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Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction:A case report

World Journal of Gastroenterology 2011年第24期17卷 2972-2975页

作者： Luigi Camera Milena Calabrese Giovanni Sarnelli Margaret Longobardi Alba Rocco Rosario Cuomo Marco Salvatore Department of Bio-morphological and Functional Sciences University "Federico II" Institute of Bioimages and Biostructures National Research Council Department of Clinical and Experimental Medicine Gastroenterology UnitUniversity "Federico II"

Chronic intestinal pseudo-obstruction(CIPO) is a rare disease due to a severe gastrointestinal motility disorder which may mimic,on both clinical and radiological grounds,mechanical *** report a case of a 26-year-old woman who presented to our institution for plain abdominal radiography for referred long-lasting constipation with recurrent episodes of abdominal pain and *** X-ray,performed both in the upright and supine position,an isolated air-fluid level was depicted in the left flank,together with a number of radiological signs suggestive of ***,subphrenic radiolucency could be observed in the upright ***,the intestinal wall of some jejunal loops appeared to be outlined in the right ***,the inferior cardiac border was clearly depicted in the upright *** patient however had no evidence ofperitoneal signs but only hypoactive bowel *** multi-detector computed tomography(MDCT) of the abdomen and pelvis was therefore *** revealed abnormal air-driven distension of the small and large bowel,without evidence of extraluminal *** radiological signs of pneumoperitoneum turned out to be false-positive *** patient was submitted to pan-colonoscopy and to anorectal manometry to rule out Hirshprung's disease,and was finally discharged with a diagnosis of CIPO.

关键词： Pseudopneumoperitoneum Abdominal radi-ography Multi-detector computed tomography motilitydisorders Chronic intestinal pseudo-obstruction

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Use of Clostridium botulinum toxin in gastrointestinal motility disorders in children

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World Journal of Gastrointestinal Endoscopy 2015年第5期7卷 433-437页

作者： Ricardo A Arbizu Leonel Rodriguez Center for Motility and Functional Gastrointestinal Disorders Division of Gas-troenterology Department of Medicine Boston Children’s Hospital Harvard Medical School

More than a century has elapsed since the identification of Clostridia neurotoxins as the cause of paralytic diseases. Clostridium botulinum is a heterogeneous group of Gram-positive, rod-shaped, spore-forming, obligate anaerobic bacteria that produce a potent neurotoxin. Eight different Clostridium botulinum neurotoxins have been described(A-H) and 5 of those cause disease in humans. These toxins cause paralysis by blocking the presynaptic release of acetylcholine at the neuromuscular junction. Advantage can be taken of this blockade to alleviate muscle spams due to excessive neural activity of central origin or to weaken a muscle for treatment purposes. In therapeutic applications, minute quantities of botulinum neurotoxin type A are injected directly into selected muscles. The Food and Drug Administration first approved botulinum toxin(BT) type A in 1989 for the treatment of strabismus and blepharospasm associated with dystonia in patients 12 years of age or older. Ever since, therapeutic applications of BT have expanded to other systems, including the gastrointestinal tract. Although only a single fatality has been reported to our knowledge with use of BT for gastroenterological conditions, there are significant complications ranging from minor pain, rash and allergic reactions to pneumothorax, bowel perforation and significant paralysis of tissues surrounding the injection(including vocal cord paralysis and dysphagia). This editorial describes the clinical experience and evidence for the use BT in gastrointestinal motility disorders in children.

关键词： Botulinum toxin Gastrointestinal motilitydisorders Children Swallowing disorders Gastroparesis Defecation disorders

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