This paper deals with the clinical history, the histopathological and scanning electron microscopy (SEM) pictures, treatment and follow up of four cases of intestinal spirochaetosis. Diarrhoea was a prominent symptom in all cases but distension and vague abdominal trouble were also present. It is suggested that heavy infestation of the gut surface epithelium by spirochaetes acts as a barrier for the normal absorptive processes and leads to diarrhoea.
Case reportA healthy woman had first experienced macroscopic haematuria in 1981 at the age of 25. Initially she had intravenous urography, renal angiography and cystoscopy, all with negative findings. Daily haematuria persisted for 3 years and was more pronounced with physical exercise but not with menstruation. She developed diffuse back-pain of increasing severity.In 1984 selective angiography of both kidneys revealed a possible tumour in the left kidney. Ultrasound examination showed a 40 mm cystic tumour at the upper pole of the left kidney. This was punctured and cytological examination revealed fragments of glands with cuboidal epithelium. This epithelium was not of renal origin and, as the puncture was performed retroperitoneally, could not have been obtained from the gastrointestinal tract. Blood cells were present inside the glandular fragments and renal endometriosis was suspected. Because of this and because of the discovery of a pelvic tumour, 15mm in diameter, she was referred to the Department of Obstetric and Gynaecology. At laparotomy an endometriotic cyst was removed from her left ovary. No endometriosis was observed elsewhere in the pelvis or abdomen.She was treated with the progestogen lynestrenol 5-15 mg/day for 6 months. The dose was increased until she developed amenorrhoea. Macroscopic haematuria ceased but microscopic References Editorial (1986) LHRH analogues in endometriosis. Rosdy E., Shgi T & Torok P. (1979) Endometnose der Lancet ii, 1016-1018. Niere (English summary). Urologe [A] 18:22-25.
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