1/70. Angiographic manifestions of regional enteritis.Regional enteritis may be a protean disease, easily diagnosed when the common clinical presentation is noted. Occasionally, however, "atypical" features lead to the clinical suspicion of neoplastic disease. Four patients underwent angiographic evaluation in this clinical setting, all demonstrating similar changes in the mesenteric arteries. A serrated, "corkscrew" pattern was present and corresponded well to the perivascular fibrosis noted histologically. Recognition of this angiographic pattern may be important in differentiating neoplastic from inflammatory disease processes.- - - - - - - - - - ranking = 1keywords = enteritis (Clic here for more details about this article) |
2/70. Is it Crohn's disease? A severe systemic granulomatous reaction to sulfasalazine in patient with rheumatoid arthritis.BACKGROUND: sulfasalazine is a widely used anti-inflammatory agent in the treatment of inflammatory bowel disease and several rheumatological disorders. Although as many as 20% of treated patients may experience reversible, dose-dependent side effects, less frequent but potentially severe, systemic reactions have also been reported. CASE PRESENTATION: A severe systemic reaction to sulfasalazine developed in a 21-year old female with rheumatoid arthritis characterized by eosinophilia, granulomatous enteritis and myelotoxicity, cholestatic hepatitis, and seizures. The clinical course and management of this patient are presented as well as a review of the incidence and outcome of severe systemic reactions to sulfasalazine. CONCLUSIONS: Granulomatous myelotoxicity and enteritis developed in a 21 year old female within 3 weeks of initiating sulfasalazine for rheumatoid arthritis. Following a short course of corticosteroids, the patient had resolution of her cholestatic hepatitis, rash, eosinophilia, and gastrointestinal symptoms with no residual manifestations at 7 months follow-up. Although severe reactions to sulfasalazine are rare and unpredictable, practicing physicians should be aware of unusual clinical presentations of toxicity when prescribing sulfasalazine.- - - - - - - - - - ranking = 0.4keywords = enteritis (Clic here for more details about this article) |
3/70. Cancer in Crohn's disease. The danger of a by-passed loop.Carcinoma developed in an excluded segment of small bowel in an 80-year old male patient, 40 years following the onset of regional enteritis and 33 years after by-pass of the terminal ileum. Within the past four years, four patients with malignancy occurring in excluded segments of the bowel in Crohn's disease have been reported from the institution. Two occurred in the small bowel and two in the colon. In three patients the lesion was associated with enterovesical fistula suggesting a possible relationship. This complication stresses the need to encourage resection rather than by-pass of all inflammatory lesions and to view all long-standing by-passed loops of intestine with suspicion. An international tumor registry of cancer in Crohn's disease is desirable to continue to document the true incidence of cancer in Crohn's disease.- - - - - - - - - - ranking = 0.2keywords = enteritis (Clic here for more details about this article) |
4/70. Acute terminal ileitis associated with pneumococcal bacteremia: case report and review of pneumococcal gastrointestinal diseases.In this report, we describe a patient with acute terminal ileitis due to streptococcus pneumoniae, review 3 previously reported cases of isolated enteritis due to S. pneumoniae, and summarize the English-language literature on primary and secondary pneumococcal gastrointestinal diseases. Various theories have been advanced to explain the pathogenesis of this rare and potentially life-threatening form of pneumococcal infection, but the mechanism by which S. pneumoniae causes gastrointestinal disease is still unknown.- - - - - - - - - - ranking = 0.2keywords = enteritis (Clic here for more details about this article) |
5/70. adenocarcinoma of the small intestine arising in Crohn's disease. Demonstration of a tumor-associated antigen in invasive and intraepithelial components.A segment of small intestine surgically removed from a man with intestinal obstruction was found to have coexisting regional enteritis and an invasive adenocarcinoma associated with an area of intraepithelial neoplasia. The cells of the adenocarcinoma and the intraepithelial neoplasia contained a tumor-associated surface antigen capable of reacting with an antiserum prepared against a colonic carcinoma. The importance of thorough sampling of specimens of regional enteritis in accurate reporting of the incidence of carcinoma is stressed, as is the use of immunohistologic techniques as an adjunct to the morphologic diagnosis of preinvasive neoplasia.- - - - - - - - - - ranking = 0.4keywords = enteritis (Clic here for more details about this article) |
6/70. Wireless capsule endoscopy in a patient with obscure occult bleeding.A case of obscure/occult bleeding in a 39-year old man with a 7-year history of chronic fatigue and iron-deficiency anemia is presented here. Esophagogastroduodenoscopy, push enteroscopy, ileocolonoscopies, and a magnetic resonance imaging small-bowel follow-through did not reveal any abnormalities. Multiple inflammatory lesions with fibrin-covered ulcers and petechial bleeding in the area of the lower jejunum and ileum were diagnosed only with capsule endoscopy. One ulcer located near the ileocecal valve was then biopsied during a repeat ileocolonoscopy, and the histology showed signs of Crohn's enteritis. The further treatment approach was changed, with medical treatment being initiated and intraoperative enteroscopy being averted. Wireless capsule endoscopy clarified the cause of the obscure/occult bleeding in this patient and contributed to the diagnosis and endoscopic imaging of an isolated Crohn's enteritis, which is the cause of bleeding in approximately 10 - 20 % of cases of occult bleeding.- - - - - - - - - - ranking = 0.4keywords = enteritis (Clic here for more details about this article) |
7/70. Bypass enteritis. A new complication of jejunoileal bypass for obesity.Four patients who had jejunoileal bypass for morbid obesity had increased frequency of diarrhea, diffuse abdominal tenderness and distention, and fever to 104 degrees F. Roentgenographic studies disclosed multiple distended loops in the bypassed bowel with few air fluid levels. Two of these patients underwent operation for suspected peritonitis from abscess or obstruction. No abscess or mechanical obstruction was found. The bypassed bowel contained many subserosal gas-filled blebs. The remaining two patients were treated with antibiotics and showed prompt improvement. "Bypass enteritis" must be considered in the postoperative period in patients undergoing surgery for morbid obesity. It responds to antibiotics and appropriate electrolyte therapy. The presumed factor is overgrowth of enteric bacteria in the distal portion of the bypassed bowel. Accurate diagnosis will obviate the need for surgical exploration to exclude peritonitis.- - - - - - - - - - ranking = 1keywords = enteritis (Clic here for more details about this article) |
8/70. Unexplained bronchopulmonary disease with inflammatory bowel disease.Six patients developed severe, unexplained, chronic bronchopulmonary disease from 3 to 13 years after the onset of nonspecific inflammatory disease of the colon. All had chronic bronchitis, bronchiectasis was diagnosed in four, and an obstructive type of pulmonary dysfunction was noted in five. Four of the six, including the two with only chronic bronchitis, had no history of smoking. There was an initial correlation between the pulmonary symptoms and the intestinal disease, except in two patients who developed overt pulmonary disease following total proctocolectomy. The frequent occurence of extraintestinal lesions has suggested that ulcerative colitis and regional enteritis are systemic disorders. Chronic unexplained bronchopulmonary disease may be another infrequent complication in such patients.- - - - - - - - - - ranking = 0.2keywords = enteritis (Clic here for more details about this article) |
9/70. Ten-year survival of a Broviac catheter.We report a patient with regional enteritis and short bowel syndrome who has been treated with home parenteral nutrition for 19 years, during 10 of which he used a single Broviac central venous catheter. The catheter finally required replacement because of progressive lumen occlusion, which was presumed to be caused by thrombosis. At the time of replacement, the catheter was found to be friable and embedded in a hard sheath that made it adherent to the wall of the internal jugular vein and prevented complete removal. At some time during the ensuing 16 months, the retained fragment embolized asymptomatically to the pulmonary artery. During the first 2 months after the placement of a new Hickman catheter, progressive flow resistance developed, probably because of calcium phosphate precipitation, although no change had been made in the parenteral formulation. It resolved immediately upon the instillation of hydrochloric acid into the catheter.- - - - - - - - - - ranking = 0.2keywords = enteritis (Clic here for more details about this article) |
10/70. Venous thromboangiitis associated with regional enteritis.Thromboembolic complications occurring in patients with Crohn's disease are increasingly reported and are associated with a high mortality. The mechanism by which the thrombogenic process occurs is unclear. As recent findings suggest that Crohn's disease is a chronic vasculitis with multifocal gastrointestinal infarctions secondary to an imbalance of the cellular hemostatic pathway, extradigestive thrombotic complications might be mediated by the same vascular immune reaction. We report an unusual case of recurrent venous thrombosis associated with regional enteritis, the main point of interest being two-fold: first, this case provides a morphological evidence for an angiitic process as the cause of extradigestive thrombosis; second, the gastrointestinal disease remained subclinical for more than four years although the patient developed major venous thrombotic complications.- - - - - - - - - - ranking = 1keywords = enteritis (Clic here for more details about this article) |
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