We describe a 36-year-old white man with an aggressive, midline intranasal and naso and oropharyngeal destructive process temporally associated with heavy (3 g/week) abuse of nasal cocaine. Necrosis and atrophy of the inferior and middle nasal turbinates bilaterally, prominent naso and oropharyngeal ulcers, and nasal septal perforation were observed clinically. ...

Spontaneous perforation of the bile duct in infancy is rare, with less than 55 cases described in the literature to date. The authors report the case of a 30-day-old neonate who presented with a 2-week history of progressive abdominal distension and intermittent jaundice. Disofenin technicium 99m sequential scintiscanning provided a ...

Variceal bleeding from ileostomy, colostomy, or ileal conduit stomas is unusual. There is no consensus on which of the various treatment options is best. A case of bleeding ileostomy varices is presented. The English-language medical literature since 1962 is reviewed and an additional 71 cases of stomal variceal bleeding are ...

To clarify the inflow and outflow vessels of esophagogastric varices, we investigated the collateral circulation using endoscopic ultrasonography (EUS; Olympus GF-UM2, 7.5 MHz, radial type) during non-shunting operations in 16 cases of portal hypertension. The main inflow vessels were the left gastric veins and the short gastric veins. The paraesophageal ...

Cases of gastrointestinal bleeding associated with non-steroidal anti-inflammatory drugs (NSAIDs) were analysed. Forty per cent of the 92 cases admitted with gastrointestinal bleeding were found to be on NSAIDs. Sixty per cent of the cases on NSAIDs had a preceding history of dyspepsia or ulcer disease and its complications. Forty ...

Campylobacter pylori specifically attaches to gastric epithelial cells and is the etiologic agent for type B gastritis. The authors report the case of a woman with the rare finding of heterotopic gastric mucosa in the rectum that was colonized with C. pylori. Histologic findings of the heterotopic mucosa revealed active ...

A 14-year-old case was reported with a primary postbulbar duodenal ulcer, which was confirmed by barium meal study and duodenoscopy. In the preoperative study, the patient showed marked gastric hyperacidity: maximal and peak acid output were 0.980 and 1.434 mEq/kg/hr, respectively. As previously described, hyperacidity appears to be a main ...

Performated carcinoma of the colon in pregnant women is a rare event. Only six cases have been reported in the literature, all except one in the recto-sigmoid. We present a case of perforated adenocarcinoma of the colon located above the peritoneal reflection and discuss the problem of diagnosis and management.

Retention of barium in the caecum (Dixon et al., 1967; Gupta and Fraser, 1985), appendix (Maglinte et al, 1981) and colonic diverticula (Burrows, 1962) has been reported after barium meal as has colonic perforation during barium enema examination (Ott and Gelfand, 1983). One case of colonic perforation after a barium ...

Aphthous ulcers are notoriously difficult to treat. We report repeated remission of recurrent aphthous ulceration in a female while taking etretinate for plantar pustular psoriasis. Although systemic retinoids are potent teratogens and are generally inappropriate for women of childbearing potential, this case report suggests further assessment of retinoids in severe ...

Panperitonitis developed in a 57-yr-old Japanese man during the course of Weber-Christian disease (WCD). Emergent operation disclosed three perforations of the ascending colon and two of the distal ileum. Histological study of the surgical specimen showed that all perforations were located at the centers of acute subserosal panniculitic foci. No ...

A retrospective analysis of 18 cases of duodenal trauma is presented. Perforations (in 10 cases) were sutured in two layers, using absorbable material, and intramural hematomas (8 cases) were left to resolve spontaneously. Nasogastric intubation was the only method of intestinal decompression, and was used in both patient groups. There ...

Endodontic perforation, a serious complication in dental practice, is among the most common problems associated with endodontic procedures. Recommended methods of treatment are surgical or conservative using calcium hydroxide paste. A method in which perforations can be obturated immediately after their detection is described. The method utilizes an apex locator ...

The English language literature on IUDs was reviewed to evaluate the uterine perforation rate associated with use of the Multiload. No reports of cervical perforation were found, and the uterine perforation rate was 0.12/1000 insertions compared to a rate of 0.68/1000 insertions for other copper-bearing IUDs. This lower rate may ...

We report a case where a chronic non-healing esophageal ulcer which developed following a course of endoscopic sclerotherapy proved to be an esophageal carcinoma. In view of 2 similar previous reports we discuss the possibility that sclerotherapy may act as a carcinogen, and suggest that all such non-healing esophageal ulcers ...

Wegener's granulomatosis is a disease characterized by necrotizing vasculitis and granulomatous inflammation. Gastrointestinal (GI) involvement is uncommon in this disorder. Only a few cases of perforation of GI tract have been reported, but vasculitis has not been demonstrated to be a cause of perforation in these cases. We report a ...

The case of a 60-year-old man with massive lower intestinal bleeding, secondary to erosion of an abnormally large submucosal muscular artery in the ascending colon, is reported. The bleeding site was localized by angiography. The clinicopathologic presentation of this case is identical to Dieulafoy's disease, which occurs almost exclusively in ...

In a consecutive prospective series of 208 Swedish primary peptic ulcer patients, 146 gastric, 55 duodenal and 7 in both sites, gastroduodenitis was found in 97.6% of the cases. The mucosal inflammation was associated with CP in 87% and 91% of the gastric and duodenal ulcer cases respectively. No significant ...

Diverticulum of the female urethra has an incidence of 1.4% to 4.7%. It is generally agreed that the majority of these are acquired lesions. There is, however, evidence that some are of congenital origin. Documented cases of diverticula with colon-type tissue are rare. A case of urethral diverticulum with colonic ...

The EEA stapler offers a relative easy technique for the control of severe bleeding from esophageal varices. Two cases are reported in which this technique in combination with proximal gastric devascularization and splenectomy was found to be superior to the performance of portosystemic shunt in emergency cases. The results of ...

A 38-yr-old woman presented with abdominal pain, hematochezia, and fever of 7 days' duration. Computerized tomographic scanning revealed a mass 6 cm in diameter adherent to the sigmoid colon. At surgery, the mass was determined to be an endometrioma with an associated tubo-ovarian abscess eroding the sigmoid colonic wall. This ...

The mucin profile of 24 endoscopic biopsies of heterotopic gastric mucosa (HGM) of the upper esophagus in adults and a control group of ten cases of Meckel's diverticula containing heterotopic gastric mucosa were studied with two combined histochemical methods: alcian blue pH 2.5/PAS and high iron diamine/alcian blue pH 2.5. ...

Saliva serves many functions in the upper digestive tract, with its roles in esophageal physiology, digestion, and gastric cytoprotection having been documented by many studies in the recent literature. Understanding the multiple functions of saliva and the consequences of its absence is of paramount importance to gastroenterologists. We present a ...

Analysis of the 27 cases of heterotopic gastric mucosa reported in the literature and a new case described here elucidates the main features of this disease: 1) all but one asymptomatic case were diagnosed in infants or in adults under 26 years old; 2) although rectal bleeding occurred in 24 ...

A total of 50 consecutive patients who were treated in JIPMER Hospital between 1970 and 1981 for corrosive injuries of the oesophagus and stomach were analysed. There were 23 males and 27 females. All but seven presented with dysphagia due to an established stricture. In addition seven of them had ...

Solitary colonic diverticula are rare. Most have been described in the cecum or ascending colon. Solitary diverticula of the transverse colon are extremely rare, and there are only a few reports in the English medical literature, all occurring in adulthood. This paper reports the case of a 13-year-old girl with ...

Acute abdominal and shoulder pain in association with a pneumoperitoneum are common signs and symptoms of perforation of a hollow viscus. We report a case that describes the development of a postcoital pneumoperitoneum in an otherwise healthy postpartum patient. The literature is discussed, and supports this case as pneumoperitoneum in ...

Appendicitis is the first 3 years of life is uncommon and most cases are perforated at laparotomy. Case records at the Adelaide Children's Hospital were reviewed over a 12-year period. The findings were that acute appendicitis in this age group is commonly associated with respiratory symptoms and diarrhoea, the appendix ...

Two cases of atheromatous embolism of the small arteries of the stomach are reported. Insofar as has been ascertained, they are the first reported cases in the literature which presented symptoms of severe gastric bleeding and were found to have bleeding gastric ulcers on endoscopy. Both patients were successfully treated ...

The efficacy and complications of esophageal tamponade as the first procedure in the routine management of acute variceal hemorrhage were evaluated in 151 consecutive bleeding episodes treated at a specialized unit. The Sengstaken-Blakemore tube was employed in the 118 cases in which emergency endoscopy demonstrated bleeding esophageal varices, and the ...

We encountered four cases of toothbrush swallowing and reviewed the literature on this subject. A total of 31 toothbrushes within the gastrointestinal tract have been reported. None have passed spontaneously. Several have caused significant complications related to pressure necrosis, including gastritis, mucosal tears, and perforation. The recommended treatment is endoscopic ...

In this review of 925 cases of total and anterior perforations of the tympanic membrane reconstructed through the use of formaldehyde-formed-fascia (3-F) grafts, the postoperative nonperforation rate is 97.6%; blunting and/or lateralization of the graft was avoided in 93.5% of cases. Closure of the postoperative air-bone gap within 20 dB ...

Colorectal perforation during barium enema examination is rare. The authors report the case of an 84-year-old woman in whom retroperitoneal perforation of the rectum occurred during barium enema examination. Potential mechanisms of injury include trauma, overinflation of the balloon, recent instrumentation and associated disease of the rectal mucosa. When the ...

A case of asymptomatic pneumomediastinum in a 14-year-old girl with anorexia nervosa and self-induced emesis is reported to emphasize the atypical aspects of this case and the importance of differentiating benign from potentially life-threatening sources of mediastinal air. Individuals who engage in purging behavior are not only at increased risk ...

Twenty-six cases are reported of ileo-cecal volvulus admitted to three community hospitals over a period of six years. The operative management of ileo-cecal volvulus is discussed. Based on the results and review of the literature the authors recommend a right hemicolectomy in the presence of gangrene or perforation, in other ...

A retrospective analysis was made of 372 consecutive patients who underwent colonoscopy because of rectal bleeding. The three distinct patterns of bleeding studied were chronic (224 cases), recent major (93 cases), and acute bleeders (55 cases). In 50% of the cases, colonoscopy detected a lesion other than diverticula. These lesions ...

Surgical emergencies caused by bowel metastases from carcinoma of the lung are very rare. A search of the English literature revealed less than 10 cases of bowel perforation and no case of haemorrhage. In this report, we describe three patients with both bowel perforation due to metastases from primary lung ...

The natural histories of stercoraceous and spontaneous perforations of the colon have many similarities which justify their being considered in the same treatise. Both entities are infrequently diagnosed preoperatively, and both entities are associated with a high mortality. Although the incidence of stercoraceous and spontaneous perforations of the colon is ...

Gastric pseudolymphoma (GPL) is a rare entity which closely mimicks malignant lymphoma. Controversy still exists concerning the risk of malignant transformation. In this report a case of GPL occurring 8 years after a gastric resection due to duodenal ulcer is described. The patient has been followed for more than 10 ...

Colonic varices is a rare condition, generally associated with portal hypertension, which normally presents as acute, severe, gastrointestinal blood loss. A case is presented in which the varicosities were observed serendipitously in a patient with a pancreatic tumor, in whom the bleeding was not variceal but due to two small ...

A rare case of uterine perforation leading to ureter obstruction and ultimately to nephrectomy is presented to emphasize the importance of a careful IUD insertion technique and follow-up of IUD patients. Complications of this kind can be avoided by prompt localization of 'missing' IUDs by ultrasonography of X-ray.

A radiological diagnosis of gastric volvulus (GV) was made in 11 of 576 consecutive upper gastrointestinal series at the University of Benin Teaching Hospital, Nigeria, over a two-year period. The clinical symptoms were thoracico-abdominal in three and abdominal in eight; these cases were evaluated as acute in three, acute upon ...

Ectopic gastric mucosa is a known entity of the mid and lower esophagus which was initially described by Schmidt in 1805. The presence of ectopic gastric mucosa in the cervical esophagus, however, was not described. A review of the literature reveals that ectopic gastric mucosa of the cervical esophagus is ...

A unique case of hematemesis is presented. The cause of upper gastrointestinal bleeding was a pyloroduodenal ulcer caused by erosion of a 5-cm gallstone impacted in the duodenal bulb. On review of the world literature of Bouveret's syndrome, this is the first case in which a preoperative diagnosis was well ...

We report a patient who developed recurrent massive lower gastrointestinal bleeding after successful obliteration of esophageal varices by sclerotherapy. A radionuclide study was very helpful in establishing diagnosis of the lesion responsible, a varix in the cecal area. Bleeding subsided after creation of a portacaval anastomosis. The literature pertaining to ...

A case of high jejunal atresia with midgut deletion in the newborn is reported. The remnant of proximal jejunum near the ligament of Treitz shared a common supporting mesentery/mesocolon with the remaining midtransverse colon. The patient was managed by side-to-side anastomosis of the jejunal and transverse colonic remnants.

Balloon tamponade of esophageal variceal hemorrhage is palliative therapy which is associated with a certain incidence of morbidity, perhaps mortality. Three cases of intrathoracic inflation of the gastric balloon of such tubes are described. The precise mechanism of thoracic placement remains uncertain. Fluoroscopy or chest x-ray should be used to ...

Varices of the colon are uncommon and when present they are usually segmental. The cause of these segmental varices is usually portal hypertension. Diffuse variceal involvement of the colon is even more uncommon and up until now the two cases described in the literature have had an idiopathic etiology. We ...

Perforation of the uterus by an intrauterine device (IUD) is not an uncommon complication of this means of birth control. Comparatively, however, perforation of the bladder is uncommon, having been reported only seven times previously in the literature. This additional case is presented with review of the current literature and ...

Distant nontraumatic clostridial myonecrosis in association with malignancy is an uncommon disorder, with only 14 well-documented cases previously reported in the English literature. Clostridium perfringens and C. septicum are the most common organisms, usually gaining access to the circulation through an ulcerated lesion of the small bowel or colon. A ...