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PubMedDate not supplied

Unusual occupational gastrointestinal and hepatic disorders.

Acute centrolobular necrosis, cancers related to occupational chemical exposures, and infectious hepatitis are widely recognized, but other occupational and environmental diseases of the gastrointestinal tract are underemphasized by comparison. This review explores the associations between workplace exposures and steatosis, increased liver microsomal activity, cholestatic liver injury, portal fibrosis and hepatic sclerosis, granulomatous liver disease, porphyria cutanea tarda, peptic ulcer disease, pancreatitis, gastroenteritis, celiac disease, and pneumatosis cystoides intestinalis.

Acute Disease↗

PubMed1990

[Renal crisis in scleroderma with normal blood pressure].

A 58-year-old man with scleroderma affecting many organs, including skin, lung and heart, developed fatal renal failure although his blood pressure was normal. He had been operated on 2 months before when free air was found under the diaphragm following spontaneous rupture of cysts of pneumatosis cystoides intestinalis.

Acute Kidney Injury↗

PubMedDate not supplied

[Spontaneous pneumoperitoneum in progressive systemic sclerosis (generalized scleroderma)].

In a twenty-nine year old female patient with progressive systemic sclerosis (scleroderma) (PSS) and an impressing involvement of the intestine (disturbance of the oesophageal motility, pseudo-obstruction, malabsorption) a spontaneous, asymptomatic pneumoperitoneum is observed. Perforation or pneumatosis cystoides intestinalis (PCI) could not be proved. The possible pathogenesis, course, prognosis and therapy of this rare complication are discussed.

Adult↗

PubMedDate not supplied

[Spontaneous pneumoperitoneum in scleroderma].

A spontaneous and asymptomatic pneumoperitoneum was observed in two women presenting with pseudoileus resulting from severe gastrointestinal involvement in progressive systemic sclerosis. In the first case, pneumoperitoneum was associated with pneumatosis cystoides intestinalis and remained unchanged during 3 years. As obstruction resisted to medical management, surgery was performed; however at laparotomy neither perforation nor obstruction of the bowel could be found; the patient died during the postoperative course. In the second case, pneumoperitoneum disappeared after medical management of low-grade intestinal ileus but the patient died 6 months later because of cardiac failure. Autopsy revealed major distention of the bowel but failed to show any signs of perforation. These findings show that, in progressive systemic sclerosis, pneumoperitoneum can occur in the absence of digestive perforation and that surgery is not required. However this complication seems to carry a very poor prognosis.

Aged↗

PubMed1993

Benign persistent pneumoperitoneum in systemic sclerosis.

We describe a 50-year-old Chinese woman who had severe gastrointestinal manifestations from systemic sclerosis complicated by spontaneous pneumoperitoneum in the absence of either visceral perforation or pneumatosis cystoides intestinalis. This is a rare complication of systemic sclerosis; only four other cases have been reported. Recognition of this condition is important so as to avoid unnecessary surgery.

Female↗

PubMed1997

Gastrointestinal manifestations of progressive systemic sclerosis.

Management of patients with progressive systemic sclerosis requires a thorough gastroenterological examination and a profound knowledge of possible gastrointestinal manifestations of the disease. The esophagus is the gastrointestinal segment most often involved. Smooth muscle atrophy leads to a loss of esophageal peristalsis, a defect of the lower esophageal sphincter, and gastric hypomotility, thus predisposing to severe reflux esophagitis. A rational diagnostic approach includes standard manometry and endoscopy. The prevention of strictures is the main aim of therapeutic efforts that may consist of lifestyle changes, prokinetic drugs, long-term application of proton pump inhibitors, and, if inevitable, surgical intervention. Involvement of the small intestine and colon is less common but may lead to life-threatening complications like chronic pseudoobstruction or pneumatosis cystoides intestinalis. The main therapeutic options consist of antibiotics for bacterial overgrowth and nutritional supplementation. Recently, a preliminary study with octreotide yielded promising results. Anorectal dysfunction can lead to fecal incontinence or rectal prolapse.

Digestive System↗

PubMed1963