Subject(s)
Anti-Inflammatory Agents/administration & dosage , Betamethasone/analogs & derivatives , Catheterization , Crohn Disease/drug therapy , Intestinal Obstruction/therapy , Adult , Betamethasone/administration & dosage , Colitis/drug therapy , Colonoscopy , Combined Modality Therapy , Drug Combinations , Female , Humans , Ileitis/drug therapy , Injections, Intralesional , Intestinal Obstruction/drug therapy , Male , Middle Aged , RecurrenceABSTRACT
Three patients with carcinoid tumors of the ileum are presented; two had severe intestinal ischemia, one with infarction of the small intestine. In all three cases, histopathological examination revealed elastic vascular sclerosis (EVS) in the mesenteric blood vessels. Intestinal ischemia in the presence of a carcinoid tumor is probably due to a combination of tumoral secretion products, vascular changes, mesenterial retraction and nodal involvement. Selective superior mesenteric artery arteriography is diagnostic. All the reported carcinoid tumors with ischemic manifestations are ileal and invaded the mesentery or had positive nodes or metastases; two-thirds had EVS, and one-third mesenterial vascular luminal narrowing. Intestinal ischemia may be the underlying cause of vague symptoms in patients with a carcinoid tumor. This tumor may be small and must be looked for during laparotomy, mild intestinal ischemia or mesenterial thickening are important signs. Early resection can prevent intestinal complications. An aggressive attitude, including debulking of metastases, is justifiable.
Subject(s)
Carcinoid Tumor/complications , Ileal Neoplasms/complications , Ileum/blood supply , Ischemia/etiology , Mesenteric Arteries/pathology , Aged , Aged, 80 and over , Elastic Tissue/metabolism , Female , Humans , Mesenteric Arteries/metabolism , Middle Aged , Sclerosis/etiology , Sclerosis/metabolismABSTRACT
Two cases of reversible cholestatic hepatitis after treatment with an amoxycillin/clavulanic acid preparation (Augmentin) are described.
Subject(s)
Amoxicillin/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Cholestasis, Intrahepatic/chemically induced , Clavulanic Acids/adverse effects , Amoxicillin/therapeutic use , Bronchitis/drug therapy , Chemical and Drug Induced Liver Injury/pathology , Cholestasis, Intrahepatic/etiology , Cholestasis, Intrahepatic/pathology , Clavulanic Acids/therapeutic use , Drug Combinations , Female , Humans , Middle Aged , Otitis/drug therapyABSTRACT
A patient on treatment with D-penicillamine developed aphthoid ulcers of the oesophagus, which healed rapidly after withdrawal of this drug. The mechanism of these probably drug-induced oesophageal ulcerations is discussed.
Subject(s)
Esophageal Diseases/chemically induced , Penicillamine/adverse effects , Arthritis, Rheumatoid/drug therapy , Esophageal Diseases/pathology , Female , Humans , Middle Aged , Penicillamine/therapeutic use , Stomatitis, Aphthous/chemically induced , Ulcer/chemically inducedABSTRACT
Six cases of intestinal anisakiasis, or herring worm disease, diagnosed over a two year period in a Belgian gastroenterology unit are described. They presented mainly as intestinal obstructions and larvae of this marine nematode were found in the intestinal wall of two of the four patients who were operated on. In two other patients awareness of the diagnosis permitted conservative treatment and spontaneous healing. In five patients symptoms developed after they had eaten herring marinated in vinegar, a hitherto little known source of the herring worm disease.
