ABSTRACT
BACKGROUND: Abdominal actinomycosis is a rare infection with a difficult diagnosis that can simulate multiple surgical scenarios such as neoplasms or complications of inflammatory bowel disease. CLINICAL CASE: We present the case of a 69-year-old female who underwent emergency surgery due to a difficult and painful tumor, suggesting an incarcerated umbilical hernia. Whitish lesions were discovered in the abdominal wall and a stenotic colonic mass was managed similar to a neoplasm. Anatomopathological study showed abdominal actinomycosis, requiring a lengthy course with penicillin. CONCLUSION: Actinomycosis infection is a chronic disease with granulomatous lesions and areas of fibrosis. Its incidence is increasing and the location usually is cervicofacial. The great challenge of this pathology lies in the diagnosis because it simulates different diseases of diverse natures. This type of infection can be treated successfully with drugs if the etiology is identified in a timely manner. However, in the case of our patient, the manner of presentation made diagnosis more difficult prior to surgical trauma.
Subject(s)
Actinomycosis/complications , Colonic Diseases/complications , Hernia, Umbilical/complications , Actinomycosis/diagnosis , Actinomycosis/drug therapy , Actinomycosis/surgery , Aged , Amoxicillin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Colectomy , Colonic Diseases/diagnosis , Colonic Diseases/drug therapy , Colonic Diseases/surgery , Colonic Neoplasms/diagnosis , Combined Modality Therapy , Diabetes Mellitus, Type 2/complications , Diagnosis, Differential , Emergencies , Female , Hernia, Umbilical/surgery , Humans , Omentum/pathologyABSTRACT
We report the case of 48 year old female patient without a history of significance importance.(refuses blood transfusion). She complaint of diarrhea of four months of duration and weight loss of 8 kg. she added episodes of hematochezia and severe anemia requiring transfusion. An intrahemorrhagic colonoscopy was performed detecting three ulcerated lesions. First at 10 cm from the anus, one in transverse colon distal, another similar ulcer in the proximal transverse The biopsies showed ulcer granulation tissue, abundant macrophages with intracytoplasmic structures consistent with histoplasmosis. Tests showed no tuberculosis or intestinal parasitosis. HIV testing (ELISA and Western Blot) were positive. The CD4 (78 cells) and extrapulmonary histoplasmosis were the criteria defined stage AIDS. The extrapulmonary histoplasmosis defines stage IV in immunosuppressed patients with HIV. Lower gastrointestinal bleeding colonic ulcer secondary to Histoplasma is a rare form presentation as a diagnostic manifestation of AIDS.
Subject(s)
AIDS-Related Opportunistic Infections/microbiology , Colonic Diseases/etiology , HIV Seropositivity/diagnosis , Histoplasmosis/etiology , AIDS-Related Opportunistic Infections/drug therapy , Amphotericin B/administration & dosage , Amphotericin B/therapeutic use , Antifungal Agents/administration & dosage , Antifungal Agents/therapeutic use , CD4 Lymphocyte Count , Colonic Diseases/drug therapy , Colonoscopy , Drug Therapy, Combination , Female , Gastrointestinal Hemorrhage/etiology , Histoplasmosis/drug therapy , Humans , Macrophages/microbiology , Middle Aged , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosage , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Ulcer/etiology , Ulcer/microbiologyABSTRACT
Oligosaccharides such as inulin (In) and polysaccharides such as galactomannans, combined with polymethacrylates on isolated films for film coatings, were obtained from aqueous-based solvents and investigated as potential vehicles for colonic drug delivery. These compositions, which are susceptible to fermentation by colonic microflora, constitute promising excipients for the development of new colon-specific therapeutic systems. The characteristics of several compositions have been demonstrated in permeability and swelling studies on isolated films composed of a polymethacrylate associated with In or galactomannans of mesquite seed gum (MSG). Results reported prove a dependency of the properties of mixed films on the polymethacrylate-polysaccharide concentration ratio and on the composition of the dissolution media. An increase in permeability through the mixed films was observed in a simulated colonic environment for the following compositions: Eudragit RS30D-MSG 70:30 w/w; Eudragit RS30D-In 90:10 w/w; Eudragit RS30D-In 76:24 w/w.
Subject(s)
Colonic Diseases/drug therapy , Excipients/chemistry , Polysaccharides/chemistry , Chemistry, Pharmaceutical , Colon/drug effects , Fermentation , Humans , Permeability , Polymethacrylic Acids/chemistryABSTRACT
A case of a 42 years-old woman suffering from lower abdominal pain, constipation and rectal bleeding during menses is reported. A barium enema showed an extrinsic filling defect on the rectosigmoid junction. Laparoscopy confirmed the clinical suspicion of endometrosis. She received danazol for a 6-month period during which she developed adverse effects that disappeared when the drug was discontinued. The patient remained asymptomatic after two years of follow up. Data from literature concerning diagnostic and treatment techniques are discussed.
Subject(s)
Colonic Diseases/drug therapy , Danazol/therapeutic use , Endometriosis/drug therapy , Estrogen Antagonists/therapeutic use , Adult , Colonic Diseases/diagnosis , Endometriosis/diagnosis , Female , Follow-Up Studies , Humans , Remission InductionABSTRACT
Se presenta una paciente de 42 años que consultó por dolor en hemiabdomen inferior, constipación y proctorragia durante los períodos menstruales. En el estudio baritado del colon se observó un defecto de relleno que ocupaba parcialmente la luz a la altura de la unión rectosigmoidea la alparoscospía confirmó la presunción clínica de endometriosis. Recibió tratamiento por 6 meses con danazol durante ese lapso presentó efectos adversos que remitieron con la suspensión de la droga. La paciente permaneció asintom tica tras dos años de seguimiento. Se discuten datos bibliogr ficos cocernientes al diagnóstico y a la terapéutica de esta entidad.
Subject(s)
Adult , Female , Humans , Colonic Diseases/drug therapy , Danazol/therapeutic use , Endometriosis/drug therapy , Estrogen Antagonists/therapeutic use , Colonic Diseases/diagnosis , Danazol/adverse effects , Endometriosis/diagnosis , Follow-Up StudiesABSTRACT
Se presenta una paciente de 42 años que consultó por dolor en hemiabdomen inferior, constipación y proctorragia durante los períodos menstruales. En el estudio baritado del colon se observó un defecto de relleno que ocupaba parcialmente la luz a la altura de la unión rectosigmoidea la alparoscospía confirmó la presunción clínica de endometriosis. Recibió tratamiento por 6 meses con danazol durante ese lapso presentó efectos adversos que remitieron con la suspensión de la droga. La paciente permaneció asintom tica tras dos años de seguimiento. Se discuten datos bibliogr ficos cocernientes al diagnóstico y a la terapéutica de esta entidad. (AU)
Subject(s)
Adult , Female , Humans , Endometriosis/drug therapy , Colonic Diseases/drug therapy , Danazol/therapeutic use , Estrogen Antagonists/therapeutic use , Endometriosis/diagnosis , Colonic Diseases/diagnosis , Danazol/adverse effects , Follow-Up StudiesABSTRACT
Cincuenta y nueve pacientes sometidos a cirugía colorrectal electiva recibieron preparación de colon por vía anterógrada y profilaxis antibiótica en dosis única con ceftriaxona y ornidazol. La preparación utilizada fue bien tolerada, obteniendo una adecuada limpieza del lumen intestinal y minimizando las alteraciones hidroelectrolíticas y del equilibrio ácido-base. No hubo sepsis ni complicaciones sépticas graves intraabdominales.
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Ceftriaxone/therapeutic use , Colonic Diseases/drug therapy , Ornidazole/therapeutic use , Rectal Diseases/drug therapy , Colonic Diseases/surgery , Rectal Diseases/surgeryABSTRACT
Pirenzepine has been widely used for the treatment of gastric and duodenal ulcer. In this work we have proved that this drug could prevent the inflammatory reaction induced in the colon with an intraluminal stimuli as the acetic acid. These data suggest the cholinergic participation in the inflammatory colonic response.
Subject(s)
Colitis/drug therapy , Colon/metabolism , Mucus/metabolism , Pirenzepine/therapeutic use , Acetates , Acetic Acid , Animals , Colonic Diseases/drug therapy , Edema/drug therapy , Male , Pirenzepine/pharmacology , Rats , Rats, Inbred StrainsABSTRACT
La pirenzepina se ha utilizado ampliamente en el tratamiento de la úlcera gástrica y duodenal. En este trabajo hemos probado que esta droga puede prevenir la acción inflamatoria inducida en el colon con un estímulo intraluminal como el ácido acético. Estos datos sugieren una participación colinérgica en la respuesta inflamatoria del colon (AU)
Subject(s)
Rats , Animals , Male , Colitis/drug therapy , Colon/metabolism , Colonic Diseases/drug therapy , Pirenzepine/therapeutic use , Mucus/metabolism , Pirenzepine/pharmacology , Edema/drug therapy , Acetates , Rats, Inbred StrainsABSTRACT
La pirenzepina se ha utilizado ampliamente en el tratamiento de la úlcera gástrica y duodenal. En este trabajo hemos probado que esta droga puede prevenir la acción inflamatoria inducida en el colon con un estímulo intraluminal como el ácido acético. Estos datos sugieren una participación colinérgica en la respuesta inflamatoria del colon