Asunto(s)
Antiinflamatorios/administración & dosificación , Betametasona/análogos & derivados , Cateterismo , Enfermedad de Crohn/tratamiento farmacológico , Obstrucción Intestinal/terapia , Adulto , Betametasona/administración & dosificación , Colitis/tratamiento farmacológico , Colonoscopía , Terapia Combinada , Combinación de Medicamentos , Femenino , Humanos , Ileítis/tratamiento farmacológico , Inyecciones Intralesiones , Obstrucción Intestinal/tratamiento farmacológico , Masculino , Persona de Mediana Edad , RecurrenciaRESUMEN
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.
Asunto(s)
Tumor Carcinoide/complicaciones , Neoplasias del Íleon/complicaciones , Íleon/irrigación sanguínea , Isquemia/etiología , Arterias Mesentéricas/patología , Anciano , Anciano de 80 o más Años , Tejido Elástico/metabolismo , Femenino , Humanos , Arterias Mesentéricas/metabolismo , Persona de Mediana Edad , Esclerosis/etiología , Esclerosis/metabolismoRESUMEN
Two cases of reversible cholestatic hepatitis after treatment with an amoxycillin/clavulanic acid preparation (Augmentin) are described.
Asunto(s)
Amoxicilina/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Colestasis Intrahepática/inducido químicamente , Ácidos Clavulánicos/efectos adversos , Amoxicilina/uso terapéutico , Bronquitis/tratamiento farmacológico , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Colestasis Intrahepática/etiología , Colestasis Intrahepática/patología , Ácidos Clavulánicos/uso terapéutico , Combinación de Medicamentos , Femenino , Humanos , Persona de Mediana Edad , Otitis/tratamiento farmacológicoRESUMEN
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.
Asunto(s)
Enfermedades del Esófago/inducido químicamente , Penicilamina/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Enfermedades del Esófago/patología , Femenino , Humanos , Persona de Mediana Edad , Penicilamina/uso terapéutico , Estomatitis Aftosa/inducido químicamente , Úlcera/inducido químicamenteRESUMEN
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.