Publication Date:
2014-02-05
Description:
Case A 66-year-old woman was admitted with severe pancreatitis of unknown aetiology. Medical history disclosed insulin-dependent diabetes. She was treated conservatively with fluid and electrolyte correction. The patient was haemodynamically stable throughout the disease course. On day 4 she developed a paralytic ileus. Parenteral nutrition was initiated. Gradually, the ileus resolved. Enteral feeding was resumed on day 13 via a nasojejunal feeding tube. Over the following days, the patient developed watery diarrhoea. PCR and cultures failed to demonstrate a microbial cause. Suddenly, at day 21, the patient excreted per anus a 49 cm long vermiform soft strand ( figure 1 ). Question What is your diagnosis? See page 524 for answer Answer From question on page 493 Macroscopically, the excreted strand had a central lumen ( figure 2 ). Histological examination showed a completely necrotic, full-thickness colonic cast. All layers of the bowel wall, including...
Keywords:
GUT Snapshot
Print ISSN:
0017-5749
Electronic ISSN:
1468-3288
Topics:
Medicine
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