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Results for “Ileitis”

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At least 19 recordsLinked to original sources

PubMed1989

Pouch ileitis.

Pouch ileitis is the most poorly understood complication of ileal reservoir surgery. Variability in definition of this syndrome may account for differences in incidence rate, associated symptoms, and response rate to therapy present in the literature. Outcomes of 19 episodes of pouch ileitis in patients having undergone prior colectomy and continent ileostomy construction for presumed ulcerative colitis were analyzed. An episode of pouch ileitis was characterized by: (1) abdominal pain, (2) increased ileal output, (3) mucosal inflammation within the continent ileostomy, and (4) absence of other recognized concurrent postoperative complications. The mean time of occurrence after construction of the continent ileostomy was 25 months (range 3-54 months). The mean length of follow-up of patients included in this analysis was 49 months from the time of continent ileostomy construction (range 22-101 months). Associated clinical symptoms included bloody effluent (53%), nausea or emesis (47%), and fever (42%). Endoscopic features were often nonspecific, with mucosal erythema (84%), edema (79%), friability (58%), and mucosal ulceration (53%) the most common. In those episodes of pouch ileitis where ileoscopy revealed no evidence of mucosal ulceration, complete resolution of the episode occurred 89% of the time, with 78% treated with antibiotics alone. In those episodes where mucosal ulceration was described on ileoscopy, 40% of episodes completely resolved after medical treatment, 20% with antibiotics alone. The varied clinical symptoms, endoscopic findings, and response to treatment raises the possibility that what has previously been described in the literature as pouch ileitis may be a heterogeneous group not of single etiology.(ABSTRACT TRUNCATED AT 250 WORDS)

Colectomy↗

PubMed1989

Experimental production of proliferative ileitis in Syrian hamsters (Mesocricetus auratus) by using an ileal homogenate free of Campylobacter jejuni.

The role of Campylobacter jejuni in the pathogenesis of proliferative ileitis of Syrian hamsters (Mesocricetus auratus) has been uncertain. C. jejuni has been implicated as the etiologic agent on the basis of the campylobacter-type morphology of the intracellular organism and the repeated microbiologic isolation of C. jejuni from hamsters with proliferative ileitis. The inability to reproduce the disease with pure culture inocula, coupled with immunohistochemical studies, however, has suggested that although C. jejuni may be present in the ilea of infected hamsters, its involvement in the pathogenesis of proliferative ileitis is questionable. In this study hamsters were inoculated with infective ileal homogenates prepared from ilea which were extensively washed to remove the ileal contents before grinding. The ilea from hamsters inoculated with this homogenate were also washed before being ground and used to experimentally inoculate a second group of hamsters. Of the 20 hamsters from this second group, 12 developed lesions typical of proliferative ileitis. Extensive microbiologic cultures from these hamsters were negative for C. jejuni. Immunofluorescence studies with a C. jejuni-specific monoclonal antibody were also negative. The use of a Campylobacter genus-specific monoclonal antibody, however, revealed numerous campylobacter-type organisms within the ileal epithelial cells of the crypts and villi. The presence of C. jejuni is therefore apparently not necessary for the production of proliferative ileitis in hamsters, and the intracellular campylobacter-type organism present in the ileal epithelial cells of infected hamsters is probably not C. jejuni.

Animals↗

PubMed1977

Radiological findings in Yersinia ileitis.

Bacteriological and clinical studies of patients with acute retional ileitis indicate that numerous patients with this diagnosis have a benign ileitis of short duration, caused by Yersinia enterocolitica, whereas others develop chronic Crohn's disease. Yersinia ileitis has some clinical and radiological features in common with Crohn's disease, but the two conditions are basically separate. In Yersinia ileitis, three stages are apparent: (a) the nodular stage, lasting up to three weeks; (b) the edematous stage (4th-5th week); and (c) resolution, observed during the 5th-8th week. The radiological findings in 25 patients with Yersinia ileitis and their distinction from Crohn's disease are described.

Adolescent↗

PubMed1991

Isolation of an intracellular bacterium from hamsters (Mesocricetus auratus) with proliferative ileitis and reproduction of the disease with a pure culture.

An intracellular bacterium was isolated from hamsters (Mesocricetus auratus) with proliferative ileitis. The organism was isolated in Intestine 407 and GPC-16 cell cultures (incubated in a microaerophilic atmosphere) from isolated and lysed epithelial cells from hamsters with proliferative ileitis. The bacterium measured 1.4 to 1.7 microns in length by 0.26 to 0.34 microns in width, was slightly curved, and had an irregular trilaminar cell wall. Inoculation of hamsters with a cell culture lysate containing the organism or a 0.65-microns-pore-size filtrate of an infected-cell lysate resulted in the typical lesions of proliferative ileitis in approximately 50% of the animals in 28 days. Hamsters inoculated with uninfected cells or a 0.2-microns-pore-size filtrate of an infected-cell lysate remained uninfected. Attempts to propagate the organism on cell-free media have been unsuccessful.

Animals↗

PubMed1991

Yersinia terminal ileitis: sonographic findings in eight patients.

To determine the sonographic features of Yersinia terminal ileitis, we analyzed the sonograms of eight patients with acute terminal ileitis. Bacteriologic or serologic confirmation of Yersinia enterocolitica infection was available in six patients. In the other two, the clinical course and radiologic findings were compatible with the diagnosis. Radiographs and endoscopy showed edematous mucosa with small elevations in the terminal ileum in all the patients. Sonograms showed thickening of the wall of the ileum in all eight patients and enlarged mesenteric lymph nodes in six patients. Although the number of the patients is small, our experience suggests that sonography can be useful for the detection of acute terminal ileitis caused by Yersinia.

Adolescent↗

PubMed1989

Ileitis and pouchitis after colectomy for ulcerative colitis.

Ileitis can occur after surgical treatment of ulcerative colitis. Following continent ileostomy or restorative proctocolectomy ileitis can become a serious clinical problem and is then known as pouchitis although this condition is yet to be clearly defined. It is likely that pouchitis is the result of an abnormal host response to a change in bacterial flora and that the nature of this host response is related to the underlying pathogenesis of ulcerative colitis. Continued study of the immunological basis of ulcerative colitis is therefore required to solve the problem of pouchitis.

Colectomy↗

PubMed1979

Multiple adenocarcinomas and premalignant changes in "backwash" ileitis.

In a patient with long-staning ulcerative colitis and "backwash" ileitis, multiple carcinomas developed in the colon and ileum. In both locations premalignant mucosal changes of the basal cell proliferation type were seen adjacent to and remote from sites of carcinoma. Although the frequency of such premalignant and malignant changes in "backwash" ileitis is unknown, their concurrence in this case suggests that ulcerative colitis involving the terminal ileum increases the risk of small bowel carcinoma.

Adenocarcinoma↗

PubMed1989

The incidence of severe chronic ileitis after abdominal and/or pelvic external irradiation with high energy photon beams.

The authors report a 7.9% incidence of late severe ileal complications after abdominal and/or pelvic external radiation therapy in 188 consecutive patients. All treatments were performed using 25 MV photon beams, with AP-PA field technique, a daily dose of 1.8-2 Gy, 5 times a week. One hundred and two (54.3%) patients were given whole pelvic irradiation up to 45-55 Gy without a boost, 64 patients (34%) received boost doses on limited volumes up to 60-65 Gy. The analysis of factors which could be useful in predicting a high risk of severe ileal sequellae, has shown that the main factor was the past history of previous laparotomy. Thus, the incidence of chronic ileitis in patients who have never been laparotomized in the past and who were treated by radiotherapy alone, was 2.2% (2/97); in contrast patients with previous abdominal surgery whatever its purpose, showed in 13/91 cases (14.3%) severe ileal complications (p less than 0.05). In addition, the risk of chronic ileitis increases with the number of previous laparotomies irrespective of delay or purpose: 10.1% after one laparotomy, 22.2% after two and 50% after three or more laparotomies. The influence of these data on the planning of abdominal and/or pelvic external irradiation is discussed.

Adult↗

PubMed1985

Crohn's ileitis complicated by amyloidosis: observations and therapeutic considerations.

We present a patient with clinically asymptomatic amyloidosis associated with Crohn's ileitis. A distinction should be made between immunocytic dyscrasia associated with amyloidosis (formerly primary or myeloma-associated amyloidosis) and acquired systemic amyloidosis (formerly secondary amyloidosis). We compare the natural course of amyloidosis complicating Crohn's disease with these complicating familial Mediterranean fever (FMF), and discuss the role of resection and the rationale behind colchicine therapy. Our patient is the first reported case in which colchicine therapy alone has been successful in the prophylactic treatment of amyloidosis complicating Crohn's ileitis.

Adult↗

PubMed1991

Potential role of histamine monochloramine in a rabbit model of ileitis.

Histamine chloramines, derived from the chlorination of histamine by granulocyte-derived oxidants, are potential mediators of intestinal injury and dysfunction in states of atopy or inflammation. We assessed the ability of histamine monochloramine to increase epithelial permeability in rabbit distal small intestine and determined whether the conditions for histamine chloramine formation are favorable in a rabbit model of ileitis. Epithelial permeability, quantified by the blood-to-lumen clearance of 51Cr-labeled ethylenediaminetetraacetic acid, was enhanced by luminal perfusion with either histamine or histamine monochloramine (10 microM), although the latter was twice as effective (p less than 0.05). In a rabbit model of ileitis induced by a luminal solution of acetic acid (200 mM) and casein (10 mg/ml) there was a marked increase in epithelial permeability and in the release into the lumen of histamine, myeloperoxidase, 6-keto-prostaglandin F1 alpha and protein. These results suggest that the conditions are favorable for histamine chloramine formation and that histamine and histamine chloramine may impair the integrity of the epithelial barrier.

Acute Disease↗

PubMed1989

Terminal ileitis associated with Blastocystis hominis infection.

We report on the previously unobserved clinical presentation of terminal ileitis secondary to Blastocystis hominis in a 37-yr-old white male. When the patient was treated with metronidazole, the symptoms improved and the radiographic abnormalities resolved. We believe that this is the first well-documented instance of terminal ileitis secondary to B. hominis.

Adult↗

PubMed1976

Acute yersinial ileitis: a distinct entity.

A case report of documented Yersinial acute ileitis is presented. A review of the literature reveals that progression to Crohn's disease is uncommon. Yersinosis can present as several symptom complexes. Mesenteric lymphadenitis and terminal ileitis, however, appear to be the most common. The diagnosis is usually made during laparotomy for possible appendicitis, because the symptom complex may be very similar. If the only finding at laparotomy is a thickened edematous ileum, postoperative titers for Yersinia should be taken. A greater awareness is necessary before the true incidence and epidemiology can be ascertained.

Acute Disease↗

PubMed1977

Acute terminal ileitis and Yersinia enterocolitica infection.

Diarrhea, moderate to high fever and pain in the RLQ associated with a tender mass or swelling of the terminal ileum arouse suspicion of acute terminal ileitis. Will diagnostic of the disease be laboratory data compatible with acute inflammatory disease and radiological findings of the terminal ileum, i.e., thickening of mucosal folds, round filling defects on the mucosa indicative of swelling of lymphoid tissue and fine irregularities of the margin without narrowing of the lumen. Yersinia infection was demonstrated in 7 of 10 patients whose stool and/or serum were examined. Yersinia enterocolitica was found to be an important causative agent of acute terminal ileitis. Its detection will be useful for differentiating the disease from acute stage of Crohn's disease.

Acute Disease↗

PubMed1976

Studies on Crohn's disease. 1. The relationship between Yersinia enterocolitica infection and terminal ileitis.

Patients with terminal ileitis or regional enterocolitis have been examined for signs of infection due to Yersinia enterocolitica serotype 3. The patients were grouped according to the length of preoperative history. Among 18 patients with preoperative symptoms of one week or less there were nine with positive signs of Yersinia enterocolitica infection. None of these patients developed the chronic form of Crohn's disease while two of the primarily Yersinia negative patients progressed to the chronic form. Among nine patients with preoperative symptoms of one week to three months there was one patient with positive signs of Yersinia enterocolitica infection. This patient has remained healthy whereas seven of the negative ones progressed to the chronic form of Crohn's disease. None of the patients with established Crohn's disease of the chronic form had signs of recent Yersinia infection. The findings indicate that patients with acute terminal ileitis and positive signs of Yersinia infection are not likely to progress to the chronic form of Crohn's disease. Bacteriologic and serologic investigation for Yersinia infection are therefore of prognostic value.

Acute Disease↗

PubMed1989

Small bowel angiodysplasia in association with Crohn's ileitis. A case report.

A case of a female patient affected by Crohn's ileitis associated with small bowel angiodysplasia is reported. Despite a good clinical and laboratory response to steroid therapy the patient showed an unexplained hypochromic microcytic anemia. At laparotomy Crohn's ileitis as well as an angiodysplastic lesion were found. Both lesions were resected in continuity. During a 2-year follow-up the patient did not show anemia despite pregnancy. It is suggested that the angiodysplastic lesion was the possible cause of hypochromic anemia and that the patient should have been operated on before, based on her recurrent anemia.

Adult↗

PubMed1977

Long-term results in the treatment of regional ileitis with coherin.

Nineteen patients with severe symptoms of ileitis, not responsive to other forms of therapy, have been treated with coherin, a peptide isolated from bovine posterior pituitary glands. This study encompasses observations over a total of 50-patient years. tcoherin has proven efficacious by three criteria: As a result of coherin treatment those patients receiving steroids could either eliminate them or reduce the dosage to safe levels. A significant number of patients whose symptoms have been controlled by coherin have demonstrated their therapeutic dependence on coherin for relief of symptoms by multiple unsuccessful attempts to discontinue treatment over a long period of time. Diarrhea, in patients with ileitis symptoms, is effectively controlled by coherin therapy on a long-term basis.

Crohn Disease↗

PubMed1976

Regional ileitis (Crohn's disease). I. Kinetics of bile acid absorption in the perfused ileum.

Bile acid absorption was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). By computerizing absorption kinetics the presence of an active transport of glycochenodeoxycholic acid (GCDC) was rendered probable by finding a saturable transport system and a competitive absorption between conjugated bile acids. At the time of investigation 5 patients had no diarrhoea, whereas 6 patients had diarrhoea as defined from the amount of faecal output. In the former group the faecal bile acid excretion was low, the ileal absorption of GCDC high, and judged from the xylose absorption the ileal absorption surface large compared to the latter group, in which the faecal bile acid excretion was high, the ileal absorption of GCDC low, and the ileal absorptive surface small. It is concluded that malabsorption of bile acids in the ileum may be of significant physiological importance in the pathogenesis of diarrhoea in patients with regional ileitis.

Adult↗

PubMed1976

Regional ileitis (Crohn's disease). II. Electrolyte and water movement in the ileum during perfusion with bile acids.

Electrolyte and water movement was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). Six patients who at the time of investigation had diarrhoea showed a constant secretion of salts and fluid during perfusion with control perfusate. Per 24 hours, the ileal effluents to colon would exceed the normal amount by 1-2 litres. In the 5 patients without diarrhoea the absorption patterns were normal. Electrolytes and water moved in parallel. Dihydroxy bile acids enhanced secretion or decreased absorption respectively, in the two groups of patients. It is concluded that functional disturbances of salt and water absorption in the inflamed ileum may be of significant physiological importance in the pathogenesis of diarrhoea observed in patients with regional ileitis.

Adult↗