Metagonimus
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Unless the host is immunocompromised, the habitat of the adult flukes is confined to the mucosa (villus and crypt), and the worms never invade deeper layers of the submucosa, muscularis mucosa, or serosa.22,66 They become adult flukes within 5 days after infection.22,66 Living in the mucosa of the small intestine, the adult worms give mechanical, chemical, and immunological stimuli to the host; these stimuli together elicit local and systemic inflammatory responses of the host.22 Thus, mild to severe mucosal inflammation, that is, duodenitis, jejunitis, or ileitis, occurs according to locations in the small intestine. An increase in the permeability of intestinal mucosa was reported in experimentally infected mice.149 Poor absorption of intestinal secretions from secretory crypt cells seems to lead to watery diarrhea.150 Decreased enzyme activities may be associated with malabsorption and diarrhea in acute infections.146
The vermiform appendix
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
Terminal ileitis in its acute form may be clinically indistinguishable from acute appendicitis unless a doughy mass of inflamed ileum can be felt. An antecedent history of abdominal cramping, weight loss and diarrhoea suggests regional ileitis rather than appendicitis. The ileitis may be non-specific, due to Crohn's disease (Figure72.8) or Yersinia infection. Yersinia enterocolitica causes inflammation of the terminal ileum, appendix and caecum with mesenteric adenopathy. If suspected, serum antibody titres are diagnostic, and treatment with intravenous tetracycline is appropriate. If Yersinia infection is suspected at operation, a mesenteric lymph node should be excised and divided, with half submitted for microbiological culture (including tuberculosis) and half for histological examination.
Nitric Oxide as a Mediator of Intestinal Mucosal Function
T. S. Gaginella in Regulatory Mechanisms — in — Gastrointestinal Function, 2017
Recently, studies have focused on developing an adaptive model of adjuvantinduced ileitis initially described by Grisham et al.61 This model involves the luminal administration of ethanol and Freund’s complete adjuvant to stimulate the local immune system and establish chronicity of gut inflammation.62 This model is more chronic than the TNBS model, with a progression of dysmorphology and inflammation over the first 2 weeks, including extensive macrophage infiltration during the second week. In this model, iNOS is expressed primarily in the second week, concomitant with injury; the iNOS selective inhibitor aminoguanidine ameliorated the local and systemic responses. Aminoguanidine is also an effective therapeutic agent in TNBS ileitis, at considerably lower doses than l-NAME63 (which is slightly selective for the constitutive isoforms of NOS13). Aminoguanidine and l-NAME confer protection in the peptidoglycan- polysaccharide model of chronic granulomatous colitis.64
Chronic ileitis with transmural migration of ingested foreign body treated by laparoscopy
Published in Acta Chirurgica Belgica, 2018
Garima Govind, H. P. Priyantha Siriwardana, Elias Sdralis, Manisha Ram, Peng Lee, Alexandros Charalabopoulos
Of those in whom the ingestion of foreign body leads to symptoms such as abdominal pain or vomiting, the most suitable imaging modality depends on the material of the foreign body. In this case, CT proved to be the best modality, as fish bone is known to be radiolucent. Although CT is the most sensitive modality for detecting all foreign bodies, ultrasound is also an alternative as it, too, can detect radiolucent foreign bodies [4]. The main limitation of ultrasound is that it cannot detect foreign bodies situated in deep tissues and especially when there is air interference [10]. In our case the main CT finding was that of mural ileal thickening and chronic inflammation suggestive of Crohn’s ileitis. This is extremely rare as most cases have a more acute presentation and chronic inflammation has rarely been reported. In the very few reports in the literature describing a chronic active inflammatory process, probably due to long-term ingestion of foreign material, the histological features of resected specimens in some respects have resembled those of Crohn’s disease [11]. It is pertinent, therefore, to ensure that foreign body ingestion is considered in patients who present with abdominal pain and in whom CT reveals chronic inflammation without a previously established diagnosis that fits with the patients’ characteristics.
Molecular diagnosis and classification of inflammatory bowel disease
Published in Expert Review of Molecular Diagnostics, 2018
Hu Zhang, Zhen Zeng, Arjudeb Mukherjee, Bo Shen
A rapidly expanding interest is to explore the roles of fecal markers in estimating and predicting the clinical course of IBD. Ho and colleagues[158] showed that the level of FC was markedly increased in severe UC, and an increased FC was a reliable marker to predict a subsequent need for colectomy. A cutoff point of 1,922.5 lg/g of FC predicts colectomy with a sensitivity of 24.0%, a specificity of 97.4%, a likelihood ratio of 9.23 and an AUC of 0.65. Kaplan–Meier analyses exhibited that using the cueoff value of 1,922.5 lg/g, 87% of patients will suffer from subsequent colectomy over a median follow-up of 1.10 years. Furthermore, an increased FC was associated with pouchitis and pre-pouch ileitis. For example, a cutoff level of 92.5 mg/kg could predict the development of pouchitis with the sensitivity and specificity of 90% and 77%, respectively[159]. This data confirmed that FC can work as a marker to predict disease course, in particular, to predict the development of pouchitis after surgery.
A plethora of manifestations following a Mycoplasma pneumoniae infection: a case report
Published in Acta Clinica Belgica, 2020
Imke Matthys, Daniel Borsboom, Sophia Steyaert, Delphine Vervloet, Kristoff Cornelis, Erik Vanderstraeten, Sébastien Kindt, Pieter Dewint, Valerie Lambrecht, Peter Sinnaeve, Christophe Van Steenkiste
A 27-year-old young man without a medical history attended the emergency department with high fever, chills and abdominal pain with diarrhea. His vital signs were stable. Physical examination revealed tenderness of the right iliac fossa and a normal cardiopulmonary examination. Initial blood tests showed 9800 white blood cells per mm3 (n.v. 4200–9100/mm3). Hemoglobin and platelet count were normal, as were the liver and renal function. C-reactive protein was increased to 290 mg/L (n.v. <5 mg/L). An urgent CT-scan of the abdomen showed terminal ileitis without evidence of any collection. Suspecting a bacterial ileocolitis, supportive therapy with intravenous fluid administration and antibiotic therapy with ciprofloxacin and metronidazole was initiated.
Related Knowledge Centers
- Ileum
- Small Intestine
- Crohn's Disease