ABSTRACT
Most patients with intestinal obstruction have had previous surgery. Rarely, the development of adhesions and resulting small bowel obstruction is attributed to previous intra-abdominal trauma. We present the case of a young man, without a history of surgery, who had been a restrained driver in a motor vehicle crash. Seven years later, the patient had an intermittent partial small bowel obstruction that recurred over the next 5 years. We review the pathophysiology and epidemiology of similar occurrences, as well as diagnostic options.
Subject(s)
Abdominal Injuries/complications , Intestinal Obstruction/etiology , Intestine, Small , Periodicity , Seat Belts/adverse effects , Abdominal Injuries/etiology , Accidents, Traffic , Adult , Contrast Media , Humans , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Male , Tissue AdhesionsABSTRACT
Hepatic angiosarcoma is a rare form of liver cancer. The history, physical examination, and liver biopsy are nonspecific. As a result, diagnosis of angiosarcoma can be challenging. We report the case of an elderly woman with congestive heart failure caused by a hepatic angiosarcoma. The massive tumor burden created extensive arteriovenous shunting and a high-cardiac-output state.
Subject(s)
Heart Failure/etiology , Hemangiosarcoma/complications , Liver Neoplasms/complications , Aged , Aged, 80 and over , Female , Hemangiosarcoma/diagnosis , Humans , Liver/pathology , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging , PrognosisSubject(s)
Pain/physiopathology , Pancreatitis, Alcoholic/physiopathology , Chronic Disease , HumansSubject(s)
Fatty Acids/toxicity , Pancreatitis, Alcoholic , Animals , Disease Models, Animal , Pancreas/drug effects , Pancreas/pathology , RatsSubject(s)
Hypercalcemia/complications , Pancreatitis/etiology , Trypsinogen/metabolism , Animals , Cats , Guinea Pigs , RatsABSTRACT
We report a case of severe colitis from diclofenac (Voltaren), one of a number of nonsteroidal anti-inflammatory drugs (NSAIDs) that can cause colonic injury. The patient, a 68-yr-old woman, presented with acute onset of bloody diarrhea, having taken diclofenac for more than 2 yr. Colonoscopy revealed deep ulcerations in the transverse colon and erythema and erosions scattered elsewhere. Biopsy findings included crypt distortion, cryptitis, hemorrhage, and some fibrosis. Also, in one biopsy taken from an area of deepest ulceration, a large, non-foreign body-type granuloma was seen, raising the specter of Crohn's colitis. All symptoms subsided within 24 h after discontinuation of the diclofenac, and follow-up colonoscopy 17 days later showed complete endoscopic and histological resolution. Patients and physicians should be aware of the possibility of colitis from NSAIDs. In rare cases, some will show granulomatous change that may be confused with Crohn's disease. Early recognition and discontinuation of NSAIDs is crucial to prevent clinical worsening that could lead to colectomy or even prove fatal.