ABSTRACT
Anastomotic ulcer is a rare complication after ileocolic resection, especially in adults without evidence of inflammatory bowel disease or tumor recurrence. We report the case of a 63-year-old male patient who presented 6 years after ileocolic resection, and also review the data of six similar cases described in the literature. The markedly reduced bile acid absorption found in our case raises the possibility of an etiological role of bile acids in the development of ileocolic anastomotic ulcers.
Subject(s)
Anastomosis, Surgical , Cecal Neoplasms/surgery , Colonic Diseases/diagnosis , Ileal Diseases/diagnosis , Ileal Neoplasms/surgery , Postoperative Complications/diagnosis , Ulcer/diagnosis , Biopsy , Colonic Diseases/pathology , Diagnosis, Differential , Endoscopy, Gastrointestinal , Humans , Ileal Diseases/pathology , Intestinal Mucosa/pathology , Male , Middle Aged , Postoperative Complications/pathology , Surgical Staplers , Ulcer/pathologyABSTRACT
Symptoms related to fungal esophagitis were studied in patients with alcoholic liver disease who underwent upper gastrointestinal endoscopy. Data of 517 patients were studied retrospectively (group I) and 100 alcoholic liver disease patients, that were successively admitted to hospital, were enrolled in the prospective part (group II). Out of the 41 cases with fungal esophagitis found in group I, data of 38 could be evaluated. In group II 13 of the 93 evaluable patients had fungal esophagitis; according to Kodsi's grading 10 patients had grade 1., one patient grade 2. and two patients grade 2-3. oesophagitis. There was no case with grade 4. esophagitis. The rate of symptoms among the 51 patients with fungal esophagitis was: anorexia 23 (45.0%), abdominal pain 22 (43.1%), vomiting 17 (33.3%), nausea 15 (29.4%), occult gastrointestinal bleeding 12 (23.5%), weight loss 9 (17.6%), melena 7 (13.7%), bloating 6 (11.7%), acidic regurgitation 3 (5.8%), haematemesis 2 (3.9%), thoracic pain 2 (3.9%), singultus 1 (1.9%), odynophagia 0 and dysphagia 0. In 7 patients (13.7%) none of the studied symptoms could be identified. Despite the relatively high frequency of symptom free fungal esophagitis reported in the literature, the total lack of odynophagia and dysphagia in our patient group was remarkable. In the lack of deglutition disorders the other symptoms do not raise the suspicion of esophagitis. The diagnosis in such cases can be established only by endoscopy.
