Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent data have confirmed that non-steroidal anti-inflammatory drugs can cause serious damage to the gastrointestinal tract involving localizations other than the well-known gastroduodenal complications. Perforation and hemorrhage of the small bowel have been reported as well as ulcerations, stenoses and diaphragm disease. The same type of lesions can occur in the large bowel in addition to ischemia and collagen colitis. Diverticular diseases of the colon can be complicated by use of non-steroidal anti-inflammatory drugs which may also trigger flare-ups of inflammatory diseases. Use in suppository form can complicate rectitis and rectal stenosis. Non-steroidal anti-inflammatory drugs apparently increase intestinal permeability by inhibiting the cyto-protective effect of prostaglandins. The exact frequency of such complications remains to be determined, but prolonged treatment in elderly subjects appears to increase risk. Current data have not shown greater or lesser toxicity for any specific drug. Non-steroidal anti-inflammatory drugs should be entertained as the cause of intestinal disorders in patients under long-term treatment.
 ...
PMID:[Non-gastroduodenal digestive toxicity of non-steroidal anti-inflammatory agents]. 895 58

Glutaraldehyde disinfectant solution may be a cause of toxic chemical colitis. We report two cases. Ultrasonic features were studied in one case and mimic colonic ischemia, inflammatory and/or infectious colitis. These findings were colonic wall thickening especially mucosal (hypoechogenicity) and submucosal (hyperechogenicity) layers. This diagnosis should be discussed when one sees a patient with echographic findings of acute left-sided colitis just after uncomplicated colonic endoscopy.
 ...
PMID:[Chemical colitis caused by glutaraldehyde]. 911 48

Focal crypt injury by neutrophils (cryptitis/crypt abscesses), or focal active colitis (FAC), is a common isolated finding in endoscopic colorectal biopsies. Focal active colitis is often thought of as a feature of Crohn's disease, but may also be seen in ischemia, infections, partially treated ulcerative colitis, and as an isolated finding in patients undergoing endoscopy to exclude neoplasia. Clinical, endoscopic, and pathological data were retrospectively reviewed from 49 patients with focal active colitis, who had no other diagnostic findings on colorectal biopsy and no history of chronic inflammatory bowel disease. The histological findings were correlated with clinical diagnoses. Follow-up information was available for 42 of 49 focal active colitis patients. None developed inflammatory bowel disease; however, 19 patients had an acute self-limited colitis-like diarrheal illness, 11 had incidental focal active colitis (patients without diarrhea that were endoscoped to exclude colonic neoplasia and found to have asymptomatic FAC), 6 had irritable bowel syndrome, 4 had antibiotic-associated colitis, and 2 had ischemic colitis. Twenty patients were immunosuppressed, and 19 were taking nonsteroidal anti-inflammatory drugs. No histological features predicted final diagnoses. FAC did not predict the development of chronic colitis, even when mild crypt distortion or slight basal plasmacytosis was present. The preponderance of acute self-limited colitis and antibiotic-associated colitis among the FAC patients, along with the high number of immunosuppressed patients, support the conclusion that most FAC cases are infectious. The incidental detection of FAC in patients undergoing endoscopy to exclude colonic neoplasia was not clinically significant. The role of nonsteroidal anti-inflammatory drugs in FAC deserves further study.
 ...
PMID:The clinical significance of focal active colitis. 971 35

Pseudomembranous colitis is often caused by Clostridium difficile; however, it may also be due to ischemia. To determine if any histologic features could be used to differentiate C difficile from ischemia, 49 biopsies of pseudomembranous colitis (25 from patients with C difficile colitis and 24 from patients with ischemic colitis) were coded, randomized, and evaluated for the presence of numerous variables, including the amount and distribution of mucosal necrosis, lamina propria hyalinization, and atrophic "micro-crypts." Hyalinization of the lamina propria was seen in 19 cases of ischemia but not in C difficile colitis (p < 0.0001). Atrophic-appearing micro-crypts were seen in 18 ischemic cases and 6 C difficile cases (p < 0.0006). Lamina propria hemorrhage, full-thickness mucosal necrosis, and a diffuse microscopic distribution of pseudomembranes were significantly more common in ischemia than C difficile. Endoscopic examination identified pseudomembranes significantly more often with C difficile than ischemia, while the endoscopic appearance of masses or polyps was seen exclusively in cases of ischemia. The presence of a hyalinized lamina propria appeared to be a specific and sensitive marker for ischemia in colon biopsies with pseudomembranes. The presence of atrophic micro-crypts, lamina propria hemorrhage, full-thickness mucosal necrosis, diffuse involvement of all the surface of all biopsies by pseudomembranes, and the endoscopic impression of a localized process, polyp, or mass were also markers of ischemia, while the endoscopic identification of diffuse pseudomembranes favored the diagnosis of C difficile.
 ...
PMID:Can ischemic colitis be differentiated from C difficile colitis in biopsy specimens? 963 Jan 87

Ischemic colitis is caused by anoxia of the colonic and rectal wall due to defective regional blood supply. The pathology examination distinguishes acute obstructive and non-obstructive gangrenous ischemic colitis from chronic segmentary stenosing ischemia on the basis of the gross aspect and microscopic criteria and is necessary for differential diagnosis. Endoscopy, which is contraindicated in acute gangrenous ischemic colitis, provides a biopsy. Acute transitory ischemia can be distinguished from chronic stenosing colitis.
 ...
PMID:[Anatomic-pathologic diagnosis of ischemic colitis]. 937 1

Gangrene of the stomach is a rare and catastrophic event, usually attributed to local pathologic conditions. Although there are no cases documented in the literature, non-occlusive arterial ischemia is sometimes listed among the causes of necrotizing gastritis. We report a case of necrotizing gastroenteritis associated with a low flow state secondary to an episode of fulminant colitis, fecal peritonitis and septic shock. The patient recovered after staged resection of the involved segments of the gastrointestinal tract.
 ...
PMID:[Necrotizing gastroenteritis associated with inflammatory bowel disease]. 944 44

This review illustrates the changing paradigms in the understanding of the pathogenesis of pneumatosis intestinalis. Although many theories have been evoked, pragmatically there appear to be four major clinical and diagnostic imaging considerations. The most common and most emergent life-threatening cause of intramural bowel gas is the result of bowel necrosis due to bowel ischemia, infarction, necrotizing enterocolitis, neutropenic colitis, volvulus, and sepsis. In the stomach, intramural gas can be caused by emphysematous gastritis or ingestion of caustic agents. These situations represent surgical emergencies. Pneumatosis is found secondary to mucosal disruption presumably due to over-distention from peptic ulcer, pyloric stenosis, annular pancreas, and even to more distal obstruction. Disruption can also be caused by ulceration, erosions, or trauma, including the trauma of child abuse. Disruption can also be iatrogenic from intracatheter jejunal feeding tubes, stent perforation, sclerotherapy, or surgical or endoscopic trauma. In these cases, the gas may be focal or linear. Treatment depends on the extent of the disruption and the underlying cause. A more subtle form of mucosal disruption may occur due to mucosal erosions and also to defects in intestinal crypts secondary to acute and subclinical enteritides that allow intraluminal bacterial gas under pressure to percolate into the bowel wall layers, particularly the submucosa (29). Pneumatosis, often linear or cystic in appearance, is seen with increased frequency in patients who are immunocompromised because of steroids, chemotherapy, radiation therapy, or AIDS. In these cases, the pneumatosis may result from intraluminal bacterial gas entering the bowel wall due to increased mucosal permeability caused by defects in bowel wall lymphoid tissue. Clinical and imaging findings are important in the differentiation of this transient pneumatosis from fulminant life-threatening causes in this subset of patients. A pulmonary cause must still be considered in cases of chronic obstructive pulmonary disease, asthma, and cystic fibrosis. It can occur with barotrauma and after chest tube placement. It may relate to increased intrathoracic pressure associated with retching and vomiting. The possibility remains that occasionally the origin of pneumatosis intestinalis will remain cryptogenic--caused but unexplained.
 ...
PMID:Pneumatosis intestinalis: a review. 953 Feb 94

The term "obstructive colitis" is defined by the presence of ulcero-inflammatory lesions in a colonic area proximal to a potentially obstructive lesion. Seven cases retrospectively identified during a 5-year period are here reported. They illustrate the clinico-pathological spectrum of this entity. Most patients were women, with a mean age of 66 years and with history of chronic underlying disease (diabetes mellitus and arterial hypertension). Abdominal distension and pain, as well as acute constipation were the main clinical symptoms. An adenocarcinoma predominantly located at the rectosigmoidal region accounted for the obstructive nature in 100% of cases. Macroscopically the colitis area was moderately dilated and there were single or confluent ulcers in the luminal surface. Characteristically, there was always a transitional preserved area between the obstruction and the colitis area. Microscopically, the mucosa was totally replaced by a granulation tissue with a relevant inflammatory infiltrate involving up to the muscularis propria. The cytometric study revealed and increase in the cell cycle (S-phase) and proliferation index, at the level of the obstructive lesion, with marked aneuploidy in cases with advanced neoplastic invasion. The role of mural hypoperfusion with localized ischemia in the pathogenesis is discussed. The similarities with other colonic inflammatory diseases are emphasized.
 ...
PMID:[Obstructive colitis: analysis of 7 patients]. 958 36

Colitis following colonoscopy is an acute, self-limited condition characterized by tenesmus and bloody diarrhea appearing within 48 hours of colonoscopy or sigmoidoscopy. Glutaraldehyde used for disinfection of the endoscopes is considered to be the main etiological agent. Three cases of severe acute self-limited colitis are described in this report. All three were observed within one week, and showed the typical anamnestic, clinical, endoscopic, histological, and radiological features of glutaraldehyde-induced colitis. The main characteristics in these cases were the time relationship with colonoscopy and the severity of the clinical presentation, with symptoms of systemic reaction and intense and diffuse edema of the colonic mucosa. The clinical and morphological features may mimic those of colonic ischemia. All three patients recovered completely within a few days, one spontaneously and two after treatment with steroids, antibiotics, and mesalazine. Acute colitis following colonoscopy should be regarded as one of the complications related to colonoscopy, and it should be taken into account in the differential diagnosis of acute colitis.
 ...
PMID:Acute colitis following colonoscopy. 968 22

Ischemic colitis is the most common manifestation of gastrointestinal ischemia. The presumed etiologies are numerous; however, it typically develops spontaneously. It is classified into the transient type, stricture type, and gangrenous type. The majority of patients with ischemic colitis, excluding the gangrenous type, follow a benign clinical course in the absence of major vasculature occlusion. It usually presents as an acute abdominal illness with bloody diarrhea. Diagnosis is confirmed by colonoscopy and/or barium enema. Nongangrenous ischemic colitis usually requires only conservative therapy, including repeated careful assessment, pain control, and fluid replacement, and is associated with a good prognosis. It may lead to the sequela of persistent segmental colitis or colonic strictures, occasionally requiring surgery. Urgent surgery and high morbidity and mortality rates are hallmarks of the gangrenous type. Special consideration must be given to those patients in whom ischemic colitis develops in the context of colon cancer or obstructive colonic lesions. Successful management of a patient with ischemic colitis requires a high degree of clinical suspicion, early diagnosis, careful follow-up, and prompt recognition of persistent disease.
 ...
PMID:[Pathophysiology and diagnosis of ischemic colitis]. 1041 55


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>