15 resultados para Pneumatosis Cystoides Intestinorum
Resumo:
Background and aims-The colons of patients with pneumatosis cystoides coli produce excessive H-2. Exposure to alkyl halides could explain this. Six consecutive patients who had pneumatosis cystoides coli while taking chloral hydrate (1-5+ g/day) are reported. Patients 2 and 3 were investigated after they had ceased chloral hydrate treatment. One produced methane, the other did not. (Pneumatosis cystoides coli patients are non-methanogenic according to the literature.) Both had overnight fasting breath H-2 of less than 10 ppm. A literature review disclosed just one patient who was using chloral at the time of diagnosed pneumatosis cystoides coli, but an epidemic of the disease in workers exposed to trichloroethylene. Methods-(i) In vitro experiments with human faeces: chloral or closely related alkyl halides were added to anaerobic faecal cultures derived from four methane-producing and three non-methanogenic human subjects. H-2 and CH4 gases were measured. (ii) In vivo animal experiment: chloral hydrate was added to drinking water of four Wistar rats, and faecal HI compared with control rats. Results-Alkyl halides increased H-2 up to 900 times in methanogenic and 10 times in non-methanogenic faecal cultures. The K-i of chloral was 0.2 mM. Methanogenesis was inhibited in concert with the increase in net H-2. In the rat experiment, chloral hydrate increased H-2 10 times, but did not cause pneumatosis. Conclusions-Chloral and trichloroethylene are alkyl halides chemically similar to chloroform, a potent inhibitor of H-2 consumption by methanogens and acetogens. These bacteria are the most important H-2-consuming species in the colon. It is postulated that exposure to these alkyl halides increases net H-2 production, which sets the scene for counterperfusion supersaturation and the formation of gas cysts. In recent times, very low prescribing rates for chloral have caused primary pneumatosis cystoides to become extremely rare. As with primary pneumatosis, secondary pneumatosis cystoides, which occurs if there is small bowel bacterial overgrowth distal to a proximally located gut obstruction, is predicted by counterperfusion supersaturation. Inherent unsaturation due to metabolism of O-2 is a safety factor, which could explain why gas bubbles do not form more often in tissue with high H-2 tension.
Resumo:
A "Pneumatosis Cystoides Intestinalis" é uma situação clínica rara que se caracteriza pela presença de múltiplos quistos de conteúdo gasoso ao nível da submucosa ou subserosa na parede do tracto gastrointestinal. A pneumatose intestinal classifica-se em idiopática e secundária. Na última forma admite-se uma relação causal com doença pulmonar obstrutiva crónica, conectivites, amiloidose, colites infecciosas, oclusão intestinal, isquémia, doença de Crohn, fármacos e iatrogenia cirúrgica e endoscópica. O espectro de manifestações clínicas compreende dor abdominal, oclusão intestinal, diarreia e hemorragia digestiva. Todavia, é frequentemente assintomática ou constitui um achado incidental no decurso de uma investigação não relacionada. Os autores apresentam o caso clínico de uma doente com pneumatose quística intestinal associada à utilização terapêutica de um antidiabético oral - acarbose (inibidor da alfa-glucosidase).
Resumo:
Pneumatosis cystoides intestinalis (PCI) is a rare illness in adults with gas filled blebs found in the submucosa or subserosa of the bowel wall. The main localization is the terminal ileum although all parts of the intestine can be affected. Clinical symptoms can vary from aqueous-slimy, bloody diarrhea to constipation and/or vague abdominal pain. Patients can also be completely asymptomatic. In symptomatic patients the therapy of PI is based on the assumed pathogenesis, so that a combined treatment of metronidazole 1500 mg daily during a period of 6-8 weeks additionally and oxygen application (PaO2 of 200-350 mmHg) for 7 days is suggested. In addition, elemental diets are recommended. Complications are indicated in the literature with 3%. In particular mechanical ileus, invagination and perforation as well as substantial intestinal bleeding up to the volvolus lead to further diagnostic and therapeutic steps. A surgical intervention is reserved for rare cases.
Resumo:
Pneumatosis Intestinalis (PI) is the presence of gas-filled cysts within the wall of the gastrointestinal tract (GIT). It is a clinical and/or radiological sign associated with a wide spectrum of diseases, so that it has a variable clinical significance. Probably, its prevalence is increasing. The nature of the diseases causing PI is been modifying in last decades. Peptic ulcers were its main cause in the past. Nowadays, probably, immunosuppressive conditions and states of increased permeability of the GIT mucosa (AIDS, transplanted patients or in chemotherapy, etc) are more common causes. PI can be shown on simple abdominal roentgenograms and computed tomographic scans obtained with lung windows. Its diagnosis include definition of the cause in addition to its presence. The treatment should be directed to the cause of the PI, fluctuating from expectant to emergency laparotomy. The present report is a contribution to the limited literature experience in this topic and calls attention to the importance of recognizing PI and its clinical significance in order to define the right conduct.
Resumo:
Diffuse intestinal pneumatosis appears as gaseous cysts in the intestinal wall in the submucosal layer or, more frequently, sub-serous layer. It affects more the jejunum than the ileum, can be diffuse and may extend into the colon. It's diagnosis is established during a small bowel transit examination, necropsy examination or during surgical exploration of the peritoneal cavity.
Resumo:
Mode of access: Internet.
Resumo:
Mode of access: Internet.
Resumo:
Acompaña nota del bibliotecario reseñando los libros solicitados para la redacción de esta memoria.
Resumo:
Mode of access: Internet.
Resumo:
Mode of access: Internet.
Resumo:
Mode of access: Internet.
Resumo:
A pneumatose intestinal, caracterizada pela presença de gás na parede do cólon, é uma condição incomum com um espectro de apresentação variável. Pode ser idiopática ou secundária a outras doenças. A tomografia computorizada é o método de diagnóstico com maior sensibilidade. Na ausência de sinais e sintomas sugestivos de complicações, como a perfuração e a peritonite, a pneumatose intestinal pode ser tratada de forma conservadora. Apresenta-se o caso de uma mulher de 59 anos com pneumatose cólica secundária a teratoma ovárico benigno. Após a cirurgia, manteve-se sintomática e foi tratada com sucesso com metronidazol e oxigenoterapia hiperbárica.
Resumo:
The clinical impact and outcome of a rare radiographic finding of hepatic portal venous gas (HPVG) as well as the effectiveness of computed tomography (CT), CT scanogram, and conventional radiography in the detection of HPVG were retrospectively analyzed. CT scans, CT scanogram, and plain film radiographs of 11 patients with HPVG were reviewed and compared with their medical records and surgical and pathology reports. Eight of the 11 patients underwent plain film radiographs 1 day before or after the CT scan. HPVG was detected at CT in all 11 patients, on CT scanogram in three (3 of 11, 27.3%), and on plain films in one (one of eight, 12.5%). In nine of 11 patients (81.8%), CT revealed an associated pneumatosis intestinalis. In six of the 11 patients (54.6%), acute mesenteric ischemia was the underlying disease for HPVG. Seven patients (63.6%) underwent emergency exploratory laparotomy. The mortality rate for HPVG alone was 27.3% (3 of 11) and for HPVG related to mesenteric bowel disease 50% (three of six). Acute mesenteric ischemia is the most common cause of HPVG, which continues to have a predictably higher mortality. CT is superior to CT scanograms and radiographs in the detection of HPVG and its underlying diseases and, therefore, should be used as the primary diagnostic tool.