Ulcerative Rectocolitis Research Articles

Perfuração espontânea de colédoco em adolescente

Spontaneous perforation of the common bile duct is rare. It happens predominantly in children and it is related to obstructive disease of the biliary tract. We present a case of an 18 year-old male patient, with ulcerative rectocolitis associated with malignant tumor of the head of pancreas. The patient developed an acute abdomen syndrome and laparotomy, a spontaneous perforation of common bile duct was evidenced. The authors make a revision of the clinical aspects of that pathology.

Salivary gland involvement in patients with chronic pancreatitis.

The salivary glands are structurally similar to the exocrine pancreas and may be involved in the course of diseases of autoimmune origin (sclerosing cholangitis, ulcerative rectocolitis, primary biliary cirrhosis). For a not-yet-quantified proportion of chronic pancreatitis (CP) cases, a possible autoimmune pathogenesis has been postulated. The aim of the study was to assess the frequency of salivary ductal system abnormalities in patients with CP. Fifty-one patients with CP consecutively admitted to our center were studied (44 men, seven women; mean age, 48.2 +/- 10.8 years). The mean duration of disease was 11.7 years (range, 1-37 years); 44 (86%) of 51 patients had pancreatic calcifications, 25 (49%) of 51 diabetes, 25 (52%) of 48 steatorrhea, and 32 (63%) of 51 underwent pancreatic surgery. As a control group, we studied 10 patients of whom four with liver cirrhosis (three alcoholic and one posthepatitis; three men, one woman; mean age, 57 +/- 12.5 years), and six with temporomandibular pain (five men and one woman; mean age, 42 +/- 10.3 years). The patients were given parotid sialography, the findings being read by two independent observers. In two CP patients, parotid sialography was unsuccessful. Fifteen (31 %) of 49 patients and none of the 10 control patients exhibited abnormalities of the glandular ducts compatible with chronic inflammation of the salivary ducts (p = 0.039). None of the CP patients had salivary intraductal calcifications. Findings of parotid ductal abnormalities are frequent in the course of CP and may indicate a common pathogenetic mechanism, even of an immune type.

Radiology of invasive amebiasis of the colon

Entamoeba histolytica is a protozoan that is endemic in various parts of the world, including some areas of the United States. It may live in the large bowel in its cyst form without harming the host (commensalism) or, for as yet poorly understood reasons, invade the tissues as a trophozoite producing invasive amebiasis of the colon. In a review of over 3,000 cases of invasive amebiasis, the clinico-pathologic forms of the disease were: ulcerative rectocolitis (95%), typhloappendicitis (3%), ameboma (1.5%), and fulminating colitis and toxic megacolon (0.5%). Different radiographic patterns are seen in each clinical form with varying degrees of specificity. It is vitally important that this disease be included in the differential diagnosis of large bowel pathology even in nonendemic areas. Several referral patients who have received inappropriate therapy for inflammatory bowel disease with near disastrous results are seen at one of our institutions (Loyola) each year.

Proctoscopy and the Nurse

anoperianal abcess and fistula, anal pruritus, and hypertrophic anal papillae. Each of these can be diagnosed by inspection or use of the examiner's eyes and careful palpation or digital examination. It would seem then that proctoscopy would be of little aid as these common lesions can be detected without its use. But no anorectal examination is complete wit' o it poroctoscopy for, until rectal adenocarcinoma has been ruled out in every case, a cancer must be thouaht of as mimicking the symptoms of these lesions or existing at the same time in the rectal ampulla or rectosigmoid of the paticnt having one or more of these common anal diseases. Rectal adenoma or polyp and rectal adenocarcinoma or cancer are on the increase because more patients are living to an age where anaplastic tissue changes are more commonly found and because more doctors are becoming convinced that proctoscopy is to be executed as a part of a general physical examination. A maxim for all surgeons who do proctology can be stated: No anorectal operation should be done until a thorough proctoscopy has been performed. In addition to ruling out malignancy, the careful proctologic surgeon wishes to rule out latent ulcerative rectocolitis, latent amebiasis, multiple polyposis, diverticulitis, and other specific inflammatory proctitis cases as tuberculosis, salmonellosis, shigellosis, brucellosis, and aller-y for he knows that anorectal surgical procedure done with any of these conditions present is a definite invitation to a stormy postoperative period, delayed tissue healing, and possible catastrophy. All of these lesions can be detected at proctoscopy. While they may pose a difficult differential diagnosis, other procedures such as the bacteriologic