Gastrointestinal Bleeding in Infants and Children
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Congenital Diarrheal Disorders: an Updated Diagnostic Approach
4168 Int. J. Mol. Sci.2012, 13, 4168-4185; doi:10.3390/ijms13044168 OPEN ACCESS International Journal of Molecular Sciences ISSN 1422-0067 www.mdpi.com/journal/ijms Review Congenital Diarrheal Disorders: An Updated Diagnostic Approach Gianluca Terrin 1, Rossella Tomaiuolo 2,3,4, Annalisa Passariello 5, Ausilia Elce 2,3, Felice Amato 2,3, Margherita Di Costanzo 5, Giuseppe Castaldo 2,3 and Roberto Berni Canani 5,6,* 1 Department of Gynecology-Obstetrics and Perinatal Medicine, University of Rome “La Sapienza”, Viale del Policlinico 1, Rome 00161, Italy; E-Mail: [email protected] 2 CEINGE-Advanced Biotechnology, Via Comunale Margherita, Naples 80131, Italy; E-Mails: [email protected] (R.T.); [email protected] (A.E.); [email protected] (F.A.); [email protected] (G.C.) 3 Department of Biochemistry and Biotechnology, University of Naples “Federico II”, Via Pansini 5, Naples 80131, Italy 4 Biotechnology Science, University of Naples “Federico II”, Via De Amicis, Naples 80131, Italy 5 Department of Pediatrics, University of Naples “Federico II”, Via Pansini 5, Naples 80131, Italy; E-Mails: [email protected] (A.P.); [email protected] (M.D.C.) 6 European Laboratory for the Investigation of Food Induced Diseases, University of Naples “Federico II”, Via Pansini 5, Naples 80131, Italy * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel./Fax: +39-0817462680. Received: 18 February 2012; in revised form: 2 March 2012 / Accepted: 19 March 2012 / Published: 29 March 2012 Abstract: Congenital diarrheal disorders (CDDs) are a group of inherited enteropathies with a typical onset early in the life. -
Colonoscopic Review and Surgical Approach in the Management of Colorectal Carcinoma–A Retrospective Study of 50 Cases
Original Paper Colonoscopic Review and Surgical Approach in the Management of Colorectal Carcinoma–A Retrospective Study of 50 cases 1 2 3 Ershad-ul-Quadir M , Rahman MMM , Rahman MM Abstract Introduction: There is no exact statistics about the with abdominal pain 12 out of 22 cases (56%) and incidence of colorectal cancer in Bangladesh. weight loss 15 cases (68%). For left colon cancer According to National Cancer Institute, London, it is commonest symptom was weight loss and weakness the 2nd most common cancer affecting more than and altered bowel habit. Almost all cases with rectal 30,000 people in each year. As many patients with carcinoma presented with bleeding per rectum. colon cancer do not develop symptoms until it is advanced and detection in early stage can only be Conclusion: About 50% of lesions were found in achieved by screening of asymptomatic person. recto-sigmoid junction and male: female ratio was Maximum patients present lately with distance 1.9:1. All efforts and modern technology should be metastases when there is nothing to treat except applied for early detection and treatment. The palliative therapy. survival rate is usually very poor in rectal carcinoma. In this study most of the cases were subjected to Objectives: To identify the risk factors, early post operative Chemo and Radiotherapy, but more symptoms, signs, treatment modalities, operative were treated with neoadjuvant chemoradiation for outcome, morbidity and mortality rate. down staging. The need for early detection of Colorectal Carcinoma (CRC) should be stressed in Materials and Methods: This retrospective study the form of screening patient awareness and was carried out at CMH Dhaka during August 2002 understanding about symptomatology. -
Treatment of Equine Gastric Impaction by Gastrotomy R
EQUINE VETERINARY EDUCATION / AE / april 2011 169 Case Reporteve_165 169..173 Treatment of equine gastric impaction by gastrotomy R. A. Parker*, E. D. Barr† and P. M. Dixon Dick Vet Equine Hospital, University of Edinburgh, Easter Bush Veterinary Centre, Midlothian; and †Bell Equine Veterinary Clinic, Mereworth, UK. Keywords: horse; colic; gastric impaction; gastrotomy Summary Edinburgh with a deep traumatic shoulder wound of 24 h duration. Examination showed a mildly contaminated, A 6-year-old Warmblood gelding was referred for treatment of 15 cm long wound over the cranial aspect of the left a traumatic shoulder wound and while hospitalised developed scapula that transected the brachiocephalicus muscle a large gastric impaction which was unresponsive to and extended to the jugular groove. The horse was sound medical management. Gastrotomy as a treatment for gastric at the walk and ultrasonography showed no abnormalities impactions is rarely attempted in adult horses due to the of the bicipital bursa. limited surgical access to the stomach. This report describes The wound was debrided and lavaged under standing the successful surgical treatment of the impaction by sedation and partially closed with 2 layers of 3 metric gastrotomy and management of the post operative polyglactin 910 (Vicryl)1 sutures in the musculature and complications encountered. simple interrupted polypropylene (Prolene)1 skin sutures, leaving some ventral wound drainage. Sodium benzyl Introduction penicillin/Crystapen)2 (6 g i.v. q. 8 h), gentamicin (Gentaject)3 (6.6 mg/kg bwt i.v. q. 24 h), flunixin 4 Gastric impactions are rare in horses but, when meglumine (Flunixin) (1.1 mg/kg bwt i.v. -
Colorectal Cancer Symptoms
Colorectal Symptoms - Suspected Colorectal Cancer Disclaimer This pathway is for symptomatic patients. see also National Bowel Cancer Screening Program (NBCSP). Contents Disclaimer ............................................................................................................................................................................................ 1 Background .................................................................................................................................................. 2 About colorectal symptoms ......................................................................................................................................................... 2 Assessment ................................................................................................................................................... 2 Rectal bleeding .................................................................................................................................................................................. 2 Gastrointestinal history .................................................................................................................................................................. 2 Previous procedures ........................................................................................................................................................................ 2 Family history of bowel cancer ................................................................................................................................................... -
An 8-Year-Old Boy with Fever, Splenomegaly, and Pancytopenia
An 8-Year-Old Boy With Fever, Splenomegaly, and Pancytopenia Rachel Offenbacher, MD,a,b Brad Rybinski, BS,b Tuhina Joseph, DO, MS,a,b Nora Rahmani, MD,a,b Thomas Boucher, BS,b Daniel A. Weiser, MDa,b An 8-year-old boy with no significant past medical history presented to his abstract pediatrician with 5 days of fever, diffuse abdominal pain, and pallor. The pediatrician referred the patient to the emergency department (ED), out of concern for possible malignancy. Initial vital signs indicated fever, tachypnea, and tachycardia. Physical examination was significant for marked abdominal distension, hepatosplenomegaly, and abdominal tenderness in the right upper and lower quadrants. Initial laboratory studies were notable for pancytopenia as well as an elevated erythrocyte sedimentation rate and C-reactive protein. aThe Children’s Hospital at Montefiore, Bronx, New York; and bAlbert Einstein College of Medicine, Bronx, New York Computed tomography (CT) of the abdomen and pelvis showed massive splenomegaly. The only significant history of travel was immigration from Dr Offenbacher led the writing of the manuscript, recruited various specialists for writing the Albania 10 months before admission. The patient was admitted to a tertiary manuscript, revised all versions of the manuscript, care children’s hospital and was evaluated by hematology–oncology, and was involved in the care of the patient; infectious disease, genetics, and rheumatology subspecialty teams. Our Mr Rybinski contributed to the writing of the multidisciplinary panel of experts will discuss the evaluation of pancytopenia manuscript and critically revised the manuscript; Dr Joseph contributed to the writing of the manuscript, with apparent multiorgan involvement and the diagnosis and appropriate cared for the patient, and was critically revised all management of a rare disease. -
Acute Abdomen
Acute abdomen: Shaking down the Acute abdominal pain can be difficult to diagnose, requiring astute assessment skills and knowledge of abdominal anatomy 2.3 ANCC to discover its cause. We show you how to quickly and accurately CONTACT HOURS uncover the clues so your patient can get the help he needs. By Amy Wisniewski, BSN, RN, CCM Lehigh Valley Home Care • Allentown, Pa. The author has disclosed that she has no significant relationships with or financial interest in any commercial companies that pertain to this educational activity. NIE0110_124_CEAbdomen.qxd:Deepak 26/11/09 9:38 AM Page 43 suspects Determining the cause of acute abdominal rapidly, indicating a life-threatening process, pain is often complex due to the many or- so fast and accurate assessment is essential. gans in the abdomen and the fact that pain In this article, I’ll describe how to assess a may be nonspecific. Acute abdomen is a patient with acute abdominal pain and inter- general diagnosis, typically referring to se- vene appropriately. vere abdominal pain that occurs suddenly over a short period (usually no longer than What a pain! 7 days) and often requires surgical interven- Acute abdominal pain is one of the top tion. Symptoms may be severe and progress three symptoms of patients presenting in www.NursingMadeIncrediblyEasy.com January/February 2010 Nursing made Incredibly Easy! 43 NIE0110_124_CEAbdomen.qxd:Deepak 26/11/09 9:38 AM Page 44 the ED. Reasons for acute abdominal pain Visceral pain can be divided into three Your patient’s fall into six broad categories: subtypes: age may give • inflammatory—may be a bacterial cause, • tension pain. -
POEMS Syndrome: an Atypical Presentation with Chronic Diarrhoea and Asthenia
European Journal of Case Reports in Internal Medicine POEMS Syndrome: an Atypical Presentation with Chronic Diarrhoea and Asthenia Joana Alves Vaz1, Lilia Frada2, Maria Manuela Soares1, Alberto Mello e Silva1 1 Department of Internal Medicine, Egas Moniz Hospital, Lisbon, Portugal 2 Department of Gynecology and Obstetrics, Espirito Santo Hospital, Evora, Portugal Doi: 10.12890/2019_001241 - European Journal of Case Reports in Internal Medicine - © EFIM 2019 Received: 28/07/2019 Accepted: 13/11/2019 Published: 16/12/2019 How to cite this article: Alves Vaz J, Frada L, Soares MM, Mello e Silva A. POEMS syndrome: an atypical presentation with chronic diarrhoea and astenia. EJCRIM 2019;7: doi:10.12890/2019_001241. Conflicts of Interests: The Authors declare that there are no competing interest This article is licensed under a Commons Attribution Non-Commercial 4.0 License ABSTRACT POEMS syndrome is a rare paraneoplastic condition associated with polyneuropathy, organomegaly, monoclonal gammopathy, endocrine and skin changes. We report a case of a man with Castleman disease and monoclonal gammopathy, with a history of chronic diarrhoea and asthenia. Gastrointestinal involvement in POEMS syndrome is not frequently referred to in the literature and its physiopathology is not fully understood. Diagnostic criteria were met during hospitalization but considering the patient’s overall health condition, therapeutic options were limited. Current treatment for POEMS syndrome depends on the management of the underlying plasma cell disorder. This report outlines the importance of a thorough review of systems and a physical examination to allow an attempted diagnosis and appropriate treatment. LEARNING POINTS • POEMS syndrome should be suspected in the presence of peripheral polyneuropathy associated with monoclonal gammopathy; diagnostic workup is challenging and delay in treatment is very common. -
Serous Papillary Adenocarcinoma of Unknown Primary in a Recurrent Paravaginal Cyst
Hindawi Case Reports in Obstetrics and Gynecology Volume 2019, Article ID 8125129, 4 pages https://doi.org/10.1155/2019/8125129 Case Report Serous Papillary Adenocarcinoma of Unknown Primary in a Recurrent Paravaginal Cyst Khilen Patel , Advaita Punjala-Patel, Angela Stephens, and John Lue Department of Obstetrics and Gynecology, Augusta University, Medical College of Georgia, 1120 15th St., Augusta, GA 30912, USA Correspondence should be addressed to Khilen Patel; [email protected] Received 14 February 2019; Revised 1 May 2019; Accepted 28 May 2019; Published 10 June 2019 Academic Editor: Giampiero Capobianco Copyright © 2019 Khilen Patel et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cystic lesions located in the paravaginal region are rare. When present, paravaginal cysts are typically benign and are incidentally found on routine gynecological exams; however, rarely they can be malignant. Treatment options for paravaginal cancers are not well studied and early diagnosis may help improve prognosis in these patients. Our case describes a 55-year-old female with a recurrent paravaginal cyst that was remarkable for serous papillary adenocarcinoma despite biopsy and fuid cytology negative for malignancy. Tis case demonstrates that malignancy should be considered highly with a recurrent paravaginal cyst, especially when present over a short interval. 1. Introduction due to postmenopausal symptoms and denied any vaginal bleeding or vaginal discharge. On bimanual examination, the Large paravaginal cysts are rare and when present are most uterus and cervix were noted to be surgically absent; however, commonlybenign.Tesecystscanbeeithercongenitalor alargepelvicmasswaspalpated.Tismasswassmooth, acquired. -
Most Common Robotic Bariatric Procedures: Review and Technical Aspects Pablo A
Acquafresca et al. Ann Surg Innov Res (2015) 9:9 DOI 10.1186/s13022-015-0019-9 REVIEW Open Access Most common robotic bariatric procedures: review and technical aspects Pablo A. Acquafresca1, Mariano Palermo1*, Tomasz Rogula2, Guillermo E. Duza1 and Edgardo Serra1 Abstract Since its appear in the year 1997, when Drs. Cadiere and Himpens did the first robotic cholecystectomy in Brus- sels, not long after the first cholecystectomy, they performed the first robotic bariatric procedure. It is believed that robotically-assisted surgery’s most notable contributions are reflected in its ability to extend the benefits of minimally invasive surgery to procedures not routinely performed using minimal access techniques. We describe the 3 most common bariatric procedures done by robot. The main advantages of the robotic system applied to the gastric bypass appear to be better control of stoma size, avoidance of stapler costs, elimination of the potential for oro- pharyngeal and esophageal trauma, and a potential decrease in wound infection. While in the sleeve gastrectomy and adjustable gastric banding its utility is more debatable, giving a bigger advantage during surgery on patients with a very large BMI or revisional cases. Keywords: Bariatric surgery, Robotic surgery, Gastric by pass, Sleeve gastrectomy, Gastric band Background laparoscopy and robotic laparoscopy is now a controver- Since its appear in the year 1997, when Drs. Cadiere and sial topic that concerns patients and surgeons alike. Himpens did the first robotic cholecystectomy in Brussels To date, the robotic technique is reported to be at least [1], the da Vinci™ Robotic Surgical System from Intuitive as safe and effective as the conventional approach for sev- Surgical, Inc., Sunny Vale, California (Fig. -
Board Review from ACP MEDICINE
BOARD REVIEW FROM MEDSCAPE Case-Based InternalInternal Medicine Self-Assessment Questions CLINICAL ESSENTIALS CARDIOVASCULAR MEDICINE DERMATOLOGY ENDOCRINOLOGY GASTROENTEROLOGY HEMATOLOGY IMMUNOLOGY/ALLERGY INFECTIOUS DISEASE INTERDISCIPLINARY MEDICINE METABOLISM NEPHROLOGY NEUROLOGY ONCOLOGY PSYCHIATRY RESPIRATORY MEDICINE RHEUMATOLOGY www.acpmedicine.com BOARD REVIEW FROM MEDSCAPE Case-Based Internal Medicine Self-Assessment Questions Director of Publishing Cynthia M. Chevins Director, Electronic Publishing Liz Pope Managing Editor Erin Michael Kelly Development Editors Nancy Terry, John Heinegg Senior Copy Editor John J. Anello Copy Editor David Terry Art and Design Editor Elizabeth Klarfeld Electronic Composition Diane Joiner, Jennifer Smith Manufacturing Producer Derek Nash © 2005 WebMD Inc. All rights reserved. No part of this book may be reproduced in any form by any means, including photocopying, or translated, trans- mitted, framed, or stored in a retrieval system other than for personal use without the written permission of the publisher. Printed in the United States of America ISBN: 0-9748327-7-4 Published by WebMD Inc. Board Review from Medscape WebMD Professional Publishing 111 Eighth Avenue Suite 700, 7th Floor New York, NY 10011 1-800-545-0554 1-203-790-2087 1-203-790-2066 [email protected] The authors, editors, and publisher have conscientiously and carefully tried to ensure that recommended measures and drug dosages in these pages are accurate and conform to the standards that prevailed at the time of publication. The reader is advised, however, to check the product information sheet accompanying each drug to be familiar with any changes in the dosage schedule or in the contra- indications. This advice should be taken with particular seriousness if the agent to be administered is a new one or one that is infre- quently used. -
Management of Locally Advanced Rectal Adenocarcinoma Oncology Board Review Manual
ONCOLOGY BOARD REVIEW MANUAL STATEMENT OF EDITORIAL PURPOSE Management of Locally The Hospital Physician Oncology Board Review Advanced Rectal Manual is a study guide for fellows and practicing physicians preparing for board examinations in oncology. Each manual reviews a topic essential Adenocarcinoma to the current practice of oncology. PUBLISHING STAFF Contributors: Nishi Kothari, MD PRESIDENT, GROUP PUBLISHER Assistant Member, Department of Gastrointestinal Bruce M. White Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL SENIOR EDITOR Khaldoun Almhanna, MD, MPH Robert Litchkofski Associate Member, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research EXECUTIVE VICE PRESIDENT Institute, Tampa, FL Barbara T. White EXECUTIVE DIRECTOR OF OPERATIONS Jean M. Gaul Table of Contents Introduction .............................1 Clinical Evaluation and Staging ..............2 Management .............................4 NOTE FROM THE PUBLISHER: This publication has been developed with Surveillance and Long-Term Effects ..........8 out involvement of or review by the Amer ican Board of Internal Medicine. Conclusion ..............................9 Board Review Questions ...................10 References .............................10 Hospital Physician Board Review Manual www.turner-white.com Management of Locally Advanced Rectal Adenocarcinoma ONCOLOGY BOARD REVIEW MANUAL Management of Locally Advanced Rectal Adenocarcinoma Nishi Kothari, MD, and Khaldoun Almhanna, MD, MPH INTRODUCTION ence to -
Journal of Clinical Toxicology Iwai Et Al., J Clin Toxicol 2014, 4:6 ISSN: 2161-0495 DOI: 10.4172/2161-0495.1000218
linica f C l To o x l ic a o n r l o u g o y J Journal of Clinical Toxicology Iwai et al., J Clin Toxicol 2014, 4:6 ISSN: 2161-0495 DOI: 10.4172/2161-0495.1000218 Case Report Open Access Utility of Upper Gastrointestinal Endoscopy for Management of Patients with Roundup® Poisoning Kenji Iwai1, Masato Miyauchi2, Daisuke Komazawa1, Ryoko Murao1, Hiroyuki Yokota2, and Atushi Koyama1 1Department of Emergency and Critical Care Medicine, Iwaki Kyoritu General Hospital, Fukushima, Japan 2Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan *Corresponding author: Masato Miyauchi, Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan, Tel: +81-3-3822-2131; E-mail: [email protected] Received date: Nov 03, 2014, Accepted date: Dec 05, 2014, Published date: Dec 08, 2014 Copyright: © 2014, Miyauchi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: Roundup® is a herbicide widely used in Japan in gardening and agriculture. When ingested, Roundup is highly toxic, but gastrointestinal decontamination, including gastric lavage, is not routinely performed after ingestion. Endoscopy may be useful in managing individuals with liquid herbicide poisoning, by identifying gastric residual contents, assessing mucosal damage and retrieving herbicide directly by aspiration. Case report: A 73 year old, 40 kg female with a history of depression was transported to our emergency room by ambulance 1 h after attempting suicide by ingesting 100 ml Roundup, which contains 48% glyphosate-potassium, and 52% surfactant and water.