Most patients with bleeding DL presented with symptoms of acute bleeding, but many had symptoms suggesting subacute or chronic bleeding. Endoscopic therapy resulted in successful hemostasis in approximately 90 % of patients during follow-up. Rebleeding was rare and particularly uncommon in those treated with combined endoscopic therapy.
Vasculitis is an accumulation of inflammatory leucocytes in the blood vessels with reactive damage to mural structures. Isolated vasculitis of the gastrointestinal tract without systemic involvement is rare. We report a unique case of a female patient who presented with abdominal pain, and was found, on serology, to have elevated inflammatory markers without autoantibodies. A computed tomography scan of the abdomen and pelvis was suggestive of vasculitis of the hepatic artery. To the best of our knowledge, this is the first case, to date, of vasculitis of hepatic artery. Vascul itis is an accumulation of inflammatory leucocytesin the blood vessels with reactive damage to mural structures. Vasculitis of the gastrointestinal tract is a manifestation of systemic vasculitis in 20% of cases, 1 but isolated vasculitis of the gastrointestinal tract without systemic involvement is rare. We report a unique case of a female patient who presented with abdominal pain, and was found, on serology, to have elevated inflammatory markers without autoantibodies. A computed tomography scan of the abdomen and pelvis was suggestive of vasculitis of the hepatic artery. To the best of our knowledge, this is the first reported case of vasculitis of the hepatic artery. There have been reports of single organ vasculitis, especially in the intestines, gallbladder, and appendix; however, to date, none have been reported in the liver. Case PresentationA 53-year-old woman with a past history of cholecystectomy was admitted with complaint of epigastric discomfort of 2-days duration. The pain was localized, and she reported bloating and nausea, but denied vomiting, fever, chills, melena, urinary or gastrointestinal complaints.Physical examination showed the patient was afebrile with stable vital signs. Her cardiovascular and respiratory examinations were normal. Abdominal examination demonstrated minimal tenderness on deep palpation of the epigastrium without distension, guarding, or rigidity. A complete blood count showed normal white blood cell count at 6.3 x 10 3 /μL and normal hemoglobin at 14.2 g/dL. Basic metabolic panel and liver enzymes were normal, and amylase and lipase levels were not elevated.Radiographs of the abdomen revealed normal bowel gas pattern, but a CT scan of the abdomen and pelvis showed circumferential thickening of the wall of the common hepatic artery and its right and left hepatic branches, with a narrowed but patent lumen, suggestive of vasculitis (figure 1). The remaining arteries of the abdomen and pelvis were unremarkable. A CT scan of the abdomen and pelvis taken 2 years prior had been unremarkable. Magnetic resonance angiography (MRA) of the visceral arteries of the abdomen and pelvis confirmed the findings.The erythrocyte sedimentation rate (ESR) upon admission was elevated at 25 mm/hr (normal 0-17 mm/hr) and C-reactive protein (CRP) was elevated at 2.6 mg/dL (normal 0-1 mg/dL). Further history and examination was done to rule out systemic vasculitis in view of the elevated sedimentation rate. The patient de...
Amiodarone is used worldwide to treat cardiac arrhythmias, as well as highly symptomatic cases of atrial fibrillation. With this expanded use, especially following its 1985 United States Food and Drug Administration approval, and its use as a long-term therapy in common practice, reports of cancers temporarily related to amiodarone have begun to increase. Animal studies, several clinical trials, numerous case reports, and a population-based cohort study have suggested that cancers may be associated with amiodarone use. This review focuses on the ever increasing evidence in the literature that suggests amiodarone therapy, especially with long-term use, may increase the potential risk of cancer development. It also expresses the need for more definitive studies to be conducted to provide clinicians with a clear answer to this important question.
Pyogenic liver abscess commonly occurs as a complication of biliary tract and gastrointestinal infections, with diverticulitis and perforated bowel becoming leading causes in recent years. We report the first case of liver abscess as a complication of asymptomatic diverticulitis with no bacteremia, as well as colovesical fistula. And, with this case presentation, we stress the importance of considering diverticulitis in asymptomatic patients with liver abscess, as well as the importance of early and prompt treatment with antibiotics and percutaneous drainage.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.