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Varghese Thomas

Publications and source records attributed to Varghese Thomas.

18 recordsLinked to original sources
PubMedDate not supplied

Carbamazepine-induced eosinophilic enteritis.

We describe a 15-year-old boy who was on carbamazepine for the past 8 years for seizure disorder, who developed recurrent episodes of small bowel obstruction. Full-thickness small bowel biopsy obtained at laparotomy was consistent with eosinophilic enteritis. He improved clinically after tapering the drug.

Adolescent↗
PubMedDate not supplied

Pancreatic pseudocyst presenting as odynophagia.

A 40-year-old man presented with abdominal pain and odynophagia. CT scan revealed a pseudocyst in the posterior mediastinum and pleural effusion complicating pancreatitis. He was managed with transpapillary pancreatic duct stenting along with other supportive measures including octreotide, and he improved symptomatically. The stent was removed after four months; there was no pseudocyst on follow up CT scan.

Adult↗
PubMedDate not supplied

Testicular choriocarcinoma with gastric metastasis presenting as hematemesis.

We report a 28-year-old man who presented with hematemesis due to choricarcinoma of testis metastatic to the stomach. Gastroscopy showed a polypoidal lesion. Testicular wedge biopsy confirmed mixed germ cell tumor, the choriocarcinomatous portion alone getting metastasized to the stomach. He was initiated on chemotherapy with actinomycin-D, etoposide and methotrexate, but died due to multiple metastases to the lung and brain.

Adult↗
PubMedDate not supplied

Tropical calcific pancreatitis presenting as kwashiorkor.

Tropical clacific pancreatitis can be accompanied by varying degrees of malnutrition but full-blown kwashiorkor is an extremely rare presentation. We report the case of a 10-year-old male who presented with clinical features of severe kwashiorkor. He had extensive pancreatic clacification and exocrine pancreatic deficiency. The child was treated with pancreatic enzyme replacement, and enteral nutrition supplemented with vitamins and micronutrients. Following therapy, he started gaining weight, the skin changes partly disappeared and his hair resumed its normal black colour.

Calcinosis↗
PubMedDate not supplied

Sub-site specific time trends of carcinoma stomach in North Kerala--a retrospective analysis.

The time trends in the incidence of carcinoma stomach in the various sub-sites in stomach have been documented in the western population. The incidence of carcinoma of gastric cardia is found to be increasing, while that of the antrum is seen to be decreasing. Data from tropics is lacking on this aspect. This retrospective study was performed to look into the site-specific time trends of carcinoma stomach. Endoscopy registers maintained in the Department of Gastroenterology, Medical College, Kozhikode, Kerala in South India were screened over the period of 20 years from 1982 to 2001. Histopathologically confirmed cases of adenocarcinoma were included in the study. The cases were categorized according to different areas of stomach--cardia, fundus, body and antrum as per International classification of diseases 0-9 (zero-nine) codes. Time trend for each sub site was calculated using one-way ANOVA and Chi-square for trend. Of the 26,886 upper GI endoscopies done over 20 years, 1771 were found to be gastric adenocarcinomas. Gastric antrum was the most common site of cancer over the years (47.8%). There was a significant rising trend for gastric cancer of the cardia without a similar trend for the cancer of the body and antrum during the study period. The sub site-specific time trends of carcinoma stomach are not similar to the pattern seen in western countries. There is a rising trend for the cancer of the cardia with a stable trend for distal cancers over 20 years.

Carcinoma↗
PubMedDate not supplied

Umbilical hemorrhage as first manifestation in a case of cirrhosis.

Portal hypertension is often associated with an extensive collateral circulation. The paraumbilical vein is a relatively common collateral pathway recognized in these patients but cutaneous bleeding from the umbilicus is rare; the same as first manifestation of cirrhosis is exceptional. We report a case of umbilical venous bleed causing hemodynamic compromise, which turned out to be a case of alcoholic cirrhosis with portal hypertension. The patient was managed with suture ligation of the vessels.

Adult↗
PubMedDate not supplied

Listening to music decreases need for sedative medication during colonoscopy: a randomized, controlled trial.

BACKGROUND: Music played during endoscopic procedures may alleviate anxiety and improve patient acceptance of the procedure. A prospective randomized, controlled trial was undertaken to determine whether music decreases the requirement for midazolam during colonoscopy and makes the procedure more comfortable and acceptable. METHODS: Patients undergoing elective colonoscopy between October 2003 and February 2004 were randomized to either not listen to music (Group 1; n=40) or listen to music of their choice (Group 2; n=38) during the procedure. All patients received intravenous midazolam on demand in aliquots of 2 mg each. The dose of midazolam, duration of procedure, recovery time, pain and discomfort scores and willingness to undergo a repeat procedure using the same sedation protocol were compared. RESULTS: Patients in Group 2 received significantly less midazolam than those in Group 1 (p=0.007). The pain score was similar in the two groups, whereas discomfort score was lower in Group 2 (p=0.001). Patients in the two groups were equally likely to be willing for a repeat procedure. CONCLUSION: Listening to music during colonoscopy helps reduce the dose of sedative medications and decreases discomfort experienced during the procedure.

Adult↗
PubMedDate not supplied

Severe colitis induced by soap enemas.

Soap enemas causing severe colitis with stricture and complications have rarely been reported. We report three patients in whom soapsud enema caused severe colitis and complications like stricture requiring surgery.

Adult↗
PubMedDate not supplied

Abrikosoff's tumor of the esophagus: case report and review of literature.

Abrikosoff's tumor or granular cell tumor is a neoplasm of neural origin, usually located in the head and neck region. A majority of these neoplasms are benign. Only 4-6% of granular cell tumors are located in the gastrointestinal tract. It is extremely unusual for these tumors to be located in the esophagus. This case is being reported in view of the rarity of this lesion. A brief review of literature with stress on diagnostic evaluation and management issues is also included.

Adult↗
PubMedDate not supplied

Colitis due to Ancylostoma duodenale.

The larva of hookworm matures into the adult stage in the small intestine, causing chronic intestinal blood loss and iron-deficiency anemia. Hookworm infestation of colon has not been reported previously. We report a 35-year-old man who presented with diarrhea with blood and mucus in stools. Colonoscopy revealed several hookworms in the colon firmly adherent to the mucosa, with oozing of blood and surrounding mucosal erosions. He was treated with mebendazole and symptoms recovered completely.

Adult↗
PubMedDate not supplied

Infected pseudocyst in tropical pancreatitis presenting as psoas abscess.

Infected pseudocyst as a consequence of tropical pancreatitis presenting as psoas abscess is unusual. We report a 40-year-old man who presented with pain in the right lumbar region. CT and MRI of the abdomen revealed pancreatic pseudocysts with abscess formation in the psoas muscle and evidence of chronic calcific pancreatitis. He was managed by percutaneous drainage of the abscess along with antibiotics and other supportive measures.

Adult↗