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Transient small bowel angioedema due to intravenous iodinated contrast media

World Journal of Gastroenterology 2012年第9期18卷 999-1002页

作者： Xiu-Hua Hu Xiang-Yang Gong Peng Hu Department of Radi-ology Sir Run Run Shaw Hospital Zhejiang University Schoolof Medicine Hangzhou 310016 Zhejiang Province China

Three cases of transient proximal small bowel angioedema induced by intravenous administration of nonionic iodinated contrast media (CM) are *** tomography (CT) images in the venous phase displayed the proximal small bowel with circumferential thickening of the wall including the duodenum and proximal segment of the *** bowel wall was normal in non-enhanced images,and normal or inconspicuous in arterial phase enhanced *** one of the three cases,the bowel wall was thickened in venous phase but disappeared in the 40 s delayed phase *** filling defect was seen in the lumen of the superior mesenteric artery and *** peritoneal effusion or mesentery abnormality was *** of these patients reported only mild abdominal discomfort and recovered without specific treatment within a short *** one patient suffered mild diarrhea after scanning which had resolved by the following *** transient anaphylactic small bowel angioedema due to intravenous iodinated contrast media was easily diagnosed based on its characteristic CT findings and clinical *** diagnosis may include inflammatory and ischemic bowel disease,as well as neoplasms.A three-phase CT protocol and good under-standing of this disorder are fundamentally important in the diagnosis of this *** supposed etiology behind the transient anaphylactic reaction to intravenous administration of iodinated CM in small bowel is similar to other CM-induced hypersensitive immediate *** predilection location of transient anaphylactic bowel angioedema is the small intestine,particularly the proximal segment.A speculated cause may be the richer supply of vessels in the small intestine,ample mucous folds and loose connective tissue in the duodenum and the jejunum.

关键词： Bowel angioedema Bowel thickening com-puted tomography Contrast media Small bowel ana-phylaxis

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Early diagnosis and therapeutic choice of Klebsiella pneumoniae liver abscess

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Frontiers of Medicine 2010年第3期4卷 308-316页

作者： Jing LI Ying FU Ji-Yao WANG Chuan-Tao TU Xi-Zhong SHEN Lei LI Wei JIANG Department of Gastroenterology Zhongshan HospitalFudan UniversityShanghai 200032China

Nowadays,pyogenic liver abscess(PLA)is still a common and severe intra-abdominal infection,and Klebsiella pneumoniae had emerged as the most common pathogenic bacteria worldwide in the past ten *** study aims to achieve an early pathogenic diagnosis and rational therapy modality for Klebsiella pneumoniae liver abscess(KLA)through clinical data analysis.A total of 197 inpatients in Zhongshan Hospital,Shanghai,diagnosed as having liver abscess between March 2001 and September 2009 were *** with monomicrobial infection were divided into two groups:patients with *** liver abscess(KLA group,n=106)and those with non-Klebsiella pneumoniae liver abscess(NKLA group,n=56).A retrospective analysis was made between these two groups on the aspects of underlying diseases,clinical characteristics,laboratory data,culture results,and imaging *** evaluate the effects of different medical interventions,monomicrobial KLA patients were further divided into four subgroups(percutaneous liver aspiration,aspiration plus antibiotics flushing,aspiration plus retained catheter,and aspiration plus antibiotics flushing and retained catheter),and corresponding therapeutic effects were *** was more likely to occur in patients with coexisting diseases such as diabetes mellitus(53.77%vs 25.00%,P=0.001)and hepatic adipose infiltration(16.04%vs 5.36%,P=0.029).compared to NKLA group,clinical characteristics including abdominal pain(40.57%vs 57.14%,P=0.044),hypodynamia(19.81%vs 46.43%,P=0.001),and hepatomegaly(4.72%vs 14.29%,P=0.033)were much milder,but with a higher fasting blood glucose level(7.84±0.36 vs 5.76±0.30,P=0.001)on admission in KLA *** addition,KLA abscess often appeared singly in the right lobe of the liver with gas forming nature(32.88%vs 13.51%,P=0.039),unsmooth rim(71.23%vs 40.54%,P=0.002),and dynamic septum enhancement(41.10%vs 16.22%,P=0.009).compared to mono aspiration subgroup,additional antibiotic flushing could not further improve

关键词： liver abscess Klebsiella pneumoniae com-puted tomography therapy

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