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At least 469 records · Page 26Linked to original sources
PubMed1997

Isolated meningeal vasculopathy associated with Clostridium septicum infection.

A 28-year-old patient with acute lymphoblastic leukemia and neutropenia developed necrotizing enterocolitis and Clostridium septicum bacteremia, followed by rhabdomyolysis, skin rash, and acute neurologic changes. Numerous cortical leptomeningeal enhancements were present on head MRI. Meningeal and brain biopsy showed segmental, full-thickness lysis of smooth muscle cells of medium-sized meningeal vessels with overall preservation of the structure of the vessel wall.

Adult↗
PubMed1989

[Neutropenic enterocolitis].

In three patients with neutropenia who had died after a short period from their basic disease (myelodysplasia, medullary carcinoma, acute myeloic leukaemia), autopsy revealed segmental necrotising enterocolitis in the caecal region (neutropenic enterocolitis). Morphologically the enterocolitis was characterised by necrotized mucosa, marked oedema of the intestinal wall, intramural gas, the absence of pseudomembranes and a nearly complete absence of inflammatory cell infiltrates. In one case a palpable abdominal tumour had been produced by pseudotumorous thickening of the intestinal wall. The pathogenesis in these three cases might be a neutropenia-associated disturbance of the intestinal flora with selective proliferation of toxin-producing clostridia.

Aged↗
PubMed2003

Shigella flexneri bacteremia in a child.

We report an unusual and lethal case of Shigella flexneri septicemia in an 8-year-old Saudi handicapped child from a social home presenting with severe toxic megacolon and acute abdomen secondary to fulminant necrotizing enterocolitis.

Abdomen, Acute↗
PubMed2004

Neutropenic enterocolitis (typhilitis) associated with docetaxel therapy in a patient with non-small-cell lung cancer: case report and review of literature.

Neutropenic enterocolitis (NE) is an unusual acute complication of neutropenia, most often associated with leukemia and lymphoma which is characterized by segmental cecal and ascending colon ulceration that may progress to necrosis, perforation, and septicemia. We present a case of neutropenic enterocolitis in a patient with non-small-cell lung cancer who received docetaxel and flavopiridol as part of a phase I clinical trial and review cases in the literature where docetaxel was involved. Given the increased use of docetaxel and other taxanes in the treatment of advanced lung cancer, physicians should be aware of this potential toxicity of therapy.

Aged↗
PubMed2001

Campylobacter myocarditis; loose bowels and a baggy heart.

We report an unusual case of acute myocarditis associated with Campylobacter jejuni enterocolitis leading to severe impairment of left ventricular systolic function. Contrast-enhanced cardiac magnetic resonance imaging was used to confirm the presence of acute myocardial inflammation and its resolution.

Acute Disease↗
PubMed2005

Invasive candidal enterocolitis followed shortly by fatal cerebral hemorrhage in immunocompromised patients.

Two immunocompromised adult patients (male, 43 years of age; female, 50 years of age) are described who developed unusual and similarly unique complications. After chemotherapy, both presented with abdominal pain and severe bloody diarrhea. Initial blood cultures were negative, and abdominal CT showed pneumatosis and thickening of colonic wall. Colonoscopy showed severe right-sided colitis. Relentless bloody diarrhea necessitated emergency right hemicolectomy in both cases. Pathologic examination of the specimens showed extensive and severe hematogenous Candida enterocolitis. Both patients died of acute cerebral hemorrhage within 3 days of hemicolectomy. Autopsy, performed on 1 of the 2 cases, showed diffuse severe cerebritis and cerebral hemorrhage secondary to hematogenous invasive candidiasis. This sequence of events is not documented in the English literature on candidal enterocolitis, which is reviewed.

Adult↗
PubMed1975

Prestenotic enteritis and enterocolitis in children: Description of a syndrome and review of five cases.

A clinical syndrome of prestenotic enteritis and enterocolitis consisting of abdominal distention and pain, intermittent diarrhea and constipation, failure to thrive, fever and in some patients, extreme prostration and death is described. The pathogenesis of this enteritis and enterocolitis apparently is related to partial mechanical obstruction of the bowel with proximal dilatation, stagnation, and capillary stasis. Acute relief from the enteritis and enterocolitis may be obtained by stomal dilatation and colonic irrigation; however, all patients in our series required surgical intervention. because mortality in this disease is significant and the results with early surgical intervention are favorable, surgical intervention is encouraged at the first sign of prestenotic enteritis or enterocolitis in children. Surgical correction of the distal stenosis produced a growth spurt in the two successfully treated patients without other growth-limiting disease.

Abnormalities, Multiple↗
PubMedDate not supplied

A plea for incidental appendectomy in pediatric patients with malignancy.

The evaluation of right lower quadrant (RLQ) abdominal pain in pediatric patients with malignancy can be difficult. However, since the mortality rate from peritoneal infections in these patients is very high, the differential diagnosis of RLQ peritoneal irritation, mainly of acute appendicitis (AA) versus neutropenic enterocolitis (NE), is crucial. Three cases of pediatric patients with malignancy demonstrating these difficulties are represented to enlighten this problem. The first patient died of multiorgan failure after operation for perforated appendicitis without generalized peritonitis. The second had a severe life-threatening postoperative complication because of delayed diagnosis of acute appendicitis. The third patient with malignant pelvic spread, underwent an unnecessary abdominal exploration for suspected AA. In all these cases and probably in many others, the clinical outcome could have been different if a previous incidental appendectomy had been performed during the primary abdominal operation. Incidental appendectomy in oncologic patients is recommended to facilitate the differential diagnosis of RLQ pain and to exclude the diagnosis of AA.

Adolescent↗
PubMed1989

Ileocolonoscopy in seronegative spondylarthropathy.

A prospective endoscopic and histologic study of terminal ileum and colorectum in 211 patients with seronegative spondylarthropathy revealed macroscopic inflammatory lesions varying from erythema to superficial erosions in 30% of the patients and microscopic inflammation in 61%. Two types of inflammation were observed: an acute inflammation resembling an infectious enterocolitis and a chronic inflammation. In idiopathic reactive arthritis both types of inflammation were equally present, whereas chronic inflammation predominated in patients with ankylosing spondylitis. In 32% of patients with chronic inflammation, the lesions particularly resembled early Crohn's disease. Repeat ileocolonscopy on 19 patients demonstrated a parallel evolution of joint symptoms and histologic lesions. All patients with acute inflammation went into clinical and histologic remission, whereas lesions persisted in patients with Crohn-like inflammation. In patients with chronic inflammation, remission and persistence were observed equally. This study identified a group of patients with seronegative spondylarthropathy which, even in the absence of gastrointestinal symptoms, showed evidence of gut inflammation, probably inducing an increased gut permeability with transgression of the oral tolerance and absorption of provocative antigens into the circulation. It is also possible that both diseases reflect a common underlying process.

Arthritis↗
PubMed2001

Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates.

OBJECTIVE: To investigate whether near infrared spectroscopy (NIRS) can detect differences in oxyhaemoglobin signal when applied to the abdomens of neonates with surgically proven splanchnic ischaemia. DESIGN: Prospective, observational cohort study. SETTING: Tertiary neonatal referral centre. PATIENTS: Medical and surgical neonates were studied. Two groups were identified, neonates with acute abdomens referred for surgery and those with normal abdomens admitted for medical reasons. INTERVENTIONS: Tissue oxygenation indexes (TOI) of cerebral and splanchnic regions were measured using near infrared spectroscopy (NIRS) and their relative values expressed as a cerebro-splanchnic oxygenation ratio (CSOR). Measurements were made on admission or immediately prior to surgery and subsequently repeated on a daily basis, whenever possible, until discharge from our unit. The area under the receiver operating characteristic (ROC) curve was evaluated and optimum diagnostic cut-off values determined. RESULTS: Forty neonates were studied: 10 with acute abdomens, including four with necrotising enterocolitis (NEC), 29 controls with normal abdomens and one with cerebral hypoxic ischaemic injury. Median CSOR for the control group was 0.96 (interquartile range 0.83-1.02) whereas the acute abdomen group had a significantly lower median CSOR value of 0.66 (0.45-0.69) (p<0.001). The area under the ROC was 0.91 (95% confidence limits 0.78-1.00) for CSOR. Taking a boundary value of CSOR for the prediction of splanchnic ischaemia as less than 0.75, intestinal ischaemia was identified with a positive predictive value of 0.75 (0.43-0.95) and excluded with a negative predictive value of 0.96 (0.81-1.0). This was a better performance than using abdominal TOI alone. CONCLUSIONS: By comparing the TOI of cerebral and splanchnic regions it may be possible to establish the presence of normal splanchnic perfusion and detect when splanchnic ischaemia develops. CSOR had a 90% (56-100%) sensitivity to detect splanchnic ischaemia in neonates. Further work is necessary to confirm these early findings and establish whether abdominal NIRS has a clinical role in detecting splanchnic ischaemia.

Abdomen, Acute↗
PubMed1990

[Acute abdomen in patients with hematologic neoplasms].

Sixteen onco-haematological patients with acute abdomen are presented. The diagnosis of acute abdominal conditions was: neutropenic enterocolitis, gastrointestinal perforation, bowel neoplastic obstruction hepatic abscess and strangulated tumoral hernia. The operative death was 31.2%; 62.5% died 2-24 months after surgery and 6.3% is alive at 72 months. The Authors conclude that in these patients the extended surgery should be performed only in prognostic all favourable cases.

Abdomen, Acute↗
PubMed2004

Intestinal thrombotic microangiopathy after allogeneic bone marrow transplantation: a clinical imitator of acute enteric graft-versus-host disease.

Thrombotic microangiopathy after bone marrow transplantation (post-BMT TMA) is a serious transplant-related complication. We identified 16 patients with TMA after allogeneic BMT who showed histopathological evidence of intestinal TMA in their gut specimens (six autopsies, 10 biopsies). In all, 14 patients had grade II-IV acute graft-versus-host disease (GVHD). The first seven patients were retrospectively diagnosed with TMA. Since six of them were diagnosed with progressive GVHD at that time because there was no awareness of the existence of intestinal TMA, they received more intensive treatment for GVHD, but all died between days +49 and +253. In contrast, the remaining nine patients were recently diagnosed with intestinal TMA on the basis of colonoscopic biopsies. For eight of these patients, the immunosuppressants were reduced, and the patients' intestinal symptoms improved gradually. Six of the nine patients were still alive 12 months after the diagnosis of TMA. Our findings suggest that the gut may be a site involved in post-BMT TMA, presenting as ischemic enterocolitis. Differentiating intestinal TMA from acute GVHD is important in patients suffering from severe and refractory diarrhea after BMT.

Acute Disease↗
PubMed1993

[Anuria after abdominal surgery in 2 newborn infants. Beneficial effect of noradrenaline].

BACKGROUND: Abdominal surgery in neonates may be complicated by acute renal failure that is sometimes due to increased intra-abdominal pressure. Correction of the decreased renal perfusion may be difficult. CASE REPORTS: Case no 1. A girl weighing 3,000 g was operated on at 3 hours of life for congenital omphalocele. Closing the defect induced increased intra-abdominal pressure and decreased systemic pressure. Despite dopamine, dobutamine, followed by furosemide, anuria persisted without manifestations of heart failure. Noradrenaline (0.1 to 0.7 micrograms/kg/min intravenously) given 24 hours after surgery resulted in normalization of systemic pressure and diuresis. Case no 2. A boy was born at gestational week 30, weighing 1,450 g. At 8 days of age, he was suffering from shock that was attributed to perforation of the bowel due to necrotizing enterocolitis. Surgery was complicated by acute circulatory and renal failure that did not respond to dopamine, dobutamine or furosemide. Infusion of noradrenaline, (0.2 to 0.6 micrograms/kg/min intravenously) induced diuresis within 3 hours. CONCLUSIONS: Noradrenaline can be useful in patients with postoperative increased intra-abdominal pressure. It should only be given after correction of hypovolemia, control of myocardial function, and when dopamine remains ineffective.

Abdomen↗