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Query: UMLS:C0007570 (celiac disease)
 13,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Occlusion of the celiac, superior mesenteric, and inferior mesenteric artery has been studied in 46 patients treated by operation. The condition was acute and was caused by embolic obstruction of the superior mesenteric artery in four cardiac patients and detachment of the inferior mesenteric artery in two patients during removal of infrarenal abdominal aortic aneurysms. The condition was chronic and involved two or all three of the vessels in 40 patient. Embolic obstruction caused severe abdominal pain but few physical signs early in the process,, but the picture of an acute abdomen indicating bowel gangrene developed in a few hours. Ischemia from inferior mesenteric detachment was observed at operation. Patients with chronic obstruction had abdominal pain, weight loss, and diarrhea. Patients with embolic obstruction were treated successfully by embolectomy, and patients developing intraoperative sigmoid ischemia were treated by reattachment of inferior mesenteric arteries to aortic graft. Various procedures were employed in patients with chronic multiple obstruction. However, graft bypass using Dacron tubing was preferable because of its simplicity and because the frequently (48%) associated occlusive disease and aneurysm of the distal aorta were treated at the same time. Confining operation to the abdomen significantly reduced the magnitude of operation and eliminated risks in this age group. Of the 46 patients, 91% survived and were relieved of their symptoms despite associated disease. The 5-year survival rate in this group of patients was 62%.
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PMID:Celiac axis, superior mesenteric artery, and inferior mesenteric artery occlusion: surgical considerations. 14 29

A 39 year old man had been suffering from chronic bowel symptoms of changing intensity. At the age of 37 the diagnosis of nontropical sprue was made. After institution of a gluten free diet the patient improved, but soon diarrhea started again. In the examination of peripheral blood smear, bone marrow and small intestinal mucosal biopsies a dominant eosinophilia was found. Since several attacks of abdominal colics and finally an acute abdomen occurred, a laparotomy was indicated. This operative intervention showed a perforation of the intestine and tumors in the bowel wall as well as numerous lymphomas spread over the whole mesentery. The histological examination of both the small intestine resect and the lymphomas proved the diagnosis of a highly malignant Non Hodgkin lymphoma (middle and large cell pleomorphic T-cell lymphoma with transition into a large cell anaplastic lymphoma [ki-1 lymphoma]). The patient received a chemotherapy with COEP but died 4 weeks after the surgery.
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PMID:[Eosinophilia as the leading symptom of highly malignant enteropathy-associated T-cell lymphoma]. 829 Dec 79

A 64-year-old man with treated hypothyroidism had 10 months of diarrhea, abdominal pain, anorexia and recent involuntary 13.6 kg weight loss. He presented to hospital with an acute abdomen that had a radiological correlate of free air under the diaphragm. He was diagnosed with a perforated mid-jejunum due to an ulcerated enteropathy-type T cell lymphoma (ETL), complicating collagenous sprue and cryptic celiac disease. Polymerase chain reaction verified monoclonal gamma- and beta-T cell receptor gene rearrangements in the neoplasm. He had a complete resolution of symptoms when treated with a gluten-free diet in the postoperative period. This is apparently the first report describing collagenous sprue and ETL as synchronous lesions. Because atypical CD8+ lymphocytes are in both the collagenous sprue epithelium and ETL, the implication is that collagenous sprue is a noninvasive component of the ETL.
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PMID:Synchronous collagenous sprue and enteropathy-type T cell lymphoma: variants of the same disease. 1515 84

First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated.
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PMID:[Abdominal bruit associated with hypertension]. 1521 82

We present four patients with non-Hodgkin's lymphoma of the small bowel. Three of the patients were men. Two patients presented with acute abdomen due to tumoral perforation and the remaining 2 presented with abdominal pain and other effects of the mass. The tumors were located in the ileum (1 patient), jejunum (2 patients) and jejunoileum (1 patient). All patients underwent resection of the affected segment. Three patients had large B-cell lymphomas and the remaining patient had a T-cell lymphoma associated with celiac disease. Different combinations of chemotherapy were administered. Only the patient with T-cell lymphoma died due to disease progression. Clinical aspects and the therapeutic strategy used in these tumors are discussed.
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PMID:[Primary small bowel lymphoma]. 1726 59

We report a case of acute liver ischemia resulting in liver failure that occurred due to celiac trunk occlusion by an aortic dissection. A 53-year-old patient presented with clinical signs of acute abdomen. He underwent an urgent laparotomy, which revealed a splenic infarction and thrombosis of the celiac artery all the way to the porta hepatis. Imaging showed that an acute thoracoabdominal aortic dissection was present, resulting in compression of the celiac trunk. The aorta was repaired with an intervascular graft; however, an acute insufficiency of the liver ensued, and the patient was urgently transplanted. To the best of our knowledge, this is the first report of vascular compromise of the liver due to acute aortic dissection that would require liver transplantation.
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PMID:Orthotopic liver transplantation in a patient with acute liver failure resulting from aortic dissection. 1808 31

Celiac disease is an immune-mediated enteropathy characterized by mucosal inflammation and villous atrophy of the small bowel upon exposure to ingested gluten. Refractory celiac disease (RCD), defined as persisting villous atrophy with crypt hyperplasia despite strict gluten-free diet, is a rare form of celiac disease with poor prognosis due to a higher rate of severe complications such as life-threatening malnutrition or the development of intestinal T-cell lymphoma. The cavitating mesenteric lymph node syndrome (CMLNS) represents a rare complication of celiac disease with unknown pathogenesis which is associated with but not restricted to RCD and not necessarily associated with a malignant course. We here report a 64-year-old patient who was referred to us with a history of refractory celiac disease. During further diagnostic work-up multiple intraabdominal cystic structures were detected by a computed tomography scan and magnetic resonance imaging. A laparotomy was performed to exclude T-cell lymphoma. Histology of the intraabdominal cysts revealed the diagnosis of cavitating mesenteric lymph node syndrome as the underlying cause of the masses. Steroid therapy was initiated which led to complete regression of diarrhoea but did not induce a diminution of mesenteric lymph nodes. Three years after the diagnosis of CMLNS, the patient presented with an acute abdomen due to a small bowel perforation caused by an enteropathy associated T-cell lymphoma. We discuss the differential diagnoses of intraabdominal masses in celiac disease and review the current literature on CMLNS.
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PMID:Cavitating mesenteric lymph node syndrome: a rare complication of refractory celiac disease. 2083 63

Spontaneous free perforation of the small intestine is uncommon, especially if there is no prior history of visceral trauma. However, free, even recurrent, perforation may complicate a defined and established clinical disorder, such as Crohn's disease. In addition, free perforation may be the initial clinical presentation of an occult intestinal disorder, such as a lymphoma complicating celiac disease, causing diffuse peritonitis and an acute abdomen. Initial diagnosis of the precise cause may be difficult, but now has been aided by computerized tomographic imaging. The site of perforation may be helpful in defining a cause (e.g., ileal perforation in Crohn's disease, jejunal perforation in celiac disease, complicated by lymphoma or collagenous sprue). Urgent surgical intervention, however, is usually required for precise diagnosis and treatment. During evaluation, an expanding list of other possible causes should be considered, even after surgery, as subsequent management may be affected. Free perforation may not only complicate an established intestinal disorder, but also a new acute process (e.g., caused by different infectious agents) or a longstanding and unrecognized disorder (e.g., congenital, metabolic and vascular causes). Moreover, new endoscopic therapeutic and medical therapies, including use of emerging novel biological agents, have been complicated by intestinal perforation. Recent studies also support the hypothesis that perforation of the small intestine may be genetically-based with different mutations causing altered connective tissue structure, synthesis and repair.
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PMID:Spontaneous free perforation of the small intestine in adults. 2511 Apr 27

Mesenteric ischemia is one of the most mortal diseases of the gastrointestinal system causing acute abdomen. In most of the patients, the etiological factor is the obstructive embolism or thrombosis of superior mesenteric artery. In the literature, there have been reports regarding also celiac trunk occlusion in rare situations. The gold standard treatment relies on early diagnosis. The originality of our report relies on the concurrent obstruction of both vascular structures.
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PMID:Acute abdomen resulting from concurrent thrombosis of celiac trunk and superior mesenteric artery. 2532 24

Enteropathy-associated T-cell lymphoma (EATL) is a rare disease found in the small bowel and is seen most commonly in patients with refractory celiac disease (RCD). We present a case of an elderly male with celiac disease (CD) diagnosed in childhood with months of abdominal pain and diarrhea despite attempting to avoid gluten in his diet. After persistent symptoms for months, the patient was admitted for an acute abdomen and was found to have small bowel perforation due to a jejunal mass that was diagnosed as an EATL. In 2-5% of adult onset CD, serious complications such as RCD or malignancy develop. The clinical course for EATL is aggressive and generally has a poor prognosis. This case highlights the importance of early clinical suspicion for a small bowel malignancy in patients with a long-standing history of CD and acute worsening of symptoms. Early workup and diagnosis is vital in improving morbidity and mortality in patients with EATL.
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PMID:An unexpected deterrent in diagnosing refractory celiac disease and enteropathy-associated T-cell lymphoma: a gluten-free diet. 3018 34


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