1/50. Asymptomatic amebic colitis in a homosexual man.We describe case of a 75-yr-old Japanese homosexual man who was diagnosed as having amebic colitis. The present case is unique in that invasive amebiasis has occurred in a homosexual man, because entamoeba histolytica in homosexual patients is considered to be a nonpathogenic and commensal organism in western countries, and that the patient has not complained of any gastrointestinal symptoms associated with minute colonic lesion of an isolated cecal ulcer. This report indicates that the absence of gastrointestinal symptoms does not rule out invasive amebiasis. Therefore, once the ameba is identified in stool specimens, even in homosexual men, it is important to differentiate pathogenic from nonpathogenic species irrespective of whether the patient is symptomatic, and to treat the patient infected with pathogenic species. By means of this strategy, we can prevent pathogenic ameba from spreading in the community.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
2/50. Skip colonic ulceration in typhoid ileo-colitis.Colonic skip lesions are typically described in Crohn's colitis, but this phenomenon has been recognized in ulcerative colitis (skipped appendiceal involvement), Behcet's colitis, cytomegaloviral colitis, and even in aeromonas hydrophilia and histoplasma capsulatum infection. However, skip lesions in typhoid ileo-colitis have not been reported in the English-language literature. We report herein a patient with skip ulcers due to typhoid fever.- - - - - - - - - - ranking = 1.8keywords = colitis (Clic here for more details about this article) |
3/50. Case of ulcerative colitis associated with oesophageal ulcer.A case of ulcerative colitis complicated by oesophageal ulcers is reported. A woman was admitted to our hospital because of exacerbations of ulcerative colitis both in 1992 (aged 15 years) and 1995 (aged 18 years). When she was admitted in 1995 she complained of bloody diarrhoea, sore throat and pain on swallowing. Oesophagogastro-duodenoscopy revealed oesophageal ulcers. Oesophageal pH monitoring (24-h) showed no evidence of gastro-oesophageal reflux disease. After the patient was treated she with oral prednisolone showed considerable improvement clinically and endoscopically. Initial dosage was 60 mg/day, and 1 week later, the dosage was gradually dropped since the patient responded favourably. The improvement of the oesophageal lesions coincided with the remission of ulcerative colitis. The oesophageal ulcers are, therefore, thought to be an extracolonic manifestation of ulcerative colitis.- - - - - - - - - - ranking = 1.6keywords = colitis (Clic here for more details about this article) |
4/50. Nongranulomatous chronic idiopathic enterocolitis: a primary histologically defined disease.Nongranulomatous chronic idiopathic enterocolitis is characterized by sudden onset of severe watery diarrhea, malabsorption, exudative enteropathy, frequent appearance of shallow ulcerations, and variable degrees of villus atrophy. In the absence of infectious and pharmacologic causes, the presence of a predominantly acute inflammatory infiltrate limited to the lamina propria establishes the diagnosis. No underlying disease appears during prolonged follow-up. The etiology remains unknown. The disease is generally corticosteroid-responsive; low-dose maintenance therapy is frequently required. The long-term prognosis is guarded. Three of 11 patients died of opportunistic infections or resistance to therapy.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
5/50. Solitary rectal ulcer syndrome (colitis cystica profunda) in spinal cord injury patients: 3 case reports.Clinically indicated endoscopic examinations of 56 patients with spinal cord injury (SCI) (31 for bleeding) were performed over a 3-year period, of which 3 (6%) showed solitary rectal ulcer syndrome (SRUS). The presentation was rectal bleeding or mucoid discharge. The endoscopic appearance was multiple pseudopolyps and occasional mucosal ulcers extending proximally 8 to 40cm from the anus. Mucosal biopsy specimens showed distorted mucosal glands and displaced smooth muscle fibers wrapping around the glands, the hallmark of SRUS. The affected patients had routinely used suppositories and digital stimulation for bowel care and had been paralyzed 7 to 50 years. None had rectal prolapse. These cases show that SRUS (colitis cystica profunda) can be found among patients with SCI.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
6/50. Radiographic and endoscopic features of colonic ulcers in systemic lupus erythematosus.The radiographic and endoscopic features of the colonic ulcers during the course of a case of systemic lupus erythematosus are illustrated. barium enema revealed the "collar button" type of penetrating ulcers in the left half of the colon and endoscopy demonstrated multiple round- or oval-shaped discrete ulcers, so-called "punched-out" ulcers with pale mucosa. These findings are compared with those of the reported cases of systemic lupus erythematosus and ulcerative colitis. Steroid and 6-mercaptopurine therapy was effective in this case.- - - - - - - - - - ranking = 0.2keywords = colitis (Clic here for more details about this article) |
7/50. Benign rectal ulcer: an underground cause of inpatient lower gastrointestinal bleeding.BACKGROUND: Although it is uncommon, significant bleeding per rectum presents one of the most difficult emergency problems. Bleeding from a rectal ulcer is not well recognized as a cause of such bleeding. methods: From July 2000 through December 2000, 195 consecutive patients with significant blood loss per rectum were reviewed. RESULTS: Forty-eight cases in whom significant gastrointestinal (GI) bleeding occurred following prior hospitalization were identified. Sources of bleeding were gastroduodenal in 38 cases (79%) and colorectal in 10 cases (21%). The causes of inpatient colorectal bleeding were benign rectal ulcer (n = 4), ischemic colitis (n = 3), neoplasia (n = 2), and diversion colitis (n = 1). CONCLUSION: The differential diagnosis for inpatients who develop new inpatient GI bleeding differs from that of patients who develop outpatient GI bleeding. Careful examination of the rectum following rectal instrumentation is critical. In addition to the standard resuscitative measures, the identification and treatment of rectal ulcers in this group of patients is of paramount importance. The treatment options for bleeding rectal ulcer include conservative therapy, cauterization, embolization, banding, and local excision.- - - - - - - - - - ranking = 0.4keywords = colitis (Clic here for more details about this article) |
8/50. Virus-associated hemophagocytic syndrome and hemorrhagic jejunal ulcer caused by cytomegalovirus infection in a non-compromised host; a case report of unusual entity.A 76-year-old man was admitted to our hospital with abdominal pain, nausea, and vomiting. The patient was diagnosed as ileus by abdominal radiography, which showed an enlarged bowel and an air-fluid level. Computed tomography of the abdomen showed a thickened intestinal wall. His general status suddenly worsened, and he was placed on a respirator and catecholamines to prevent acute respiratory distress syndrome, septic shock, and disseminated intravascular coagulation. He had continuous fresh anal bleeding. Total colonoscopy showed bloody stool originating from the ileum. Emergency operation was performed for hemorrhagic shock under general anesthesia. Intraoperative jejunal endoscopy revealed deep linear ulcers with bleeding in the jejunum, and 30 cm of the jejunum was resected. Histopathologic examination revealed cytomegalic cells with intranuclear inclusion bodies in the tissues surrounding the ulcers, and it was diagnosed as cytomegaloviral enterocolitis with hemophagocytic syndrome in a non-compromised adult.- - - - - - - - - - ranking = 0.2keywords = colitis (Clic here for more details about this article) |
9/50. cytomegalovirus colitis manifested with a ring like ileocecal valve ulcer in a Korean AIDS patient.A 32-year-old man, who had no previous medical history, was hospitalized with 3-week duration of abdominal pain, fever, and watery diarrhea. Initial colonoscopy showed subepithelial hemorrhagic spots throughout the entire colon together with well-circumscribed ulcer around the ileocecal valve. Serologic test disclosed hiv-positive and repeated biopsies at ulcer base finally revealed that the patient had cytomegalovirus ulcer in ileocecal area.- - - - - - - - - - ranking = 0.8keywords = colitis (Clic here for more details about this article) |
10/50. Ileal ulcers and cytomegalovirus infection in a case of churg-strauss syndrome.churg-strauss syndrome, or allergic granulomatous angiitis, is an uncommon vasculitic syndrome. We describe a 53-year-old man with churg-strauss syndrome and subsequent opportunistic cytomegalovirus enterocolitis. During intensive care, including steroid-pulse therapy, the patient developed rapidly progressive anemia caused by active bleeding from his small intestine, resulting in resection of 20 cm of ileum. diagnosis of churg-strauss syndrome was confirmed both by characteristic clinical features and by histology. Histologic examination also revealed multiple shallow ulcers accompanied by cytomegalovirus infection. Characteristic angiitis was found in the ileum with normal-like mucosa, and it was not necessarily associated with ileal ulcers. This finding suggests that cytomegalovirus infection may be one of the causes or exacerbating factors for ileal ulcers in churg-strauss syndrome, although ulcers of the intestine have usually been considered to be caused by ischemia resulting from angiitis.- - - - - - - - - - ranking = 0.2keywords = colitis (Clic here for more details about this article) |
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