Fibrosing Colonopathy Presenting in a Patient with Cystinosis.

Fibrosing colonopathy is a unique pathology characterized by long segment stricture, usually of the ileocecal region. Historically, it is most commonly described in patients with cystic fibrosis (CF). Fibrosing colonopathy is felt to be secondary to excessive doses of exogenous lipase medication. This condition is rarely seen in the last decade. In this case presentation, fibrosing colonopathy was identified in a patient with the lysosomal storage disorder of cystinosis. Fibrosing colonopathy has not previously been described in patients with cystinosis. The patient was found to have fibrosing colonopathy after perforation of the colon during a colonoscopy for bloody diarrhea. This case report aims to draw attention to a noteworthy case of fibrosing colonopathy in a patient who does not have cystic fibrosis, but rather cystinosis.

Border-fence falls versus domestic falls at a South Texas trauma center.

Objectives: Falling from height may lead to significant injuries and time hospitalized; however, there are few studies comparing the specific mechanism of fall. The purpose of this study was to compare injuries from falls after attempting to cross the USA-Mexico border fence (intentional) with injuries from domestic falls (unintentional) of comparable height. Methods: This retrospective cohort study included all patients admitted after a fall from a height of 15-30 ft to a level II trauma center between April 2014 and November 2019. Patient characteristics were compared by falls from the border fence with those who fell domestically. Fisher's exact test, χ2 test and Wilcoxon Mann-Whitney U test were used as appropriate. A significance level of α<0.05 was used. Results: Of the 124 patients included, 64 (52%) were falls from the border fence while 60 (48%) were domestic falls. Patients sustaining injuries from border falls were on average younger than patients who had domestic falls (32.6 (10) vs 40.0 (16), p=0.002), more likely males (58% vs 41%, p<0.001), fell from a significantly higher distance (20 (20-25) vs 16.5 (15-25), p<0.001), and had a significantly lower median injury severity score (ISS) (5 (4-10) vs 9 (5-16.5), p=0.001). Additionally, compared with domestic falls, border falls had fewer injuries to the head (3% vs 25%, p=0.004) and chest (5% vs 27%, p=0.007), yet more extremity injuries (73% vs 42%, p=0.003), and less had an intensive care unit (ICU) stay (30% vs 63%, p=0.002). No significant differences in mortality were found. Conclusion: Patients sustaining injuries from border crossing falls were slightly younger, and although fell from higher, had a lower ISS, more extremity injuries, and fewer were admitted to the ICU compared with patients sustaining falls domestically. There was no difference in mortality between groups. Level of evidence: Level III, retrospective study.