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PubMed1987

The effect of orally administered Entamoeba histolytica on Wistar and athymic (rnu rnu) rats observed during a 12-month period.

Groups of LacP (Wistar) and rnu rnu athymic rats were dosed orally with cultured trophozoites of 2 strains of Entamoeba histolytica, zymodeme II, and observed for up to 12 months. One group of Wistar rats remained infected but with no apparent disease for 6 months; faecal samples from another became negative after one week. All the athymic rats were still infected at 12 months and amoebae could be cultured from their stools. The effect of even long-term infection was usually only mild erosion of the caecal wall and only 2 rats developed typical chronic lesions and ulcers. Amoebae were isolated in culture from the apparently unaffected livers of 2 rats 12 months after infection.

Animals↗
PubMedDate not supplied

An unusual case of ileocaecal tuberculosis in an 80-year-old Caucasian male.

An 80-year-old Caucasian male presented with a seven-week history of diarrhoea and weight loss. Distal duodenal biopsies showed partial villous atrophy but he failed to respond to a gluten-free diet. Subsequently he developed a right iliac fossa mass associated with radiological evidence of ileocaecal ulceration. Colonoscopic biopsies from the caecum showed non-caseating granulomata and Ziehl-Neelsen (ZN) staining and culture for acid-fast bacilli (AFB) were negative. Crohn's disease was diagnosed and he was started on steroids. Although he showed an initial response, his condition then deteriorated and he died after six weeks. ZN staining of tissue at postmortem showed AFBs. Although a rare diagnosis in the UK, a high index of suspicion should be maintained for ileocaecal TB in patients with appropriate clinical features, even if classical risk factors for TB are absent.

Aged↗
PubMed2000

How frequently do large bowel diverticula perforate? An incidence and cross-sectional study.

The aetiology of perforation of large bowel diverticula is poorly understood and a case-control study is required to identify the causes. Before such a study can be attempted, the incidence must be determined and groups at particular risk identified. Cases of perforated large bowel diverticula living in the Norwich postal code region treated between 1995 and 1997 were identified. Fifty-eight cases presented in a population of 531 241. The incidence was 4.0 cases per 100,000 per year, increased with age and was higher in men than women (5.8 vs 3.1). The most frequently used drugs were non-steroidal anti-inflammatory drugs (NSAIDs) (29%) and opiate analgesics (26% of cases). This is the first report of the incidence of perforated diverticular disease and allows a calculation of the population size needed to recruit sufficient cases for an aetiological investigation. The differences in incidence between genders should prompt a search for factors which differ between the sexes such as diet. NSAIDs are a known risk factor, although the data show that opiate analgesics should be investigated.

Adult↗
PubMed1986

Ileocecal histoplasmosis mimicking Crohn's disease in a patient with Job's syndrome.

A 16-years-old male with a history of Job's syndrome and a recent diagnosis of Crohn's disease was admitted to the hospital because of abdominal pain, nonbloody diarrhea, weakness, and fever. Due to failure to respond to medical therapy it was decided that an operation was indicated, and resection of the terminal ileum and right colon was performed. Cecum and ileum were inflamed, and pathologic studies revealed the presence of budding yeasts which on special stain were diagnostic of Histoplasma species. Successful management was accomplished with oral ketoconazole.

Adolescent↗
PubMed2000

Ileocecal ulcer with a cecocecal fistula in Behçet's disease.

We describe a case of Behçet's disease (BD) which showed the ileocecal ulcer and cecocecal fistula. This 38-year-old man had appendectomy six years ago because of colicky pain in the right lower abdomen (RLA). There are some reports on fistula formation in BD. In those, some are related to surgery and others are not. BD with cecocecal fistula, possibly associated with a past operation, has not been reported in the literature.

Adult↗
PubMed1998

[An appendiceal-vesical fistula in a patient with cystic fibrosis].

Cystic fibrosis is an hereditary disease in which abnormally viscous secretion of exocrine glands causes chronic pulmonary infections and gastrointestinal disorders. The authors report the case of a patient with cystic fibrosis and appendicitis complicated by appendico-vesical fistula. The appendico-vesical fistula has been described during appendicitis; its association with the cystic fibrosis however has never been reported in the literature.

Adult↗
PubMed1992

[Systemic chronic candidiasis following typhlitis caused by Candida albicans].

Typhlitis is an infrequent infectious complication which may appear during a period of intense granulocytopenia, generally in patients with acute leukemia. The most common causal germs are Gram negative bacilli although the importance of Candida sp. as an etiologic agent of this disease is ever more frequent. The case of a 14 years old patient with acute lymphoblastic leukemia who, after chemotherapy treatment, presented typhlitis by Candida albicans followed by chronic systemic candidiasis (CSC) is described. The role that Candida albicans may play in some cases of typhlitis is discussed as is the relation between the appearance of typhlitis and the posterior development of CSC.

Adolescent↗
PubMed1995

[Invagination of vermiform appendix in an asymptomatic adult: a case report].

Invagination of the vermiform appendix (appendiceal intussusception) is a very rare disease. Most cases occur in patients under 10 years of age. The clinical presentation of invagination of the vermiform appendix is extremely variable and most cases are symptomatic. The pathogenesis of invagination of appendix is still not clear, but some precipitating factors have been identified. Herein, we report one case of primary invagination of the vermiform appendix in a adult without any symptom. Etiology, precipitating factor, clinical presentation, classification, and diagnosis method are discussed.

Appendix↗
PubMedDate not supplied

Ultrasound diagnosis of "dry type" ileocecal tuberculosis: a case report.

Abdominal tuberculosis is a common curable disease in third world countries. CT is the most sensitive imaging technique. The purpose of this paper is to report the ultrasound diagnosis of a missed dry type ileocecal tuberculosis. A 40 year old patient was admitted to hospital for loin pain and was discharged following negative ultrasound and IVU tests. Symptoms recurred and a barium enema, follow through and abdominal CT were conducted. Barium studies were non specific and CT was normal. Sigmoidoscopy was negative for inflammatory bowel disease. A second ultrasound indicated a "coned" cecum with edematous and dilated terminal ileum. A diagnosis of tuberculosis was suggested. Colonoscopy showed typical lesions in the cecum with nodular terminal ileum. Biopsies were supportive of a tuberculosis diagnosis. In conclusion, an ultrasound with a high index of clinical suspicion is a useful test for the diagnosis of ileocecal tuberculosis. The coned contracted cecum with a dilated edematous terminal ileum are important diagnostic signs.

Adult↗
PubMed2000

[Ileocecal manifestation of Schoenlein-Henoch purpura as a rare differential Crohn disease diagnosis].

In the case of a 21-year-old patient gastroscopy and coloscopy were performed because of recurrent abdominal pain with diarrhea and vomiting. Colonoscopy showed moderate signs of inflammation of the rectum and aphthoid ulcerations in the terminal ileum. Since the macroscopic and clinical presentation was compatible with Crohn's disease, therapy with sulfasalacine was started. Because histology showed only lymphoid hyperplasia and the patient was asymptomatic at that time, the medication was ceased. Recurrence of abdominal pain and weight loss, proteinuria and a recurrent palpable purpura of the shanks in synopsis with the result of the previous colonoscopy led to a suspected diagnosis of Schoenlein-Henoch purpura with cutaneous, renal and abdominal manifestation which was confirmed by dermal and renal biopsies.

Adult↗
PubMed1996

[Low digestive hemorrhage caused by amebic colitis].

Amebiasis is an infectious disease produced by Entamoeba histolytica, which has invasion capacity of the colon mucosa. It has different clinical forms, varying from the asymptomatic carrier state to severe, although not frequent, fulminant or necrotizing colitis, with an important necrosis of the colon mucosa. Perforation or intestinal bleeding are possible. We report one case of patient who had a history of recent travel to India. Was admitted with a clinical picture of abdominal pain, diarrhea and fever. Initially he received treatment with Metronidazole and steroids, because of doubts in the endoscopy diagnosis of Crohn's Disease versus Amebic Colitis. The patient developed a fulminant colitis, that required emergency surgery because of lower intestinal massive bleeding. During the operation perforations of the caecum and rectum were found. We performed a total colectomy with ileostomy and closing of the stump rectal. Six months later a second operation was made for the reconstruction of the intestinal continuity by an ileal pouch and rectal anastomosis.

Adult↗
PubMed1997

Acute abdomen. Special considerations for the neurologically and immunologically impaired child.

The neurologically or immunologically impaired child suspected of having an acute abdomen presents a formidable challenge. However, a thorough understanding of the underlying pathophysiology of the disease on the normal host response to an intraabdominal disease permits early recognition and initiation of treatment. Classic findings of the acute abdomen are the exception rather than the rule. These children require constant vigilance and repeated examination. Radiographic studies should be used early and often. The advent of minimally invasive surgical techniques offers the opportunity to intervene early both diagnostically and therapeutically. Ultimately, however, the best outcomes will be achieved by those who employ sound surgical judgment and avoid unnecessary therapeutic delay owing to inexperience, inattention, or indecision.

Abdomen, Acute↗
PubMed1992

[Is enterolithiasis a disease occurring more frequently in desert climate? Apropos of 8 cases].

This work is a report about 8 cases of enterolithiasis treated in our University Hospital between 1980 and 1990. We emphasize the rarity of this condition. We also note its relative frequency (5 of 8 cases) in the Bedouin population of our mostly desertic area, and question the possible impact of a diet rich in goat's milk and/or of tuberculosis, which is still endemic in some tribes. We then discuss the difficulties of diagnosis and the essential contribution of small bowel radiographs. The etiologies of enterolithiasis are reviewed, as well as the various modalities of treatment.

Adult↗
PubMed1995

Presentation of endometriosis to general surgeons: a 10-year experience.

The presentation and management of 24 patients with endometriosis (median age 34 (range 21-68)years) presenting to general surgeons over a period of 10 years (1985-1994) was reviewed. Patients presented with an abdominal wall swelling related to a previous Pfannenstiel incision (seven patients), umbilical swelling (four), inguinal canal swelling (two), incidentally following appendicectomy (five), terminal ileal obstruction (two), rectal bleeding (two) and urinary symptoms (two). Endometriosis was not suspected in most patients but was confirmed by surgical excision or resection with minimal morbidity. No recurrence occurred during a median follow-up of 53 (range 9-113) months. Endometriosis is a disease rarely seen by general surgeons and is often diagnosed incidentally or on histological examination. Cyclical symptoms associated with menstruation are present in 50 per cent of patients and should suggest the diagnosis in those presenting with scar-related and/or subcutaneous swellings. Simple excision or resection of the presenting lesion provides adequate treatment but, since pelvic endometriosis may be present, referral to a gynaecologist is recommended in every case.

Abdominal Muscles↗
PubMed2005

Inverted appendix mistaken for a polyp during colonoscopy and leading to intussusception.

A spectrum of appendiceal diseases, ranging from simple mucous distension to acute perforated appendicitis, are seen in patients with CF. We report a 6 year old boy with CF and recurrent periumbilical pain. During colonoscopy, a fleshy pedunculated mass at the junction of the ascending colon and caecum was mistaken for a polyp and excised. However, histopathological examination suggested it was a segment of inverted appendix. The remnant of the inverted appendix was subsequently found to be associated with an intussusception.

Appendectomy↗
PubMedDate not supplied

[Appendiceal "mucocele": apropos of 2 cases].

Two patients affected by appendiceal mucocele underwent emergency operation in our Department. Clinical findings and surgical management of the disease are discussed as well as controversy regarding the pathologic classification of the disease. The term "mucocele" is not referred to an exact histopathologic lesion: it describes the gross enlargement of the appendix, due to the accumulation of mucus in the dilated lumen. Currently such lesions are classified as nonneoplastic or as retention appendiceal cysts or as mucous-secreting tumours; the benign forms are cured by appendectomy, the malignant ones often require right colectomy for technical reasons. Pseudomyxoma peritonei significantly decreases survival of patients suffering from mucinous cystadenocarcinoma, but it does not affect survival in case of mucinous cystadenoma.

Aged↗
PubMed1995

Ultrasound in the differential diagnosis of appendicitis.

The purpose of this study was to determine the accuracy of sonography in detecting diseases other than appendicitis in the clinical setting of suspected appendicitis. Six hundred and nine patients were evaluated using graded compression ultrasound (US). A broad spectrum of diseases was suggested in the group of patients who eventually turned out not to have appendicitis (n = 426), including gastrointestinal (154), gynaecological (32), biliary (11), urological (8), and miscellaneous (5) abnormalities. However, out of these there were three cases of incorrect sonographic diagnoses with serious sequelae. Appendicitis coincidental with another disease capable in itself of explaining the patients' symptoms was confirmed in seven out of 10 patients where sonographically suggested; in six patients out of this group only the suggested alternative condition was held responsible for the symptoms while the inflamed appendix was overlooked. US is of considerable value in establishing alternative diagnoses in patients with equivocal signs of appendicitis. However, one should always consider the possibility of co-existing appendicitis in patients where US has revealed another condition which could be held in itself responsible for the patient's symptoms.

Adolescent↗
PubMed1998

[Iterative intestinal intussusception and appendiceal mucocele in an infant with mucoviscidosis].

UNLABELLED: Cystic fibrosis is a common and potentially life-threatening hereditary disease which can affect numerous organs, particularly the digestive tract. CASE REPORT: A 4.5-year-old boy exhibited two little known clinical manifestations: an appendiceal mucocele and repeated intussusceptions. In spite of an appendectomy, intussusception relapsed and an ileocolic resection was necessary 2 years later. DISCUSSION: Appendiceal diseases in cystic fibrosis represent a large spectrum, ie, distention on the appendiceal lumen, engorged with sticky mucous matter, which becomes an appendiceal mucocele, peritonitis with an appendiceal perforation due to delayed diagnosis since acute appendicitis is difficult to diagnose in these patients. Intussusception is rarely observed in cystic fibrosis. CONCLUSION: Appendiceal mucocele could be a cause of intussusception. If an appendectomy is performed, resection of a part of the cecum, around the appendix, could be useful in preventing again mucocele formation.

Appendectomy↗