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Results for “CECAL DISEASES”

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PubMed1999

Necrotizing mycotic vasculitis with cerebral infarction caused by Aspergillus niger in a horse with acute typholocolitis.

An 18-year-old Morgan mare was presented to the Veterinary Medical Teaching Hospital, University of Illinois, with a 10-day history of watery diarrhea, depression, and dysphagia. On admission, the animal was severely dehydrated, depressed, and unable to swallow and had no clinical signs of diarrhea. The respiratory and heart rate and body temperature were within normal limits. Following fluid therapy, the mare developed severe watery diarrhea and continued to be depressed, incoordinated, and dysphagic. The animal died on the fourth day after admission and was sent to the Laboratories of Veterinary Diagnostic Medicine for necropsy. Gross postmortem findings were consistent with an acute cerebral infarction in the right cerebral hemisphere, an acute necrotizing typhlocolitis, multifocal petechial and ecchymotic hemorrhages, enlarged and congested pars intermedia of the pituitary gland, and marked bilateral adrenocortical hyperplasia with multifocal areas of necrosis and hemorrhage. Histologic evaluation of the affected brain demonstrated an area of coagulative necrosis of the gray matter, with hemorrhage, vasculitis, and thrombosis. There were many fungal hyphae 3.5-6.0 microm, pale basophilic, septate, and occasionally branching at 45 degrees present in the arterial walls and throughout the necrotic tissue. Immunohistochemical analysis revealed Aspergillus niger as the etiologic agent responsible for the mycotic vasculitis and infarction in the brain. Bacteria culture and immunohistochemical staining of the colon and cecum failed to demonstrate specific pathogens.

Acute Disease↗
PubMed2006

Appendiceal involvement in Crohn's disease: gray-scale sonography and color Doppler flow features.

OBJECTIVE: The objective of our study was to evaluate appendiceal involvement in Crohn's disease with gray-scale and color Doppler sonography and differentiate it from acute appendicitis. MATERIALS AND METHODS: Analysis of the sonographic examinations was performed over 5 years in 190 patients with an established diagnosis of Crohn's disease. Data analyzed were as follows: visualization of the appendix; thickness and color Doppler signal (grade 0, 1, or 2) of the appendix and adjacent intestinal loop (cecum, terminal ileum, or both); involvement of other intestinal segments; and abscesses. The findings were compared with those of 49 consecutive patients with sonographic findings of acute appendicitis. RESULTS: Thirty-nine patients with Crohn's disease (21%) had appendicular involvement. All but one patient showed thickening of the terminal ileum, and 46% of patients also showed thickening of the cecum. The thickness of the ileum was more than 5 mm (only the anterior wall) in 64% of patients. Appendicular hyperemia was seen in 72% of patients. Involvement of other segments was seen in 23 patients (59%) and adjacent abscesses in six (15%). Irregular thickness of the submucosa was seen in nine cases (23%) and fibrofatty proliferation in 19 (49%). In patients with ileocecal regional disease, ileum thickness of more than 5 mm and visible color in the ileum were the most valuable signs, both for the diagnosis of Crohn's disease and to differentiate it from acute appendicitis (positive predictive value, 96%; negative predictive value, 74%). CONCLUSION: Appendicular involvement in Crohn's disease is a relatively frequent event (21%). Sonography and color Doppler sonography may be useful for differentiating Crohn's disease with appendicular involvement from acute appendicitis.

Acute Disease↗
PubMedDate not supplied

[Appendiceal oxyuriasis: a case report and review of the literature].

The authors describe a case of appendicular oxyuriasis and then go on to review the international literature on this condition. Nothing in the case report provides the surgeon with useful pointers which may help him distinguish between appendicular oxyuriasis and common appendicitis. This is in line with all the existing literature which yields no elements capable of suggesting an accurate preoperative diagnosis. Only anamnestic evidence of previous oxyuriasis can help the clinician in this direction. It should be noted, however, that there are no significant differences in postoperative morbidity between "common" acute appendicitis and appendicitis due to oxyuriasis, when the parasitosis is adequately treated.

Acute Disease↗
PubMed1986

[Treatment of acute perforated appendicitis with intraperitoneal cefazolin].

Until recently intra-abdominal sepsis following surgery for perforated appendicitis has remained a frequent occurrence. In 1975 Fowler reported an incidence of one intra-abdominal abscess in 36 perforated appendicitis treated with a protocol consisting of saline irrigation at surgery, followed by intraperitoneal administration of cephaloridine q. 6 hours for 48 hours. The same antibiotic was then given i.v. for 72 hours. He concluded that this method was an effective way to minimize post-op intra-abdominal abscess, and that the intraperitoneal route was more effective, for this purpose, than systemic administration. More recently, with better knowledge of the role of anaerobes, improved results have also been obtained by adding clindamycin or metronidazole to the antibiotic regimen. A prospective study based on two groups of patients randomly assigned to two protocols was undertaken. The study group consisted of 45 children operated for perforated appendicitis with abscess or generalized peritonitis. These patients were treated with Fowler's protocol. Because it is less nephrotoxic and is active against the same organisms, cefazolin was used instead of cephaloridine. The control group consisted of 43 patients, also operated for perforated appendicitis, treated with saline irrigation at surgery, with either i.v. gentamycin or tobramycin and clindamycin or metronidazole for an average of 7.8 +/- 3.1 days. Both groups were fairly well matched in terms of age, sex, severity of disease, and bacterial flora. They showed an identical 6% post-op intra-abdominal sepsis rate. Days before afebrile, days under gastric suction, complications and average hospital stay were comparable in both groups. The wound infection rate was 20% in the study group and 9% in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMed1997

[The role of surgery in the treatment of appendicular abscesses].

The management of appendiceal abscesses is still discussed and many different approaches are nowadays adopted. The aim of this study was to analyze retrospectively our experience with this disease to value the results of drainage of the abscess and appendectomy in one stage in presence of appendiceal abscesses. We studied 44 patients consecutively observed in our Department of General Surgery all submitted to drainage of the abscess and appendectomy for acute appendicitis with periappendiceal abscess. Preoperative ultrasonography showed an accuracy of 85.7% in detecting the presence of an abscess. Mean size of the abscesses were 5 cm (from a minimum of 3 cm to a maximum of 9 cm). The mean duration of surgical operation was 48 minutes (min 35'-max 95'), with a mean in-hospital stay of 6.2 days. Morbidity rate was 9% and was due in 75% of cases to wound infection and in 25% of cases to wound dehiscence. Neither major morbidity nor mortality were observed. In consideration of the results the authors conclude that even in presence of an appendiceal abscess, appendectomy with abscess drainage is not only a safe operation with a low morbidity rate but the procedure of choice allowing a significative reduction of hospitalization and health cost.

Abscess↗
PubMed1999

The association of cigarette smoking with a high risk of recurrence after ileocolonic resection for ileocecal Crohn's disease.

The purpose of this retrospective study was to examine the influence of cigarette smoking on the recurrence of Crohn's disease after resection. Between 1975 and 1990, 141 patients underwent primary ileocolonic resection for ileocecal Crohn's disease, 79 of whom were nonsmokers and 62 of whom were smokers at the time of their operation. The 5- and 10-year cumulative recurrence-free rates were 65% and 45% for the smokers, and 81% and 64% for the nonsmokers, the former values being significantly lower than the latter values (P = 0.007). The smokers were further divided into two subgroups according to the number of cigarettes smoked per day; as mild smokers who smoked fewer than 15 per day (n = 31) and heavy smokers who smoked 15 or more per day (n = 31). The cumulative recurrence-free rate was lower in the heavy smokers compared with the mild smokers. These findings strongly suggest that smoking is associated with a high recurrence rate after ileocolonic resection for ileocecal Crohn's disease.

Adult↗
PubMed2001

[Epidermoid cyst of the cecum].

This paper describes a case of an epidermoid cyst arising in the anterior wall of the coecum. Epidermoid and dermoid cysts of the coecum are exceptionally rare. These cysts arise by the sequestration of squamous epithelium during embryological development, or following trauma or surgery. The true cysts are the result of inclusion or sequestration of ectodermal elements at the time of closure of the neural groove. Acquired epidermoid cysts are of traumatic or iatrogenic origin, due to implantation of the epidermis. In this reported case the patient had no previous abdominal surgery which is why this cyst represents the congenital variant of the disease.

Adult↗