Assuntos
Calcinose/etiologia , Leite/efeitos adversos , Injúria Renal Aguda/etiologia , Alcalose/complicações , Animais , Antiácidos/uso terapêutico , Dietoterapia/efeitos adversos , Úlcera Duodenal/terapia , Feminino , Humanos , Hipercalcemia/complicações , Hipercalcemia/etiologia , Masculino , Pessoa de Meia-IdadeRESUMO
We present a case of an atraumatic, occult rupture of the spleen. It is only in a distinct minority of cases, that the splenic capsule remains intact, thereby preventing intraperitoneal bleeding. Nevertheless, this condition can be accompanied by a severe loss of blood. A nonoperative management can be considered. Reviewing the literature on splenic rupture, the lack of uniformity in nomenclature is striking. The etiological and morphological classifications are reviewed.
Assuntos
Ruptura Esplênica/diagnóstico , Seguimentos , Hematoma/diagnóstico , Hemorragia/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Ruptura Espontânea , Ruptura Esplênica/classificaçãoRESUMO
A severe nutritional deficiency status is described in a 22-year-old patient with Crohn's disease. The clinical picture on admission was dominated by an episode of gastrointestinal bleeding secondary to clotting disturbances (vitamin K deficiency) and severe cachexia due to a protein energy malnutrition. The mechanisms of severe nutritional disturbances in Crohn's disease are multifactorial. In this patient, lymphatic leakage into the intestinal lumen was a major contributing factor in the pathogenesis of protein-losing enteropathy, fat malabsorption, and lymphocytopenia. The authors were able to demonstrate this intestinal lymph loss by nuclear imaging.
Assuntos
Doença de Crohn/complicações , Fígado Gorduroso/etiologia , Hipoproteinemia/etiologia , Mucosa Intestinal/metabolismo , Linfa/metabolismo , Distúrbios Nutricionais/etiologia , Adulto , Doença de Crohn/terapia , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/terapia , Seguimentos , Humanos , Hipoproteinemia/diagnóstico , Hipoproteinemia/terapia , Mucosa Intestinal/patologia , Masculino , Distúrbios Nutricionais/diagnóstico , Distúrbios Nutricionais/terapia , Prognóstico , Índice de Gravidade de DoençaRESUMO
Chronic watery diarrhoea is the main symptom of the microscopic colitis syndrome, including collagenous colitis (CC), lymphocytic colitis (LC), and not otherwise specified (NOS) colitis. The goal of this study was to evaluate the anti-diarrhoeal effect of cholestyramine in non collagenous microscopic colitis. The records of 13 patients with LC and 7 patients with NOS, who had received cholestyramine as first line therapy and who responded to a questionnaire, were reviewed. On an intention to treat basis, a good clinical effect of cholestyramine was achieved in 75 % of the patients in both LC and NOS colitis. There was no therapeutic effect in 15 % of the patients, who all had LC. In general, the anti-diarrhoeal effect appeared within one week of treatment. Cholestyramine provides a rapid and adequate symptomatic relief of the diarrhoea in non collagenous microscopic colitis.