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At least 667 records · Page 37Linked to original sources
PubMed1997

Eosinophilic ileitis with perforation caused by Angiostrongylus (Parastrongylus) costaricensis. A case study and review.

Angiostrongylus costaricensis (classified under the more specific genus Parastrongylus by different authors) is a filiform intestinal nematode endemic to Central and South America, which afflicts primarily the pediatric population 1 to 13 years of age. Only three cases of adult infections have been previously documented outside the endemic region. To our knowledge, we report the first such case in the western United States, as well as the oldest patient yet recorded. Our patient is a 73-year-old woman living in Los Angeles who presented with an acute abdomen 4 weeks following a 5-month visit to El Salvador. Examination of the gross ileum removed at exploratory laparotomy revealed a perforation associated with a segmentally thickened intestinal wall. Microscopic examination showed eosinophilic ileitis, arterial lumens containing nematodes morphologically consistent with A costaricensis, eggs in the submucosa, and arteriolitis with thrombosis.

Aged↗
PubMed1998

Ultrasonography in suspected acute appendicitis in childhood-report of 1285 cases.

OBJECTIVE: For the assessment of the diagnostic value of real-time ultrasonography (US) in children with suspected acute appendicitis (a.A.) the results of graded compression US are compared with clinical and histological final diagnoses. METHODS: In a prospective study over nearly 9 years we examined 1285 children aged 1-15 years (m=514, f=771). Using a 5-MHz curved array transducer the right lower quadrant was examined in a graded compression technique. RESULTS: Prevalence of histologically proven a.A. was remarkably low (9%). In diagnosis of acute appendicitis in childhood US achieves a sensitivity of 92%, specificity of 98%, a positive predictive value of 90% and a negative predictive value of 98%. The overall accuracy was 98%. Mesenteric lymphadenitis was seen in 181 cases (prevalence 12%) and terminal ileitis occasionally accompanied by mesenteric lymphadenitis was seen in 116 cases (prevalence 9%). CONCLUSION: In children with suspected appendicitis US of the abdomen gives great diagnostical value for differential diagnosis of a.A. and other more frequent inflammatory diseases of the ileocoecal region. Thus US provides further reliable information to the referring physician. Consequently it is necessary to perform US in each child with acute abdominal pain, even if clinical diagnosis seems to be well established.

Acute Disease↗
PubMed2005

Small bowel hydro-MR imaging for optimized ileocecal distension in Crohn's disease: should an additional rectal enema filling be performed?

PURPOSE: To assess the impact of an additional rectal enema filling in small bowel hydro-MRI in patients with Crohn's disease. MATERIALS AND METHODS: A total of 40 patients with known Crohn's disease were analyzed retrospectively: 20 patients only ingested an oral contrast agent (group A), the other 20 subjects obtained an additional rectal water enema (group B). For small bowel distension, a solution containing 0.2% locust bean gum (LBG) and 2.5% mannitol was used. In all patients, a breathhold contrast-enhanced T1w three-dimensional volumetric interpolated breathhold examination (VIBE) sequence was acquired. Comparative analysis was based on image quality and bowel distension as well as signal-to-noise ratio (SNR) measurements. MR findings were compared with those of conventional colonoscopy, as available (N = 25). RESULTS: The terminal ileum and rectum showed a significantly higher distension following the rectal administration of water. Furthermore, fewer artifacts were seen within group B. This resulted in a higher reader confidence for the diagnosis of bowel disease, not only in the colon, but also in the ileocecal region. Diagnostic accuracy in diagnosing inflammation of the terminal ileum was 100% in group B; in the nonenema group there were three false-negative diagnoses of terminal ileitis. CONCLUSION: Our data show that the additional administration of a rectal enema is useful in small bowel MRI for the visualization of the terminal ileum. The additional time needed for the enema administration was minimal, and small and large bowel pathologies could be diagnosed with high accuracy. Thus, we suggest that a rectal enema in small bowel MR imaging be considered.

Adult↗