[Diagnostic and therapeutic problems in ulcerative colitis]. / Problemy diagnostyczne i terapeutyczne we wrzodziejacym zapaleniu jelita grubego.

This article discusses two specific atypical cases of ulcerative colitis encountered in the Inpatient Internal Diseases Department at Czerniakowski Hospital, Warsaw, Poland. Ulcerative colitis usually manifests itself primarily in the gastrointestinal tract, what made these cases exceptional was the involvement of multiple organs which complicated the diagnosis. The first of this cases presented a rare combination of symptoms of ulcerative colitis, cytomegalovirus infection, and polychondritis. The second case involved a patient initially diagnosed with myelogenous leukemia, however subsequent investigation revealed a sever case of ulcerative colitis and not leukemia as originally suspected.

[Coexistence of von Willebrand's disease with mitral valve prolapse]. / Wspólistnienie wypadania platka mitralnego, choroby von Willebranda i padaczki u mllodej kobiety.

The authors present the case of mitral valve prolapse. In a young woman with three-year history of systematically treated epilepsia mitral valve prolapse with a spurious string within left ventricle has been diagnosed echocardiographically in coincidence with the symptoms of haemorrhagic diathesis of von Willebrand type in form of haemoptysis and or/massive haemorrhages in mouth occasionally being preceded by heart rhythm disturbances. No local changes have been observed in otorhinolaryngologic examination, bronchoscopy and gastroscopy. Possible mutual dependence of 3 above stated abnormalities is being discussed. It is not excluded, that mitral prolapse may constitute the primary entity and epilepsia is of secondary character as a result of cerebral ischaemic incidents or of cerebral embolism. It is also a matter of discussion to what extent abrupt haemodynamic disturbances connected with critical fall of systemic blood pressure due to mitral prolapse may influence the haemorrhagic episodes.

[Barrett esophagus diagnosed after appendectomy in a patient with diabetes mellitus]. / Przelyk Barretta rozpoznany po operacji wyrostka robaczkowego u chorego na cukrzyce.

A pathogenetic outline of oesophageal inflammatory lesions with special emphasis on Barrett's oesophagitis has been presented. As recorded in a history of a 65-year old patient at first the stenocardia-mimicking pains occurred a few days after appendectomy. Gastrobulboscopy performed (after coronary insufficiency had been excluded) revealed extensive inflammatory and erosive lesions of the oesophagus and multiple ulcerations of the duodenum. According to the several authors the rapid manifestation of the inflammatory lesions of the oesophagus may be related to the intubation necessary for laparotomy. It may refer particularly to diabetic patients. Control endoscopies showed that a six-week treatment resulted in a total disappearance of mucosal changes. It might be thoughtful to take into consideration a possibility of oesophageal inflammation in clinical differentiation of stenocardia mimicking pains in diabetics who underwent the intubation.