Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Apr 1995
Nonsteroidal antiinflammatory drugs are associated with gastric outlet obstruction.
Nonsteroidal antiinflammatory drug associated gastric ulcerations are often prepyloric and painless; when recurrent, such ulcers may lead to pyloric scarring and gastric outlet obstruction. We performed a retrospective case control study to seek an association between gastric outlet obstruction and nonsteroidal antiinflammatory drug use. ⋯ The duration of nonsteroidal antiinflammatory drug use was also significantly longer in patients with gastric outlet obstruction than in control patients. Chronic nonsteroidal antiinflammatory drug use is associated with gastric outlet obstruction.
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J. Clin. Gastroenterol. · Apr 1995
Case ReportsTuberculous pancreatitis: a diagnostic problem. Case report and review of literature.
A 22-year-old Pakistani man presented with a 1-year history of recurrent attacks of pancreatitis of unknown etiology that had required hospitalization and extensive investigation in Pakistan. He was admitted with abdominal pain, fever, and weight loss. An ultrasound and computed tomographic scan of the abdomen revealed abdominal lymphadenopathy, bulky and inhomogeneous pancreas, and a large fluid collection anterior to the right lobe of the liver. ⋯ Because of a strong clinical suspicion of tuberculosis, the patient was started on antituberculous chemotherapy; 4 weeks later the aspirate grew Mycobacterium tuberculosis (hominis). The patient improved rapidly and has remained well after 18 months follow-up. A high index of clinical suspicion and appropriate microbiological investigation is required for the diagnosis of this rare, but potentially curable cause of pancreatitis.
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J. Clin. Gastroenterol. · Oct 1994
Comparative StudyHospital care of acute nonvariceal upper gastrointestinal bleeding: 1991 versus 1981.
Developments important to the care of upper gastrointestinal (UGI) bleeding occurred in the 1980s. We compared the features, care, and outcome of patients hospitalized with acute nonvariceal UGI bleeding in 1991 (n = 216) and 1981 (n = 105). Most patient characteristics and the hemoglobin values were similar. ⋯ Rates of rebleeding (including patients readmitted for recurrent bleeding within 1 week of discharge) and surgery were similar. Mortality was 2.8% in 1991, similar to the 1981 death rate. Because of the excellent 1991 patient outcome, we continue to care for most patients with acute nonvariceal UGI bleeding with urgent endoscopy and short hospitalization.
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J. Clin. Gastroenterol. · Sep 1994
Case ReportsHenoch-Schönlein purpura complicated by upper gastrointestinal bleeding with an unusual endoscopic picture.
In the course of Henoch-Schönlein purpura, diverse gastrointestinal manifestations are common. We report a patient with Henoch-Schönlein purpura complicated by upper gastrointestinal bleeding. A peculiar endoscopic picture not previously described is presented and articles about the endoscopic findings in this disease are reviewed. It is concluded that endoscopy can be useful in the diagnosis of Henoch-Schönlein purpura, especially for those patients without typical skin rash.
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J. Clin. Gastroenterol. · Jul 1994
Gastrointestinal dysfunction in Parkinson's disease. A report of clinical experience at a single center.
We describe our clinical experience in the evaluation of gastrointestinal symptoms in patients with Parkinson's disease. Dysphagia, heartburn, medication-related nausea, and constipation were the predominant symptoms. ⋯ Studies of anorectal sphincter and pelvic floor function in those patients with constipation demonstrated a high incidence of abnormal external anal sphincter dysfunction. We conclude, first, that dysphagia in patients with Parkinson's disease should not be assumed to result solely from oropharyngeal dysfunction but deserves detailed evaluation and, second, that constipation in Parkinson's disease is commonly consequent on anorectal sphincter and pelvic floor dysfunction.