Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report

Context. coating products are widely used for making surfaces water and dirt repellent. however, on several occasions the use of these products has been associated with lung toxicity. Objective. in the present study, we evaluated the toxic effects of an aerosolized tile-coating product. Methods. Thirty-nine persons, who reported respiratory and systemic symptoms following exposure to the tile-coating product, were clinically examined. The product was analysed chemically and furthermore, the exposure scenario was reconstructed using a climate chamber and the toxicological properties of the product were studied using in vivo and by in vitro surfactometry. Results. The symptoms developed within few hours and included coughing, tachypnoea, chest pain, general malaise and fever. The physical examination revealed perihilar lung infiltrates on chest radiograph and reduced blood oxygen saturation. The acute symptoms resolved gradually within 1-3 days and no delayed symptoms were observed. By means of mass spectrometry and X-ray spectroscopy, it was shown that the product contained non-fluorinated alkylsiloxanes. The exposure conditions in the supermarket were reconstructed under controlled conditions in a climate chamber and particle and gas exposure levels were monitored over time allowing estimation of human exposure levels.Mice exposed to the product developed symptoms of acute pulmonary toxicity in a concentration-and time-dependent manner. The symptoms of acute pulmonary toxicity likely resulted from inhibition of the pulmonary surfactant function as demonstrated by in vitro surfactometry. Among these patients only a partial association between the level of exposure and the degree of respiratory symptoms was observed, which could be because of a high inter-individual difference in sensitivity and time-dependent changes in the chemical composition of the aerosol. Conclusion. Workers need to cautiously apply surface coating products because the contents can be highly toxic through inhalation, and the aerosols can disperse to locations remote from the worksite and affect bystanders.

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“…The symptoms are comparable to what has been reported in other case series with aerosolized coating products. 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

Pulmonary toxicity following exposure to a tile coating product containing alkylsiloxanes. A clinical and toxicological evaluation

Duch

Nørgaard

Hansen

et al. 2014

Clinical Toxicology

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“…Moreover, Crohn’s disease will induce fibro-fatty modification of the mesentery, which is not found in patients with an inflamed Meckel’s diverticulum [ 22 ]. Rarely, Crohn’s disease and Meckel diverticulum may coexist, with involvement of the diverticulum by terminal ileitis causing diverticulitis, which may progress towards abscess and perforation [ 23 ] (Fig. 7 ).…”

Section: Image Reviewmentioning

confidence: 99%

Computed tomography of complicated Meckel’s diverticulum in adults: a pictorial review

et al. 2010

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ObjectiveTo show various CT aspects of complicated Meckel’s diverticulum in adult patients to facilitate the preoperative diagnosis of this rare pathology in emergency settings.MethodsA computer search of medical records over a 15 year period identified 23 adult patients who underwent surgery for acute abdomen generated by a complicated Meckel’s diverticulum. CT images available for review were analyzed, and some specific patterns leading to the diagnosis of complicated Meckel’s diverticulum are presented in this review.ResultsComplications were related to inflammation (14 patients), bleeding (5 patients), intestinal obstruction (3 patients), and penetrating foreign body (1 patient). The presence of a Meckel’s diverticulum was usually suggested at CT scan by an abnormal outpouching, blind-ending digestive structure connected to the terminal ileum by a neck of variable caliber. Depending on the type of complications, the diverticulum was surrounded by mesenteric inflammatory changes, or presented as a localized fluid or air-fluid collection contiguous with the terminal ileum. The diverticulum was also the source of active bleeding or acted as the lead point to intestinal obstruction or intussusception.ConclusionCT findings of complicated Meckel’s diverticulum are polymorphic and should be considered in the evaluation of adult patients with acute abdomen.

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Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report

Cited by 2 publications

References 7 publications

Pulmonary toxicity following exposure to a tile coating product containing alkylsiloxanes. A clinical and toxicological evaluation

Pulmonary toxicity following exposure to a tile coating product containing alkylsiloxanes. A clinical and toxicological evaluation

Computed tomography of complicated Meckel’s diverticulum in adults: a pictorial review

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