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PubMed1999

Type I acute aortic dissection accompanied by ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery.

We report a case of acute type I aortic dissection with ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery. The patient was a 52-year-old man who visited the hospital with major complaints of sudden low back pain and melena. Mesenteric ischemia was suspected, and angiography revealed type I aortic dissection with accompanying blood flow insufficiency in the superior mesenteric artery. Because catheterization during angiography improved the blood flow disorder and prevented intestinal necrosis, it was possible to replace the ascending aorta with a prosthetic graft. Arterial pulsation in the mesentery was recovered by the operation and the patient's life was saved without bowel resection. This case demonstrates that prompt surgical or percutaneous relief of ischemia in major organs is important to save lives in the cases of acute aortic dissection with ischemic complications.

Acute Disease↗
PubMedDate not supplied

Successful medical management of neutropenic enterocolitis (typhlitis) in a child with acute lymphoblastic leukemia.

We report a case of acute lymphoblastic leukemia that was complicated by neutropenic enterocolitis (typhlitis) during the initial period of remission-induction chemotherapy. The patient's clinical symptoms resolved after aggressive treatment with intravenous fluids and electrolytes, nasogastric decompression, bowel rest, total parenteral nutrition, broad-spectrum antibiotics, and granulocyte colony-stimulating factor. Netropenic enterocolitis should always be considered in neutropenic leukemic children with the triad of fever, vomiting, and abdominal pain. Gastrointestinal hemorrhage may also accompany the symptoms described above. Plain roentgenogram, ultrasonography and computed tomography of the abdomen are helpful for making the diagnosis of this clinical condition. Early recognition and proper medical management of neutropenic enterocolitis may prevent the need for surgical intervention, and/or be life-saving.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Neutropenic enterocolitis as a presenting complication of acute lymphoblastic leukemia: an unusual case marked by delayed perforation of the descending colon.

Neutropenic enterocolitis (NE) is a life-threatening complication most commonly seen in patients receiving intensive chemotherapy for acute leukemia. The condition usually affects the terminal ileum, cecum, or ascending colon. In rare instances, NE may occur before the initiation of chemotherapy or involve more distal bowel. The authors report the case of a 2-year-old girl who had NE affecting the descending colon as a presenting complication of acute lymphoblastic leukemia. Despite aggressive medical interventions, including granulocyte infusions, she had a delayed bowel perforation that was managed successfully with surgery. This case highlights the challenges of treating patients who have NE as an initial manifestation of acute leukemia.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

The role of radiology in Campylobacter enterocolitis.

A series of 18 patients with diarrhoea and positive stool cultures for Campylobacter jejuni is presented. The most important radiological features were thickening of ileal mucosal folds, of interhaustral indentations and of the ileocaecal valve, lymphoid hyperplasia and microulcerations. Radiology, as well as endoscopy, are both nonspecific in Campylobacter jejuni enterocolitis. The importance of radiology is to exclude more typical features of other causes of inflammatory bowel diseases. Moreover, before the result of the stool culture is available, the radiological features should suggest the suspicion of an acute infectious enterocolitis by Campylobacter jejuni as possible diagnosis.

Adult↗
PubMed1996

Interleukin 10 suppresses experimental chronic, granulomatous inflammation induced by bacterial cell wall polymers.

BACKGROUND AND AIMS: Interleukin 10 (IL10) inhibits monocyte/macrophage and T lymphocyte effector functions. This study examined the effect of systemically administered IL10 on acute and chronic granulomatous enterocolitis, hepatitis, and arthritis in a rat model. METHODS: Lewis rats were injected intramurally with streptococcal peptidoglycan-polysaccharide (PG-APS) polymers. Beginning 12 hours before PG-APS injection, rats were treated daily with subcutaneous murine recombinant IL10 or vehicle for three or 17 days. RESULTS: IL10 attenuated acute enterocolitis in a dose dependent fashion (p < 0.01). Protective effects were more profound in the chronic granulomatous phase with decreased enterocolitis and markedly inhibited leucocytosis, hepatic granulomas, and chronic erosive arthritis (p < 0.001). IL10 downregulated tissue IL1, IL6, tumour necrosis factor alpha, and interferon gamma gene expression, consistent with the in vitro effects of IL10 on PG-APS-stimulated splenocytes. Caecal IL1 protein concentrations and IL2 and interferon gamma secretion by in vitro stimulated mesenteric lymph nodes were downregulated in IL10 treated animals. CONCLUSIONS: These results indicate that exogenous IL10 can inhibit experimental granulomatous inflammatory responses and suggest that IL10 treatment could be an effective new therapeutic approach in human disorders such as Crohn's disease, rheumatoid arthritis, and sarcoidosis.

Actins↗
PubMed1979

Asymptomatic cecal stenosis after necrotizing enterocolitis.

Survival of infants with necrotizing enterocolitis may be complicated by intestinal stricture(s) as a result of healing of ischemic segments of bowel. An asymptomatic cecal stenosis not visible on barium enema was identified at operation for reestablishment of intestinal continuity. Infants recovering from acute necrotizing enterocolitis deserve continued surveillance for mechanical and functional abnormalities of the gastrointestinal tract. Patency of the intestinal lumen distal to the ostomy site should be clearly demonstrated by the surgeon when continuity is reestablished.

Cecal Diseases↗
PubMed1981

Intestinal stenosis resulting from necrotizing enterocolitis.

Fourteen infants with intestinal stenosis as a late sequela of necrotizing enterocolitis were treated at Texas Children's and Ben Taub General Hospitals from 1972 to 1979. Barium enema studies are the keystone in making the diagnosis and should be performed in any infant with abdominal distention or poor feeding after recovery from acute necrotizing enterocolitis. Spontaneous resolution of stenosis is a definite clinical entity, and nonobstructed infants should be given a trial for resolution. This trial should be for a limited time. The operative therapy for the infant with obstruction or the infant who fails to have spontaneous resolution of stenosis must be individualized. Resection with primary anastomosis best serves those infants with limited stenotic lesions, minimal dilatation of the intestinal lumen and no other complicating medical problems. Intestinal diversion with later resection and enterostomy closure should be reserved for infants with intestinal obstruction and complicating medical problems.

Adolescent↗
PubMedDate not supplied

A Campylobacter coli foodborne outbreak in Belgium.

In May 1995, the Scientific Institute of Public Health was informed of an outbreak of gastrointestinal illness in a congregational school in the Brussels area. The field investigation identified 24 cases with mild to severe gastrointestinal and general symptoms of acute bacterial enterocolitis. Campylobacter coli was detected in the stools of 5 patients. A retrospective cohort study suggested that a mixed salad (containing ham and feta cheese) was the probable source of infection, but the route of contamination remained unknown. The rapid investigation of such episodes of collective foodborne infections is essential for the implementation of adequate control measures.

Acute Disease↗
PubMed1978

[Necrotizing enterocolitis and its surgical management. Study of 35 cases].

Thirty five cases of necrotizing enterocolitis, seen in the past five years in this clinic, are reviewed. Twenty four cases were seen up to December 1977 and eleven cases from January to March 1978 due to a neonatal I.C.U. epidemy. The relationship between some of the accepted perinatal pathogenic factors and the development of necrotizing enterocolitis is analyzed. The temporal relationship of the time of diagnosis to the onset of treatment is an important consideration for the prognosis. We propose surgical treatment if after eighteen hours of treatment there is no improvement. A guideline for the early treatment and surgical indications of acute necrotizing enterocolitis, is suggested.

Enterocolitis, Pseudomembranous↗
PubMed1964

ULCERATIVE COLITIS: DISEASE PATTERNS AND MEDICAL MANAGEMENT.

The extent of anatomical involvement (rectosigmoid, left colon, entire colon, segmental, and enterocolon) and clinical behaviour (acute fulminating, recurrent colitis, and chronic continuous colitis) must be considered in assessing the prognosis and management of patients with ulcerative colitis. The severity of symptoms and signs is highly variable. It ranges from the virtually asymptomatic patient with mild proctitis to the patient with acute fulminating colitis with arthritis, skin lesions and "toxic megacolon" who constitutes a medical emergency. Consequently, there is no single therapeutic formula to be applied in this disease. Treatment is reviewed with reference to the recent literature.

Adrenal Cortex Hormones↗
PubMed1989

[Methicillin-resistant staphylococcal enterocolitis developed after induction chemotherapy in a case of acute promyelocytic leukemia].

A case of methicillin-resistant staphylococcal (MRSA) enterocolitis following combination chemotherapy for acute promyelocytic leukemia is presented. MRSA enterocolitis has characteristic clinical features of high fever, frequent vomiting and watery diarrhea, and its mortality rate is very high without a proper antibiotic therapy. When the patient with hematological malignancy has the above-mentioned clinical manifestations during antineoplastic chemotherapy, appropriate antibiotics for MRSA should be promptly begun before a bacteriological diagnosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Necrotizing enterocolitis: an overlooked life-threatening complication of acute diarrhoeal illness in infants and children.

A 7-month-old girl developed necrotizing enterocolitis with extensive pneumatosis intestinalis following an acute diarrhoeal illness. This was preceded by the use of an anti-motility drug and repeated attacks of paralytic ileus. It is noteworthy that all the published cases of necrotizing enterocolitis following acute diarrhoeal illness in infants and children are from tropical countries. This might be related to the use of anti-diarrhoeal drugs and associated malnutrition resulting in hypokalaemia and hypoalbuminaemia.

Diarrhea, Infantile↗
PubMed1991

Immunopathological and immunochemical analysis of autoimmune enterocolitis in mice.

BALB/c (H-2d) and C57BL/6 (H-2b) mice were immunized with one or two doses of allogeneic or syngeneic mucosal antigen (MA) from small intestinal mucosa. This antigen was also characterized by immunoenzymatic assay (ELISA), by SDS-PAGE and by Western blotting. Single-dose immunized mice of either strain, sacrificed 30 days after immunization, synthesized marginal levels of anti-MA antibodies, as assessed by ELISA tests. BALB/c mice receiving two doses of the immunogen produced antibodies at a highly significant level (p less than 0.001) when compared to C57BL/6 mice belonging to the same experimental group. BALB/c mice immunized with syngeneic MA gave a humoral anti-MA response similar to that of BALB/c immunized with allogeneic MA. All experimental mice, irrespective of their genetic background or the number of doses of MA received, develop a cell-mediated immune response to MA. BALB/c mice immunized with two doses of allogeneic or syngeneic MA developed lesions mainly located in the small intestine, characterized by macroscopical and microscopical vascular congestion and hemorrhaging, epithelial cell loss, mononuclear cell infiltration of the lamina propria, cryptal degeneration and granuloma formation. Immunochemical analysis showed varying degrees of cross-reactivity between MA, liver and kidney saline extracts when heterologous anti-MA sera were tested by ELISA. Absorption of these sera with mouse liver or kidney saline extract lyophilizates reduced reactivity of anti-MA antibodies, although the degree of residual activity remained high. SDS-PAGE of mouse MA, kidney, and liver extracts revealed the presence of two polypeptidic bands of less than 17 kD molecular weight belonging to MA. Immunoblotting (Western blot) analysis revealed that heterologous or isologous anti-MA antibodies incubated with mouse MA reacted with the same epitopes as well as with others shared by other organs. Absorption of these sera with liver or kidney saline extracts revealed two organ-specific epitopes belonging to MA. Data presented here support the possibility of a genetic control of the susceptibility of BALB/c mice to the development of an acute autoimmune enterocolitis (AEC). This response appears to be a function of the amount of immunogen administered as well as the genetic background of immunized mice. The presence of a cell-mediated immune response to MA alone, however, is not sufficient for lesions to appear the histopathological alterations characteristic of AEC are present only in experimental groups where detectable levels of anti-MA antibodies are found. The antibody response seems to be directed against two unique epitopes belonging to MA.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗