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JAAPA 2018 Dec;31(12):30-33

Dan M. Tzizik practices in the ED at Portsmouth (N.H.) Regional Hospital. Roy A. Borchardt is supervisor of advanced practice providers at M.D. Anderson Cancer Center's Department of Infectious Diseases, Infection Control and Employee Health, in Houston, Tex. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Chagas disease is a parasite infection primarily transmitted to humans via the bite of triatomine insect vectors. Up to 8 million people are estimated to be infected with Chagas disease in the Americas. Patients who do not receive treatment can develop severe cardiac debility, gastrointestinal organ dysfunction, and may die. Read More

J Gastrointest Surg 2018 Sep 4. Epub 2018 Sep 4.

Department of Surgery, Traumatology and Acute Care, Hôpital du Sacré-Coeur de Montréal, Montreal, Québec, Canada.

Am J Case Rep 2018 May 14;19:557-561. Epub 2018 May 14.

Department of General Surgery, Colorectal Surgery Section, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

BACKGROUND Intestinal hypoganglionosis is very rare and accounts for 3% to 5% of all classified congenital intestinal innervation disorders. Isolated hypoganglionosis of the colon is a particularly rare form of the disease, and differential diagnosis includes association with Hirschsprung's disease and chronic intestinal pseudo-obstruction (CIPO) related to visceral myopathies. Most cases are diagnosed at an early age or in childhood with only a few cases reported in adults. Read More

J Biol Regul Homeost Agents 2018 Mar-Apr;32(2):415-423

DIBIMIS, Ospedali Riuniti Villa Sofia – Vincenzo Cervello, Division of Internal Medicine, Palermo, Italy.

Few data are available about the clinical course of severe colonic Crohn’s disease (CD). The aim of this study is to describe the clinical course of severe Crohn’s colitis in a patient cohort with isolated colonic or ileocolonic CD, and to compare it with the clinical course of patients with severe ulcerative colitis (UC). Thirty-four patients with severe Crohn’s colitis were prospectively identified in our cohort of 593 consecutive hospitalized patients through evaluation of the Crohn’s Disease Activity Index score and the Harvey-Bradshaw Index. Read More

Inflamm Bowel Dis 2018 Jun;24(7):1510-1519

Interventional Inflammatory Bowel Disease (i-IBD) Unit, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Background And Aims: Pouch sinus is a serious complication in patients undergoing ileal pouch-anal anastomosis. The aim of this study was to verify the efficacy and safety of endoscopic needle knife sinusotomy (NKSi) in the management of pouch sinus.

Methods: All consecutive patients with a pouch sinus treated with NKSi from 2008 to 2016 were identified. Read More

Rozhl Chir 2018 ;97(3):133-138

Hirschsprungs disease (HD) in adults is extremely rare, only three publications in Czech and Czechoslovak journals making reference to the condition after childhood. We present two cases of adult patients with HD. The first case is a 46-year-old male patient suffering from chronic constipation since childhood and diagnosed with megacolon at the age of 16; however, no further detailed diagnosis was done. Read More

Front Microbiol 2018 1;9:351. Epub 2018 Mar 1.

Centro de Biología Molecular Severo Ochoa (CSIC), Madrid, Spain.

Chagas disease is a multisystemic disorder caused by the protozoan parasite , which affects ~8 million people in Latin America, killing 7,000 people annually. Chagas disease is one of the main causes of death in the endemic area and the leading cause of infectious myocarditis in the world. infection induces two phases, acute and chronic, where the infection is initially asymptomatic and the majority of patients will remain clinically indeterminate for life. Read More

Parasitol Res 2018 Apr 22;117(4):1147-1158. Epub 2018 Feb 22.

Morphology Department, Federal University of Minas Gerais, Belo Horizonte, 31.270-901, Brazil.

Chagas disease is an infection caused by the parasite Trypanosoma cruzi that affects millions of people worldwide and is endemic in Latin America. Megacolon is the most frequent complication of the digestive chronic form and happens due to lesions of the enteric nervous system. The neuronal lesions seem to initiate in the acute phase and persist during the chronic phase, albeit the mechanisms involved in this process are still debated. Read More

Crit Care Nurs Clin North Am 2018 Mar 29;30(1):109-121. Epub 2017 Nov 29.

College of Health Sciences, School of Nursing, Walden University, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA.

Gastrointestinal (GI) motility problems are common complications in critical care patients. GI problems contribute to an increased risk of morbidity and mortality. Toxic megacolon (TM) is a type of acquired megacolon categorized as a medical emergency and includes severe inflammation affecting all layers of the colon wall. Read More

Vojnosanit Pregl 2017 Jan;74(1):78-80

Introduction: Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation and congenital megacolon.

Case Report: We presented transverse colon volvulus in a 16-year-old boy with cerebral palsy. Read More

Clin Med Insights Gastroenterol 2017 13;10:1179552217746692. Epub 2017 Dec 13.

Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA.

Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Read More

Eur J Pediatr 2018 Mar 22;177(3):403-408. Epub 2017 Dec 22.

Institute of Medical Microbiology and Hygiene, National Consultant Laboratory for Clostridium difficile, University of Saarland Medical Centre, Homburg, Germany.

In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. Read More

Z Gastroenterol 2017 Dec 6;55(12):1499-1508. Epub 2017 Dec 6.

Klinik und Poliklinik für Innere Medizin A, Universitätsklinikum Greifswald.

In patients with ileus with dilated intestine in imaging studies, endoscopic decompression appears a feasible option. However, its use is often uncritical and without scientific evidence. Before considering endoscopic intervention, CT-imaging should differentiate between mechanical obstruction and paralytic ileus/intestinal pseudo-obstruction. Read More

Semin Pediatr Surg 2017 Dec 5;26(6):367-372. Epub 2017 Oct 5.

Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Pediatric Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania. Electronic address:

The incidence of pediatric-onset ulcerative colitis (UC) is rising. Children often present with a more severe disease phenotype as compared to adults with over a third requiring hospitalization for the management of acute severe ulcerative colitis (ASUC). Further, in pediatric patients presenting with inflammatory bowel disease (IBD) limited to the colon, a definitive diagnosis of UC vs. Read More

BMJ Case Rep 2017 Oct 9;2017. Epub 2017 Oct 9.

The Royal Stoke University Hospital, Stoke-on-Trent, UK.

Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression. Read More

J Trauma Acute Care Surg 2017 Oct 4. Epub 2017 Oct 4.

aAcademic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, B152TH bNIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, B152TH cUniversity of Birmingham, Birmingham, UK.

There has been recent evidence from a large multi-center study sponsored by the Eastern Association for the Surgery of Trauma that colon-sparing surgery reduces mortality for patients with severe Clostridium difficile associated disease (CDAD) when compared to total colectomy. Amoebic colitis shares many pathologic and clinical features to CDAD, such as worsening diarrhoea, patchy colonic ulceration and necrosis, toxic megacolon, pseudomembranous colitis, perforation, and death. However, published research regarding amoebic colitis is sparse. Read More

S Afr J Surg 2017 Sep;55(3):20-26

Division of Gastroenterology, Department of Medicine, Groote Schuur Hospital and University of Cape Town.

Background: Acute Severe Ulcerative Colitis (ASUC) is a life-threatening condition which requires urgent and aggressive medical therapy to reduce mortality, morbidity and avoid surgery. To facilitate this process, it is essential to identify patients at high risk of poor outcomes and emergency colectomy. Numerous such risk factors have been described in Western literature, however there is no local data addressing this issue. Read More

Clin Auton Res 2018 02 20;28(1):67-81. Epub 2017 Jul 20.

Neurology Department, Raigmore Hospital, Inverness, UK.

Objectives: To review infectious diseases that may cause autonomic dysfunction.

Methods: Review of published papers indexed in medline/embase.

Results: Autonomic dysfunction has been reported in retrovirus (human immunodeficiency virus (HIV), human T-lymphotropic virus), herpes viruses, flavivirus, enterovirus 71 and lyssavirus infections. Read More

Neurogastroenterol Motil 2017 Oct 19;29(10):1-13. Epub 2017 May 19.

Department of Histology, State University of Londrina, Londrina, Paraná, Brazil.

Background: Experimental and clinical studies have shown that myenteric neuron cell death during infection with Trypanosoma cruzi mainly occurs in the esophagus and colon, resulting in megaesophagus and megacolon, respectively. Evidence suggests that the cyclooxygenase enzyme (COX) is involved in the T. cruzi invasion process. Read More

Colorectal Dis 2017 Apr;19(4):O97-O102

Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.

Aim: To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making.

Method: All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups. Read More

Blood Res 2016 Dec 23;51(4):281-285. Epub 2016 Dec 23.

Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.

Pediatr Emerg Care 2016 Nov;32(11):785-788

From the Departments of *Pediatric Surgery and †Pediatrics, University of Mannheim, Medical Faculty of Heidelberg, Mannheim, Germany.

Objectives: Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxic megacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so far undiagnosed HD. Read More

Internist (Berl) 2016 Dec;57(12):1182-1190

Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie und Infektiologie), Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Clostridium difficile (C. difficile) is an anaerobic, Gram-positive, spore-forming, toxin-secreting bacillus. It is transmitted via a fecal-oral route and can be found in 1-3 % of the healthy population. Read More

Arq Bras Cir Dig 2016 Jul-Sep;29(3):201-205

Discipline of Coloproctology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, SP, Brazil.

Introduction: : Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy.

Objective: : To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches. Read More

BMJ Case Rep 2016 Oct 12;2016. Epub 2016 Oct 12.

Madras Medical College, Institute of Surgical Gastroenterology, Chennai, Tamilnadu, India.

A 23-year-old woman presented to the outpatients department with symptoms of acute onset perianal pain of 2 weeks' duration and constipation. She was a known case of Hirschsprung's disease and was operated on in infancy. Rectal examination ruled out acute fissure or perianal sepsis, and subsequent colonoscopy was normal. Read More

World J Gastroenterol 2016 Jul;22(26):5867-78

Varut Lohsiriwat, Division of Colon and Rectal Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. Read More

J Pediatr Surg 2016 Nov 5;51(11):1782-1785. Epub 2016 Jul 5.

Department of Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address:

Background: Neonatal sigmoid volvulus is a rare entity. It is associated with Hirschsprung's disease. Presentation is acute abdominal distention, vomiting and obstipation. Read More

Euroasian J Hepatogastroenterol 2016 Jul-Dec;6(2):190-193. Epub 2016 Dec 1.

Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Polland.

We present a case of ulcerative colitis (UC) in a patient during the first severe relapse with colonic dilatation and coexisting of giant renal tumor. Kidney tumor was constricting on colon and imitating toxic megacolon (TM). The patient with severe acute colitis (SAC) was admitted to the Department of Gastroenterology and Hepatology with inflammatory bowel disease (IBD) diagnosed in the previous month, based on clinical symptoms, endoscopy, and histopathology results. Read More

BMJ Case Rep 2016 May 26;2016. Epub 2016 May 26.

Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Sigmoid volvulus is a rare and potentially life-threatening condition that is usually seen in adults, however, when diagnosed in children, it is often associated with Hirschsprung's disease (HD). We report a case of an 11-year-old boy who presented with a history of constipation since 1.5 months of age, with acute onset of severe abdominal pain and marked distention of the abdomen. Read More

Bull Emerg Trauma 2015 Apr;3(2):70-2

Department of General and Minimal Access Surgery, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, J & K, India.

Fecaloma is a mass of hardened feces being impacted mostly in rectum and sigmoid. The most common sites of the fecaloma is the sigmoid colon and the rectum. There are several causes of fecaloma and have been described in association with Hirschsprung's disease, psychiatric patients, Chagas disease, both inflammatory and neoplastic, and in patients suffering with chronic constipation. Read More

Rev Esp Enferm Dig 2016 Dec;108(12):841

UGC Aparato Digestivo, Hospital Universitario Virgen de la Victoria.

We present the case of a young bolivian woman who suffered two acute and impressive colonic complications due to a Chagasic megacolon. Read More

PLoS One 2016 5;11(4):e0153038. Epub 2016 Apr 5.

Departamento de Patologia Geral Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

We developed a novel murine model of long-term infection with Trypanosoma cruzi with the aim to elucidate the pathogenesis of megacolon and the associated adaptive and neuromuscular intestinal disorders. Our intent was to produce a chronic stage of the disease since the early treatment should avoid 100% mortality of untreated animals at acute phase. Treatment allowed animals to be kept infected and alive in order to develop the chronic phase of infection with low parasitism as in human disease. Read More

Rev Esp Enferm Dig 2016 Nov;108(11):742-746

Unidad de Trasplante Hepático, Hospital Universitario Virgen del Rocío, ESPAÑA.

Hirschsprung's disease is characterized by absence of ganglion cells in submucosal and myenteric plexus of distal bowel. Most cases become manifest during the neonatal period, but in rare instances, this disease is initially diagnosed in adult age. It usually presents as severe constipation with colonic dilatation proximal to the aganglionic segment. Read More

J Crohns Colitis 2016 Apr 18;10(4):395-401. Epub 2016 Jan 18.

Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France

Background: Therapeutic monoclonal anti-cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) antibodies are associated with immune-mediated enterocolitis. The aim of this study was to provide a detailed description of this entity.

Methods: We included patients with endoscopic signs of inflammation after anti-CTLA-4 infusions for cancer treatment. Read More

Redox Biol 2015 Dec 23;6:617-39. Epub 2015 Oct 23.

Instituto de Química e Biotecnologia (IQB), Universidade Federal de Alagoas (UFAL), Brazil. Electronic address:

Oxidative stress (OS) is considered as one of the etiologic factors involved in several signals and symptoms of inflammatory bowel diseases (IBD) that include diarrhea, toxic megacolon and abdominal pain. This systematic review discusses approaches, challenges and perspectives into the use of nontraditional antioxidant therapy on IBD, including natural and synthetic compounds in both human and animal models. One hundred and thirty four papers were identified, of which only four were evaluated in humans. Read More

Glob Heart 2015 Sep;10(3):139-44

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Division of Cardiology, University of Washington, Seattle, WA, USA.

Chagas disease, caused by infection with the protozoa Trypanosoma cruzi is transmitted most often by Triatominae insect vectors, but also through blood transfusion, organ transplant, and congenital transmission. Between 5 and 18 million people are currently infected and the infection is estimated to cause more than 10,000 deaths annually. The disease has 3 phases: acute, indeterminate, and chronic. Read More

Med Klin Intensivmed Notfmed 2015 Oct 23;110(7):506-9. Epub 2015 Sep 23.

Medizinische Klinik, Israelitisches Krankenhaus, Orchideenstieg 14, 22297, Hamburg, Deutschland.

Acute colonic pseudo-obstruction (ACPO) is characterized by marked colonic dilatation which develops over several days. ACPO is due to a motility disorder and is not caused by colonic obstruction and occurs in patients with severe, often acute underlying diseases or postoperatively. It is associated with a 25-30% mortality overall that increases to up to 50% in patients who develop complications (e. Read More

J Dig Dis 2015 Oct;16(10):558-67

University of Genoa, Department of Surgery, IRCCS Azienda Ospedaliera Universitaria San Martino, Istituto Nazionale per la Ricerca sul Cancro, Italy.

Ulcerative colitis (UC) is a chronic inflammatory disease of the mucosa of the colorectum. The treatment of UC depends on the severity of symptoms and the extent of the disease. Acute severe colitis (ASC) occurs in 12-25% of patients with UC. Read More

J Surg Res 2016 Jan 28;200(1):117-21. Epub 2015 Jul 28.

Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California. Electronic address:

Background: Current transgenic animal models of Hirschsprung disease are restricted by limited survival and need for special dietary care. We used small animal colonoscopy to produce chemically ablated enteric nervous system in the distal colon and rectum of normal mice.

Materials And Methods: Adult C57BL/6 mice underwent colonoscopy with submucosal injection of 75-100 μL of saline (n = 2) or 0. Read More

J Pediatr Gastroenterol Nutr 2016 Feb;62(2):259-63

*Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center †Hebrew University of Jerusalem, Jerusalem, Israel ‡Alder Hey Children's NHS Foundation Trust, Liverpool, UK §Children's Hospital of Eastern Ontario IBD Centre ||Department of Pediatrics, University of Ottawa, Ottawa, Canada ¶Connecticut Children's Medical Center, Hartford, CT #Nationwide Children's Hospital, Ohio State University, Columbus **SickKids Hospital, University of Toronto, Toronto, Canada.

Background: Abdominal x-ray (AXR) can identify complications in acute severe colitis (ASC) and may assist in selecting high-risk children for early aggressive treatment. We aimed to describe AXR findings in pediatric ASC and to explore radiological predictors of response to intravenous corticosteroid (IVCS) therapy.

Methods: A total of 56 children with ASC were included in a multicenter, retrospective 1-year cohort study (41% boys, mean age 12. Read More

Klin Padiatr 2015 Jul 3;227(4):235-8. Epub 2015 Jun 3.

Introduction: Enemas are used in pediatric patients with constipation. Retention of phosphate containing enemas with prolonged resorption or reduced renal elimination of phosphate can result in life-threatening hyperphosphatemia with subsequent lethal hypocalcemia and acidosis.

Case Presentation: We report the case of a 6-month-old child who received phosphate-containing enema to treat acute aggravation of constipation. Read More

Clin Colon Rectal Surg 2015 Jun;28(2):112-7

Colorectal Surgery Program, Department of Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia ; Section of Colon and Rectal Surgery, Washington Hospital Center, Washington, District of Columbia.

Acute colonic pseudoobstruction (ACPO), often referred to as Ogilvie syndrome, is a clinical entity characterized by severe colonic distension (adult acute megacolon) in the absence of mechanical obstruction. It can result in abdominal ischemia and perforation if left untreated. This article discusses the epidemiology and current pathophysiologic theories of ACPO as well as the clinical presentation and diagnostic modalities utilized to identify the disease. Read More

Int J Surg Case Rep 2015 29;11:83-86. Epub 2015 Apr 29.

Florida Hospital Division of Colon and Rectal Surgery,Orlando, FL, USA.

Introduction: Ulcerative colitis is an idiopathic inflammatory bowel condition whose peak incidence coincides with fertility in female patients. In pregnancy, acute fulminant colitis is rare, and, when it becomes refractory to maximum medical therapy, emergency colectomy is mandated. Over the past quarter century, there have been few reports of this rare event in the literature. Read More

Internist (Berl) 2015 Jun;56(6):648-52

Abteilung Innere Medizin, Park-Klinik Weissensee, Lehrkrankenhaus der Charité - Universitätsmedizin Berlin, Schönstr. 80, 13086, Berlin, Deutschland,

The motility of the colon is modulated by the enteric nervous system. It is very complex, governing backward and forward movements of the feces. Primary megacolon and megarectum are clinically diverse. Read More

Ned Tijdschr Geneeskd 2015 ;159:A8733

Universitair Medisch Centrum Groningen, afd. Kinderchirurgie, Groningen.

Background: 1 in every 5,000 children is born with Hirschsprung's disease (HD). Total colonic aganglionosis is an extended form of HD and is present in 2-13% of all patients with the disease.

Case Description: Paediatricians from a general hospital referred a 12-day-old male neonate on account of suspected abdominal obstruction and sepsis. Read More

J Clin Virol 2015 May 14;66:103-6. Epub 2015 Mar 14.

Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Division of Medicine, Villa Sofia-V. Cervello Hospital, Palermo University, Palermo, Italy. Electronic address:

Background: Human Cytomegalovirus (HCMV) infection has been reported to be a cause of refractory ulcerative colitis (UC). Toxic megacolon (TM) is a rare but severe complication of an acute attack of UC.

Objectives: Aim of this study is to evaluate in a case-control study the association between HCMV and TM. Read More

BMJ Case Rep 2015 Mar 25;2015. Epub 2015 Mar 25.

Intensive Care Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.

Hypercalcaemia is an emergency with severe consequences. Dehydration can be an uncommon cause of hypercalcaemia, as seen in this case. A 63-year-old woman with type 2 diabetes mellitus, hypothyroidism and osteoporosis, was admitted to the emergency room with abdominal distension and vomiting for 24 h. Read More

BMJ Case Rep 2015 Feb 25;2015. Epub 2015 Feb 25.

Department of General Surgery, Izmir Tepecik Teaching and Research Hospital, Izmir, Turkey.

Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a clinical syndrome characterised by gross dilation of the caecum and right hemicolon, which sometimes extends to the sigmoid colon and rectum in the absence of an anatomic lesion in the intestinal lumen. It is characterised by impaired propulsion of contents of the gastrointestinal tract, which results in a clinical picture of intestinal obstruction. A careful examination of the markedly distended colon can exclude several colonic pathologies, including mechanical obstruction and other causes of toxic megacolon. Read More

Parasitol Res 2015 May 25;114(5):1847-56. Epub 2015 Feb 25.

Departamento de Morfologia, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, 31.270-901, Brazil.

Megacolon is frequently observed in patients who develop the digestive form of Chagas disease. It is characterized by dilation of the rectum-sigmoid portion and thickening of the colon wall. Microscopically, the affected organ presents denervation, which has been considered as consequence of an inflammatory process that begins at the acute phase and persists in the chronic phase of infection. Read More