ABSTRACT
PURPOSE: Acromegaly causes multiple comorbidities, including gastrointestinal disorders. The present study evaluated the frequency of hiatal hernia and other upper gastrointestinal pathologies in patients with acromegaly, given that visceromegaly and reduced nitric oxide levels in acromegaly may impact diaphragm and lower esophageal sphincter function and thus possibly the development of hiatal hernia. METHODS: Thirty-nine acromegaly patients followed our center for the previous 6months were recruited. Upper gastrointestinal endoscopy was performed once in all patients to evaluate hiatal hernia, esophagitis, gastroduodenitis and ulcer. RESULTS: Twenty-three patients were male and 16 female. Upper gastrointestinal endoscopy found hiatal hernia, esophagitis and gastroduodenitis or gastric ulcer in 3 (7.6%), 2 (1.7%) and 31 (79.4%) patients, respectively. Pathologic examination of gastric antrum biopsy found intestinal metaplasia in 12 (30.7%) patients, and Helicobacter pylori was positive in 13 (33.3%). There were no significant correlations between age, gender, disease duration or preoperative adenoma size on the one hand and hiatal hernia or other endoscopic findings on the other. Similarly, neither surgical success nor recurrence was associated with endoscopic findings. CONCLUSIONS: The study showed that prevalence of gastritis, duodenitis, peptic ulcer and intestinal metaplasia is higher and prevalence of hiatal hernia lower in acromegaly patients than in the healthy population. Various unknown disease-related pathophysiological conditions may play a role; there is a need for further studies.
Subject(s)
Acromegaly/complications , Acromegaly/epidemiology , Gastrointestinal Diseases/epidemiology , Upper Gastrointestinal Tract/pathology , Acromegaly/pathology , Adult , Endoscopy, Gastrointestinal , Esophagitis/complications , Esophagitis/diagnosis , Esophagitis/epidemiology , Female , Gastritis/complications , Gastritis/diagnosis , Gastritis/epidemiology , Gastrointestinal Diseases/complications , Gastrointestinal Diseases/diagnosis , Hernia, Hiatal/complications , Hernia, Hiatal/diagnosis , Hernia, Hiatal/epidemiology , Humans , Male , Middle Aged , Peptic Ulcer/complications , Peptic Ulcer/diagnosis , Peptic Ulcer/epidemiology , Prevalence , Upper Gastrointestinal Tract/diagnostic imagingABSTRACT
Hepatic portal venous gas is most often associated with extensive bowel necrosis due to mesenteric infarction. Mortality exceeds 75% with this condition. The most common precipitating factors include ischemia, intra-abdominal abscesses and inflammatory bowel disease. In this report, we present a 75-year-old woman with extensive hepatic portal and mesenteric venous gas due to colonic diverticulitis. She had a 10-year history of type II diabetes mellitus and hypertension. She was treated by sigmoid resection and Hartmann's procedure and discharged from the hospital without any complications.
