Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009319 (colitis)
 19,384 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute colonic ischemia is the common cause of colitis in elderly population. However, isolated ischemic necrosis of cecum is rare entity, often associated with variety of conditions. Here we present a case of a 73-year old woman with a past history of hypertension presented with clinical symptoms of right lower quadrant abdominal pain and tenderness localized to the right lower quadrant, guarding and rebound tenderness. With diagnosis of acute appendicitis, the patient underwent laparoscopy where the cecal partial necrosis was discovered. Necrotic area of cecum was excised using two endoscopic cutters and laparoscopic appendectomy was performed. Pathologist report showed thrombosis of vessels and necrosis of entire cecal wall. The patient completely recovered without any surgical complications. This is the first case of partial cecum necrosis laparoscopicaly managed and with a partial cecal resection only.
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PMID:Partial cecal necrosis treated by laparoscopic partial cecal resection. 1724 75

The evaluation of patients with colitis of recent onset is a relatively common clinical challenge. The main considerations are infectious colitides, idiopathic IBD, ie, ulcerative and Crohn's colitis, and colonic ischemia. An initial risk assessment on the basis of such factors as concurrent symptoms in contacts, travel history, medications, and human immunodeficiency virus risk factors should be followed by a thorough clinical history, physical examination, stool studies, blood tests, and, in selected cases, endoscopic examination and serologic tests. Biopsies can be decisive in distinguishing among the different types of acute colitis and might help identify specific etiologies. The diagnostic yield of biopsies is maximized by appropriate sampling of the colonic mucosa and by sharing the clinical and endoscopic findings with the pathologist, eg, via a copy of the endoscopy report.
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PMID:Diagnosis of colitis: making the initial diagnosis. 1791 88

The intestinal wall can be visualized using high resolution transabdominal ultrasound. The normal intestinal wall thickness in the terminal ileum, cecum, and right and left colon is <2mm when examined with graded compression. It is important to appreciate that a contracted intestinal segment can be misinterpreted as a thickened wall. Vascularisation can be mainly displayed in the second hyperechoic layer (submucosal layer) as well as vessels penetrating the muscularis propria. Imaging of the gastrointestinal wall is dependent on the experience of the examiner as well dependent on the equipment used. Acute or chronic inflammation of the intestinal wall is accompanied by increased perfusion of the mesentery, which can be displayed non-quantitatively with colour duplex. In contrast, ischemia is characterised by hypoperfusion of the mesenteric arteries and the bowel wall. The most promising sonographic approach in assessing splanchnic arteries and the bowel wall is combining the analysis of superior and inferior mesenteric inflow by pulsed Doppler scanning (systolic and diastolic velocities, resistance index) with the end-organ vascularity by colour Doppler imaging diminishing the influence of examination technique only displaying bowel wall vascularity. Colour Doppler imaging has been described as helpful in a variety of gastrointestinal disorders, particularly in patients with Crohn's disease, celiac disease, mesenteric artery stenosis and other ischemic gastrointestinal diseases, graft versus host disease and hemorrhagic segmental colitis.
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PMID:Sonographic assessment of splanchnic arteries and the bowel wall. 1792 66

Geranylgeranylacetone (GGA), an anti-ulcer agent, has anti-inflammatory potential against experimental colitis and ischemia-induced renal inflammation. However, molecular mechanisms involved in its anti-inflammatory effects are largely unknown. We found that, in glomerular mesangial cells, GGA blocked activation of nuclear factor-kappaB and consequent induction of monocyte chemoattractant protein 1 (MCP-1) by inflammatory cytokines. It was inversely correlated with induction of unfolded protein response (UPR) evidenced by expression of 78kDa glucose-regulated protein (GRP78) and suppression of endoplasmic reticulum stress-responsive alkaline phosphatase. Various inducers of UPR including tunicamycin, thapsigargin, A23187, 2-deoxyglucose, dithiothreitol, and AB(5) subtilase cytotoxin reproduced the suppressive effects of GGA. Furthermore, attenuation of UPR by stable transfection with GRP78 diminished the anti-inflammatory effects of GGA. These results disclosed a novel, UPR-dependent mechanism underlying the anti-inflammatory potential of GGA.
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PMID:Blunted activation of NF-kappaB and NF-kappaB-dependent gene expression by geranylgeranylacetone: involvement of unfolded protein response. 1797 Dec 94

Isolated ulcers of the large intestine are not associated with an underlying colitis and may be an incidental finding on screening colonoscopy or present with abdominal pain, hematochezia, chronic gastrointestinal bleeding, and rarely, perforation. A common cause of isolated colonic ulcers is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), with ulcers in the cecum and right colon. Isolated rectal ulcers are caused by ischemia, solitary rectal ulcer syndrome (SRUS), radiation, or fecal impaction. Stercoral ulceration and nonspecific ulcers of the colon are rare but can cause colonic perforation. Infectious causes include tuberculosis and amebiasis. Histology is important to rule out malignancy but is not helpful for diagnosis except in SRUS and certain infections. The approach to isolated colonic ulceration includes biopsy of the ulcer and surrounding tissue, cessation of any NSAIDs, management of constipation, and recognition of the patient with SRUS. Inflammatory bowel disease should be ruled out in appropriate patients.
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PMID:Isolated colonic ulcers: diagnosis and management. 1799 45

Inguinal hernia is a common condition that usually presents with swelling and mild groin discomfort. Complications include bowel obstruction and strangulation. We report a case of a 50 year-old man who developed lower gastrointestinal bleeding secondary to an indirect inguinal hernia. Colonoscopy showed an ileocecal valve polyp, florid inflammation of cecum and ascending colon and ulcerations of the terminal ileum. Histology showed nonspecific colitis and angiodysplasia of the polyp. Surgical correction of the hernia led to the resolution of the endoscopic changes. The trauma associated with intermittent herniation of small bowel probably led to ischemia, resulting in the observed changes.
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PMID:Lower gastrointestinal bleeding: an unusual manifestation of inguinal hernia. 1821 35

Phlebosclerotic colitis (PC) is a rare form of ischemic colitis that usually affects the right hemicolon. It is due to ischemia induced by phlebosclerosis in the branches of the superior mesenteric vein that disturb venous return from the colon. The clinical course is different from that of the more common type of ischemic colitis caused by arterial disease. We encountered a 73-year-old woman with PC who had the characteristic computed tomographic finding of fine linear venous calcification that was mainly perpendicular to the long axis of the colon.
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PMID:Phlebosclerotic colitis. 1868 72

Radiation colitis refers to the characteristic changes in the mucosa of the colon and rectum secondary to pelvic radiation. Based on the interval from radiation to mucosal changes or symptoms, there are two well-defined forms of radiation colitis: acute, manifested by mucosal sloughing causing diarrhea, mucus discharge, and tenesmus; and chronic, characterized by obstructed defecation or ischemia of the mucosa due to obliterative endarteritis and resulting in mucosal telangiectasias, mucosal pallor, and friability causing rectal bleeding. Up to 25% of all patients receiving pelvic radiation develop mild symptoms, and 2% to 3% develop moderate to severe symptoms. Radiation colitis can be difficult to treat in some patients. There are several options for treating its symptoms. Argon plasma coagulation is the most common method of treating telangiectasias. Topical formaldehyde has also been used for distal telangiectasias. Obstructed defecation caused by radiation strictures (which are very fibrotic) usually can be treated successfully with stool softeners, colonic dilation, or steroid injection. Surgery should be avoided if possible because of its technical difficulty and the high incidence of postoperative complications such as anastomotic leak and fistula formation. New advances in radiation delivery techniques (eg, intensity-modulated radiation therapy) using specialized computer algorithms and medications such as amifostine may decrease the incidence of radiation colitis.
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PMID:Approaches to the prevention and management of radiation colitis. 1879 28

Recent studies have demonstrated that cytokine levels and inflammation can be regulated by specifically augmenting cholinergic signaling via the efferent vagus nerve and the alpha7 subunit-containing nicotinic acetylcholine receptor (alpha7nAChR). Cholinergic modalities, acting through vagus nerve- and/or alpha7nAChR-mediated mechanisms have been shown to suppress excessive inflammation in several experimental models of disease, including endotoxemic shock, sepsis, ischemia-reperfusion injury, hemorrhagic shock, colitis, postoperative ileus and pancreatitis. These studies have advanced the current understanding of the mechanisms regulating inflammation. They have also provided a rationale for exploring new possibilities to treat excessive, disease-underlying inflammation by applying selective cholinergic modalities in preclinical and clinical settings. An overview of this research is presented here.
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PMID:Cholinergic modulation of inflammation. 1907 59

Ischemic colitis is the most common type of intestinal ischemia and has a clinical spectrum of injury that ranges from mild and transient ischemia to acute fulminant colitis. The aim of this study was to explore endoscopic findings and clinicopathologic characteristics of ischemic colitis and be accurate enough to avoid missed diagnosis or misdiagnosis. A retrospective analysis was undertaken of endoscopy findings and clinicopathologic characteristics of 85 cases of ischemic colitis from March 2005 to April 2008 in the endoscopy center of our hospital. All cases underwent colonoscopy with biopsy within 2 weeks of the onset of symptoms, and all specimens with forceps were stained with hematoxylin-eosin and observed under light microscopy. Of the 85 cases of ischemic colitis (24 men and 61 women, average age 61.36 +/- 14.49 years old, range 29-84), 71 were over 50 years of age. These cases were associated with the basal diseases such as hypertension, cardiovascular disorders, diabetes, and hematological diseases as well as a history of abdominal operation. The clinical features usually presented with sudden onset of abdominal pain, diarrhea, and hematochezia. Ischemic lesions were located mainly in the left colon with segmental form (only descending colon affected 16%, only splenic flexure 14%, and only sigmoid colon 23%). The 85 patients consisted of the non-gangrenous type (82), which were composed of reversible IC (76) and chronic IC (6), and the gangrenous type (3). Endoscopic appearance of the transient ischemic colitis consisted of petechial hemorrhages, edematous and fragile mucosa, segmental erythema, scattered erosion, longitudinal ulcerations, and sharply defined segment of involvement. Ischemic colitis of stricture was characterized by full-thickness mucosa, lumens stricture, and diseased haustrations. The mucosa of gangrenous colitis with cyanotic and pseudopolyps was endoscopically observed as well. Clinicopathologic characteristics showed mucosal inflammation accompanied by erosion, granulation tissue hyperplasia and gland atrophy, lamina propria hemorrhage, and macrophages with hemosiderin pigmentation in submucosa in particular. Although endoscopy findings and clinicopathologic characteristics of ischemic colitis are nonspecific, colonoscopy with biopsy plays a vital role in the early diagnosis of ischemic colitis.
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PMID:Endoscopic findings and clinicopathologic characteristics of ischemic colitis: a report of 85 cases. 1908 15


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