Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0162316 (iron deficiency anemia)
 3,806 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of tension pneumothorax, which occurred secondary to colonic perforation during a colonoscopy. The patient was a 77-year-old woman in whom acute respiratory decompensation developed suddenly during a diagnostic colonoscopy for iron deficiency anemia. We diagnosed bilateral pneumothoraces, tension pneumothorax, pneumomediastinum, pneumoperitoneum, and emphysema of the face, neck, and chest. At laparotomy, a posterior colonic perforation was identified at the site of an ileocolic anastomosis performed 3 years earlier. We performed a primary repair and the patient was discharged from hospital 12 days later. Although diagnostic colonoscopy-induced intestinal perforation is rare, it is the most common and serious complication associated with this procedure. Occasionally, air spreads from the retroperitoneum into continuous tissue planes and decompresses into the adjacent structures. To our knowledge, this is the first report of two unique manifestations of diagnostic colonoscopy-induced intestinal perforation: tension pneumothorax and perforation at the site of a previous anastomosis. Both of these conditions should be considered in the event of acute respiratory failure in the endoscopy suite.
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PMID:Tension pneumothorax secondary to colonic perforation during diagnostic colonoscopy: report of a case. 1663 57

Idiopathic pulmonary hemosiderosis (IPH) is an uncommon cause of diffuse alveolar hemorrhage (DAH). Patients with IPH usually present with hemoptysis, and the diagnosis is often delayed by years. Patients often present with intermittent episodes of hemoptysis interspersed between periods of relative normalcy. However, massive hemorrhage resulting in acute respiratory failure and non-remitting hemoptysis have also been described. The classic triad includes hemoptysis, radiologic lung infiltrate, and iron deficiency anemia. Several hypotheses regarding the pathogenesis of IPH have been proposed. These risk factors include an autoimmune, allergic or genetic predisposition, and possible environmental exposure. Since IPH appears to be responsive to corticosteroids, the autoimmune hypothesis is considered to play a crucial role. A diagnosis of IPH requires exclusion of other etiologies of DAH, including infection, medications, toxic inhalation, vasculitis, and anti-glomerular basement membrane disease, among others. Histologically, IPH is characterized by the presence of hemosiderin-laden macrophages in the alveolar space without any evidence of vasculitis or immunocomplex deposition. Corticosteroid therapy represents the primary modality of treatment. Other immunosuppressive medications have also been used with varying success, especially in the setting of steroid-refractory disease. The prognosis of IPH in adults is somewhat better compared to the pediatric population. The severity of the initial presentation does not predict future outcomes. Which risk factors and patient characteristics are associated with a poor outcome are also unknown. More research is necessary to elucidate the pathophysiology and appropriate treatment.
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PMID:Idiopathic pulmonary hemosiderosis: A state of the art review. 3324 95