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Keloth T, AbdullGaffar B, Ahmad M. Histopathologic Findings of Button Battery-Related Changes in a Perforated Meckel's Diverticulum: Report of Three Cases. Fetal Pediatr Pathol 2023; 42:253-258. [PMID: 35543308 DOI: 10.1080/15513815.2022.2074588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: A button battery can cause perforation of Meckel's diverticulum if sequestered in this blind ending bowel segment. Reported cases focused on clinical manifestations, management options, radiologic and intraoperative findings. We highlight the histopathologic features in perforated Meckel's diverticula due to ingested button batteries. Case report: Three toddlers presented with perforated Meckel's diverticula after button battery ingestion. Histologic examination of the diverticula showed multiple burn-like mucosal ulcerations and liquefactive wall perforations of the tips, associated with prominent siderotic pigment deposits and calcifications. There were various residual materials with variable staining patterns in the luminal debris, necrotic tissue and adjacent to submucosal blood vessels. Conclusion: There is accelerated deposition of iron and calcium associated with button batteries.
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Affiliation(s)
- Tasnim Keloth
- Pathology, Dubai Hospital, Dubai, United Arab Emirates
| | | | - Munir Ahmad
- Pediatric Surgery, Latifa Hospital, Dubai, United Arab Emirates
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Reinisch W, Colombel JF, D’Haens G, Sandborn WJ, Rutgeerts P, Geboes K, Petersson J, Eichner S, Zhou Q, Robinson AM, Read HA, Thakkar R. Characterisation of Mucosal Healing with Adalimumab Treatment in Patients with Moderately to Severely Active Crohn's Disease: Results from the EXTEND Trial. J Crohns Colitis 2017; 11:425-434. [PMID: 27815351 PMCID: PMC5881717 DOI: 10.1093/ecco-jcc/jjw178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/31/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Mucosal healing [MH] is an important goal for patients with Crohn's disease [CD], yet is incompletely characterised. We investigated whether MH differed by segments across the colon and ileum in patients who received adalimumab maintenance treatment in the EXTEND study. METHODS In this double-blind study in adults with moderate to severe ileocolonic CD and mucosal ulceration, all patients received adalimumab induction [Week 0, 160 mg; Week 2, 80 mg]. At Week 4, patients were randomised to 40 mg adalimumab or placebo every other week until Week 52. In this post-hoc analysis, MH was assessed by CD Endoscopic Index of Severity [CDEIS], Simple Endoscopic Score for CD [SES-CD], and Colonic and Ileal Global Histologic Disease Activity Scores [CGHAS/IGHAS]. RESULTS Baseline endoscopic severity was similar across segments. At Week 52, mean changes in CDEIS surface involved and ulcerated surface were -68.5% to -90.6% in the rectum, sigmoid/left colon, and transverse colon compared with -22.3% to -50.0% in the right colon and ileum. Favourable shifts by Week 52 in ulcer size and ulcerated surfaces per SES-CD were more pronounced in the rectum, sigmoid/left colon, and transverse colon vs the right colon and ileum. At Week 52, CGHAS and IGHAS healing was more common in the colon [28.3%] vs the ileum [21.2%]. CONCLUSIONS This analysis suggests differing propensities of the ileocolonic segments to heal endoscopically during adalimumab treatment. In the sigmoid/left and transverse colon, higher MH rates may be achieved, compared with the ileum, in patients with moderate to severe CD.
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Affiliation(s)
- Walter Reinisch
- Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada; and Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria
| | - Jean-Frédéric Colombel
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Geert D’Haens
- Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands; and Imelda GI Clinical Research Center, Bonheiden, Belgium
| | - William J. Sandborn
- Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA
| | - Paul Rutgeerts
- Division of Gastroenterology, Department of Internal Medicine, University of Leuven, Leuven, Belgium
| | - Karel Geboes
- Department of Pathology, University of Leuven, Leuven, Belgium
| | - Joel Petersson
- Global Medical Affairs Gastroenterology, AbbVie Inc., North Chicago, IL, USA
| | - Samantha Eichner
- Global Medical Affairs Gastroenterology, AbbVie Inc., North Chicago, IL, USA
| | - Qian Zhou
- Data and Statistical Sciences, AbbVie Inc., North Chicago, IL, USA
| | - Anne M. Robinson
- Global Medical Affairs Gastroenterology, AbbVie Inc., North Chicago, IL, USA
| | - Holly A. Read
- Global Medical Affairs Gastroenterology, AbbVie Inc., North Chicago, IL, USA
| | - Roopal Thakkar
- Global Medical Affairs Gastroenterology, AbbVie Inc., North Chicago, IL, USA
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