1/22. Systemic lupus erythematosus with a giant rectal ulcer and perforation.A 41-year-old man with systemic lupus erythematosus (SLE) who developed pelvic inflammation due to perforation of a giant rectal ulcer is described. The patient presented with persistent diarrhea, abdominal pain and fever without development of disease activity of SLE. Endoscopic and radiological examinations revealed a perforated giant ulcer on the posterior wall at the rectum below the peritoneal evagination. The ulcerated area was decreased after a colostomy was performed at the transverse colon to preserve anal function. The patient is currently being monitored on an outpatient basis. It should be noted that life-threatening complications such as perforated ulcer of the intestinal tract could occur without SLE disease activity.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. Idiopathic giant esophageal ulcers in a renal transplant patient responsive to steroid therapy.Idiopathic giant esophageal ulcers in immunocompromised patients have been described only in patients with acquired immunodeficiency syndrome. A solitary report of an idiopathic giant esophageal ulcer in an immunocompetent patient exists. We describe a case of idiopathic esophageal ulceration ultimately responsive to steroid therapy in a 31-year old immunosuppressed, human immunodeficiency virus-negative renal transplant patient. The case is described with particular reference to the evaluation, differential diagnosis, and therapeutic response to steroids. Similarities in presentation and treatment to giant esophageal ulcers in human immunodeficiency virus infection suggest an underlying immune defect as the likely cause. This is the first described case of giant esophageal ulceration responsive to steroids in an immunosuppressed human immunodeficiency virus-negative patient. This entity should be added to the differential diagnosis of esophageal ulceration in solid organ transplant recipients.- - - - - - - - - - ranking = 1.3333333333333keywords = giant (Clic here for more details about this article) |
3/22. Temporal arteritis presenting with scalp ulceration.We report the case of a 75-year-old-woman who presented with bilateral scalp ulcerations and blindness, accompanied by severe headache and scalp tenderness, due to bilateral temporal arteritis without systemic involvement. A biopsy taken from the border of an ulceration showed evidence of giant cell arteritis. She was treated with oral prednisone, 60 mg per day. The ulcerations healed in a few weeks but the vision loss was irreversible. This case highlights for temporal arteritis the importance of accurate and timely diagnosis as well as the need for prompt therapy with systemic steroids in order to avoid major complications, namely loss of vision. It also demonstrates that scalp necrosis and ulcerations are skin signs associated with a poor prognosis.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
4/22. Idiopathic giant esophageal ulcer in an hiv-positive child.We report a 3-year old hiv-positive female with a 2-cm deep ulcer in the mid-esophagus. A presumptive diagnosis of idiopathic giant ulcer was made after infectious pathogens had been excluded. The child was successfully treated with steroids. Although infectious causes of giant esophageal ulcers in hiv-positive children are common, the diagnosis of idiopathic giant ulcer must be considered in order to institute proper therapy.- - - - - - - - - - ranking = 1.1666666666667keywords = giant (Clic here for more details about this article) |
5/22. thalidomide in refractory vulvar ulcerations associated with Crohn's disease.We report a case of recurrent vulvar ulcerations developed on vegetations associated with Crohn's disease. Lesions responded to low-dose thalidomide treatment. A biopsy revealed a neutrophilic infiltrate with rare giant cells. Vulvar manifestations were consistent with metastatic Crohn's disease or with a reactive neutrophilic dermatitis. thalidomide reduces the activity of tumor necrosis factor (TNF) alpha by accelerating the degradation of its mRNA. Nowadays, it has become a promising drug in a broad variety of disorders in which TNF-alpha seems to play a pivotal role, including inflammatory bowel diseases. This is the first case report presenting the efficacy of thalidomide in the treatment of vulvar involvement in Crohn's disease.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
6/22. Approach to a giant inguinoscrotal hernia.We present an extremely huge and longstanding, giant inguinoscrotal hernia extending to below the knee with an ulcer at its base. Though hernias of this magnitude are rare, their management can be demanding and challenging. Nevertheless, in an emergency situation, the repair of the hernial defect is not essential, especially in a compromised patient. In fact, the most important step is excision of the devitalised tissue, and the final surgery can be delayed. In nonemergency management, definitive surgery can be planned either by a period of preoperative staged pneumoperitoneum, repairing after a resection of bowel and omentum, or replacing the content and ventilation of the patient to avoid the pressure on the cardiorespiratory system by forcing the tissue. This case highlights the problems encountered in management of huge hernias.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
7/22. thalidomide neuropathy in childhood.thalidomide was withdrawn from world markets in 1961 following recognition of its teratogenic effects. More recently, however, thalidomide treatment has been reintroduced to adult and paediatric practice for a variety of dermatologic, immunologic, rheumatologic and neoplastic disorders. Neuropathy is a significant side effect of thalidomide therapy, which may limit its clinical use. We report four cases of sensorimotor axonal neuropathy in children aged 10-15 years, treated with thalidomide for myxopapillary ependymoma, Crohn's disease and recurrent giant aphthous ulceration. thalidomide neuropathy is often associated with proximal weakness and may progress even after discontinuation of treatment, in the phenomenon of 'coasting'. Children treated with thalidomide should undergo regular neurophysiologic studies in order to detect presymptomatic or progressive peripheral neuropathy.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
8/22. Tuberculous infection of the male genitalia.The extremely rare occurrence of genital tuberculosis affecting the penis, seminal vesicles, epididymides, vas deferens and Cowper's gland is described. diagnosis was made by demonstration of fragmented acid fast bacilli in the discharge, and caseating epithelioid cell granulomata with Langhan's giant cells detected on histopathology. Response to antitubercular drugs was prompt.- - - - - - - - - - ranking = 0.16666666666667keywords = giant (Clic here for more details about this article) |
9/22. Nonspecific giant ulcer of the sigmoid colon--a case report.An unusual case of a 44 year old woman who developed a nonspecific ulcer of the sigmoid colon is reported herein. She presented with lower abdominal pain and fever and colonoscopy revealed a large, sigmoid colon ulcer with normal surrounding mucosa and a well-defined margin. A temporary sigmoidostomy was done to decompress the bowel content and, after the abdominal pain and fever had subsided, the involved segment with an ulcer of 6.1 X 2.5 cm was resected. Her postoperative course was uneventful and she has remained well since.- - - - - - - - - - ranking = 0.66666666666667keywords = giant (Clic here for more details about this article) |
10/22. Fistulous degeneration of a giant esophageal ulcer in a patient with acquired immune deficiency syndrome.Esophageal involvement in human immunodeficiency virus (hiv) disease can take many forms, including the recently described giant solitary ulcerations thought to be due to cytomegalovirus or, more recently, mycobacterium species. Current experience suggests that steroids may provide symptom relief and healing in selected patients. We report a case of fistulous change in one such ulcer, with documented endoscopic, radiologic, and pathologic findings. No organism was identified by culture or pathologic staining, leading to a postulated role for the persistent irritation of medications.- - - - - - - - - - ranking = 0.83333333333333keywords = giant (Clic here for more details about this article) |
| | Next -> |