These practice parameters are an update of the previously published recommendations regarding the use of autotitrating positive airway pressure (APAP) devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. Continuous positive airway pressure (CPAP) at an effective setting verified by attended polysomnography is a standard treatment for obstructive sle...

Introduction Eosinophilic gastroenteritis is an uncommon disease characterized by peripheral eosinophilia and eosinophilic infiltration of the gastrointestinal tract. The bone marrow shows a reactive eosinophilia and the symptoms and signs usually reflect the layer of bowel which is most severely affected. Predominant mucosal disease may be associated with malabsorption, muscle disease with obs...

Large bowel obstruction (LBO) is most commonly due to malignancy, volvulus, hernia, diverticular disease and inflammatory bowel disease. LBO due to adhesions is unusual. A literature review was conducted which revealed that only a few such cases have been reported. We report two cases of LBO secondary to adhesions in patients, one with and one without a past abdominal surgical history. We highl...

A 57-year-old woman was admitted to our hospital with abdominal pain and vomiting. Her abdomen was distended, and obstructive bowel sounds were discovered on examination. Diffuse abdominal tenderness was present, but no palpable masses were apparent. Abdominal computed tomography confirmed a large gallstone obstructing the small bowel. Colonoscopy revealed a large gallstone lodged at the termin...

Mesenteric cysts are rare abdominal tumors. About 60% of these cysts occurs before 5 years of age and can be located anywhere in the gastrointestinal tract, but are most often found in the small bowel mesentery. The clinical presentation depends on the location and size of the cyst and many cases are asymptomatic and are diagnosed incidentally. The most common symptoms are abdominal pain, bloat...

Phytobezoar is a concretion of indigestible fibers derived from ingested vegetables & fruits. Primary small bowel phytobezoar is rare and almost always obstructive. It is commonly seen in adults but is rarely reported in pediatric age group. We present the clinical profile of two children (aged 4 and 12 years) with primary intestinal phytobezoar. The case of the 4 year old son of a tailor prese...

Solid tumors are much more common than hematologic malignancies. Although severe and prolonged neutropenia is uncommon, several factors increase the risk of infection in patients with solid tumors, and the presence of multiple risk factors in the same patient is not uncommon. These include obstruction (most often caused by progression of the tumor), disruption of natural anatomic barriers such ...

doscopy. A double-balloon enteroscopy was performed for partially obstructive attacks of abdominal pain suspicious of small-bowel invaginations by big polyps; enteroscopy confirmed the diagnosis. A majority of polyps were localized in the jejunum, and a polypectomy of lesions greater than 1 cm was performed. Histology was consistent with harmatomatous polyps. The entire small bowel was explored...

Gastric bypass patients are at risk for small-bowel obstruction secondary to adhesions, internal hernias, intussusception and volvulus. Most gastric bypass patients do not present with classic obstructive symptoms. We present a rare case of concurrent intussusception and volvulus in a woman with previous history of internal hernia following laparoscopic Roux-en-Y gastric bypass surgery.

Symptomatic Mullerian duct cyst is a rare entity in children. A 9-month-old male infant presented with bowel and urinary obstructive symptoms. Imaging investigations revealed a cystic mass in the rectovesical pouch compressing bladder neck and rectum. At laparotomy, a Mullerian duct cyst was found. Most of the cyst was excised and the remaining cyst mucosa was cauterized. The child improved the...