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At least 217 records · Page 12Linked to original sources
PubMed1994

Clozapine-associated neutropenic enterocolitis.

Clozapine's use has been restricted to the treatment of schizophrenic patients unresponsive to conventional antipsychotics, secondary to its propensity to cause agranulocytosis. Because of this restriction, side effects associated with clozapine's use have probably not been fully elucidated. The authors describe a case of a male schizophrenic who developed clozapine-induced agranulocytosis and subsequently a neutropenic enterocolitis. Neutropenic enterocolitis related to clozapine-induced neutropenia or agranulocytosis has not previously been reported in the literature. The history of clozapine, its side effects, and the phenomenon of neutropenic enterocolitis are briefly reviewed.

Agranulocytosis↗
PubMed2006

Sonographic signs of neutropenic enterocolitis.

AIM: To investigate the sonographic features at time of diagnosis and follow-up in patients with neutropenic enterocolitis. METHODS: The sonographic findings in 14 patients with neutropenic enterocolitis were described and evaluated regarding symptoms and clinical outcome. RESULTS: In all patients with neutropenic enterocolitis, the ileocoecal region was involved with wall thickening >10 mm. A transmural inflammatory pattern, hypervascularity of the thickened bowel wall and free abdominal fluid were the common findings. The sonographically revealed thickness of the bowel wall was associated with lethal outcome (P<0.03). In the 11 surviving patients,the improvement of clinical symptoms was accompanied by progressive reduction of intestinal wall thickness. CONCLUSION: High-end sonography of the bowel is a helpful tool for diagnosis,assessment of prognosis and follow-up of patients with neutropenic enterocolitis.The ultrasonographically revealed bowel thickness reflects the severity and the course of the disease, and seems to be predictive for the clinical outcome.

Adult↗
PubMed2004

Abnormalities in liver enzyme levels during Salmonella enteritidis enterocolitis.

OBJECTIVE: To evaluate the prevalence, associated factors, and time-course changes of abnormal liver enzyme serum levels in adult patients with Salmonella enteritidis enterocolitis. METHODS: The clinical records of 104 patients (age range 15-86 years, 46.2% males) admitted to hospital because of S. enteritidis enterocolitis were reviewed. The prevalence of abnormal liver enzyme levels was evaluated, as well as its possible relationship to data of systemic inflammatory response, severe sepsis, and bacteremia. In addition, time-course changes in serum levels of liver enzymes were studied in 16 cases with available follow-up after hospital discharge. RESULTS: In patients without a pre-existing cause for liver enzyme abnormalities (n = 84), the prevalence of serum AST elevation was 23.0% (95% CI 15.4-34.5%), of serum ALT elevation was 17.9% (95% CI 0.6-20.0%), and of GGT elevation was 19.0% (95% CI 11.6-29.3%). The prevalence of abnormality for any of these enzymes (AST, ALT, or GGT) was 35.7% (95% CI 25.7-46.8%). The prevalence of altered serum alkaline phosphatase was lower. Alteration in liver enzyme serum levels was moderate in the majority of cases, and was found in association with the presence of fever. Serum enzyme levels decreased during the convalescence period after hospital discharge. CONCLUSIONS: Abnormalities in liver enzyme levels are frequent during severe enterocolitis due to S. enteritidis in adult patients. These abnormalities are moderate and self-limited.

Adolescent↗
PubMed2000

[Recurrent Clostridium difficile enterocolitis].

Pseudomembranous enterocolitis generally occurs after antibiotic treatment. The standard treatment is oral metronidazol or vancomycin. Nevertheless, relapses of Clostridium difficile enterocolitis are observed in 10-25% of cases. Factors associated with recurrences include endogenous reinfection by spore formation, selective IgG1 or IgA deficiency or infection with mutated strains of Clostridium difficile. Recurrent Clostridium difficile enterocolitis may be treated with repeat oral vancomycin combined with Sacchoromyces boulardii, with intravenous immunoglobulin for severe colitis.

Aged↗
PubMed2003

[A case of methicillin resistant Staphylococcus aureus enterocolitis presenting with massive diarrhea].

Methicillin resistant Staphylococcal aureus (MRSA) enterocolitis is characterized by high fever, abdominal distension, and watery diarrhea that leads to severe dehydration, shock, a sharp decrease in the white cell counts and sometimes multiple organ failure. Clinically, it can be an another cause of nosocomial diarrhea. If MRSA enteritis is suspected from the clinical symptoms, prompt treatment and strict prophylactic measures including vancomycin, are most important for its management. We recently observed a case of MRSA enterocolitis as a nosocomial infection in a patient with acute pancreatitis. This patient showed uncontrolled massive diarrhea, fever, and multiple organ failure. We report a case of MRSA enterocolitis with a review of literatures.

Cross Infection↗
PubMedDate not supplied

Successful medical management of neutropenic enterocolitis (typhlitis) in a child with acute lymphoblastic leukemia.

We report a case of acute lymphoblastic leukemia that was complicated by neutropenic enterocolitis (typhlitis) during the initial period of remission-induction chemotherapy. The patient's clinical symptoms resolved after aggressive treatment with intravenous fluids and electrolytes, nasogastric decompression, bowel rest, total parenteral nutrition, broad-spectrum antibiotics, and granulocyte colony-stimulating factor. Netropenic enterocolitis should always be considered in neutropenic leukemic children with the triad of fever, vomiting, and abdominal pain. Gastrointestinal hemorrhage may also accompany the symptoms described above. Plain roentgenogram, ultrasonography and computed tomography of the abdomen are helpful for making the diagnosis of this clinical condition. Early recognition and proper medical management of neutropenic enterocolitis may prevent the need for surgical intervention, and/or be life-saving.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Neutropenic enterocolitis in a patient with ovarian cancer after treatment with high-dose carboplatin and granulocyte macrophage-colony stimulating factor (GM-CSF).

A 50-yr-old women is described with relapsed ovarian cancer. She developed neutropenic enterocolitis after treatment with high-dose carboplatin (1000 mg/m2) and granulocyte macrophage-colony stimulating factor (GM-CSF). The clinical features and the pathogenesis of neutropenic enterocolitis are discussed. This case is the first report of neutropenic enterocolitis associated with the treatment of carboplatin.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Neutropenic enterocolitis in adults with acute leukemia].

Neutropenic enterocolitis, also known as typhlitis or ileocecal syndrome, in leukemic patients undergoing chemotherapy has a high reported mortality. A recent increase in the incidence of neutropenic enterocolitis is associated with aggressive chemotherapy for acute leukemia. In this report, we report the incidence, diagnosis, and treatment of neutropenic enterocolitis during low-dose DCMP and high-dose DCMP regimen for 95 adults with acute nonlymphocytic leukemia, and review the literature pertaining appropriate medical and surgical management, and method of prevention. Finally we propose the favorable results of gut sterilization for the treatment and prevention of the disease.

Adult↗
PubMed1989

[Neutropenic enterocolitis].

In three patients with neutropenia who had died after a short period from their basic disease (myelodysplasia, medullary carcinoma, acute myeloic leukaemia), autopsy revealed segmental necrotising enterocolitis in the caecal region (neutropenic enterocolitis). Morphologically the enterocolitis was characterised by necrotized mucosa, marked oedema of the intestinal wall, intramural gas, the absence of pseudomembranes and a nearly complete absence of inflammatory cell infiltrates. In one case a palpable abdominal tumour had been produced by pseudotumorous thickening of the intestinal wall. The pathogenesis in these three cases might be a neutropenia-associated disturbance of the intestinal flora with selective proliferation of toxin-producing clostridia.

Aged↗
PubMed1987

[Intestinal stenosis, sequelae of necrotizing enterocolitis. Analysis of 9 cases].

Intestinal necrosis was a complication of necrotizing enterocolitis of the newborn in 9 of 42 cases. In 6 neonates it followed medical treatment of the enterocolitis, presenting in this case as an occlusive syndrome. After surgical treatment (3 cases) the diagnosis was made from radiologic imaging prior to reestablishment of digestive continuity. Surgery was necessary in all cases, and procedures used are described (technic, date of operation). The prognosis of enterocolitis is worsened by this stenosis (1 death in the 9 cases).

Enterocolitis, Pseudomembranous↗
PubMed1985

Necrotizing enterocolitis: a chronic colonic disease.

While acute necrotizing enterocolitis is a common neonatal condition, the chronicity of the pathologic process is often overlooked. Between 1979 and 1983 at the Foothills Hospital in Calgary, a diagnosis of acute necrotizing enterocolitis was made in 211 infants. Seventeen infants (8%) required urgent surgical treatment in addition to standard medical management. Overall, 206 (98%) infants survived the acute episode. Long-term survival was 92% (194 children). The 12 late deaths were ascribed to chronic cardiovascular, pulmonary and cerebral diseases and "short gut syndrome". Colonic strictures developed in 9% of those treated medically; strictures distal to the mucous fistula developed in 50% of those requiring urgent resection and exteriorization. None of the strictures, which formed between 14 days and 18 months after the diagnosis was made, resolved spontaneously. They tended to be multiple and to involve longer segments in infants who required surgery. Diarrhea prolonged the morbidity in these children. The time course and varied presentation of strictures in this series suggests a rationale for management of infants who survive acute necrotizing enterocolitis.

Chronic Disease↗
PubMed1985

[Parallel morphological and functional research on chronic enterocolitis patients using the authors' own method for the simultaneous performance of perfusion and biopsy of the small intestine].

Thirty two patients were studied with chronic enterocolitis and 9 patients without any small intestinal diseases, with normal histomorphological picture of small intestinal mucosa--control group. The method of simultaneous performance of perfusion and biopsy of small intestine was used. Glucose resorption rate in small intestine was studied and histomorphological, electron--microscopic and enzymologic (disaccharidases) studies were carried out on jejunal mucosa. Data about chronic enterocolitis without atrophy were established in 17 patients, in 10--initial partial atrophy, in 5--advanced partial and subtotal atrophy of jejunal mucosa. Reduced glucose resorption rate was established in small intestine in the patients with chronic enterocolitis as compared with that of the control group. Glucose resorption rate correlates with the severity of the histomorphological changes in small intestinal mucosa. Disturbed resorption rate was established via jejuno--perfusion in patients with clinically not manifested syndrome of malresorption and absence of histomorphological changes in small intestinal mucosa, but with established ultrastructural changes in enterocytes.

Adult↗
PubMed1979

Neonatal necrotizing enterocolitis: review and current concepts.

Necrotizing enterocolitis poses a serious threat to the increasing number of "at risk" neonates. Its clinical picture is characterized by abdominal distension, gastric retention, bile vomitus, and bloody stools. Abdominal roentgenograms demonstrate loops of intestine with intramural gas. Many of the neonates with necrotizing enterocolitis have been successfully managed by aggressive medical treatment. A review of the clinical course of 64 neonates with necrotizing enterocolitis in the acute phase suggests that either persistence of abdominal distention, development of edema and erythema of the abdominal wall, or pneumoperitoneum are indications for surgical intervention. Seven neonates presented with colonic stenosis several months after the management of the acute phase of necrotizing entercolitis.

Constriction, Pathologic↗
PubMed1978

Cow's milk intolerance presenting as necrotizing enterocolitis.

Case history is reported of an infant who was changed from breast to bottle feeding at fourth day of life, who on ninth day developed bilious vomiting and bloody diarrhoea. Later gas was found in colonic wall on X-ray. Necrotizing enterocolitis was diagnosed and infant managed with total intravenous alimentation. On recovery although she tolerated breast milk, return to cow's milk formula lead to return of bloody diarrhoea. Subsequently she thrived on a cow's milk-free diet based on chicken meat formula. At four months after total of 15 ml cow's milk she had an acute anaphylactic reaction. She recovered and is well on milk-free diet. Thus, this infant has recovered from necrotizing enterocolitis but has evidence of persistent cow's milk protein intolerance. The hypothesis is put forward that in this child cow's milk protein played a major role in the pathogenesis of necrotizing enterocolitis.

Animals↗
PubMed1982

Enterocolitis complicating chrysotherapy. Case report and review of the literature.

We report a case of a 71-yr old man with seronegative rheumatoid arthritis, who developed severe enterocolitis during gold therapy. Radiological studies, endoscopy and biopsies showed diffuse involvement of the stomach, duodenum and small and large intestines. The clinical course was prolonged and complicated by multiple infections. Of the 10 cases with chrysotherapy-induced enterocolitis reported in the literature, 3 were from Israel. There may be a relationship between the development of enterocolitis following gold therapy, ethnic group and HLA-B8 and DRw3 antigens.

Aged↗
PubMed1980

Interobserver variability in the radiographic diagnosis of necrotizing enterocolitis.

A total of 17 radiographs from seven babies with clinical evidence of necrotizing enterocolitis were examined by six pediatric radiologist and four neonatologists from the Southern California area. The participants were asked to interpret each radiograph as to the presence or absence of necrotizing enterocolitis and to indicate whether pneumoperitoneum was present. A substantial degree of interobserver variability was observed, with only one of the 17 films yielding universal agreement. We propose that this interobserver variability in interpreting abdominal films of neonates with clinically suspected necrotizing enterocolitis may in fact contribute to the reported difference in incidence of this disease among centers.

Diagnostic Errors↗
PubMed1978

[Necrotizing enterocolitis and its surgical management. Study of 35 cases].

Thirty five cases of necrotizing enterocolitis, seen in the past five years in this clinic, are reviewed. Twenty four cases were seen up to December 1977 and eleven cases from January to March 1978 due to a neonatal I.C.U. epidemy. The relationship between some of the accepted perinatal pathogenic factors and the development of necrotizing enterocolitis is analyzed. The temporal relationship of the time of diagnosis to the onset of treatment is an important consideration for the prognosis. We propose surgical treatment if after eighteen hours of treatment there is no improvement. A guideline for the early treatment and surgical indications of acute necrotizing enterocolitis, is suggested.

Enterocolitis, Pseudomembranous↗
PubMed1994

[Collagenous enterocolitis. Apropos of a case and review of the literature].

Collagenous enterocolitis is a recent entity of which only two cases have been published. The authors report the association of collagenous colitis and collagenous sprue in a 67-year-old woman. The diagnosis of collagenous enterocolitis is based on the presence of a duodenal collagen deposit with partial villous atrophy associated with collagenous colitis. The symptom appeared one month after non-steroidal antiinflammatory treatment. The authors discuss the role of drug toxicity in the pathogenesis of collagenous enterocolitis.

Aged↗