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Demirli Atıcı S, Üstün M, Avcı EK, Kaya T, Çalık B. A Rare Cause of Right Lower Quadrant Abdominal Pain: Isolated Cecal Necrosis. TURKISH JOURNAL OF COLORECTAL DISEASE 2022; 32:31-35. [DOI: 10.4274/tjcd.galenos.2021.2020-8-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Hamdeh S, Micic D, Hanauer S. Drug-Induced Colitis. Clin Gastroenterol Hepatol 2021; 19:1759-1779. [PMID: 32360808 DOI: 10.1016/j.cgh.2020.04.069] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/31/2020] [Accepted: 04/20/2020] [Indexed: 02/07/2023]
Abstract
Drug-induced colitis encompasses a wide spectrum of colon disorders that can manifest microscopically or macroscopically. Patients present with new-onset colitis or exacerbations of inflammatory bowel diseases; in some cases, colitis resolves with discontinuation of medication. Mucosal injury can be focal or extensive, involving the entire colonic mucosa, and sometimes involves other parts of the gastrointestinal tract. It has been a challenge to determine the proportion of new-onset colitis caused by medication and there are few data on the overall prevalence. We review the drugs that have been linked with development of drug-induced colitis and strategies for physicians who believe their patients have this disorder-usually discontinuation of the drug believed to cause colitis and treatment with steroids or immune-modulating therapies. Physicians must be aware of medications that can cause colitis.
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Affiliation(s)
- Shadi Hamdeh
- Department of Internal Medicine, Division of Gastroenterology, Hepatology and Motility, University of Kansas, Kansas City, Kansas.
| | - Dejan Micic
- Department of Internal Medicine, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, Illinois
| | - Stephen Hanauer
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Ito T, Takasaki K, Takada M, Tomioka A. Ischaemic colitis diagnosed by sigmoidoscopy during pregnancy. BMJ Case Rep 2021; 14:e239975. [PMID: 33947673 PMCID: PMC8098988 DOI: 10.1136/bcr-2020-239975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 11/03/2022] Open
Abstract
A 21-year-old woman visited out hospital for lower abdominal pain and bloody diarrhoea at 19 weeks of pregnancy. Endoscopic findings revealed longitudinal ulcerations with hyperaemia and oedema in the sigmoid colon. These findings and clinical presentation confirmed the diagnosis of ischaemic colitis. Conservative treatment, including fasting and intravenous hydration, was administered, and the patient made a good recovery. After discharge, there was no recurrence during pregnancy and postpartum period. It is important to make early diagnosis and treatment, and multidisciplinary teamwork between obstetricians, gastroenterologist and endoscopist is required.
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Affiliation(s)
- Tsubasa Ito
- Department of Obstetrics and Gynecology, Self Defense Force Sapporo Hospital, Sapporo, Japan
| | - Kazuki Takasaki
- Department of Obstetrics and Gynecology, Self Defense Force Sapporo Hospital, Sapporo, Japan
| | - Minori Takada
- Department of Obstetrics and Gynecology, Self Defense Force Sapporo Hospital, Sapporo, Japan
| | - Akira Tomioka
- Department of Gastroenterology, National Defense Medical College, Tokorozawa, Japan
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Silverman M, Aroniadis OC, Feuerstadt P, Fenster M, Huisman T, Mansoor MS, Bhutta AQ, Brandt LJ. Older patients are significantly more likely to have colon ischaemia-associated conditions that are chronic and complex. Aliment Pharmacol Ther 2019; 49:1502-1508. [PMID: 31020678 DOI: 10.1111/apt.15268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/12/2019] [Accepted: 03/27/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Colon ischaemia is a common disease which has been associated with various medications and comorbidities. AIM To test the hypothesis that there are differences in the frequencies of these associations in older compared with younger patients. METHODS A retrospective cohort study was performed of patients hospitalized with colon ischaemia at two major medical centres from 2005-2017. Clinical, colonoscopic and pathologic criteria were used to identify patients admitted with colon ischaemia; patients with other types of colitis were excluded. Demographic and medical data were extracted. Two cohorts were created: patients aged 18-64 years and patients > 65 years. These were compared using SAS 14.3. RESULTS A total of 788 patients were included, of which 271 (34.4%) were of ages 18-64 years, and 517 (66.6%) were 65 years old or older. In the older cohort, constipation-inducing medications (83.8% vs 64.1%; P = <0.0001), diuretics (38.1% vs 25.1%; P = <0.001) and nonsteroidal anti-inflammatory drugs (58% vs 41.5%; P = <0.0001) were more common than in the younger cohort. Antipsychotic medication use was more common in the younger cohort (10.4% vs 5.4%; P = 0.01). There was a higher percentage of younger patients with a history of hypercoaguable state (1.9% vs 0.2%; P = 0.03) and dialysis dependence (22.9% vs 8.7%; P = <0.01), while a higher percentage of patients in the older cohort had a history of chronic obstructive pulmonary disease (12% vs 6.3%; P = 0.01) or atrial fibrillation (18.9% vs 10.3%; P = <0.01). CONCLUSIONS Our study shows that older patients are more likely to have colon ischaemia-associated conditions that are chronic and complex, while younger patients are more likely to have acute colon ischaemia-associated conditions.
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Affiliation(s)
- Michael Silverman
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH
| | - Olga C Aroniadis
- Division of Gastroenterology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | - Paul Feuerstadt
- Division of Gastroenterology, Yale University School of Medicine, New Haven, Connecticut
- Gastroenterology Center of Connecticut, Hamden, Connecticut
| | - Marc Fenster
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Tsipora Huisman
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Abdul Qadir Bhutta
- Department of Internal Medicine, Yale New Haven Hospital, New Haven, Connecticut
| | - Lawrence J Brandt
- Division of Gastroenterology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
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Vodusek Z, Feuerstadt P, Brandt LJ. Review article: the pharmacological causes of colon ischaemia. Aliment Pharmacol Ther 2019; 49:51-63. [PMID: 30467871 DOI: 10.1111/apt.15052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/05/2018] [Accepted: 10/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Colon ischaemia is the most common ischaemic disorder of the gastrointestinal system, can affect any segment of the colon, and may present with a range of symptoms. Diagnosis can be challenging due to symptom overlap with other conditions, varied aetiology, and often rapid and self-resolving course. AIM To review comprehensively the literature regarding the pharmacological aetiologies of colonic ischaemia to enhance the understanding of the various mechanisms of disease, presentations, distribution, and outcomes. METHODS A PubMed search for "colon ischaemia" and "ischaemic colitis" alone as well as in combination with various known pharmacologic causes was performed. Only the highest quality and relevant literature was included in this review. The quality of the literature for each association was rated by the authors and a consensus was made when discrepancies were encountered. Only associations that were deemed "moderate" or "strong" were included. RESULTS The literature considering pharmacologically associated colonic ischaemia is diverse, lacks codification and is characterised by numerous case reports and case series. Constipation-inducing drugs, digoxin, hormonal therapies, illicit drugs, immunomodulators, laxatives, and NSAIDs were strongly associated with colonic ischaemia. Antimicrobials, appetite suppressants, chemotherapies, decongestants, diuretics, ergot alkaloids, serotonin agents, statins, and vasopressor agents were moderately associated. CONCLUSIONS Patients presenting with abdominal pain, diarrhoea, or bloody stool need to be evaluated for the possibility of this condition and treated accordingly. Timely diagnosis is necessary to improve patient outcomes. This review aims to increase awareness among clinicians regarding the presentation of pharmacologically induced colonic ischaemia.
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Affiliation(s)
- Ziga Vodusek
- Frank H. Netter, MD. School of Medicine, Quinnipiac University, North Haven, Connecticut
| | - Paul Feuerstadt
- Gastroenterology Center of Connecticut, Yale University School of Medicine, Hamden, Connecticut
| | - Lawrence J Brandt
- Division of Gastroenterology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
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Marginean EC. The Ever-Changing Landscape of Drug-Induced Injury of the Lower Gastrointestinal Tract. Arch Pathol Lab Med 2017; 140:748-58. [PMID: 27472233 DOI: 10.5858/arpa.2015-0451-ra] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
CONTEXT -There is an ever-growing armamentarium of pharmacologic agents that can cause gastrointestinal (GI) mucosal injury, the most common symptoms being diarrhea, constipation, nausea, and vomiting. These are often self-limiting and without serious sequelae, but some symptoms are of greater concern, like drug-induced mucosal ulceration that can manifest as GI hemorrhage, stricture formation, and even perforation. Histologically, there is significant overlap between drug-induced injuries and various disease entities. A single type of medication may cause multiple patterns of injury, which can involve the entire GI tract or just some parts of it. OBJECTIVE -To review the most common drug-induced injury patterns affecting the colon, which may be recognized by the surgical pathologist on colonic mucosal biopsies. This review does not address the injuries occurring in the upper GI tract. DATA SOURCES -A PubMed review of English-language literature, up to December 2015, on drug-induced injury of GI tract was performed. CONCLUSIONS -There are numerous drugs that damage the colonic mucosa. The most common drugs are included in this review according to their histologic pattern of injury. It is important for the pathologist to keep in mind that a single drug type can induce many histologic patterns of mucosal injury that can mimic many disease entities. Although there are some histologic clues helpful in the diagnosis of drug-induced colonic injury, correlation with clinical history and especially medication history is essential to improve diagnostic accuracy.
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Affiliation(s)
- Esmeralda Celia Marginean
- From the Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Abstract
Many drugs and chemical agents can cause enteritis and colitis, producing clinical gastrointestinal side effects, the most common of which are diarrhoea, constipation, nausea and vomiting. Significant histological overlap exists between some patterns of medication or chemical injury and various disease entities. A particular medication may cause multiple patterns of injury and may mimic common entities such as coeliac disease, Crohn's disease, infectious enteritis and colitis. Thus, given the common absence of specific histopathological features, the diagnosis often relies upon thorough clinicopathological correlation. This review concentrates on selected examples of medication-induced injury of the intestinal tract in which the pathology can be recognized, particularly on biopsies, with a focus on newly described medication-induced gastrointestinal effects.
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Affiliation(s)
- Aoife J McCarthy
- Department of Histopathology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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De Lima A, Galjart B, Wisse PHA, Bramer WM, van der Woude CJ. Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? - a systematic review. BMC Gastroenterol 2015; 15:15. [PMID: 25849032 PMCID: PMC4339426 DOI: 10.1186/s12876-015-0244-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/29/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Gastrointestinal endoscopy plays a crucial role in the diagnosis and management of gastrointestinal disorders. When endoscopy is indicated during pregnancy, concerns about the effects on pregnancy outcome often arise. The aim of this study was to assess whether lower gastrointestinal endoscopies (LGEs) across all three trimesters of pregnancy affects pregnancy outcomes. METHODS A systematic literature search was performed using Embase (including MEDLINE), Medline OvidSP, Cochrane Central Register of Controlled Trials, Web-of-Science, Google scholar and Pubmed. All original research articles from 1990 until May 2014 involving pregnant women who underwent LGE for any indication were included. Adverse pregnancy events like spontaneous abortion, preterm birth and fetal demise were assessed for a temporal and etiological relation with the LGE. RESULTS In total, 5514 references were screened by two independent reviewers. Eighty-two references met the inclusion criteria and were selected. Two retrospective, controlled studies, one uncontrolled study and 79 case reports were identified. In the three studies, birth outcomes did not differ between women undergoing LGE during pregnancy, compared to women that had an indication for LGE but in whom LGE was not performed because of pregnancy. In 79 case reports, 92 patients are described who underwent 100 LGE's during pregnancy. LGEs performed in all trimesters (n = 32, 39 and 29) were both temporally and etiologically related to 1, 3 and 2 adverse events, respectively. CONCLUSION Based on the available literature, this review concludes that lower gastrointestinal endoscopy during pregnancy is of low risk for mother and child in all three trimesters of pregnancy.
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Affiliation(s)
- Alison De Lima
- Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center Rotterdam, ‘s Gravendijkwal 230, Room Hs-306, 3015 CE Rotterdam, The Netherlands
| | - Boris Galjart
- Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center Rotterdam, ‘s Gravendijkwal 230, Room Hs-306, 3015 CE Rotterdam, The Netherlands
| | - Pieter HA Wisse
- Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center Rotterdam, ‘s Gravendijkwal 230, Room Hs-306, 3015 CE Rotterdam, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - C Janneke van der Woude
- Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center Rotterdam, ‘s Gravendijkwal 230, Room Hs-306, 3015 CE Rotterdam, The Netherlands
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Manickam P, Jaurigue M, Batke M, Cappell MS. Recurrent ischemic colitis associated with oral contraceptive therapy. J Dig Dis 2014; 15:331-3. [PMID: 24612474 DOI: 10.1111/1751-2980.12139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Palaniappan Manickam
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
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Abstract
Ischemia is a common type of gastrointestinal injury that can be clinically misdiagnosed due to its often mild and transient clinical presentation as well as a tendency to masquerade as other disorders. A wide range of etiologies can contribute to the development of ischemia. These include hypovolemic states, systemic diseases such as vasculitis and hypercoagulable states, mechanical obstruction, therapeutic drug effects, infection, and a host of other diseases. An accurate diagnosis of ischemia relies on a strong clinical suspicion in combination with endoscopic and pathologic findings. Most cases show histologic features that are diagnostic of ischemia, but do not point to a specific differential diagnosis, whereas the cause of ischemia can be recognized or suspected based on careful review of vascular changes in others. This review is focused on providing an overview of ischemic enterocolitis and its differential diagnosis.
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Affiliation(s)
- Georgina Uberti
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, Ohio
| | - John R Goldblum
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, Ohio
| | - Daniela S Allende
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, Ohio.
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Ajani S, Hurt RT, Teeters DA, Bellmore LR. Ischaemic colitis associated with oral contraceptive and bisacodyl use. BMJ Case Rep 2012; 2012:bcr-12-2011-5451. [PMID: 22843752 DOI: 10.1136/bcr-12-2011-5451] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A woman with a history of hip replacement presented 3 days prior to revision of the hip with abdominal pain, diarrhoea and haematochezia. These symptoms began 6 h after she began taking bisacodyl in preparation for her upcoming surgery. She was on low-dose estradiol for hormone replacement therapy (HRT). Subsequent colonoscopy and biopsies were consistent with acute colonic ischaemia (CI). She was treated with intravenous fluids and antibiotics and discharged and told to stop HRT and bisacodyl. Follow-up colonoscopy 1 month after discharge was normal. This case adds to the three other previously reported cases of bisacodyl-associated CI.
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Affiliation(s)
- Shahnaz Ajani
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Seon CS, Park YS, Park SH, Ryu SR, Jo YJ, Kim SH, Son BK, Ahn SB. A Case of Oral-contraceptive Related Ischemic Colitis in Young Woman. Clin Endosc 2011; 44:129-32. [PMID: 22741124 PMCID: PMC3363065 DOI: 10.5946/ce.2011.44.2.129] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Revised: 08/26/2011] [Accepted: 08/31/2011] [Indexed: 01/24/2023] Open
Abstract
Ischemic colitis is generally considered a disease of the elderly. The causes of ischemic colitis include low-flow states due to cardiac dysfunction or hypovolemia and certain medications including estrogen. Here we report a case of ischemic colitis in a 26-year-old woman. She had no specific medical history except taking oral-contraceptives for a long time. The mechanism of estrogen-induced ischemic colitis is not clearly understood. But we recommend that oral-contraceptives should be considered as a cause of ischemic colitis in young women.
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Affiliation(s)
- Choon Sik Seon
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Young Sook Park
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Se Hwan Park
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Sang Ryol Ryu
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Yun Ju Jo
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Seong Hwan Kim
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Byoung Kwan Son
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
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Zervoudis S, Grammatopoulos T, Iatrakis G, Katsoras G, Tsionis C, Diakakis I, Calpaktsoglou C, Zafiriou S. Ischemic colitis in postmenopausal women taking hormone replacement therapy. Gynecol Endocrinol 2008; 24:257-60. [PMID: 18569029 DOI: 10.1080/09513590802002163] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND AND AIM Estrogen and progestins have established effects on the gastrointestinal tract and ischemic colitis was related in the past with certain regimens including both hormones. On this basis, we aimed to evaluate a group of postmenopausal women who presented with ischemic colitis after taking hormone replacement therapy (HRT) for the last several months. METHOD Postmenopausal women taking conjugated estrogens, conjugated estrogens plus medroxyprogesterone acetate, 17beta-estradiol plus norethisterone and estradiol valerate plus norgestrel are included in the present study. All patients, without a medical history of bowel problems, reported an acute crisis of colitis a few months after the beginning of the treatment. RESULTS Fasting, parenteral nutrition, intravenous antibiotic treatment with metronidazole and discontinuation of HRT proved successful. Antibiotics were continued after the patients' discharge from the hospital. A second-look colonoscopy, 3 to 4 months after the initial episode, was normal in all cases. CONCLUSION Ischemic colitis is a rare complication of HRT that should not be ignored when HRT is prescribed.
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Affiliation(s)
- S Zervoudis
- Department of Gynaecology, Lito Hospital and ATEI Technological University of Athens, Athens, Greece.
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Hwang SS, Chung WC, Lee KM, Kim HJ, Paik CN, Yang JM. Ischemic colitis due to obstruction of mesenteric and splenic veins: A case report. World J Gastroenterol 2008; 14:2272-6. [PMID: 18407609 PMCID: PMC2703860 DOI: 10.3748/wjg.14.2272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.
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Naidoo TD, Paruk N, Moodley J. Shock associated ischaemic colitis following massive obstetric haemorrhage. J OBSTET GYNAECOL 2007; 27:320-1. [PMID: 17464827 DOI: 10.1080/01443610701241308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- T D Naidoo
- Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
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Schneider CG, Zehler O, Kastl S, Izbicki JR. Chirurgisches Konzept bei akuter mesenterialer Ischämie. Visc Med 2006. [DOI: 10.1159/000091944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Günal O, Oktar BK, Ozçinar E, Sungur M, Arbak S, Yeğen B. Estradiol treatment ameliorates acetic acid-induced gastric and colonic injuries in rats. Inflammation 2004; 27:351-9. [PMID: 14760943 DOI: 10.1023/b:ifla.0000006703.53427.da] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To evaluate the role of estrogen treatment on the healing of acetic acid-induced gastric or colonic injury, rats were given 17beta estradiol benzoate (0.001, 0.1, and 10 mg/kg) or vehicle for 7 days (following the induction of ulcer) or 4 days (following the induction of colitis) until they were decapitated. Food intake and fecal output were decreased by estradiol treatment but gastric emptying rate was not changed. Estradiol (10 mg/kg) reduced gastric ulcer index and colonic damage score compared to vehicle-treated groups. SEM and light microscopy demonstrated a significant reduction in the severity of ulcers and colitis by estradiol treatment. Gastric microscopic score was not changed by estradiol treatment, whereas in the colonic tissue score was significantly reduced. Elevated gastric MPO levels were reduced in gastric but not in colonic tissues as compared with corresponding vehicle groups. In conclusion, exogenous estradiol treatment at pharmacological doses improves the healing of both gastric and colonic injury induced by acetic acid in rats.
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Affiliation(s)
- Omer Günal
- Department of General Surgery, Düzce School of Medicine, Abant Izzet Baysal University, Düzce, Istanbul, Turkey
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