in malondialdehyde (MDA) content as a result of lipid peroxidation and endothelial dysfunction. In this study, oral administration of AE and Am significantly reduced systolic blood pressure, organ weight index, and MDA content in tissues but increased significantly the plasma nitrite and nitrate concentrations. The endothelium-dependent relaxant activities of acetylcholine (10⁻¹⁰–10⁻³ M) in norepinephrine (NE)-precontracted aorta were increased in AE- and Am-treated rats. Particularly strong endothelium-dependent relaxant activities were observed in AE-treated (50 mg/kg) rats. The endothelium-independent relaxant activities of sodium nitroprusside (10⁻¹⁰–10⁻³ M) in NE-precontracted aorta were not changed. The results of this study suggest that AE has both antihypertensive and end-organ protective effects in SHR.

Dangyuja (Citrus grandis Osbeck) Peel Improves Lipid Profiles and Alleviates Hypertension in Rats Fed a High-Fat Diet / 한국실험동물학회지

Obesity is a major public health problem and significant risk factor for many serious diseases including coronary artery disease, cancer, and diabetes. This study was performed to investigate the hypolipidemic effects and anti-hypertensive effect of Dangyuja (Citrus grandis Osbeck) peel, which is bred on Jeju island, in rats fed a high-fat diet. This study was conducted on 4 equal rat groups which were fed as follows; normal diet group (ND), high fat diet group (HFD), high fat diet supplemented with powdered peel of Dangyuja (1%, wt/wt) group (HFD+Dangyuja), and high fat diet treated with sibutramine simultaneously at a dose of 10 mg/kg group (HFD+Sibutramine). After feeding the high fat diet, body weight gain and relative weight of adipose tissues and liver significantly increased in HFD group, but Dangyuja peel supplementation protected these HFD-induced changes. The levels of serum triglyceride, total cholesterol, low-density lipoprotein (LDL)-cholesterol, and the atherogenic index significantly decreased in the HFD+Dangyuja peel group compared with the HFD group. The systolic blood pressure was significantly increased by feeding the high fat diet, whereas the supplementation of Dangyuja peel effectively prevented the elevation of blood pressure. Therefore, these results suggest that Dangyuja exerts a beneficial effect on obesity by improving lipid metabolism and alleviating obesity-related hypertension.