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Volume 75 - 2012 - Fasc.4 - Letters

Collagenous colitis and ileitis under treatment with duloxetine

Collagenous colitis (CC) is a disease that causes chronic diarrhea, that could be diagnosed with a normal colonoscopic examination. Diagnosis is based on the histopathologic examination of the mucosa containing thickened subepithelial collagen layer (1). Etiology and pathophsiology of CC are not known exactly (2). In this article, the first case with CC and CI (Collagenous ileitis) associated with duloxetine [Serotonin norephinefrine reuptake inhibitor (SNRI)] treatment for major depres- sion is presented.


A new cause of acute hepatitis : Gemifloxacin

We wish to draw attention to a largely unreported side effect of the drug Gemifloxacin, drug induced hepato- toxicity, which has been observed in our institution. Gemifloxacin is a recently introduced fluoro- quinolone antibiotic which is frequently used for its broad spectrum. In generally gemifloxacin is well toler- ated with most side effects being comparable with other compounds. The most frequent side effects are abdomi- nal pain, diarrhoea, and headaches (1).


Gangliocytic Paraganglioma of the duodenum : A rare entity

Gangliocytic paraganglioma (GP) is a rare condition and the available data consist mainly of case descrip- tions. The lesion was first described by Dahl et al. in 1957 (1). The term GP was introduced by Kepes and Zcharias and is derived from his histological features of neurendocrine tumor, paraganglioma and ganglio- neuroma. The tumor is typically located in the second or third part of the duodenum (2).


An unusual complication of nasogastric tube

Multiple case reports of complications of malposi- tioned feeding tubes continue to surface. Most are due to inadvertent placement in the respiratory tract. Isolated reports of a nasally placed tube entering the brain follow- ing head injury continue to occur, as do reports of esophageal and gastric perforation in neonates. A recent study showed that malpositioned tubes are not routinely recorded in risk management databases (1). But maybe the most important complication of nasogastric tubes (NGT) is GI bleeding. It has been reported that pro- longed use of NGT can even result in life-threatening aortoesophageal fistula formation in patients with a double aortic arch (2). Herein we report a case with a buried NGT and GI hemorrhage after the unsuccessful attempt to remove the NGT.


Multicentric CD34 negative epithelioid angiosarcoma of the digestive system

We would like to report a particular case of a gastro- intestinal angiosarcoma that recently occurred in our hospital. A 74-year-old male was referred to our surgical department because of severe anemia due to repeated episodes of melena and right cervical swelling associat- ed with an oral lump of the upper dental arcade which was bleeding profusely (Fig. 1). A gastroscopy showed some haemorrhagic gastric and duodenal polyps, some of which were removed. A colonoscopy revealed the presence of multiple rectal, sigmoid and colonic polyps grossly similar to the gastric ones (Fig. 1). A total body CT scan showed multiple nodules, localized both in peri- toneum, next to duodenum, spleen and mesenteric artery and in retro-peritoneum. Histological examination of gastric and rectal polyps showed epithelioid malignant cells with large clear cytoplasm, pleomorphic nuclei and often an eosinophilic nucleolus.


Choledochal cyst and crossed fused ectopic kidney - a hitherto unknown association

Choledochal cyst is an uncommon biliary tract anom- aly defined as dilatation of extrahepatic bile tree with or without intrahepatic biliary dilatation. It is one of the important differential diagnosis of jaundice and abdomi- nal pain in the pediatric population. Though association with various developmental anomalies is already known, its combination with Crossed fused ectopic kidney has not been reported before in the literature to the best of our knowledge.