1/96. Watermelon-stomach as a cause of chronic iron deficiency anemia in a patient with systemic sclerosis.Watermelon-stomach is a rare cause of gastrointestinal bleeding. There has been an increasing number of reports on the association of this lesion with diseases of the scleroderma group, causing chronic, sometimes severe gastrointestinal blood loss. The present report presents the case of a 75-year-old female with limited cutaneous systemic sclerosis and watermelon-stomach, which was the cause of her long-standing sideropenic anemia.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
2/96. association of lymphocytic colitis with linear IgA dermatosis.The case of a 66-year-old female patient is presented, who suffered from chronic watery diarrhea. In addition, she developed linear IgA dermatosis after oral treatment of a presumed yeast infection with nystatin. To evaluate the reason for her diarrhea, colonoscopy was performed. The macroscopic aspect of the colon mucosa was described as normal with no specific alterations for chronic inflammatory bowel disease or for bacterial infections. In contrast, the histologic examination revealed the typical characteristics of lymphocytic colitis. This disease is thought to be caused by immunological reactions against as yet unknown luminal antigens. After treatment with steroids and dapsone the diarrhea as well as the skin disease disappeared. To our knowledge, the present report describes for the first time the association of linear IgA dermatosis with lymphocytic colitis after oral treatment with nystatin. A possible causative link between these two disease entities is discussed.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
3/96. Electrophysiologic recovery after vitamin e-deficient neuropathy.A case report is presented of an electrophysiologic recovery from vitamin e-deficient neuropathy after treatment with water-soluble vitamin e in a patient with chronic hepatobiliary disease. The patient was a 64-year-old man who had experienced progressive difficulty in ambulation, with ataxia, over the previous 3 years. The symptoms were associated with pain, tingling sensation in the extremities, and reduced fine motor activity. The patient had chronic hepatobiliary disease, with recurrent cholangitis and external drainage of bile acid through a T-tube for more than 20 years. vitamin e level was barely detectable (<0.5 mg/L). Sensory conduction was absent in both sural nerves. Other sensory and motor conduction studies in the upper and lower extremities showed decreased amplitude. The patient was treated with water-soluble vitamin e. After 4 months of therapy, his ambulation function improved, but pain and tingling sensation in both hands remained. Sensory nerve action potentials appeared in both sural nerves, and amplitudes of other sensory nerves were increased. In a second follow-up study after 9 months, all of the evaluated parameters in the nerve conduction studies, as well as the vitamin e level, were normal. The authors conclude that vitamin e-deficient neuropathy is reversible and electrophysiologic recovery can occur with water-soluble vitamin e therapy.- - - - - - - - - - ranking = 3keywords = water (Clic here for more details about this article) |
4/96. Chronic microscopic enterocolitis with severe hypokalemia responding to subtotal colectomy.The authors present the first case report of a 50-year-old woman with a 33-year history of severe, chronic watery diarrhea and hypokalemia secondary to chronic active microscopic enterocolitis with patterns similar to lymphocytic colitis but with acute cryptitis and terminal ileum involvement microscopically. The progressive nature of her illness resulted in multiple hospital admissions secondary to hypokalemia with subsequent chronic renal failure. High continuous doses of oral potassium supplements failed to correct the hypokalemic episodes. After subtotal colon resection, the patient made a marked clinical improvement with normal serum potassium levels without receiving potassium supplementation.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
5/96. Chronic cough due to bronchobiliary fistula.Bronchobiliary fistula is a rare cause of chronic cough. Here we describe a 70-year-old woman complaining of chronic cough and copious dark-yellow watery sputum. The presence of air in the biliary tract in the lower cuts of a computerized tomography scan of the chest and positive bile in the sputum led to the suspicion of bronchobiliary fistula. The diagnosis was confirmed by percutaneous transhepatic cholangiography. drainage of the intrahepatic biliary tract resulted in complete resolution of her symptoms.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
6/96. Surreptitious laxative abuse: keep it in mind.The clinical example is one of diarrhea induced by the surreptitious use of laxatives. A 45-year-old man had a 3-year history of diarrhea, which had been fully investigated, without a cause having been identified. His general health appeared to be affected little, but he had the clinical features of an associated depressive illness. The diagnosis of laxative abuse was supported by the finding of abnormally high concentrations of magnesium in fecal water. He admitted initially, and later denied, the surreptitious ingestion of laxatives. This example is discussed with regard to features that were typical and atypical of the syndrome of laxative abuse. The significant points to be appreciated are 1) that any chronic, watery diarrhea that has eluded diagnosis after an adequate investigation is possibly self-induced, and 2) that awareness of this syndrome and its prevalence in selected cohorts can lead to direct and inexpensive documentation of the diagnosis.- - - - - - - - - - ranking = 2keywords = water (Clic here for more details about this article) |
7/96. Microscopic colitis syndrome: lymphocytic colitis and collagenous colitis.Microscopic colitis is a syndrome consisting of chronic watery diarrhea, a normal or near-normal gross appearance of the colonic lining, and a specific histological picture described as either lymphocytic colitis or collagenous colitis. Since its initial descriptions a quarter of a century ago, microscopic colitis has become a frequent diagnosis in patients with chronic diarrhea. Understanding of the cause and pathogenesis of microscopic colitis remain incomplete, but potentially important clues have been discovered that shed light on predisposing factors. In particular, specific HLA-DQ genotypes may be permissive for the development of microscopic colitis, and suggest a linkage to the pathogenesis of celiac sprue. Although the differential diagnosis of chronic watery diarrhea is broad, the diagnosis of microscopic colitis is straightforward, involving endoscopic inspection of the colonic mucosa and proper pathologic interpretation of biopsy specimens. As the limitations of drugs ordinarily used for other forms of inflammatory bowel disease are being recognized, new approaches, such as the use of bismuth subsalicylate, are being evaluated. The prognosis of patients with microscopic colitis syndrome remains good, and symptomatic improvement can be expected in most patients.- - - - - - - - - - ranking = 2keywords = water (Clic here for more details about this article) |
8/96. The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract.BACKGROUND: The treatment of angiodysplasia and watermelon stomach, vascular abnormalities implicated in gastrointestinal bleeding of obscure origin, is a major clinical problem. AIM: To determine the efficacy of octreotide in patients with long-standing gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, resistant to previous treatments and not suitable for surgery because of old age and/or concomitant disorders. patients AND methods: We treated 17 patients (seven had isolated angiodysplasia, seven had multiple upper and lower gastrointestinal angiodysplasia, and three had watermelon stomach) with octreotide (0. 1 mg subcutaneous t.d.s. for 6 months). Six of the patients had liver cirrhosis, one had Glanzmann-type platelet derangement, two had cardiovascular diseases and one had chronic uraemia. RESULTS: octreotide treatment stopped bleeding in 10 patients. A transient improvement was observed in four, who needed subsequent cyclical retreatment to correct low haemoglobin levels. No effect was observed in three, probably due to the severity of the concomitant disorders. CONCLUSIONS: octreotide is a safe drug that may be useful to control the recurrent gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, especially in patients who are not candidates for surgery due to old age and/or concomitant disorders.- - - - - - - - - - ranking = 4keywords = water (Clic here for more details about this article) |
9/96. Lymphocytic colitis, induced by ticlopidine.Lymphocytic colitis is a chronic inflammatory colonic disease characterized by watery diarrhea and a dense infiltration of the colonic mucosa with lymphocytes. The etiology is unknown but an immune reaction to various immunostimulatory agents including pathogenic or commensal bacteria, products of bacterial metabolism of dietary degradation, or antigens derived directly from the diet, and autoimmune phenomena are discussed. We observed a patient with all features of lymphocytic colitis characterized by a prominent intraepithelial T-cell component. The colitis resolved completely when therapy with ticlopidine--an agent inhibiting platelet aggregation--was stopped. This observation suggests that medical history concerning drug ingestion may reveal the etiology of lymphocytic colitis and allows cure of this otherwise difficult to treat disorder.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
10/96. Scintigraphic evaluation of colonic transit in two patients with idiopathic chronic constipation.Bowel transit in two women with protracted constipation was evaluated after oral administration of In-111 DTPA in water. Serial abdominal images were obtained for as long as 96 hours to assess transit through the stomach, small bowel, and colon. In both patients, large bowel transit was delayed. A pattern of colonic inertia was observed in one patient, whereas retention in the distal colon was seen in the other patient. Both patients underwent total colectomy with marked symptomatic relief. Colonic transit studies of these patients are presented, and the literature is reviewed.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
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