thickened wall of the distal sigmoid colon, an ileosigmoid fistula (Fig. A), and lymphadenopathy in the abdomen and pelvis with a maximum measurement of 4.0×2.6 cm. Barium enema revealed the two paths around the rectosigmoid junction. One was the usual sigmoid colon with remarkable mucosal abnormalities. The other was the ileosigmoid fistula Question: A 43-year-old man presented with diarrhea a...

A 54-year-old female with chronic headache was admitted to our hospital because of hematochezia. She had routinely taken loxoprofen sodium because of severe headache. Emergent colonoscopic examination revealed ulceration of the cecum. After administration of loxoprofen sodium was discontinued and administration of sulfasalazine was initiated, her intestinal bleeding subsided. Two months after d...

background: colonoscopy is used for both diagnostic as well as therapeutic purposes in patients with lower gi symptoms. the aim of this study was to assess the clinical manifestations and to determine the colonoscopic findings of children with lower gi symptoms attending a pediatric hospital in tehran. materials and methods: during a 5-year period (1996-2001), all children less than 16 years of...

We report about a previously healthy 72-year-old woman, presented with 6 days of left lower quadrant abdominal pain and constipation. There was no report of fever, melena, hematochezia or change in appetite. The physical exam demonstrated a distended abdomen with palpable left lower quadrant pain, without guarding. CT showed images compatible with a sigmoid diverticulitis and a calcification of...

A 62 year-old patient with therapy-refractory pouchitis after proctocolectomy for ulcerative colitis was admitted with hematochezia and abdominal discomfort. A malignant melanoma (MM) was found after repeated biopsies of the pouch. Complete staging revealed no evidence for distant metastases and the patient underwent abdominoperineal pouch resection. Six weeks later, the patient was readmitted ...

Eosinophilic colitis (EC) is a rare part of spectrum of diseases called eosinophilic gastrointestinal disease (EGID). It was found to have bimodal distribution involving neonates and adults in age groups of 30 - 50 with male preponderance. We present this case of a 78-year-old woman who came to the hospital with abdominal pain, hematochezia and unintentional weight loss, and was found to have E...

Clinical problem and differentials. Vomiting is the forceful ejection of stomach and proximal duodenal contents through the mouth. Vomiting can be induced by vestibular, vagal, chemoreceptor trigger zone, or direct input to the emetic center. Diarrhea is a characterized by increased frequency of defecation, increased fluid content of the stool, or increased volume of stool. Markedly increased f...

HYPEREOSINOPHILIC SYNDROME (HES) HAS THREE DEFINING FEATURES: marked hypereosinophilia for at least 6 months, no confirmed etiology for the eosinophilia, and eosinophilia-related symptoms or organ dysfunction. However, a shorter period of hypereosinophilia with symptoms requiring eosinophil-lowering therapy is also acceptable. We report a case of HES presenting as eosinophilic colitis. Although...

Figure 2 Histopathological examination showed inflammatory granulation tissue. Kinyoun stain revealed multiple acid-fast bacilli (arrows). Culture of tissue in L wenstein-Jensen media yielded Mycobacterium tuberculosis. Intestinal tuberculosis should form part of differential diagnosis of patients presenting with lower gastrointestinal bleeding. Figure 1 A 20-year-old man with a complaint of he...

In order to provide appropriate and timely treatment for an acute gastrointestinal bleed, it is vital to determine the site of hemorrhage. Historical clues and exam may be insufficient to differentiate upper from lower gastrointestinal bleeds and clinicians may utilize nasogastric lavage for diagnostic clarity. Nasogastric tube placement is a common procedure in the Emergency Department and is ...