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Biomedical subjects

Sri Prakash Misra

Publications and source records attributed to Sri Prakash Misra.

10 recordsLinked to original sources
PubMed2006

Ileocecal masses in patients with amebic liver abscess: etiology and management.

AIM: To assess the causes of ileocecal mass in patients with amebic liver abscess. METHODS: Patients with amebic liver abscess and ileocecal mass were carefully examined and investigated by contrast-enhanced CT scan followed by colonoscopy and histological examination of biopsy materials from lesions during colonoscopy. RESULTS: Ileocecal masses were found in seventeen patients with amebic liver abscess. The cause of the mass was ameboma in 14 patients, cecal tuberculosis in 2 patients and adenocarcinoma of the cecum in 1 patient. Colonic ulcers were noted in five of the six (83%) patients with active diarrhea at presentation. The ileocecal mass in all these patients was ameboma. Ulcers were seen in only one of the 11 (9%) patients without diarrhea. The difference was statistically significant from the group with diarrhea (P< 0.005). CONCLUSION: Ileocecal mass is not an uncommon finding in patients with amebic liver abscess. Although, the ileocecal mass is due to ameboma formation in most cases, it should not be assumed that this is the case in all patients. Colonoscopy and histological examination of the target biopsies are mandatory to avoid missing a more sinister lesion.

Adult↗
PubMed2004

Factors influencing colonic involvement in patients with amebic liver abscess.

BACKGROUND: The frequency of colonic involvement in patients with amebic liver abscess has not been studied in detail. The factors influencing colonic involvement also are unknown. METHODS: Seventy-one patients with amebic liver abscess were studied. Colonoscopy was performed in all patients. RESULTS: Abdominal pain and fever were the most common presenting manifestations. Ten patients (14%) had diarrhea at admission. Ten other patients had a history of diarrhea during the preceding 2 months. Thirty-nine (55%) patients had colonic ulcers. Colonic ulcers were present in 18 of the 20 (90%) patients with ongoing diarrhea or a history of recent diarrhea, and in 21 of 51 (41%) patients without diarrhea (p<0.001). Thirty (42%) patients had small, discrete ulcers in the cecum, the ascending colon, or the region of the hepatic flexure. Nine patients had large, multiple ulcers with surrounding inflammation. In these patients, the ulcers were present either in the left colon (n=7) or throughout the colon (n=2). The mean (standard deviation) age of patients with 5 or more ulcers was significantly greater than that of patients with fewer than 5 ulcers (49.8 [14.6] years vs. 37 [11.7] years; p<0.05). Multiple ulcers were noted in 7 of the 10 patients (70%) with diarrhea at admission and in two of the 61 patients (3%) in whom diarrhea was not a presenting symptom (p<0.001). No association was noted between the location of the abscess in the liver and the colonic lesions. CONCLUSIONS: Colonic ulcers are a common finding, occurring in more than half of patients with amebic liver abscess. They are more likely to be present if the patient has diarrhea as a presenting symptom or has had diarrhea in the recent past. Multiple, large, and left-sided ulcers are more common in elderly patients and in those in whom diarrhea is the presenting symptom. However, there is no association between the location of the abscess in the liver and colonic lesions.

Adolescent↗
PubMed2004

Ileal varices and portal hypertensive ileopathy in patients with cirrhosis and portal hypertension.

BACKGROUND: The endoscopic appearance of portal hypertensive intestinal vasculopathy is well described in the stomach, the jejunum, and the colon, but there is no description of changes that occur in the ileum. METHODS: The terminal ileum was intubated at colonoscopy in 44 patients with cirrhosis and portal hypertension and 46 control patients. Changes in the terminal ileum were noted. In addition, anorectal varices and colopathy were carefully noted and recorded. RESULTS: Ileal varices and/or portal hypertensive ileopathy were present in 16 of 44 (36%) patients with cirrhosis and portal hypertension but not in any control patient ( p < 0.01). Ileal varices were present in 8 patients (18%) with cirrhosis/portal hypertension and none of the control patients ( p < 0.05). Portal hypertensive ileopathy was noted in 11 patients (25%) with cirrhosis and portal hypertension and in none of the control patients ( p < 0.05). Ileal varices had no association with any other parameter studied. However, ileopathy was observed in 9 of the 23 patients with colopathy and in only two of the 21 patients without colopathy ( p < 0.05). CONCLUSIONS: Ileal varices and mucosal changes of portal hypertensive ileopathy occur in patients with cirrhosis and portal hypertension. In the population studied, ileopathy was significantly more common in patients who had portal hypertensive colopathy.

Adult↗
PubMed2003

Colonic mucosa in patients with portal hypertension.

BACKGROUND AND AIMS: To do a histomorphometric study of vascular changes in colonic mucosa of patients with portal hypertension (PHT) and to find their association with clinical and upper and lower gastrointestinal endoscopic observations. METHODS: Full length colonoscopy was carried out in 55 patients with portal hypertension and 25 controls. Hemorrhoids, anorectal varices and colopathy were carefully looked for and recorded. Two biopsies each were taken from the caecum, ascending colon, transverse colon, descending colon and rectum. Sections from all the five sites were examined for histopathological changes with special reference to changes in mucosal capillaries. Morphometric assessment of the diameter of the capillary and thickness of the capillary wall was performed. These histomorphometric changes were correlated with clinical parameters and findings of upper and lower gastrointestinal endoscopic findings. RESULTS: Dilated and congested capillaries as well as capillaries with irregular thickening of the wall were seen in a significantly higher number of sections from patients than controls in biopsies from all the five sites from caecum to rectum. On morphometry, the diameter of the capillaries and the thickness of the capillary wall in biopsies from all the five sites in patients was significantly higher than that in the control group. Apart from vascular changes, edema and inflammatory infiltrate in lamina propria were the other significant histological features noted. No significant association between clinical and endoscopic features and histomorphometric assessment was found. CONCLUSION: Dilated tortuous mucosal capillaries with irregular thickening of wall, edema of lamina propria and mild chronic inflammatory infiltrate are the major histopathological changes seen in colonic biopsies of patients with PHT, showing that PHT produces changes in the colonic mucosa similar to those seen in the mucosa of upper GI tract. However, the histological changes had no correlation with the clinical or endoscopic findings except that the thickness of the capillary wall was higher in patients who had undergone endoscopic sclerotherapy as opposed to those who had not received sclerotherapy.

Adolescent↗