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Revista Espanola de Enfermedades... Mar 2024A 69-year-old male, three years post-endovascular exclusion for an abdominal aortic aneurysm, presented with asthenia and fever. An abdominal CT scan showed no...
A 69-year-old male, three years post-endovascular exclusion for an abdominal aortic aneurysm, presented with asthenia and fever. An abdominal CT scan showed no gastrointestinal tract communications, abscess, or contrast extravasation. Tc-99m-HMPAO-labeled leukocytes scintigraphy with SPECT/CT revealed increased uptake on the posterior surface of the aortic graft, along with air bubbles in its right iliac limb. Upper gastrointestinal endoscopy was performed, revealing a duodenal ulcer in the transition between the second and third portions. The ulcer exhibited yellow graft tissue at its center. The patient underwent in situ reconstruction, involving the replacement of the infected prosthetic graft, and the duodenal defect was addressed through segmental resection and duodenojejunal anastomosis. Secondary aorto-duodenal fistula (SADF), a rare complication of vascular surgery, may arise from factors such as local infection or graft-bowel contact. SADF, often located in the duodenum, poses a high mortality risk, necessitating early diagnosis. Clinical presentation varies from significant upper gastrointestinal bleeding to obscured bleeding.
PubMed: 38469815
DOI: 10.17235/reed.2024.10358/2024 -
European Journal of Case Reports in... 2024Large-scale clinical studies for COVID-19 vaccines have shown the infection-preventing effect and short-term adverse effects. Some rare illnesses such as eosinophilia...
INTRODUCTION
Large-scale clinical studies for COVID-19 vaccines have shown the infection-preventing effect and short-term adverse effects. Some rare illnesses such as eosinophilia can develop following COVID-19 vaccinations.
CASE DESCRIPTION
We report a case of 65-year-old man with unexplained abdominal pain that developed 2 weeks after COVID-19 mRNA vaccination. The patient had received a second dose of COVID-19 mRNA vaccine and revealed eosinophilia at the first visit to our hospital. Eosinophil infiltration was observed in the lamina propria of the duodenum by a step biopsy. Montelukast 10 mg was administered as the initial treatment of eosinophilic gastroenteritis (EGE), and the abdominal pain was improved.
DISCUSSION
The strong influence of COVID-19 vaccination on the development of EGE remains unproven. Reports of eosinophilia following COVID-19 vaccination have discussed that COVID-19 mRNA vaccination triggered an eosinophilic response.
CONCLUSION
This case presented EGE that developed following COVID-19 mRNA vaccination, which would be a rare adverse event.
LEARNING POINTS
Eosinophilia can develop following COVID-19 mRNA vaccination.To evaluate the relationships of these illnesses with vaccination, clinicians should collect information on vaccinations history and vaccination dates through interviews.It is clinically practical to know the differential diseases that may develop after a new vaccination.
PubMed: 38455695
DOI: 10.12890/2024_004316 -
Transplant Infectious Disease : An... Apr 2024
Topics: Humans; Kidney Transplantation; Cholestasis; Cytomegalovirus Infections; HIV Infections
PubMed: 38450784
DOI: 10.1111/tid.14263 -
La Tunisie Medicale 2023Helicobacter pylori infection is the most common infectious disease worldwide. It is associated with duodenal and gastric ulcer disease and the risk of gastric...
Helicobacter pylori infection is the most common infectious disease worldwide. It is associated with duodenal and gastric ulcer disease and the risk of gastric neoplasia. The management of helicobacter pylori infection currently represents a real challenge for clinicians, given the ever-increasing rate of resistance of Helicobacter pyolori to various antibiotics. In this consensus document, we present recommendations adapted to the Tunisian context, including indications for the detection of helicobacter pylori infection, indications for the use of different diagnostic methods, and a therapeutic strategy for the management of Helicobacter pylori infection.
Topics: Humans; Helicobacter Infections; Consensus; Helicobacter pylori; Anti-Bacterial Agents; Duodenum
PubMed: 38445398
DOI: No ID Found -
Wiadomosci Lekarskie (Warsaw, Poland :... 2024Aim: To determine the role of TLR4 gene polymorphisms as risk factors for peritonitis severity in patients undergoing surgery for acute inflammatory diseases of the...
OBJECTIVE
Aim: To determine the role of TLR4 gene polymorphisms as risk factors for peritonitis severity in patients undergoing surgery for acute inflammatory diseases of the abdominal cavity.
PATIENTS AND METHODS
Materials and Methods: The study included 139 patients who were operated on for acute abdominal diseases (acute appendicitis and cholecystitis, perforated gastric or duodenal ulcer, etc.). Depending on the number of points on the modified APACHE II scale, patients were divided into two groups: Group 1 - 1-3 points (63 patients, 45.3%) and Group 2 - 4 or more points (76 patients, 54.7%). Polymorphisms rs1927911, rs2149356 and rs4986790 were determined by polymerase chain reaction.
RESULTS
Results: The rs1927911 polymorphism of the TLR4 gene was protective for the development of peritonitis (according to the allelic model, OR 0.48; 95% CI 0.27-0.84; p=0.015). Regression analysis revealed a reduced (p=0.015) risk of severe peritonitis in rs1927911 A/A or G/A genotype carriers (OR 0.42; 95% CI 0.21-0.84) compared with G/G genotype carriers. There was no effect on the severity of peritonitis of TLR4 polymorphisms rs2149356 and rs4986790. There was a tendency to increase the frequency of the mutant G rs4986790 allele in patients with severe peritonitis (χ2=2.17; p<0.001). The analysis of the association of TLR4 gene polymorphisms with the phenotype of patients showed that carriers of mutant homozygotes and heterozygotes in the presence of severe peritonitis were older, had a tendency to coagulopathy, higher leukocytosis and leukocyte clotting rate.
CONCLUSION
Conclusions: Thus, the importance of TLR in the development of severe peritonitis was confirmed and the protective role of the rs1927911 promoter polymorphism was established.
Topics: Humans; Abdominal Cavity; Case-Control Studies; Genetic Predisposition to Disease; Peritonitis; Polymorphism, Single Nucleotide; Toll-Like Receptor 4
PubMed: 38431805
DOI: 10.36740/WLek202401105 -
Updates in Surgery Apr 2024The surgical treatment of acute necrotizing pancreatitis has significantly evolved in recent years with the advent of enhanced imaging techniques and minimally invasive...
The surgical treatment of acute necrotizing pancreatitis has significantly evolved in recent years with the advent of enhanced imaging techniques and minimally invasive surgery. Various minimally invasive techniques, such as video-assisted retroperitoneal debridement (VARD) and endoscopic transmural necrosectomy (ETN), have been employed in the management of acute necrotizing pancreatitis and are often part of step-up approaches. However, almost all reported step-up approaches only employ a fixed minimally invasive technique prior to open surgery. In contrast, we implemented different minimally invasive techniques during the treatment of acute pancreatitis based on the extent of pancreatic necrosis. For acute necrotizing pancreatitis of the pancreatic bed with or without extension into the left retroperitoneum, we performed mesocolon-preserving laparoscopic necrosectomy for debridment. The quantitative indication for pancreatic debridment in our institute has been described previously. For acute necrotizing pancreatitis of the pancreatic bed with or without extension into the left retroperitoneum, mesocolon-preserving laparoscopic necrosectomy was performed for debridment. To safeguard the mesocolon, the pancreatic bed was entered via the gastrocolic ligament, and the left retroperitoneum was accessed via the lateral peritoneal attachments of the descending colon. Of the 77 patients requiring pancreatic debridment, 41 patients were deemed suitable for mesocolon-preserving laparoscopic necrosectomy by multiple disciplinary team and informed consent was acquired. Of these 41 patients, 27 underwent percutaneous drainage, 10 underwent transluminal drainage, and 2 underwent transluminal necrosectomy prior to laparoscopic necrosectomy. Two patients (4.88%) died of sepsis, three patients (7.32%) required further laparotomic necrosectomy, and five patients (12.20%) required additional percutaneous drainage for residual infection. Three patients (7.32%) experienced duodenal fistula, all of which were cured through non-surgical treatments. Nineteen patients (46.34%) developed pancreatic fistula that persisted for over 3 weeks, with 17 being successfully treated non-surgically. The remaining two patients had pancreatic fistulas that lasted over 3 months; an internal drainage procedure has been planned for them. No patient developed colonic fistula. Mesocolon-preserving laparoscopic necrosectomy proved to be safe and effective in selected patients. It can serve as a supplementary procedure for step-up approaches or as an alternative to other debridment procedures such as VARD, ETN, and laparotomic necrosectomy.
Topics: Humans; Pancreatitis, Acute Necrotizing; Mesocolon; Acute Disease; Laparoscopy; Minimally Invasive Surgical Procedures; Pancreatic Fistula; Drainage; Debridement; Treatment Outcome
PubMed: 38429596
DOI: 10.1007/s13304-024-01773-y -
Acta Parasitologica Mar 2024The epidemiological survey was carried out to determine the prevalence of eimeriosis in broiler chickens slaughtered depending the season, to determine the different...
AIM
The epidemiological survey was carried out to determine the prevalence of eimeriosis in broiler chickens slaughtered depending the season, to determine the different Eimeria species causing the coccidiosis in poultry farms; and to assess the impact of Eimeria parasite on histomorphological structure and oxidative stress parameters of the intestine.
MATERIALS AND METHODS
The study was conducted from December 2018 to December 2019 in the province of Bejaia, Algeria. The intestines chickens (n = 366) were obtained immediately after slaughter, each cut into different segments (duodenum, jejunum, ileum, and caecum). Microscopic and parasitological examinations were performed according to standard procedures. Histomorphometric measurements of intestine were obtained using Image J software. Oxidative stress parameters were carried out from intestine tissue.
RESULTS
Eimeria spp. were detected in 73.77% (95% CI 71.20-76.34) of broiler gut samples. The prevalence varied significantly according to the season, with the lowest rates in winter (42.81%, 95% CI 40.35-45.27) and the highest in autumn (97.92%, 95% CI 97.6-99.4). All seven Eimeria species were identified, most commonly E. necatrix (27.70%), E. brunetti (26.47%), and E. tenella (20.96%). The mean lesion score ranged from 1.51 ± 0.05 to 1.79 ± 0.04. Significant differences in VH/CD ratio of intestinal epithelium (P < 0.001) were observed in different intestinal portions of infested broiler chickens compared to non-infested. The mean MDA concentration of intestinal segments was significantly higher in Eimeria species infested broilers compared to non-infested (P < 0.05). The results show at least one difference in CAT, SOD, and ABTS concentrations (P < 0.05) in both chicken's groups.
CONCLUSION
Our results revealed that coccidiosis is extremely prevalent in slaughtered broilers, with an abundance of pathogenic Eimeria species. Also, it was concluded that infestation induces tissue structure alterations which coincides with the oxidative damage.
Topics: Animals; Coccidiosis; Chickens; Algeria; Poultry Diseases; Eimeria; Prevalence; Seasons; Intestines; Oxidative Stress
PubMed: 38424401
DOI: 10.1007/s11686-024-00806-1 -
Experimental and Therapeutic Medicine Apr 2024The primary objective of the present study was to investigate the efficacy and safety of endoscopic therapy for acute obstructive suppurative cholangitis (AOSC) in...
The primary objective of the present study was to investigate the efficacy and safety of endoscopic therapy for acute obstructive suppurative cholangitis (AOSC) in patients with different underlying conditions. The present study comprised 47 patients diagnosed with AOSC, with a mean age of 70±14 years. Minimally invasive endoscopic treatments, including endoscopic duodenal papillary sphincterotomy, endoscopic duodenal nasobiliary drainage and/or placement of an endobiliary duct stent drainage tube, were performed. Variations in the levels of the white blood cell count, liver function, procalcitonin (PCT) and carbohydrate antigen-199 (CA199) were examined, compared and evaluated both prior to and following endoscopic retrograde cholangiopancreatography (ERCP). Among the 47 patients, 45 had a high fever, although their body temperature returned to normal after 7 days of ERCP treatment. The infection was difficult to control completely in two cases, including one case of biliary anastomosis secondary tumor with stenosis and AOSC and another case of an elderly patient with multiple choledocholithiasis complicated with sepsis. Within 7 days following treatment, the abdominal pain was resolved in 27 patients and jaundice subsided in 29 patients. On the 7th day after endoscopic treatment, the blood leukocyte, liver function, PCT and CA-199 parameters of all patients were significantly improved compared with those at admission. A total of 35 bile cultures yielded positive results, with accounting for 11 cases (31.4%), accounting for 7 cases (20%), accounting for 5 cases (14.3%), accounting for 4 cases (11.4%) and other strains making up the remaining 17 cases. No serious complications were encountered with these patients, such as perforation, bleeding, severe pancreatitis or mortality, following ERCP. In conclusion, ERCP has been shown to be a safe and effective minimally invasive treatment method for elderly patients with AOSC, yielding a high rate of success.
PubMed: 38414791
DOI: 10.3892/etm.2024.12416 -
International Journal of Cancer Jul 2024
Topics: Humans; China; Esophageal Neoplasms; Stomach Neoplasms; Duodenal Neoplasms; Risk Factors; Cohort Studies; Helicobacter Infections; Case-Control Studies; Helicobacter pylori
PubMed: 38396338
DOI: 10.1002/ijc.34889 -
Indian Journal of Pathology &... Apr 2024Gastroduodenal perforation commonly due to spontaneous perforation of a pre-existing peptic ulcer is a surgical emergency. On laparotomy, approximately 60%-70%...
Gastroduodenal perforation commonly due to spontaneous perforation of a pre-existing peptic ulcer is a surgical emergency. On laparotomy, approximately 60%-70% perforations are duodenal and 15%-20% gastric. The most prevalent etiology are Helicobacter pylori infection in 65%-70% and non-steroidal anti-inflammatory drugs (NSAIDS) abuse in 30%-50% cases depending on the prevalence of H. pylori infection. We report here the autopsy findings in a 29-year-old male who collapsed suddenly in the emergency room of our hospital after a bout of massive hematemesis.
Topics: Humans; Male; Adult; Duodenal Ulcer; Peptic Ulcer Perforation; Autopsy; Fatal Outcome; Hematemesis; Duodenum; Histocytochemistry
PubMed: 38391300
DOI: 10.4103/ijpm.ijpm_129_22