Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Oct 2000
Review Case ReportsAngioedema of the small bowel due to an angiotensin-converting enzyme inhibitor.
We describe a case of a 72-year-old woman who presented with two episodes of abdominal pain, vomiting, and diarrhea. Abdominal computed tomographic scans done during each episode demonstrated edema of the small bowel. Review of the patient's history revealed that she had been started on a treatment of lisinopril for hypertension 1 month before the first episode and had her prescribed dose increased 24 hours before each presentation. ⋯ All cases, including ours, occurred in women. Angioedema of the small bowel associated with ACE inhibitors is rare and often is not recognized before surgical exploration. Angioedema of the gastrointestinal tract should be considered in symptomatic patients taking ACE inhibitors.
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Safety of endoscopic procedures has been a major issue over the last 10 years. Outbreak of new infectious diseases (type C) hepatitis, Creutzfeldt-Jakob disease) underlines the necessity for strengthening cleaning and disinfection guidelines. ⋯ Improvements from a hygienic point of view of both endoscopes and washer-disinfectors are important goals for manufacturers. Adequate training of endoscopic staff is one of the most crucial points to achieve the highest quality control standards in digestive endoscopy.
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Nine hundred seventy-nine cases of pill esophagitis due to nearly 100 different medications are reviewed. Pill-induced injuries occur when caustic medicinal pills dissolve in the esophagus rather than passing rapidly into the stomach as intended. Most patients suffer only self-limited pain, but esophageal hemorrhage, stricture, and perforation may occur, and fatal injuries have been reported. The incidence of this iatrogenic injury can be reduced but not eliminated by emphasizing the importance of taking pills while upright and with plenty of fluids.
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J. Clin. Gastroenterol. · Mar 1999
Review Case ReportsDuodenal ulceration into the cystic artery with massive hemorrhage.
This is a case presentation of a unique cause of intestinal bleeding. A duodenal ulcer eroded into the superficial branch of the cystic artery, causing massive intestinal hemorrhage. ⋯ We performed a transfixing ligation of the bleeding vessel, serosal suture of ulcer of the gallbladder, and simple closure of the duodenal ulcer with covering greater omentum. There were no serious complications after the operation, and the patient made an uneventful recovery.
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J. Clin. Gastroenterol. · Mar 1999
Review Case ReportsPrimary leiomyosarcoma of the greater omentum.
We report a case of primary greater omental leiomyosarcoma successfully resected by omentectomy. Palpation of a painless abdominal mass at physical examination motivated medical imaging examination. ⋯ Computed tomography and angiography determined the greater omental origin of the tumor before surgery. A review of the literature is also presented.