Assuntos
Síndrome de Alagille/diagnóstico , Adolescente , Síndrome de Alagille/tratamento farmacológico , Colagogos e Coleréticos/uso terapêutico , Varizes Esofágicas e Gástricas/etiologia , Hematemese/etiologia , Humanos , Cirrose Hepática/etiologia , Masculino , Ácido Ursodesoxicólico/uso terapêuticoAssuntos
Transtornos da Motilidade Esofágica/complicações , Refluxo Gastroesofágico/complicações , Idoso , Antiulcerosos/uso terapêutico , Transtornos de Deglutição/tratamento farmacológico , Transtornos de Deglutição/etiologia , Transtornos da Motilidade Esofágica/diagnóstico , Transtornos da Motilidade Esofágica/tratamento farmacológico , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Humanos , Masculino , Omeprazol/uso terapêutico , Vômito/tratamento farmacológico , Vômito/etiologiaAssuntos
Carcinoma de Células Escamosas/complicações , Doença Celíaca/complicações , Neoplasias Esofágicas/complicações , Adulto , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Doença Celíaca/dietoterapia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Estenose Esofágica/etiologia , Esofagoscopia , Evolução Fatal , Feminino , Humanos , Cooperação do PacienteRESUMO
Erosive polyarthritis in Crohn's disease is rare and raises diagnostic and pathophysiological problems. A case with destructive lesions of the shoulders and hips is reported in a 43-year-old woman with a 26-year history of Crohn's disease. Ankylosis of the spine and hips, motion range limitation of the shoulders and wrists, and boutonnière deformity of the third finger of the right hand were present. Tests were negative for rheumatoid factor and the HLA-B27 antigen. Plain radiographs showed a triple rail pattern at the spine; synostosis of the hips; and destructive lesions of the shoulders, wrists, tarsal bones, and third proximal interphalangeal joint of the right hand. Glucocorticoid therapy was effective in suppressing the bowel symptom flares but only partially improved the joint symptoms, whose treatment relied mainly on nonsteroidal antiinflammatory agents and rehabilitation therapy. Erosive arthritis in Crohn's disease is frequently monoarticular, with the hip being the most common target. It can complicate a spondylarthropathy or reveal granulomatous synovitis. Polyarticular forms pose difficult diagnostic and therapeutic challenges and add to the disability caused by the bowel disease. The potential role of genetic factors remains to be studied.
Assuntos
Artrite/etiologia , Doença de Crohn/complicações , Articulação do Quadril , Articulação do Ombro , Adulto , Feminino , HumanosRESUMO
The authors report two cases of primary intestinal involvement in Hodgkin's disease, the first concerning the duodenum and the second the ileum. Both patients had a stenotic syndrome. The diagnosis was made by tumor histology in the first case and of a regional lymph node in the second. Treatment involved a course of chemotherapy and radiotherapy in the first case and surgical excision and chemotherapy in the second.
Assuntos
Neoplasias Duodenais/patologia , Doença de Hodgkin/patologia , Neoplasias do Íleo/patologia , Adulto , Terapia Combinada , Constrição Patológica/patologia , Feminino , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
Esophageal tuberculosis is a rare etiology of dysphagia. Such a location is also rare in comparison with other digestive tract sites of the disease (3.2%). Esophageal involvement may be secondary or primary. Diagnosis is particularly difficult in the latter situation. At any event, the diagnosis can only be histological by examination of endoscopic biopsy material. Treatment is essentially medical and leads to recovery in most patients.
