Isolated colonic ulcers: Diagnosis and management

A case of a 32-year-old motorcyclist, who sustained an open comminuted fracture of the left tibia and subsequently developed spontaneous cecal perforation following successful fixation of the fracture and reconstruction of the soft tissue defect with a rectus abdominis free flap, is reported. Although benign cecal perforation has been described in patients with thermal burns and blunt trauma of the abdomen or pelvis, our association has not been reported previously in the medical literature. It is important to recognize cecal perforation early as it is associated with a high mortality from peritonitis and septicaemia.

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“…[20][21][22][23] Benign cecal ulceration has been described in patients with thermal burns [6][7][8] and blunt trauma of the abdomen or pelvis.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb trauma

Stevens

Moss

2009

Microsurgery

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“…In the rectum, isolated mucosal ulceration must be differentiated from solitary rectal ulcer, radiation-induced changes, ischemia, and infections, especially tuberculosis and amebiasis. 3 Diaphragm disease is very rare and is considered to be pathognomonic to NSAIDs. Originally described in terminal ileum, 4 it has also been reported in right colon.…”

Section: Most Common Drug-induced Histologic Patterns Of Injury In Comentioning

confidence: 99%

The Ever-Changing Landscape of Drug-Induced Injury of the Lower Gastrointestinal Tract

Marginean

2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.—There is an ever-growing armamentarium of pharmacologic agents that can cause gastrointestinal (GI) mucosal injury, the most common symptoms being diarrhea, constipation, nausea, and vomiting. These are often self-limiting and without serious sequelae, but some symptoms are of greater concern, like drug-induced mucosal ulceration that can manifest as GI hemorrhage, stricture formation, and even perforation. Histologically, there is significant overlap between drug-induced injuries and various disease entities. A single type of medication may cause multiple patterns of injury, which can involve the entire GI tract or just some parts of it. Objective.—To review the most common drug-induced injury patterns affecting the colon, which may be recognized by the surgical pathologist on colonic mucosal biopsies. This review does not address the injuries occurring in the upper GI tract. Data Sources.—A PubMed review of English-language literature, up to December 2015, on drug-induced injury of GI tract was performed. Conclusions.—There are numerous drugs that damage the colonic mucosa. The most common drugs are included in this review according to their histologic pattern of injury. It is important for the pathologist to keep in mind that a single drug type can induce many histologic patterns of mucosal injury that can mimic many disease entities. Although there are some histologic clues helpful in the diagnosis of drug-induced colonic injury, correlation with clinical history and especially medication history is essential to improve diagnostic accuracy.

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“…Differenzialdiagnostisch kommen eine Ischämie, ein singuläres RektumUl kusSyndrom, Bestrahlungsfolgen, Kotfisteln oder impaktierter Stuhl infrage. Infektiöse Erreger kön nen Tuberkulose oder Amöben sein [21].…”

Section: Dickdarmunclassified

Nichtsteroidale Antirheumatika und Gastrointestinaltrakt

Schick

Schulz

2010

Gastroenterologe

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Nichtsteroidale Antirheumatika (NSAR) wirken analgetisch, antipyretisch und antiphlogistisch. Weltweit werden sie vor allem zur Schmerzbekämpfung eingesetzt. Ihre Einnahme ist jedoch mit einer erheblichen Anzahl von Nebenwirkungen verbunden. Die Risiken von NSAR bestehen vor allem in Schleimhautläsionen, Dyspepsie, gastrointestinalen Blutungen, Ulzerationen, Perfora tionen und Stenosen. NSAR können in so genannte traditionelle NSAR, selektive NSAR (Zyklo oxygenasehemmer, COX1 und COX2Inhibitoren) und ASS unterteilt werden. Die Einführung von COX2Inhibitoren erfolgte zur Reduktion von Nebenwirkungen, jedoch zeigten große Studi en eine zu hohe Anzahl von kardiovaskulären Ereignissen, was zur Rücknahme einiger Präparate vom Markt führte. Läsionen im oberen Gastrointestinaltrakt infolge von NSAREinnahme sind lange bekannt. Mit der Einführung der Kapselendoskopie, der Ballonenteroskopie und der stärke ren Beachtung von Kolonläsionen zeigte sich ein ähnlich häufiges Auftreten von Nebenwirkungen im mittleren und unteren Gastrointestinaltrakt. In diesem Artikel werden die gastrointestinalen Ri siken vom Ösophagus bis zum Kolon erörtert und aktuelle Empfehlungen gegeben. SchlüsselwörterUlzera · Ösophagitis · Perforationsblutung · Magenausgangsstenose · Nichtsteroidale Antirheu matika Non-steroidal antiinflammatory drugs and gastrointestinal tract AbstractThe administration of nonsteroidal antiinflammatory drugs (NSAID) against pain is accepted worldwide, although it is well known that they cause potentially serious adverse effects. The risks from NSAIDs consist of mucosal lesions in the gastrointestinal (GI) tract, dyspepsia, gastrointes tinal bleeding, ulcera, perforation and stenosis. NSAIDs can be classified into traditional and se lective inhibitors of cyclooxygenase (COX1 and COX2 inhibitors) and aspirin. The discovery of COX2 inhibitors was celebrated as a new desired improvement for adverse events for a short time period, but large studies revealed a significant incidence of cardiovascular events in combination with COX2 inhibitors, which ended in a partial withdrawal of COX2 inhibitors from the mar ket. Adverse events were first only registered in the upper GI tract but with the introduction of bal loon enteroscopy and capsule endoscopy and the intensified view on detected lesions in the colon, a similar number of adverse events from NSAIDs could be registered in the lower GI tract. In this article gastrointestinal adverse events from the esophagus up to the colon will be discussed. Final ly an overview of the present recommendations is given.

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Isolated colonic ulcers: Diagnosis and management

Cited by 30 publications

References 37 publications

Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb trauma

Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb trauma

The Ever-Changing Landscape of Drug-Induced Injury of the Lower Gastrointestinal Tract

Nichtsteroidale Antirheumatika und Gastrointestinaltrakt

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