ABSTRACT
INTRODUCTION: Eosinophilic gastroenteritis is an unusual disease characterized by an eosinophilic infiltration of the gastrointestinal tract. The esophageal location of this disorder is uncommon and is usually revealed by dysphagia. Diagnosis is obtained by histology during endoscopy after exclusion of differential diagnosis. Treatment is based on systemic corticosteroids, which improve dramatically symptoms and endoscopic lesions. CASE REPORT: We report an 88-year-old man who presented eosinophilic gastroenteritis with esophageal injury complicated by gastrointestinal haemorrhage and fistule. CONCLUSION: Eosinophilic gastroenteritis may have a potentially unfavourable outcome. The treatment of complicated forms is not codified and often empirical.
Subject(s)
Enteritis/complications , Eosinophilia/complications , Gastritis/complications , Aged, 80 and over , Diagnosis, Differential , Enteritis/diagnosis , Enteritis/drug therapy , Eosinophilia/diagnosis , Eosinophilia/drug therapy , Esophageal Fistula/complications , Esophageal Fistula/diagnosis , Esophageal Fistula/surgery , Gastritis/diagnosis , Gastritis/drug therapy , Gastroscopy , Humans , Male , Prednisone/therapeutic useABSTRACT
Pneumatosis cystoides intestinalis is a rare disease characterized by the presence of gas into the colonic wall. Symptoms are non specific and, most of the time, the diagnosis is done by an abdominal CT scan. We report a case of pneumatosis cystoides intestinalis which occurred in a patient with a colorectal cancer in palliative stage. This patient was treated by 5 fluorouracil (5FU), folinic acid and oxaliplatin chemotherapy, after a first lign of chemotherapy with 5FU, irinotecan and cetuximab. The association of chemotherapy is most likely probable.
Subject(s)
Colorectal Neoplasms/drug therapy , Pneumatosis Cystoides Intestinalis/diagnosis , Aged , Anti-Bacterial Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Male , Palliative Care , Pneumatosis Cystoides Intestinalis/drug therapyABSTRACT
Systemic amyloidosis usually does not spare the digestive tract but its involvement is rarely symptomatic. The clinical manifestations are not specific. We report a 64-year-old patient, presenting with a weight loss related to an AL amyloidosis. The amyloidosis was apparently limited to the digestive tract. We discuss the various presentations of the digestive amyloidosis and we insist on the seriousness of this localization.
Subject(s)
Amyloidosis/pathology , Intestines/pathology , Paraproteinemias/pathology , Protein-Losing Enteropathies/pathology , Amyloidosis/complications , Amyloidosis/drug therapy , Biopsy , Diagnosis, Differential , Duodenum/pathology , Fatal Outcome , Gastrointestinal Hemorrhage/etiology , Humans , Intestinal Mucosa/pathology , Jejunum/pathology , Male , Middle Aged , Paraproteinemias/etiology , Prognosis , Protein-Losing Enteropathies/etiology , Severity of Illness Index , Weight LossABSTRACT
The superior mesenteric artery (SMA) syndrome is an atypical cause of high intestinal obstruction in adults. Formerly considered controversial, this syndrome has now been recognized as a real clinical entity which results from extrinsic compression of the third portion of the duodenum by reduction of the angle formed between the SMA and the aorta, usually favoured by rapid and dramatic weight loss. We report a case observed in a 25-year-old female. The abdominal scan provided the diagnosis. Laparoscopic duodenojejunostomy provided cure after failure of initial conservative treatment.
Subject(s)
Intestinal Obstruction/etiology , Superior Mesenteric Artery Syndrome/diagnosis , Adult , Contrast Media , Duodenostomy , Female , Humans , Jejunostomy , Laparoscopy , Superior Mesenteric Artery Syndrome/surgery , Tomography, X-Ray Computed , Vomiting , Weight LossABSTRACT
An observation of chronic ulcerative ileo-jejunitis associated with a hemophagocytic syndrome leading to death is described. It was not associated with coeliac disease. The hemophagocytic syndrome had no other etiology than chronic ulcerative ileo-jejunitis. The relations between these two disorders are discussed.
Subject(s)
Enteritis/complications , Histiocytosis, Non-Langerhans-Cell/etiology , Ileal Diseases/complications , Jejunal Diseases/complications , Ulcer/complications , Adult , Chronic Disease , Enteritis/pathology , Fatal Outcome , Histiocytosis, Non-Langerhans-Cell/pathology , Humans , Ileal Diseases/pathology , Jejunal Diseases/pathology , Male , Ulcer/pathologyABSTRACT
OBJECTIVES: Spontaneous chest pain attacks are uncommon during 24-hour esophageal pH monitoring in patients suffering from angina-like chest pain suspected to be acid-related. The aim of this study was to assess the diagnostic value of exertional esophageal pH monitoring and to prove that exercise testing induces chest pain and gastro-esophageal reflux and therefore improves symptomatic correlation study. METHODS: Forty three patients suffering from angina-like chest pain underwent treadmill exercise testing during a 24-hour esophageal pH monitoring. Symptom analysis was made using the symptom-association probability described by Weusten. RESULTS: During the 24-hour pH monitoring, 10 patients (23%) had a pathologic esophageal acid exposure, 20 (46%) experienced chest pain and 3 (7%) had a symptom association probability > 95%. During the exercise testing on a treadmill, 19 patients (44%) had gastro-esophageal reflux, and 14 (32%) experienced chest pain, coinciding with a gastro-esophageal reflux in 8 (19%). After exercise testing, the symptom-association probability analysis was significantly changed in 9 patients (21%), > 95% in 6 patients (14%). CONCLUSION: Exercise testing on a treadmill induces chest pain episodes during a 24-hour esophageal pH monitoring and therefore improves symptomatic correlation study in patients suffering from angina-like chest pain.
