AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. Th...AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. There were 53 females and 32 males （age 74.6 ± 9.4 years, range 45-89 years）. The patients were diagnosed as IC. The following variables were analyzed including age, sex, period of time from the appearance of symptoms to admission, medical history, medication, stool frequency, clinical symptoms and signs, blood tests （hemogram and basic biochemical profile）, and endoscopic findings. Patients were divided in mild IC group and severe IC group （surgery and/or death）. Qualitative variables were analyzed using chi-square test and parametric data were analyzed using Student＇s t test （P 〈 0.05）. RESULTS： The mild IC group was consisted of 69 patients （42 females and 27 males, average age 74.7 ± 12.4 years）. The severe IC group was composed of 16 patients （11 females and 5 males, average age of 73.8 ± 12.4 years）. One patient died because of failure of medical treatment （no surgery）, 15 patients underwent surgery （6 after endoscopic diagnosis and 9 after peroperatory diagnosis）. Eight of 85 patients （9.6%） died and the others were followed up as out-patients for 9.6 ± 3.5 mo. Demographic data, medical history, medication and stool frequency were similar in both groups （P 〉 0.05）. Seriously ill patients had less hematochezia than slightly ill patients （37.5% vs 86.9%, P = 0.000）. More tachycardia （45.4% vs 10.1%, P = 0.011） and a higher prevalence of peritonism signs （75% vs 5.7%, P = 0.000） were observed in the severe IC group while the presence and intensity of abdominal pain were similar between two groups. Two patients with severe IC had shock when admitted. Regarding analytical data, more seriously ill patients were found to have anemia and hyponatremia than the mildly ill patients （37.5% vs 10.1%, P = 0.014 and 46.6% vs 14.9%, P = 0.012展开更多
Ischemic colitis is the most common form of intestinal ischemia.It is a condition that is commonly seen in the elderly and among individuals with risk factors for ischemia.Common predisposing conditions for ischemic c...Ischemic colitis is the most common form of intestinal ischemia.It is a condition that is commonly seen in the elderly and among individuals with risk factors for ischemia.Common predisposing conditions for ischemic colitis are major vascular occlusion,small vessel disorder,shock,some medications,colonic obstructions and hematologic disorders.Ischemic colitis following colonoscopy is rare.Here,we report two cases of ischemic colitis after a routine screening colonoscopy in patients without risk factors for ischemia.展开更多
Upper gastrointestinal bleeding remains a significant cause of hospital admissions. Even though the incidence of peptic ulcer disease and gastritis is decreasing, the incidence rates in neoplasm, Dieulafoy’s lesions,...Upper gastrointestinal bleeding remains a significant cause of hospital admissions. Even though the incidence of peptic ulcer disease and gastritis is decreasing, the incidence rates in neoplasm, Dieulafoy’s lesions, angiodysplasia, and esophagitis are trending up, which necessities physicians to be aware of those pathologies and their specifics. Here, we represent a case of a 62-year-old male on dual antiplatelet therapy who was transferred to our hospital due to severe melena with suspicion of upper gastrointestinal bleeding. Due to hemodynamic instability, the patient was intubated and started on vasopressors. However, several repeated EGDs and CTs of the abdomen with GI bleeding protocol did not reveal the location of active bleeding to stop it. At the same time, clinically, the patient was hemodynamically unstable with continued melena. On the last EGD, a small area of concern resembling gastric varix was clipped for identification purposes, and the patient underwent a selective angiogram with further diagnosis of Dieulafoy’s lesion, which was successfully embolized. Our case demonstrates that Dieulafoy’s lesions can present as severe life-threatening hemorrhage, hard to diagnose with traditional methods such as EGD or CTs, in which case it is recommended to proceed with an angiogram sooner rather than later for further diagnosis and treatment if needed.展开更多
Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/p...Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion.展开更多
基金Supported by a grant from the Instituto de Salud Carlos III (03/02)
文摘AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. There were 53 females and 32 males （age 74.6 ± 9.4 years, range 45-89 years）. The patients were diagnosed as IC. The following variables were analyzed including age, sex, period of time from the appearance of symptoms to admission, medical history, medication, stool frequency, clinical symptoms and signs, blood tests （hemogram and basic biochemical profile）, and endoscopic findings. Patients were divided in mild IC group and severe IC group （surgery and/or death）. Qualitative variables were analyzed using chi-square test and parametric data were analyzed using Student＇s t test （P 〈 0.05）. RESULTS： The mild IC group was consisted of 69 patients （42 females and 27 males, average age 74.7 ± 12.4 years）. The severe IC group was composed of 16 patients （11 females and 5 males, average age of 73.8 ± 12.4 years）. One patient died because of failure of medical treatment （no surgery）, 15 patients underwent surgery （6 after endoscopic diagnosis and 9 after peroperatory diagnosis）. Eight of 85 patients （9.6%） died and the others were followed up as out-patients for 9.6 ± 3.5 mo. Demographic data, medical history, medication and stool frequency were similar in both groups （P 〉 0.05）. Seriously ill patients had less hematochezia than slightly ill patients （37.5% vs 86.9%, P = 0.000）. More tachycardia （45.4% vs 10.1%, P = 0.011） and a higher prevalence of peritonism signs （75% vs 5.7%, P = 0.000） were observed in the severe IC group while the presence and intensity of abdominal pain were similar between two groups. Two patients with severe IC had shock when admitted. Regarding analytical data, more seriously ill patients were found to have anemia and hyponatremia than the mildly ill patients （37.5% vs 10.1%, P = 0.014 and 46.6% vs 14.9%, P = 0.012
文摘Ischemic colitis is the most common form of intestinal ischemia.It is a condition that is commonly seen in the elderly and among individuals with risk factors for ischemia.Common predisposing conditions for ischemic colitis are major vascular occlusion,small vessel disorder,shock,some medications,colonic obstructions and hematologic disorders.Ischemic colitis following colonoscopy is rare.Here,we report two cases of ischemic colitis after a routine screening colonoscopy in patients without risk factors for ischemia.
文摘Upper gastrointestinal bleeding remains a significant cause of hospital admissions. Even though the incidence of peptic ulcer disease and gastritis is decreasing, the incidence rates in neoplasm, Dieulafoy’s lesions, angiodysplasia, and esophagitis are trending up, which necessities physicians to be aware of those pathologies and their specifics. Here, we represent a case of a 62-year-old male on dual antiplatelet therapy who was transferred to our hospital due to severe melena with suspicion of upper gastrointestinal bleeding. Due to hemodynamic instability, the patient was intubated and started on vasopressors. However, several repeated EGDs and CTs of the abdomen with GI bleeding protocol did not reveal the location of active bleeding to stop it. At the same time, clinically, the patient was hemodynamically unstable with continued melena. On the last EGD, a small area of concern resembling gastric varix was clipped for identification purposes, and the patient underwent a selective angiogram with further diagnosis of Dieulafoy’s lesion, which was successfully embolized. Our case demonstrates that Dieulafoy’s lesions can present as severe life-threatening hemorrhage, hard to diagnose with traditional methods such as EGD or CTs, in which case it is recommended to proceed with an angiogram sooner rather than later for further diagnosis and treatment if needed.
文摘Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion.
