Background: Ulcerative colitis (UC) is characterized by chronic relapsing-remitting inflammation of the gastrointestinal tract. The chronic inflammatory process may predispose to atherosclerosis. The aim of the study was to assess the carotid intima-media thickness (CIMT) and its relation to subclinical atherosclerosis and to follow up cardiovascular complications in patients with UC. Methods: 83 patients with proven UC in remission were enrolled in the study. 42 age- and sex-matched healthy controls were taken. Patients with known risk factors for atherosclerosis were excluded from the study. Baseline blood investigations along with C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fasting lipid profile were done. CIMT was measured using B-mode Doppler imaging study. Results: The mean age of the UC patients was 37.06 ± 14.87 years. Left-sided colitis (45.8%) was the commonest type of presentation according to the extent of the disease. Mean CIMT (0.55 ± 0.17) was significantly higher in UC patients when compared to mean CIMT (0.46 ± 0.13) in the control group (p = 0.002). In Pearson correlation analysis, age, ESR, and CRP were positive and significantly correlated with CIMT. Multiple linear regression analysis (R2 = 0.18, p = 0.0026) revealed that age and CRP were significant independent predictors of mean CIMT. On following up for 6 months, 4 patients with UC had complications in the form of venous thrombosis. Conclusion: CIMT is a simple, noninvasive, reliable and objective auxiliary vascular parameter of structural alteration in UC patients.
Context: Diverticula are acquired or congenital outpouchings of the gastrointestinal tract, normally occurring at points of weakness in the wall of the alimentary canal. They can be present at any point from the esophagus to the anus, with colonic diverticulosis accounting for the majority of cases. While often asymptomatic, diverticula of the gastrointestinal (GI) tract are clinically significant due to potential life-threatening complications. Familiarity with key epidemiologic, etiologic, clinical, imaging, and therapeutic features of various diverticula is therefore important. This review is meant to serve as a concise guide highlighting the distribution, epidemiology, presentation, classic imaging findings, and treatment for the spectrum of GI diverticula. Evidence Acquisition: We reviewed the fluoroscopic, computed tomography (CT), and magnetic resonance imaging (MRI) features of the most commonly encountered GI diverticula. Diverticula that are anatomically adjacent often share features such as symptomatology, optimal diagnostic imaging modality, and management. Thus, we categorized them by location along the GI tract. Esophageal (Zenker's, Killian-Jamieson, midthoracic, epiphrenic), false and true gastric, small bowel (duodenal, jejunoileal, and Meckel's), and large bowel (appendiceal, cecal, ascending/descending/sigmoid colonic) diverticula are discussed. Results and Conclusions: Although commonly incidental, diverticula of the GI tract can be clinically significant due to complications. This pictorial essay describes the epidemiologic, etiologic, clinical, and therapeutic features as well as imaging findings associated with the range of GI diverticula encountered in clinical practice.
Video capsule endoscopy is now the first-line tool in evaluating and diagnosing obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel neoplasms. Capsule retention is an uncommon but clinically significant complication. How to best retrieve these retained capsules is currently being debated. In this case report, we describe a retained capsule successfully retrieved using double-balloon enteroscopy. This case also highlights the fact that capsule retention can occur even in the absence of signs and symptoms suggestive of intestinal obstruction.
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