Cases reported "Colonic Diseases"

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1/32. Profuse lower gastrointestinal haemorrhage as an indication for surgery in necrotising enterocolitis.

    An infant developed massive lower gastrointestinal haemorrhage secondary to necrotising enterocolitis after cardiac surgery. The haemorrhage was only controlled following a colectomy.
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2/32. Intramural haemorrhage of the colon.

    Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a 69-year-old Caucasian woman with a haemorrhage in the colonic splenic flexure and descending colon. Both had a one-stage resection with anastomosis. The child survived; the woman died two days after the operation. The preoperative diagnosis of bleeding colonic lesions remains difficult especially when facilities for investigation are scarce. It is re-emphasized that in patients with acute abdomen it is not necessary to insist on accurate preoperative diagnosis before offering appropriate treatment.
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keywords = haemorrhage
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3/32. octreotide treatment of massive hemorrhage due to cytomegalovirus colitis.

    cytomegalovirus (CMV)-associated colitis can result in abdominal pain, diarrhea, significant blood loss and perforation. The standard therapy for CMV colitis includes supportive measures and antiviral medications. Severe hemorrhage due to CMV colitis often necessitates surgical resection. We present a case of a patient who was undergoing chemotherapy for acute B-cell lymphoblastic leukemia and developed significant abdominal pain and diarrhea followed by massive hematochezia. colonoscopy showed numerous actively bleeding deep ulcers in the cecum. A provisional diagnosis of CMV colitis was made and she was started on ganciclovir. Histological assessment confirmed the diagnosis of CMV colitis. She continued to bleed profusely per rectum over the following five days, passing up to 1 L to 1.5 L of blood per day. She required 10 units of packed red blood cells over this time period. The patient refused surgical intervention and after discussion of possible options, octreotide was instituted. Her blood loss stopped almost immediately and she required no further transfusions. She tolerated the medication well and was discharged home at a later date in stable condition. This is the first reported case of the use of octreotide in the treatment of massive hematochezia from CMV colitis.
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keywords = blood loss
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4/32. Massive lower gastrointestinal haemorrhage from abdominal tuberculosis.

    This is a report of a 27-year-old Nigerian male who presented with massive lower gastrointestinal haemorrhage requiring seven units of whole blood to finally stabilize him. physical examination and other laboratory investigations as well as sigmoidoscopy were not helpful in establishing a diagnosis. barium enema had indicated a suspicious narrowing of the transverse colon which led to advising laparotomy. The definitive diagnosis was established following laparotomy and biopsy, histology of which revealed tuberculosis. Following the institution of anti-tuberculous therapy the patient's response was outstandingly remarkable.
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keywords = haemorrhage
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5/32. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan.

    For 4 days before surgical repair of a diverticulitic colovesical fistula and for 6 days after, a 63-year-old man was treated with 2 g of intravenous cefotetan disodium every 12 hours for associated urosepsis with bacteremia. Postoperatively, the patient followed a diet of intravenous nutrition only. Uneventful convalescence was interrupted by signs of sudden major blood loss, accompanied by prolonged prothrombin time. After stabilization with packed red blood cells, fresh plasma, crystalloids, and parenteral vitamin k, laparotomy revealed a huge intra-abdominal clot, which was evacuated. This case illustrates the risk of unexpected hypoprothrombinemia and hemorrhage in a cefotetan-treated surgical patient who demonstrated none of the usual comorbid conditions generally described in patients with antibiotic-induced hypoprothrombinemia. Like cefamandole nafate, cefoperazone sodium, moxalactam disodium, and other cephalosporins containing the methylthiotetrazole side chain, cefotetan appears to pose an unusual risk of major bleeding.
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ranking = 1.2029812955433
keywords = blood loss
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6/32. Arterioenteric fistulae: diagnosis and treatment by angiography.

    Two cases of massive gastrointestinal haemorrhage caused by arterioenteric fistulae are presented. In both cases, bleeding was controlled by interventional angiography. In the first case, a fistula between an aberrant right subclavian artery and a reconstructed oesophagus was temporarily occluded with a balloon catheter as a pre-surgical measure. In the second case a communication between the external iliac artery and the colon in a patient with invasive cervical cancer was treated by embolization. An arterioenteric fistula should be considered as a possible cause of acute gastrointestinal haemorrhage in post-operative or cancer patients and aortography or pelvic arteriography may be required to make the diagnosis.
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keywords = haemorrhage
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7/32. nimodipine: evidence for clinically significant gastrointestinal side-effects.

    nimodipine, now widely used for treatment and prevention of cerebrovascular spasm, is regarded as a safe drug. Despite a preferential action on cerebral vessels, there is clinical and experimental evidence of effects on systemic vascular and intestinal smooth muscle cells. Gastro-intestinal side-effects, however, have not been reported in clinical studies dealing with treatment of vasospasm following subarachnoid haemorrhage. We report on a patient with subarachnoid haemorrhage who developed an acute life-threatening pseudo-obstruction of the colon, a variant of adynamic ileus, while being treated with intravenous nimodipine. The relationship between this complication and calcium antagonist therapy is discussed and therapeutic strategies are presented. We conclude that neurosurgeons and neurologists should be aware of calcium antagonist--related ileus in patients treated with nimodipine.
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ranking = 0.33333333333333
keywords = haemorrhage
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8/32. Intestinal strictures presenting with gastrointestinal blood loss.

    The typical manifestations of intestinal strictures include abdominal distention, bilious vomiting, hematochezia, diarrhea, disaccharide intolerance, and occasional growth failure. However, chronic gastrointestinal (GI) blood loss from ulcers at the site of the stricture has not been noted as a major feature. We report three patients in whom an intestinal stricture presented with minimal evidence of obstruction, but with GI bleeding and anemia. Our experience indicates that intestinal strictures with ulcers must be considered in the differential diagnosis of blood loss, and that surgical intervention may be required if GI blood loss is chronic and laboratory results are negative.
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keywords = blood loss
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9/32. angiodysplasia of the colon: diagnosis and treatment.

    gastrointestinal hemorrhage of obscure origin remains a difficult clinical problem, but newer methods of study, particularly endoscopy and angiography, have made inroads into this morass of diagnostic dilemmas. vascular malformations represent entities that are relatively infrequent of occurrence and also difficult of detection. These characteristics render them particularly refractory to recognition. Once diagnosed, however, they are quite readily treated surgically, without resort to "blind" resections or multiple bowel entries. This report deals with three instances of obscure but important persistent blood loss into the gastrointestinal tract. In each instance, identification by customary diagnostic methods was unsuccessful, but was finally made through endoscopy and promptly cured through surgery. The bleeding in all 3 cases proved pathologically to have been caused by vascular malformations, which we have subsumed under the term "angiodysplasia."
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keywords = blood loss
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10/32. Arteriovenous malformation in chronic gastrointestinal bleeding.

    arteriovenous malformations of the gastrointestinal tract are uncommon and treatment is problematic because routine barium contrast studies and endoscopy fail to demonstrate the lesion. diagnosis is by selective mesenteric arteriography, demonstrating a characteristic vascular tuft and very early venous phase. Two cases of arteriovenous malformation are presented and 47 other reported cases are reviewed. Forty-five per cent were found in the cecum; 37, or 80%, involved the distal ileum, cecum ascending colon, or hepatic flexure. Seventy-five per cent of all patients fall into the 50--80 year age range. The literature reveals a recurring pattern of chronic gastrointestinal blood loss, anemia, and delay (even negative abdominal explorations) before the diagnosis is finally made. A more aggressive approach to chronic gastrointestinal bleeding is suggested through the use of selective mesenteric arteriography.
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keywords = blood loss
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