The American journal of gastroenterology
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Am. J. Gastroenterol. · Jul 1997
Review Case ReportsSplenic rupture: an unusual complication of colonoscopy.
Splenic rupture is an uncommon complication of colonoscopy. A high index of suspicion is a crucial factor in the prompt diagnosis of this rare but potentially fatal complication. We report a case of splenic rupture diagnosed 3 days after a colonoscopy and requiring splenectomy. ⋯ The factors mandating further evaluation of persistent abdominal pain after colonoscopy are hemodynamic instability, clinical features of acute abdomen, leukocytosis, and/or acute anemia. The onset of abdominal pain associated with one or more of these critical factors is usually within 24 h after colonoscopy. An emergent CT scan of the abdomen is the modality of choice to further evaluate these clinical features, but intestinal perforation and external bleeding must first be excluded.
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Am. J. Gastroenterol. · Jul 1997
Significance of interleukin-1beta and interleukin-1 receptor antagonist genetic polymorphism in inflammatory bowel diseases.
Genetic susceptibility to inflammatory bowel disease is well recognized. There is also increasing evidence for the activation of the mucosal immune system and the production of inflammatory cytokines, i.e., interleukin (IL)-1ra and IL-1beta in the inflammatory bowel disease. The aim of this study was to analyze the IL-1beta and IL-1ra gene polymorphism and linkage disequilibrium coefficient between the different alleles of these genes in patients with Crohn's disease (CD) or ulcerative colitis (UC), according to the severity of the disease. ⋯ IL-1ra and IL-1beta gene polymorphism analysis from a clinical standpoint might help in defining UC prognosis. However, functional studies at both the circulating and mucosal level with stratification on allele associations, especially IL-1ra allele 2-IL-1beta allele 2 subgroups must be realized before therapeutic implications.
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Am. J. Gastroenterol. · May 1997
Randomized Controlled Trial Clinical TrialCO2 provocation of panic: symptomatic and manometric evaluation in patients with noncardiac chest pain.
Occult panic disorder (PD) may underlie 10-43% of chest pain syndromes in patients with normal coronary arteries. A variety of agents, such as intravenous lactate, oral caffeine, and inhaled CO2, has been identified that may provoke panic attacks in susceptible patients. The aims of this study were (1) to better define the relationship between noncardiac chest pain syndromes and panic disorder; and (2) to assess the diagnostic utility of PD provocative testing with inhaled CO2 in eliciting chest pain and/or esophageal manometric disturbances. ⋯ CO2 inhalation is as effective as Tensilon in provoking chest pain in patients with noncardiac chest pain. The high prevalence of PD in such patients suggests that CO2 inhalation, a known panicogen, may be useful in evaluating such patients. The mechanism of CO2 induced chest pain remains unknown, but does not appear to be attributable to demonstrable esophageal motility abnormalities.
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Am. J. Gastroenterol. · May 1997
Correlation between patterns of antral contractility and gastric emptying of radiopaque markers.
Gastric clearance of radiopaque markers (ROMs) has been proposed as an easy and noninvasive technique for assessment of gastric emptying. This study was conducted to evaluate the role of antral obliterating contractions in gastric emptying of ROMs in healthy volunteers. ⋯ There was a considerable intersubject variation in the time of first antral obliterating contraction after the test meal. In the healthy volunteers, all ROMs were passed when there was a postprandial antral obliterating contraction. However, some of the ROMs still passed from the stomach in the absence of antral obliterating contractions.