1/27. Generalized AA-amyloidosis in a 58-year-old Caucasian woman with an 18-month history of gastrointestinal tuberculosis.We report on a 58-year-old Caucasian woman who went to a general practitioner about recurrent abdominal pain, night sweats and weight loss of a few weeks' duration. Once gynaecological disease had been ruled out, the patient was admitted to hospital with severe abdominal pain and intestinal obstruction and a right-sided hemicolectomy was performed. Following the investigation of osteolytic lumbar vertebrae, 18 months after visiting the general practitioner the patient was finally found to be suffering from generalized AA-amyloidosis secondary to gastrointestinal tuberculosis. This had been misinterpreted as Crohn's disease. Re-examination of the specimens from the right-sided hemicolectomy demonstrated that scanty deposits of AA-amyloid were present 9 months after the first presentation. AA-amyloid can thus be present in serious inflammatory disease even during the first 9 months after the initial clinical presentation.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/27. Pancreatic tuberculosis with obstructive jaundice--a case report.Isolated pancreatic tuberculosis (TB) is very rare and its treatment somewhat controversial. We report a case of pancreatic TB diagnosed as pancreatic carcinoma. An 82-yr-old man presented with right upper abdominal pain and obstructive jaundice, without fever or weight loss. ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography showed a mass lesion in the pancreatic head, which caused stricturing of the distal common bile duct and pancreatic duct in the head of the gland. As malignancy was suspected, he underwent a Whipple procedure (pancreaticoduodenectomy). Histological examination of the resection specimen disclosed typical features of tuberculosis in the pancreatic head, lymph nodes, and at the ampulla of vater. The rest of the abdominal cavity was unremarkable. After receiving antimicrobial therapy for tuberculosis for 6 months, he remains well, without jaundice or a recurrent mass visible by ultrasound.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
3/27. Toxic amebic colitis coexisting with intestinal tuberculosis.A patient with a fulminant amebic colitis coexisting with intestinal tuberculosis had a sudden onset of crampy abdominal pain, mucoid diarrhea, anorexia, fever and vomiting with signs of positive peritoneal irritation. Fulminant amebic colitis occurring together with intestinal tuberculosis is an uncommon event and may present an interesting patho-etiological relationship. The diagnosis was proven by histopathologic examination of resected specimen. Subtotal colectomy including segmental resection of ileum, about 80 cm in length, followed by exteriorization of both ends, was performed in an emergency basis. Despite all measures, the patient died on the sixth postoperative day. The exact relationship of fulminant amebic colitis and intestinal tuberculosis is speculative but the possibility of a cause and effect relationship exists. Fulminant amebic colitis may readily be confused with other types of inflammatory bowel disease, such as idiopathic ulcerative colitis, Crohn's disease, perforated diverticulitis and appendicitis with perforation. This report draws attention to the resurgence of tuberculosis and amebiasis in korea, and the need for the high degree of caution required to detect it.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
4/27. Solitary pancreatic tuberculosis in immunocompetent patients mimicking pancreatic carcinoma.In this study, two cases of biopsy-proven pancreatic tuberculosis are reported. The patients presented with fever, anorexia, fatigue, abdominal pain and weight loss. A differential diagnosis of fever of unknown origin was conducted. Computed tomography (CT) revealed a cystic mass image in the pancreatic head in one patient, and a hypodense lesion in the pancreatic head in the other. The first patient was diagnosed by a wedge biopsy specimen obtained in the exploratory laparotomy. The other patient was diagnosed by percutaneous fine-needle aspiration biopsy. Both patients were successfully treated with quadruple antituberculous therapy for 12 months. We concluded that especially in young patients who present with a mass in the pancreas, pancreatic tuberculosis should be considered among the differential diagnoses, particularly in developing countries and immunosuppressed individuals.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
5/27. Recurrent giant longitudinal duodenal ulcer with massive hemorrhage in a helicobacter pylori-negative patient.A 67-year-old man, in whom a linear ulcer running from the duodenal bulb to the descending part had been noted 3 years previously, was admitted to our hospital because of abdominal pain and melena. duodenoscopy revealed a bleeding giant longitudinal ulcer, which was more extensive than before. Tests for Helicobacter pylori (Hp) were negative. The ulcer was cured by endoscopic hemostasis and repeated blood transfusions. attention must be paid to Hp-negative post-bulbar duodenal ulcers because of the frequent complications including hemorrhage.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
6/27. Inflammatory bowel perforation during immune restoration after one year of antiretroviral and antituberculous therapy in an hiv-1-infected patient: report of a case.PURPOSE: This article reports an unusual presentation of bowel perforation. methods: We report the case of a 30-year-old HIV-infected male who suffered from an advanced state of CD4 cell depletion (29 CD4 cells per 106/l). abdominal pain and diarrhea led to further examinations. RESULTS: colonoscopy revealed a severe tuberculous ileocecal inflammation. tuberculosis and HIV infection were treated. The patient's response to antiretroviral therapy was excellent. After 11 months of potent antiretroviral treatment and 12 months of antituberculous therapy he suffered from acute abdominal pain with fever and ileus. laparotomy revealed two intestinal perforations of the jejunum and inflammation of the whole ileocecal region. CONCLUSION: Immunopathologic reactions caused by immune restoration are novel presentations of highly active antiretroviral treatment as shown here. The presented patient is an unusual case with a very late onset of inflammatory response, which led to intestinal perforation.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
7/27. Colonic tuberculosis.Tubercle bacillus was discovered in 1882 by Robert Koch. With the introduction of chemotherapy for tuberculosis in the 1940s the incidence of this entity decreased. The incidence of the tuberculosis of the colon began to increase at the 1980s with the rise in numbers of patients considered as high risk for this entity, such as HIV-infected individuals, patients with chronic renal disease, and immunosuppressed patients with prolonged steroid therapy. We report on two patients with history of chronic abdominal pain and weight loss with a palpable mass in the right lower quadrant. In one patient chest radiography revealed a miliary reticulonodular pattern. In both, abdominal CT scan showed retroperitoneal lymphadenopathy and colonic wall thickness. Colonoscopic examination showed ulcerative lesions and ileocecal valve disruption. Microscopic examination of intestinal content showed evidenced M. tuberculosis. tuberculosis of the colon should be suspected in patients suffering from chronic abdominal pain and weight loss.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/27. A case of strongyloides stercoralis and mesenteric tuberculous infection with acute abdominal pain in an HIV-positive patient.We describe an HIV-positive female patient who had acute abdominal pain as the initial presentation of strongyloides stercoralis infection. The diagnosis was established by identifying rhabditiform larvae in stool. She also had intra-abdominal tuberculosis without intestinal perforation. To our knowledge, this is the first reported case of such a presentation.- - - - - - - - - - ranking = 2.5keywords = abdominal pain (Clic here for more details about this article) |
9/27. Ileo-caecal tuberculosis mimicking colonic tumour--case report.A case of ileocaecal tuberculosis simulating a colonic tumour is reported. A 43 year old male patient presented with abdominal pain, weight loss, fever and right iliac fossa mass. Laboratory investigations and ultrasonography were not specific. laparotomy with ileocaecal resection was carried out and histopathological examination confirmed the diagnosis of tuberculosis.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
10/27. Tuberculous gastric perforation: report of a case.A 21-year-old woman presented with a 2-day history of acute abdominal pain. Contrast-enhanced computed tomography (CT) showed a perforation in the lesser curve of the stomach. The patient suffered a bout of hematemesis, following which an endoscopy showed a bleeding blood vessel at the edge of the perforation. We performed an emergency distal gastrectomy, including the ulcer site. Histopathological examination revealed tuberculous granulation tissue and acid-fast bacilli in the ulcer. The patient was given antituberculosis therapy (ATT) postoperatively, and was well when last seen 1 year 5 months after surgery. We analyzed the clinical data of five cases of tuberculous gastric perforation (TGP), reported between 1948 and 2003, including our patient. The patients ranged in age from 21 to 45 years, with a mean age of 36.8 years (SD /- 10.21), and a male to female ratio of 3 : 2. The diagnosis was confirmed by surgery or autopsy. Abdominal lymphadenopathy was present in all patients. gastrectomy was performed in four patients, and two were given ATT. All four patients in the previous reports died of their disease.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
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