Assuntos
Endossonografia , Pâncreas/anormalidades , Pancreatopatias/diagnóstico , Diagnóstico Diferencial , Endossonografia/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/congênito , Pancreatopatias/diagnóstico por imagem , Pancreatopatias/cirurgia , Sensibilidade e EspecificidadeAssuntos
Colecistite/etiologia , Febre Tifoide/complicações , Doença Aguda , Adulto , Colecistite/diagnóstico , Meios de Contraste , Feminino , Vesícula Biliar/diagnóstico por imagem , Humanos , Iminoácidos , Fígado/diagnóstico por imagem , Testes de Função Hepática , Cintilografia , Salmonella typhi/isolamento & purificação , Febre Tifoide/diagnósticoRESUMO
Three patients had diverticulitis and extraintestinal manifestations of arthritis and pyoderma gangrenosum. In each, a mistaken diagnosis of idiopathic inflammatory bowel disease was first made because of extraintestinal complaints associated with the gastrointestinal symptoms of diverticular disease. The joint and skin manifestations were refractory to various treatments, including oral and intradermal steroids, immunosuppressive agents, and hyperbaric oxygen. Segmental resection of the involved colon promptly and completely resolved all symptoms, without recurrence 26 to 38 months after surgery. Microscopic examination of the resected specimens showed only diverticulitis without any evidence of chronic idiopathic inflammatory bowel disease. Patients with diverticulitis may have extraintestinal manifestations as do patients with other inflammatory diseases of the colon. The failure to recognize this relationship may result in misdiagnosis and prolonged medical therapy, whereas segmental colonic resection may be curative.
Assuntos
Artrite/etiologia , Doença Diverticular do Colo/complicações , Pioderma/etiologia , Idoso , Artrite/terapia , Colectomia , Colite/diagnóstico , Doença de Crohn/diagnóstico , Diagnóstico Diferencial , Doença Diverticular do Colo/diagnóstico , Doença Diverticular do Colo/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pioderma/terapia , RecidivaRESUMO
A new H2-receptor antagonist, nizatidine (150 mg h.s.), was compared with placebo as maintenance therapy in a randomized, parallel, double-blind, one-year study of 513 patients with recently healed duodenal ulcer. Endoscopies were performed at 0, 3, 6, and 12 months and at unscheduled times if symptoms of active peptic ulcer disease were present. Cumulative ulcer recurrence rates for nizatidine and placebo were 13 versus 40% at 3 months, 24 versus 57% at 6 months, and 34 versus 64% at 12 months. The differences were significant (p less than 0.001) at each treatment period. Smokers in both treatment groups had significantly greater recurrence rates than non-smokers. Symptoms of peptic ulcer disease were significantly less in nizatidine-treated patients in the first 3 months of treatment. Adverse events, including those related to peptic ulcer disease, occurred more frequently in placebo-treated patients. Nizatidine proved to be safe and effective in preventing recurrences of duodenal ulcer.
