ABSTRACT
One of the rare side effects of chronic usage of non-steroidal anti-inflammatory drugs is colopathy, which is characterised by colonic inflammation, ulceration and formation of diaphragms in late stages. We treated a case of colonic diaphragm disease with similar findings in our unit recently. We present the case herewith, followed by a discussion of the management of this interesting rare but benign condition.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Colonic Diseases/chemically induced , Colonic Diseases/diagnosis , Colonic Diseases/surgery , Endoscopy, Digestive System , Female , Humans , Middle Aged , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 73-year-old man presented acutely with upper gastrointestinal (GI) haemorrhage. Upper GI endoscopy was suggestive of a pancreatic or submucosal duodenal neoplasm invading the stomach. He underwent laparoscopically assisted distal gastrectomy. Histopathological examination showed the rare entity of primary gastric squamous cell carcinoma. He underwent adjuvant chemotherapy and remains disease free at 6 months.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Stomach Neoplasms/diagnosis , Aged , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Diagnosis, Differential , Humans , Male , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Treatment OutcomeABSTRACT
A previously fit man was investigated for right-sided abdominal pain and an appendicular foreign body (FB) caused by ingested lead shot was found. He had associated urinary tract infection causing his symptoms and hence was treated conservatively. We present this rare case, followed by discussion of the causes, investigations, clinical significance and management of appendicular FBs.
Subject(s)
Appendicitis/diagnostic imaging , Appendicitis/etiology , Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Animals , Anti-Bacterial Agents/therapeutic use , Deglutition , Diagnosis, Differential , Humans , Lead , Male , Middle Aged , Tomography, X-Ray Computed , Urinary Tract Infections/complications , Urinary Tract Infections/drug therapyABSTRACT
AIM: Diaphragmatic disease is rare. This review aims to increase awareness of this condition and its management. METHOD: A literature search was conducted using the key terms 'colon' or 'colonic' in combination with 'diaphragm' or 'diaphragm disease' for publications until August 2012. All cases of colonic diaphragm syndrome were identified and the required data were collected. RESULTS: Forty-five cases of colon diaphragm disease were included. The highest incidence was in the seventh decade of life, with a female preponderance (40F:5M). Most patients presented with chronic (median 3 months) and multiple symptoms. The median use of nonsteroidal anti-inflammatory drugs (NSAIDs) was 5 years including diclofenac as the most commonly used NSAID. Colonoscopy was the most informative investigation and the ascending colon was the most common site of diaphragm disease. Nearly two-thirds of the patients were treated by discontinuing NSAID treatment combined with other forms of treatment, mostly surgery. CONCLUSION: Diaphragm disease of the colon is a rare condition associated with long-term use of NSAIDs with a range of presentations and symptoms. Based on this review, when colon diaphragm disease is diagnosed we would recommend a trial cessation of NSAIDs. Therapeutic endoscopic techniques should be considered but surgery may be required for definitive treatment.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Colonic Diseases/chemically induced , Age Distribution , Aged , Aged, 80 and over , Animals , Colon, Ascending/physiopathology , Colonic Diseases/epidemiology , Colonic Diseases/physiopathology , Colonoscopy , Female , Humans , Male , Middle Aged , Sex Distribution , SyndromeABSTRACT
Hypoxia inducible factor 1α (HIF 1α) plays a major role in the pleitropic response observed secondary to hypoxic conditions in tumors. Its expression in the tumor cells has been correlated to tumor aggressiveness and prognosis in squamous cell carcinoma (SCC) of the esophagus in Far Eastern population, but limited information is available on the prognostic role of HIF 1α in SCC of esophagus in European population. This information may help in choosing appropriate therapeutic strategies and possibly developing a monoclonal antibody with therapeutic potential targeting the HIF 1α. Tumor samples from 36 patients diagnosed with SCC of the esophagus were collected. Prepared tissue sections were stained with validated and specific monoclonal antibodies for HIF 1α and the expression was correlated with the disease pattern and survival. Out of 36 patients, 17 patients showed low and 19 high expression of HIF 1α. There was no difference in the disease-free and overall survival between these two groups (P > 0.05, log rank test). Regression analysis showed that HIF 1α was not an independent prognostic factor for survival (P > 0.05). HIF 1α did not show prognostic value in SCC of the esophagus in our study on European population, in agreement with previous studies. Novel strategies on the therapeutic manipulation of HIF 1α in cancer are to be explored further and may have a role to play in improving treatment outcome.
