Editor-in-Chief, Deputy Editor 2017-2019

 

Editor-in-Chief:

Tom MOREELS

 

Deputy Editor:

Nicolas LANTHIER

 

Case Reports



A patient who survived total colonic ulcerative colitis surinfected by cytomegalovirus complicated by toxic megacolon and disseminated intravascu-lar coagulation


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The authors report the case of a patient aged 60-year-old who survived ulcerative colitis complicated by toxic megacolon and disseminated intravascular coagulation. This patient was not known for this ulcerative colitis and was first hospitalised for a suspicion of diverticulitis. The admission symptoms were fever, abdominal pain and bloody diarrhoea. The evolution was defavorable under antibiotics and sulfasalazine. The patient was readmitted 5 days after he left hospital, and the diagnosis of UC was based on colon biopsy made during the first hospitalisation. A treatment with methylprednisolone was started and the patient worsened day by day with apparition of toxic megacolon and disseminated intravascular coagulation. Subtotal colectomy was performed for degradation of general status and coagulation factors. Pathological findings confirmed ulcerative colitis with toxic megacolon. Cytomegalovirus inclusions were demonstrated on the colonic specimen and confirmed by PCR. In this report the authors discuss the etiology of toxic megacolon and disseminated intravascular coagulation in ulcerative colitis surinfected by cytomegalovirus. Mortality of these pathologies is high necessitating rapid diagnosis of cytomegalovirus infection by sigmoid biopsy. Management requires immunosupression interruption and ganciclovir therapy, or surgery in unsuccessful medical treatment. [Product Details...]



A rare extrahepatic syndrome related to acute hepatitis type B : Epididymitis in an adolescent


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Hepatitis B is a common, vaccine-preventable infection with high mortality and morbidity rates worldwide. Numerous extrahepatic syndromes have been described in patients with either acute or chronic viral hepatitis B. But there is no previous report of co-existence of HBV infection and epididymitis in the English literature. We would like to present and discuss a 12-year-old male patient with epididymitis that might be relation exist with an underlying acute hepatitis B infection. [Product Details...]



Broken stent in oesophageal malignancy : A rare complication


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Metallic expandable stents are used increasingly for palliative treatment of inoperable malignant tumours of oesophagus to improve dysphagia. We report a rare case of oesophageal stent fracture that was broken and left in situ within the stomach uneventfully until the end of the patients life after the application of another stent. [Product Details...]



EUS-guided endoscopic resection using band ligation of oesophageal granular cell tumour : Report of a case


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A 60-year-old Japanese man was referred for treatment of a polypoid oesophageal tumour. Radiographic examination of the upper gastrointestinal tract disclosed a nodule with central depression in the lower esophagus. By endoscopy the nodule was yellowish and appeared submucosal. Endoscopic ultrasonography demonstrated a hypoechoic solid tumour limited in submucosa without lymph node involvement. Endoscopic resection using band ligation was performed under guidance by endoscopic ultrasonography. By histologic examination the tumour consisted of large cells arranged in nests. These cells had abundant granular cytoplasm and small round nuclei. They expressed S-100 protein and were CD68, and periodic acid-Schiff positive. No expression of smooth muscle actin was noted. The tumour was limited in submucosa. Findings were consistent with complete endoscopic resection. This report may be the first concerning an oesophageal granular cell tumour successfully treated with EUS-guided endoscopic resection using band ligation. [Product Details...]



Lipohyperplasia of the ileocecal valve as a cause of intussusception


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We present a case of lipohyperplasia of the ileocecal valve causing episodes of intussusception, and visualized by abdominal ultrasound and CT as a target - like appearance. At surgery, a large yellow soft mass was in the region of the ileocecal valve, raising the suspicion of lipohyperplasia. Resection of the fatty tissue from the ileocecal valve was performed at operation, after histologic diagnosis on frozen section. Our case suggests that limited resection removing the terminal ileum is effective and preferable to more extensive resection. [Product Details...]



Oesophageal perforation by an anterior cervical fixation device : Management in debilitated patients


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Oesophageal perforation following anterior cervical fixation has been reported in the neurosurgical and orthopaedic literature as a rare complication of such procedure. The complications associated with oesophageal perforation may range from minor symptoms to mediastinitis and death. We report two oesophageal perforations following cervical fixation device migration in patients with poor prognosis, managed successfully with conservative surgical and endoscopic techniques. [Product Details...]


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