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Biomedical subjects

G B Rankin

Publications and source records attributed to G B Rankin.

18 recordsLinked to original sources
PubMed1990

Extraintestinal and systemic manifestations of inflammatory bowel disease.

Extraintestinal and systemic manifestations occur commonly in patients with inflammatory bowel disease, specifically ulcerative colitis and Crohn's disease, and affect most all organ systems of the body. The occurrence of such widespread manifestations strongly suggests that these disorders are systemic in nature and may have a common mechanism. Extraintestinal manifestations may be incidental findings that cause no symptoms, but more commonly complicate the management of the underlying inflammatory bowel disease, being a source of considerable morbidity and mortality. Some extraintestinal manifestations not only correlate with a specific disease state but also with the location, extent, and degree of activity and disease. Most extraintestinal manifestations found in patients with inflammatory bowel disease involving the small intestine appear to correlate with some underlying pathophysiologic mechanism.

Biliary Tract Diseases↗
PubMed1985

Surveillance for colonic carcinoma in ulcerative colitis.

To evaluate the efficacy of surveillance colonoscopy with biopsy for the detection of high-grade dysplasia (HGD) or colonic carcinoma in patients with chronic ulcerative colitis, we undertook a retrospective review of 248 patients who underwent 370 examinations (mean duration of disease 12 yr). High-grade dysplasia or carcinoma was found in 24 examinations in 16 patients, with a mean duration of disease of 16 yr. There were 15 patients with HGD. Nine patients had HGD alone, 6 had HGD and carcinoma, and 1 had carcinoma without HGD. The overall incidence of HGD was 6%. Dysplasia-associated lesions or mass were the most consistent indicators of carcinoma, the combination being present in four instances. Of the 7 patients with cancer, 6 were recognized by colonoscopy, and 1 patient with negative visual endoscopic findings was discovered using surveillance biopsies. The conclusions of this study are that dysplasia is a reliable histopathologic marker and correlates with the presence of cancer in chronic ulcerative colitis; the absence of dysplasia correlates with the absence of cancer. The presence of dysplasia-associated lesions or mass with HGD is the strongest indication for operation. This study supports the use of surveillance colonoscopy in managing high-risk ulcerative colitis patients.

Adolescent↗
PubMed1984

Spontaneous improvement of Cronkhite-Canada syndrome in a postpartum female.

A case report of a 34-year-old female with the Cronkhite-Canada syndrome is presented. The patient developed the characteristic clinical features of intestinal polyposis, skin pigmentation, alopecia, and onychodystrophy which later resolved. An unusual feature was that symptoms developed during the postpartum period. This is the youngest female patient described with the syndrome. The etiology, pathophysiology, clinical manifestations, and management of the Cronkhite-Canada syndrome are reviewed.

Adult↗
PubMed1980

Colonoscopy in the diagnosis of unexplained rectal bleeding.

Three hundred six patients with unexplained rectal bleeding were examined by colonoscopy. Significant lesions were found in 30% including polyps having a diameter of 0.5 cm or larger in 14%, carcinoma in 8%, and a small number of patients with inflammatory bowel disease, vascular formations, and radiation colitis. Colonoscopic findings in a large subgroup of patients with diverticulosis established by barium enema did not differ significantly from those of the group as a whole. Significant lesions were also identified in 22% of small subsets of patients with occult bleeding or unexplained melena.

Adenoma↗
PubMed1979

Clinical features and natural history of Crohn's disease.

Records of 1084 patients entered into the National Cooperative Crohn's Disease Study were analyzed to gather information concerning the natural history and clinical features of Crohn's disease. The age of onset reached a single peak between the second and fourth decade and was evenly distributed in both sexes. There was an average interval of 35 mo from onset of symptoms to diagnosis. Involvement of both colon and terminal ileum was the most frequent pattern and was present in 55% of patients. The disease was confined to the terminal ileum, other areas of the small intestine, or colon-only in 14%, 3%, and 15% of patients, respectively. Sigmoidoscopic abnormalities were seen in 34% of all patients and 51% of patients with Crohn's colitis. Diarrhea, abdominal pain, weight loss, and fever were present in the majority of the patients. Lower GI bleeding, fever, and perianal complications characterized patients with colon-only involvement. The frequency of extra intestinal manifestations was similar in all groups. Among patients who were randomized to placebo, 32% achieved a spontaneous remission by the end of 17 wk, and 53% of these were still in remission at the end of 24 mo. Clinical remission was associated with an improvement in barium x-rays in 18% of the patients. The predicted factors associated with favorable outcome in placebo-treated patients were: previous surgical removal of all observable disease, absence of perianal disease, and Crohn's Disease Activity Index value under 200.

Adult↗
PubMed1979

National Cooperative Crohn's Disease Study: extraintestinal manifestations and perianal complications.

Among 569 patients with Crohn's disease, 24% had a history of at least one extraintestinal manifestation and 36% had a history of perianal disease before randomization. Multiple extraintestinal manifestations occurred in the same patient more frequently than would be expected by chance. Seventy-six percent of patients with ileocolitis had perianal disease, extraintestinal manifestations, or both. This was significantly greater than the 58% incidence in patients with disease confined to the small bowel. Perianal complications alone were significantly more common in patients with colitis or ileocolitis than in those with disease of only the small bowel. This was true also of internal fistulization. There was a significant positive association between perianal disease and the presence of extraintestinal features. Perianal abscess appeared to respond to sulfasalazine and anal fissure to prednisone or azathioprine. These results require confirmation in larger series of patients.

Adult↗
PubMed1976

Endoscopic features of gastroduodenal Crohn's disease.

The clinical, roentgenographic and endoscopic findings in 14 patients with Crohn's disease of the stomach and/or duodenum are described. To date, this is the largest series of endoscopic findings of Crohn's disease of gastroduodenal region. The endoscopic findings include (1) mucosal nodularity or "cobblestoned" mucosa; (2) multiple aphthous-like ulcerations and/or linear ulcerations; (3) thickening of the antral folds; (4) antral narrowing with evidence of hypoperistalsis; (5) duodenal strictures. The diagnosis of gastric duodenal Crohn's disease is achieved by combining recognition of clinical features and roentgenographic and endoscopic features. The endoscopic features correlate well with the roentgenographic findings in our 14 patients. Tissue for histological diagnosis of Crohn's disease of the gastroduodenal area is rarely obtained by endoscopic biopsy, but peroral suction biopsy specimens may increase the rate of histological confirmation.

Adolescent↗
PubMed1975

Congenital duodenal diaphragms in adults: a delayed cause of intestinal obstruction.

Congenital duodenal diaphragms in the adult are uncommon, unsuspected lesions that infrequently cause intestinal obstruction. The diaphragms may be single or multiple and are usually located near the ampulla of Vater. Three cases are summarized and the recent literature reviewed. At least 35 cases have been reported. Treatment most often consisted of duodenotomy,excision of the web and duodenal closure.

Aged↗
PubMedDate not supplied

Use of old and new oral 5-aminosalicylic acid formulations in inflammatory bowel disease.

Although sulfasalazine, a 5-aminosalicylic acid (5-ASA) agent, is still the anti-inflammatory agent of choice for ulcerative colitis and Crohn's disease, newer formulations, which release drug to specific regions of the colon for maximal efficacy, also can be appropriate first-line agents. This article reviews recent clinical studies of therapy with older and newer 5-ASA formulations.

Administration, Oral↗