Perforations and fistulae in gastrointestinal tuberculosis

2002 ◽  
Vol 43 (5) ◽  
pp. 501-506 ◽  
Author(s):  
B. Nagi ◽  
A. Lal ◽  
R. Kochhar ◽  
D. K. Bhasin ◽  
B. R. Thapa ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Clinical Signs ◽  
Tuberculous Infection ◽  
Common Site ◽  
Tuberculosis Patients ◽  
Gastrointestinal Tuberculosis ◽  
Extrinsic Compression ◽  
Contrast Studies ◽  
Associated Abnormalities

Background: Perforation and fistulae, though uncommon, are serious complications of gastrointestinal tuberculosis. Patients with acute tuberculous perforation are subjected to surgery, whereas localized perforation and fistulae with subtle clinical signs are detected by barium contrast examination. There has been no report on radiological series regarding the incidence of perforation and fistulae, detected by barium contrast studies. Material and Methods: A retrospective analysis of barium contrast studies of 684 proven cases of gastrointestinal tuberculosis seen over a period of 15 years was done to detect the incidence of perforation and fistulae. Results: Fifty-two patients (7.6%) with localized perforation and fistulae were seen. Twenty-eight patients had evidence of perforation, and 24 patients showed fistulae formation. The most common site of perforation and fistulae was the small bowel followed by the colon. Associated abnormalities noted were ulcerations, strictures, nodular filling defects and extrinsic compression. Conclusion: Perforation and fistulae along with other associated abnormalities of the gastrointestinal tract are suggestive of tuberculosis, particularly in a population predisposed to tuberculous infection.

scholarly journals The HIV manifestations within the gastrointestinal tract: A pictorial review

2017 ◽  
Vol 21 (2) ◽  
Author(s):  
Alexandra Renn ◽  
Farhat Kazmi ◽  
Nasir Khan ◽  
Bhavin Rawal ◽  
Elaine O’Boyle
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Kaposi's Sarcoma ◽  
Anal Carcinoma ◽  
Kaposi’S Sarcoma ◽  
Cd4 Count ◽  
Gastrointestinal Tuberculosis ◽  
Cytomegalovirus Colitis ◽  
Pictorial Review

The aim of the pictorial review are to review the HIV manifestations within the gastrointestinal tract. We have detailed five conditions, with reference to the patients’ CD4 count – gastrointestinal tuberculosis, Kaposi’s sarcoma, small bowel lymphoma, cytomegalovirus colitis and anal carcinoma.

scholarly journals Jejunojejunal intussusception secondary to metastatic uveal melanoma after 11 years of remission

2019 ◽  
Vol 12 (6) ◽  
pp. e229535
Author(s):  
Hifza Waheed Butt ◽  
Sarthak Soin ◽  
Faisal Ali ◽  
Antoni Wojtkowski
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Uveal Melanoma ◽  
Cutaneous Melanoma ◽  
Subcutaneous Tissue ◽  
Vascular Supply ◽  
Adult Intussusception ◽  
Rare Occurrence ◽  
Common Site ◽  
Malignant Cutaneous Melanoma

Malignant cutaneous melanoma frequently metastasises to gastrointestinal tract, small bowel being the most common site likely due to its rich vascular supply. However, most common sites for metastatic uveal melanoma are the liver (93%), lung (24%), bone (16%), skin/subcutaneous tissue (11%) and lymph nodes (10%). 1 We present a case of 46-year-old man with jejunojejunal intussusception secondary to metastatic uveal melanoma status postbrachytherapy after 11 years of remission. We aim to highlight the rare occurrence of adult intussusception secondary to uveal melanoma after a prolonged period of remission.

scholarly journals Metastatic Melanoma Presenting as Intussusception in an 80-Year-Old Man: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Alghamdi ◽  
Yumna Omarzai
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Metastatic Melanoma ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Common Site ◽  
Neoplastic Process ◽  
History Of ◽  
Uncommon Neoplasm

Malignant melanoma of the gastrointestinal tract is an uncommon neoplasm that could be primary or metastatic. Small intestine represents the most common site for the metastatic melanoma; however, it could be found anywhere in the gastrointestinal tract. Intussusception is a rare cause of intestinal obstruction in adults compared to children. In 90% of the cases, the underlying cause can be found, and in 65% of the cases, intussusception is caused by the neoplastic process. The majority of the neoplasms are benign, and about 15% are malignant. Metastatic melanoma is one of the most common metastatic malignancies to the gastrointestinal tract; however, the premortem diagnosis is rarely made. Here, we report an uncommon clinical presentation of metastatic melanoma causing intussusception in an 80-year-old man. This diagnosis should be considered in a differential diagnosis in any patient who presents with gastrointestinal symptoms and a history of melanoma.

Treatment of tuberculosis patients with diet

1929 ◽  
Vol 25 (9) ◽  
pp. 994-995
Author(s):  
М. Zaitsev
Keyword(s):  
Gastrointestinal Tract ◽  
Metabolic Disorders ◽  
Medical Literature ◽  
Surgical Patients ◽  
Tuberculosis Patients

The question of the nutrition of patients has recently occupied a prominent place in the German medical literature, as well as in Berlin clinics. Nutrition for infants, nutrition for patients obsessed with diseases of the gastrointestinal tract, nutrition for those suffering from metabolic disorders, nutrition for surgical patients, pre- and postoperative - cause a lot of controversy in medical circles and more and more attracts the attention of practitioners.

Trace Element Deficiencies during Total Parenteral Nutrition

1977 ◽  
Vol 11 (9) ◽  
pp. 536-541 ◽  
Author(s):  
Robert Lee Hull ◽  
Dennis Cassidy
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Parenteral Nutrition ◽  
Trace Element ◽  
Total Parenteral Nutrition ◽  
Therapeutic Agent ◽  
Copper Deficiency ◽  
Diagnostic Features ◽  
Case Presentation

The diagnostic features of copper deficiency are discussed, and a case presentation is compared with other reports in the literature. The need for copper supplement is stressed when total parenteral nutrition (TPN) is given to patients whose gastrointestinal tract is either shortened or incapable of reabsorbing copper. Since copper is recycled through the small bowel by way of the bile, any dysfunction of this area can lead to copper deficiency during TPN if inadequate amounts of copper are added to the basic TPN solutions. It is suggested that Dr. Shils' formula be used twice weekly for prophylaxis during long-term hyperalimentation and daily as a therapeutic agent when a deficiency is diagnosed.

Capsule endoscopy in small bowel Crohn’s disease and Tuberculosis

2017 ◽  
Vol 47 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Surinder Singh Rana ◽  
Vishal Sharma ◽  
Ravi Sharma ◽  
Ritambhra Nada ◽  
Rajesh Gupta ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Ileocecal Valve ◽  
Final Diagnosis ◽  
Diagnostic Challenge ◽  
Large N ◽  
Aphthous Ulcers

Differentiation of small bowel tuberculosis (SBTB) from Crohn’s disease (CD) is a diagnostic challenge. We studied 52 patients with suspected SBTB or CD with terminal ileal involvement, who were prospectively enrolled. After confirming patency of the gastrointestinal tract, 26 patients underwent capsule endoscopy (CE). A final diagnosis of CD was found in 18 patients and SBTB in eight patients. All SBTB patients had involvment of the ileocecal valve (ICV) with large (n = 6) and aphthous (n = 2) ulcers in the ileal segment. In CD, ICV involvement was seen in five (33%) patients. Large and aphthous ulcers were observed in seven (47%) and 15 (100%) patients, respectively. On comparison with CD, patients with SBTB had increased frequency of ICV involvement ( P = 0.002) and lesser frequency of aphthous ulcers ( P = 0.007). CE can help in differentiating CD from SBTB by the position of its involvement and the type of ulcers present.

scholarly journals ‘Short’ Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with a Surgically Altered Upper Gastrointestinal Tract

2011 ◽  
Vol 25 (11) ◽  
pp. 615-619 ◽  
Author(s):  
S Cho ◽  
P Kamalaporn ◽  
G Kandel ◽  
P Kortan ◽  
N Marcon ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Upper Gastrointestinal Tract ◽  
Papilla Of Vater ◽  
Endoscopic Retrograde ◽  
Bilioenteric Anastomosis ◽  
Double Balloon ◽  
Surgically Altered Anatomy ◽  
Working Length ◽  
Upper Gastrointestinal

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) remains a challenge for endoscopists in patients with surgically altered anatomy of the upper gastrointestinal tract. Double-balloon enteroscopes (DBEs) have revolutionized the ability to access the small bowel. The indication for its therapeutic use is expanding to include ERCP for patients who have undergone small bowel reconstruction. Most of the published experiences in DBE-assisted ERCP have used conventional double-balloon enteroscopes that are 200 cm in length, which do not permit use of the standard ERCP accessories. The authors report their experience with DBE-assisted ERCP using a ‘short’ DBE in patients with surgically altered anatomy.METHODS: A retrospective review of patients with previous small bowel reconstruction who underwent ERCP with a ‘short’ DBE at the Centre for Therapeutic Endoscopy and Endoscopic Oncology (Toronto, Ontario) between February 2007 and November 2008 was performed.RESULTS: A total of 20 patients (10 men) with a mean age of 57.9 years (range 26 to 85 years) underwent 29 sessions of ERCP with a DBE. Six patients underwent Billroth II gastroenterostomy, seven patients Roux-en-Y hepaticojejunostomy, five patients Roux-en-Y gastrojejunostomy, one patient Roux-en-Y esophagojejunostomy and one patient a Whipple’s operation with choledochojejunostomy. Some patients (n=12 [60%]) underwent previous attempts at ERCP in which the papilla of Vater or bilioenteric anastomosis could not be reached with either a duodenoscope or pediatric colonoscope. All procedures were performed with a commercially available DBE (working length 152 cm, distal end diameter 9.4 mm, channel diameter 2.8 mm). The procedures were performed under conscious sedation with intravenous midazolam, fentanyl and diazepam, except in one patient in whom general anesthesia was administered. Either the papilla of Vater or bilioenteric anastomosis was reached in 25 of 29 cases (86.2%) in a mean duration of 20.8 min (range 5 min to 82 min). Bile duct cannulation was successful in 24 of 25 cases in which the papilla or bilioenteric anastomosis was reached. Therapeutic interventions were successful in 15 patients (24 procedures) including sphincterotomy (n=7), stone extraction (n=9), biliary dilation (n=8), stent placement (n=9) and stent removal (n=8). The mean total duration of the procedures was 70.7 min (range 30 min to 117 min). There were no procedure-related complications.CONCLUSION: DBEs enable successful diagnostic and therapeutic ERCP in patients with a surgically altered anatomy of the upper gastrointestinal tract. It is a safe, feasible and less invasive therapeutic option in this group of patients. Standard ‘long’ DBEs have limitations of long working length and the need for modified ERCP accessories. ‘Short’ DBEs are equally as effective in reaching the target limb as standard ‘long’ DBEs, and overcomes some limitations of long DBEs to result in high success rates for endoscopic therapy.

EP.TU.533A rare clinical presentation of Goblet Cell Adenocarcinoma of the appendix: Recommendations for safe & effective management

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ganeshan Ramsamy ◽  
Zoe Slack ◽  
Giovanni Tebala
Keyword(s):  
Small Bowel ◽  
Goblet Cell ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Operative Management ◽  
Small Bowel Resection ◽  
Right Hemicolectomy ◽  
Bowel Ischaemia ◽  
Operative Recovery

Abstract Background Goblet cell carcinoma (GCC) is a rare mixed neoplasm arising from the appendix, consisting of glandular and neuroendocrine tissue. It typically presents in adults with a mean age of 55-65 years old. Diagnosis is usually incidental via histopathological examination after 0.3% to 0.9% of all appendicectomies. Literature remains sparse on classification and prognosis of GCC, and cases documented in younger patients. Aims To highlight an interesting clinical presentation and intra- and post-operative management of GCC. To increase awareness for future practice when managing patients with GCC. Methods A 37 year-old male presented with left sided abdominal pain, constipation and fresh rectal bleeding. Computed Tomography demonstrated extensive SMV thrombus causing small bowel ischaemia. On the Intensive Care Unit, he underwent thrombolysis through a Transjugular Intrahepatic Porto-Systemic Shunt. A few days later, he developed bowel obstruction, necessitating a small bowel resection secondary to an ischaemic stricture. 9 months later, he presented with clinical signs of appendicitis. After an uneventful appendicectomy, he was diagnosed with GCC upon histopathological examination of the specimen. Results The patient made an uneventful post-operative recovery. A multidisciplinary team (MDT) decision was made to perform a completion right hemicolectomy, with histology confirming pT3N1M0 GCC. Adjuvant chemotherapy with 5-Fluorouracil was started. Conclusion This case highlights GCC with a preceding clinical course not yet published in the literature. It stresses the importance of the MDT in managing GCC. Although primarily diagnosed histologically, a clinical suspicion of GCC of the appendix is worth considering in pro-thrombotic patients.

scholarly journals Intestinal obstruction caused by small bowel adenocarcinoma misdiagnosed as psychogenic disorder

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227326
Author(s):  
Hirotada Nishie ◽  
Taketo Suzuki ◽  
Hiroshi Ichikawa ◽  
Hiromi Kataoka
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Psychiatric Treatment ◽  
Severe Depression ◽  
Nausea And Vomiting ◽  
University Hospital ◽  
Small Bowel Adenocarcinoma ◽  
Antidepressant Agents ◽  
Decompression Tube

We describe a case of intestinal obstruction caused by a small bowel adenocarcinoma misdiagnosed as psychogenic disorder. A woman in her 40s was admitted to Nagoya City University Hospital with fatigue, anorexia, nausea and vomiting. CT, oesophagogastroduodenoscopy and colonoscopy revealed no signs of organic abnormality in her gastrointestinal tract. As the patient had previously been diagnosed with and treated for depression, her symptoms were suspected to be due to psychogenic disorder. Therefore, she was diagnosed with severe depression and was administered antidepressant agents. Despite intense psychiatric treatment, her symptoms worsened and she was later diagnosed with ileus due to adenocarcinoma in the jejunum. After drainage by insertion of a transnasal decompression tube, a partial jejunum resection was performed. After the resection, the patient’s symptoms including fatigue and depression resolved without the use of antidepressant agents.

Sign in / Sign up

Export Citation Format

Share Document