The radiographic features of 20 cases of pathologically confirmed heterotopic pancreatic rests involving the stomach were analyzed. Aberrant pancreatic tissue in the stomach produces a broader spectrum of radiographic findings than had been thought. The mass produced by the aberrant tissue is often larger and more sessile than usually anticipated, and may simulate a mural neoplasm or adenomatous polyp. While most cases occur in the distal antrum or prepyloric area, some occur in the more proximal portion of the antrum. Less than half of the cases in this series included the finding of a small central niche. When a niche was present, it was often large in relation to the mass, and simulated a gastric ulcer or ulcerating neoplasm.
The clinical, radiologic, and histologic features of 16 patients hospitalized with clindamycin-associated colitis are presented. The findings are tabulated and compared to 33 cases reported in the literature. The majority of patients were caucasian females over 40 years of age. The clinical presentation varied from mild persistent diarrhea to acute surgical abdomen. Proctoscopic examination revealed nonspecific colitis in 9 and pseudomembranous colitis in 7 cases. No specific radiologic or histologic fingings for postanitbiotic colitis were found. Therapy was nonspecific and varied according to the severity of the clinical course. Clinically, there appeared to be some benefit from systemic steroid therapy. 4 of the 16 patients died. None of the recovered patients have had spontaneous relapses off medication during follow-up evaluation. The pathogenic mechanism for postantibiotic colitis secondary to clindamycin remains unknown and does not appear dose related. Clindamycin therapy should be limited to disorders with specific indications.
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