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An uncommon cause of abdominal pain in a child: Meckel diverticulum

Journal of Acute Disease 2017年第5期6卷 229-231页

作者： anna chiara iolanda contini Tamara Caldaro Giovanni Federici di Abriola Erminia Romeo Valerio Balassone Francesca Rea Filippo Torroni Paola De Angelis Simona Faraci Giulia Angelino Renato Tambucci Luigi Dall'Oglio Digestive Surgery and Endoscopy Unit Bambino GesùChildren HospitalIRCCS00165 RomeItaly

Meckel diverticulum, a common congenital anomaly of the small intestine, can be responsible of several complications due to the presence of ectopic gastric mucosa and represents a challenge for diagnosis. We present the case of a 11-year boy suffering from intestinal pain and bleeding in which radiological examinations unexpectedly raised the suspicion of Meckel diverticulum. The diagnosis was confirmed using 99mTc-pertechnetate scintigraphy. At surgery, a fistulous tract between Meckel diverticulum and an inflamed appendix was found. The authors discuss the role of medical nuclear imaging which, notwithstanding its limitations, is of fundamental importance to achieve a correct and timely diagnosis. This is of particular relevance in unusual cases, as the one presented, in which Meckel diverticulum is found concurrently with other intestinal abnormalities.

关键词： Appendix Meckel Scintigraphy

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Endoscopic retrieval of a duodenal perforating teaspoon

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World Journal of Gastrointestinal Endoscopy 2013年第4期5卷 186-188页

作者： Ivo Bokoski Andrea Tringali Rosario Landi Pietro Familiari anna chiara iolanda contini Claudio Pintus Guido Costamagna Digestive Endoscopy Unit Catholic University of Rome Pediatrics Department Catholic University of Rome Digestive Endoscopy Unit Catholic University of Rome

Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall.

关键词： Foreign body ingestion Upper endoscopy Bowel perforation Bulimia

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Role of Chlamydia in the Development of Ocular Adnexal Lymphoma

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Journal of Cancer Therapy 2013年第2期4卷 662-677页

作者： Carlo contini Silva Seraceni Martina Maritati Francesco Cavazzini Paolo Perri Department of Bio- medical Sciences Section of Hematology University S. Anna Hospital Ferrara Italy Department of Biomedical Sciences and Specialistic Surgery Section of Ophthalmology University of Ferrara Ferrara Italy Department of Medical Sciences Section of Infectious Diseases University S. Anna Hospital Ferrara Italy

The aetiology of OAL is undefined, although much attention has been recently focused on determining whether OAL is caused by an autoimmune disorder, chronic antigenic stimulation or both. It is becoming evident that infectious agents underlying chronic eye infection, as Chlamydia, may play a role in ocular lymphomagenesis. The high prevalence of Chlamydophila psittaci in patients with OAL has suggested a potential oncogenic role for its tendency to cause chronic and persistent infections, although it has been documented an evident geographical variability and response to antibiotic treatment. For C. pneumoniae, the findings so far obtained are very limited not only for identification in OAL but also for the specific treatment with antibiotics. The recent molecular and cultural evidence of C. trachomatis in patients with OAL, seems to suggest that also this pathogen may contribute to pathogenesis of such lymphoma. The potential application of bacteria-eradicating therapy at local and systemic level may ultimately result in safer and more efficient therapeutic option for patients affected by these malignancies. Moreover, a close collaboration between experts in ophthalmology, infectious diseases and hematology will help, in the future, to effectively manage this disease. This review attempts to weigh the currently available evidence regarding the role that Chlamydia play in development of OAL and focuses on patients with OAL observed at our Institution.

关键词： Ocular Adnexa Lymphoma Chlamydia PCR Antibiotic Doxycycline

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ConservativeapproachinPeutz-JeghersSyndrome:Single-balloon enteroscopyandsmallbowelpolypectomy

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World Journal of Gastrointestinal Endoscopy 2014年第7期6卷 318-323页

作者： Torroni F Romeo E Rea F De Angelis P Foschia F Faraci S Federici di Abriola G contini AC Caldaro T Dall’Oglio L Filippo Torroni Erminia Romeo Francesca Rea Paola De Angelis Francesca Foschia Simona Faraci Giovanni Federici di Abriola Anna Chiara Contini Tamara Caldaro Luigi Dall’Oglio Department of Surgery and Transplantation Digestive Surgery and Endoscopy Unit Bambino Gesù Children’s Hospital IRCCS 00165 Rome Italy

AIM: To assess the usefulness of the balloon assisted enteroscopy in preventing surgical intervention in pa-tients with Peutz-Jeghers syndrome (PJS) having a small bowel large polyps. METHODS: Seven consecutive asymptomatic pts(age 15-38 years) with PJS have been collected; six under-went polypectomy using single balloon enteroscopy(Olympus SIF Q180) with antegrade approach using push and pull technique. SBE system consists of the SIF-Q180 enteroscope, an overtube balloon control unit(OBCU Olympus Balloon Control Unit) and a dispos-able silicone splinting tube with balloon(ST-SB1). All procedures were performed under general anesthesia. Previously all pts received wireless capsule endos-copy(WCE). Prophylactic polypectomy was reservedmainly in pts who had polyps > 15 mm in diameter. The balloon is inflated and deflated by a balloon control unit with a safety pressure setting range from-6.0 kPa to +5.4 kPa. Informed consent has been obtained from pts or parents for each ***: Six pts underwent polypectomy of small bowel polyps; in 5 pts a large polyp > 15 mm(range 20-50 mm in diameter) was resected; in 1 patient with WCE negative, SBE was performed for previous surgi-cal resection of gastrointestinal stromal tumors. In 2 pts endoscopic clips were placed due to a polypectomy. No surgical complication have been reported. SBE with resection of small bowel large polyps in PJS pts was useful to avoid gastrointestinal bleeding and emergency laparotomy due to intestinal intussuscep-tions. No gastrointestinal tumors were found in sub-sequent enteroscopic surveillance in all seven pts. In order surveillance, all pts received WCE, upper en-doscopy, ileocolonoscopy every 2 years. No pts had extraintestinal malignant lesions. SBE was performed when WCE was positive for significant polyps(> 15 mm).CONCLUSION: The effective of prophylactic polyp-ectomy of small bowel large polyps(> 15 mm) could be the first line treatment for conservative approach in management of PJS

关键词： Peutz-Jeghers syndrome Balloon assisted enteroscopy Polypectomy

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