• Title/Summary/Keyword: intestinal bleeding

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Non-Surgical Management of Gastroduodenal Fistula Caused by Ingested Neodymium Magnets

  • Phen, Claudia;Wilsey, Alexander;Swan, Emily;Falconer, Victoria;Summers, Lisa;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.336-340
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    • 2018
  • Foreign body ingestions pose a significant health risk in children. Neodymium magnets are high-powered, rare-earth magnets that is a serious issue in the pediatric population due to their strong magnetic force and high rate of complications. When multiple magnets are ingested, there is potential for morbidity and mortality, including gastrointestinal fistula formation, obstruction, bleeding, perforation, and death. Many cases require surgical intervention for removal of the magnets and management of subsequent complications. However, we report a case of multiple magnet ingestion in a 19-month-old child complicated by gastroduodenal fistula that was successfully treated by endoscopic removal and supportive care avoiding the need for surgical intervention. At two-week follow-up, the child was asymptomatic and upper gastrointestinal series obtained six months later demonstrated resolution of the fistula.

An Unusual Cause of Gastrointestinal Hemorrhage: Gastrocolic Fistula Caused by Colon Cancer Invasion (위장관 출혈의 증상으로 진단된 대장암에 의한 위대장루)

  • Cho, Jeong Hyeon;Kim, In Tae;Choi, Jin Yi;Chun, Song Wook;Kang, Beo Deul;Bae, Sang Kyun;Kim, Hee Man;Song, Ji Sun
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.43-46
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    • 2013
  • Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.

The Effect of Thalidomide on Entero-Behcet's Disease (장관 베체트병 환자에서 Thalidomide의 치료 효과)

  • Kim, Jung Hak;Nam, Voki;Moon, Ho Sik;Kim, Jin Ook;Sung, Choon Ho
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.104-106
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    • 2009
  • Behcet's disease is a chronic relapsing vasculitis characterized by recurrent aphthous oral and genital ulcers with uveitis. Multiple organs can be involved. Entero-Behcet's disease is often uncontrollable, relapsing, and can cause acute intestinal bleeding, fistula formation, or perforation. Corticosteroids, immunosuppressors, and colchicines are used to treat Entero-Behcet's disease with varying degree of success. Thalidomide may also be feasible. We present a 29-year-old male Entero-Behcet's patient suffering from abdominal pain, diarrhea, and back pain. He did not respond to prior treatments, but responded to thalidomide.

A Case of Gastrointestinal Stromal Tumor in a Child (소아에서 발생한 위장관 간질 종양 1예)

  • Yun, Kyung-Bin;Kim, Jae-Young;Ryu, Jae-Hong;Sul, Ji-Young;Kang, Dae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.71-75
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    • 2007
  • Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal tumors of the digestive tract. They have been commonly observed in adults but have been rarely described in children. They arise typically from the intestinal wall and rarely in the mesentery, omentum, or retroperitoneum. GISTs originate from the interstitial cell of Cajal and are characterized by overexpression of the receptor tyrosine kinase c-kit. Up to 94% of these tumors express the CD117 on immunohistochemical stain. Surgery is the main modality of treatment for primary resectable GIST. Completely resectable GIST with low risk has excellent prognosis after primary surgical intervention, with over 90% of the 5-year survival. We report a case of 10-year-old girl presenting with an upper gastrointestinal bleeding caused by gastrointestinal stromal tumor.

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Henoch-Sch$\ddot{o}$nlein Purpura in Pediatric Surgery (소아외과에서의 Henoch-Sch$\ddot{o}$nlein 자반증)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.45-49
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    • 2000
  • Henoch-Sch$\ddot{o}$nlein purpura is a systemic vasculitis of unknown etiology that is probably related to an autoimmune phenomenon. Henoch-Sch$\ddot{o}$nlein purpura is characterized by a purpuric rash, arthralgia, nephritis, and gastrointestinal manifestations. We reviewed 169 children hospitalized with a diagnosis of Henoch-Sch$\ddot{o}$nlein purpura between 1989 and 1998. One-hundred thirty-nine (82.2 %) had gastrointestinal findings including abdominal pain, nausea, vomiting and gastrointestinal bleeding. Surgical consultations were obtained for ten children, and laparotomy was performed in five. Three children suspected of having appendicitis underwent appendectomy. None had appendicitis. One child thought to have been intestinal strangulation was found to have hemorrhagic edema of the proximal jejunum and of the distal ileum. Another child underwent resection for an hemorrhagic infarct of the distal ileum. A high index of suspicion of this disease entity in the differential diagnosis of abdominal pain in children can avoid unnecessary laparotomy in most cases. However, life-threatening gastrointestinal complications may occur in low percentage of cases. Prompt recognition and adequate radiologic evaluation of the abdominal manifestation of this entity is necessary for early surgical intervention.

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The Improving Effect of Gastrodia elata Blume on DSS-induced Colitis in Mice

  • Ahn, Eun-Mi;Kim, Su-Jin
    • Biomedical Science Letters
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    • v.24 no.3
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    • pp.168-174
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    • 2018
  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by abdominal pain, rectal bleeding and diarrhea. Gastrodia elata Blume (GE) has been used for the treatment of various diseases including neurodegenerative diseases and inflammatory disease. However, there has been no information on whether GE regulates intestinal inflammation. The aim of this study is to elucidate whether GE can protect against dextran sulfate sodium (DSS)-induced colitis in a mouse model. The colitis mice were induced by drinking water containing 5% DSS for 7 days. Body weight, colon length and clinical score were assessed to determine the effects on colitis. The levels of inflammatory cytokines, tumor necrosis factor $(TNF)-{\alpha}$ and interleukin (IL)-6 in colitis tissue were also measured. The results showed that mice administrated with DSS showed clinical signs including weight loss and reduced colon length. GE inhibited the DSS-induced loss of body weight and shortening of colon and increased Disease activity index score. Additionally, we observed that GE suppressed the levels of $TNF-{\alpha}$ and IL-6 in DSS-treated colon tissues. Collectively, these findings provide experimental evidence that GE might be a useful therapeutic agent for patients with UC.

Suppurative Meckel Diiverticulum in a 3-Year-Old Girl Presenting with Periumbilical Cellulitis

  • Park, Ji Sook;Lim, Chun Woo;Park, Taejin;Cho, Jae-Min;Seo, Ji-Hyun;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.66-70
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    • 2015
  • Meckel diverticulum (MD) is one of the most common congenital gastrointestinal anomalies and occurs in 1.2-2% of the general population. MD usually presents with massive painless rectal bleeding, intestinal obstruction or inflammation in children and adults. Suppurative Meckel diverticulitis is uncommon in children. An experience is described of a 3-year-old girl with suppurative inflammation in a tip of MD. She complained of acute colicky abdominal pain, vomiting and periumbilical erythema. Laparoscopic surgery found a relatively long MD with necrotic and fluid-filled cystic end, which was attatched to abdominal wall caused by inflammation. Herein, we report an interesting and unusual case of a suppurative Meckel diverticulitis presenting as periumbilical cellulitis in a child. Because of its varied presentations, MD might always be considered as one of the differential diagonosis.

Metastatic Bilateral Renal T-Cell Lymphoma in a Persian Cat

  • Kim, Mi-Ryung;Son, Jung-Min;Lee, Seoung-Jin;Jang, Seong-Hwan;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.36 no.6
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    • pp.353-357
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    • 2019
  • A two-year-old spayed female Persian cat demonstrated weight loss, anorexia, and vomiting for one week. Hematologic findings suggested chronic renal failure. Radiography and ultrasonography revealed severe bilateral renomegaly with hypoechoic nodules and subcapsular hypoechoic rim. Fine needle aspiration of the kidney revealed malignant lymphoma. The cat received in-hospital treatment for chronic renal failure for seven days, followed by chemotherapy (cyclophosphamide, vincristine, and prednisolone). The cat tolerated chemotherapy well and chronic kidney disease was alleviated. However, complete remission was not achieved. After 93 days of treatment, the cat exhibited anisocoria and mental dullness. Brain magnetic resonance imaging revealed hypertrophy and enhancement of cranial nerves. Chemotherapy was replaced with lomustine (10 mg orally), and two weeks later, cytosine arabinoside (50 mg/㎡ subcutaneously), twice daily for consecutive days. Five days after substitution chemotherapy, the patient showed anemia due to severe intestinal bleeding and died. Post-mortem examination and histopathologic analysis confirmed renal T-cell lymphoma with metastasis to the central nervous system, colon, and nasal cavity. Survival time was 117 days after the diagnosis of renal lymphoma.

Long lasting mesalazine-induced pancytopenia in a patient with ulcerative colitis

  • Ko, Juyeon;Song, Hyun Joo;Han, Sanghoon;Moon, Chiyoon
    • Journal of Medicine and Life Science
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    • v.16 no.2
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    • pp.46-51
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    • 2019
  • Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

Inhibitory Activity of 4-O-Benzoyl-3'-O-(O-Methylsinapoyl)Sucrose from Polygala tenuifolia on Escherichia coli β-Glucuronidase

  • Kim, Jang Hoon;Vinh, Le Ba;Hur, Mok;Koo, Sung-Cheol;Park, Woo Tae;Moon, Youn-Ho;Lee, Yoon Jeong;Kim, Young Ho;Huh, Yun-Chan;Yang, Seo Young
    • Journal of Microbiology and Biotechnology
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    • v.31 no.11
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    • pp.1576-1582
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    • 2021
  • Bacterial β-glucuronidase in the intestine is involved in the conversion of 7-ethyl-10-hydroxycamptochecin glucuronide (derived from irinotecan) to 7-ethyl-10-hydroxycamptothecin, which causes intestinal bleeding and diarrhea (side effects of anti-cancer drugs). Twelve compounds (1-12) from Polygala tenuifolia were evaluated in terms of β-glucuronidase inhibition in vitro. 4-O-Benzoyl-3'-O-(O-methylsinapoyl) sucrose (C3) was highly inhibitory at low concentrations. C3 (an uncompetitive inhibitor) exhibited a ki value of 13.4 μM; inhibitory activity increased as the substrate concentration rose. Molecular simulation revealed that C3 bound principally to the Gln158-Tyr160 enzyme loop. Thus, C3 will serve as a lead compound for development of new β-glucuronidase inhibitors.