Assuntos
Anti-Inflamatórios/administração & dosagem , Betametasona/análogos & derivados , Cateterismo , Doença de Crohn/tratamento farmacológico , Obstrução Intestinal/terapia , Adulto , Betametasona/administração & dosagem , Colite/tratamento farmacológico , Colonoscopia , Terapia Combinada , Combinação de Medicamentos , Feminino , Humanos , Ileíte/tratamento farmacológico , Injeções Intralesionais , Obstrução Intestinal/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
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.
Assuntos
Tumor Carcinoide/complicações , Neoplasias do Íleo/complicações , Íleo/irrigação sanguínea , Isquemia/etiologia , Artérias Mesentéricas/patologia , Idoso , Idoso de 80 Anos ou mais , Tecido Elástico/metabolismo , Feminino , Humanos , Artérias Mesentéricas/metabolismo , Pessoa de Meia-Idade , Esclerose/etiologia , Esclerose/metabolismoRESUMO
Two cases of reversible cholestatic hepatitis after treatment with an amoxycillin/clavulanic acid preparation (Augmentin) are described.
Assuntos
Amoxicilina/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Colestase Intra-Hepática/induzido quimicamente , Ácidos Clavulânicos/efeitos adversos , Amoxicilina/uso terapêutico , Bronquite/tratamento farmacológico , Doença Hepática Induzida por Substâncias e Drogas/patologia , Colestase Intra-Hepática/etiologia , Colestase Intra-Hepática/patologia , Ácidos Clavulânicos/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Otite/tratamento farmacológicoRESUMO
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.
Assuntos
Doenças do Esôfago/induzido quimicamente , Penicilamina/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Doenças do Esôfago/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Penicilamina/uso terapêutico , Estomatite Aftosa/induzido quimicamente , Úlcera/induzido quimicamenteRESUMO
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.