The American journal of gastroenterology
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Am. J. Gastroenterol. · Dec 1989
Case ReportsFulminant liver failure and pancreatitis associated with the use of sulfamethoxazole-trimethoprim.
We report the case of a 26-yr-old patient with fulminant liver failure and acute hemorrhagic pancreatitis secondary to the use of trimethoprim-sulfamethoxazole (Bactrim DS). Our patient presented with skin rash and decreased C3 and C4 levels, which we believed was due to a hypersensitivity reaction secondary to the sulfonamide component (sulfamethoxazole). To our knowledge, this is the first case reported in which sulfamethoxazole-trimethoprim has been implicated as a cause of fulminant liver failure and acute hemorrhagic pancreatitis simultaneously, and emphasizes the need of discontinuing this medication as soon as there is evidence of liver and pancreatic dysfunction.
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Am. J. Gastroenterol. · Oct 1989
Case ReportsRare case of internal hernia with a new type of hepatodiaphragmatic interposition of the stomach and colon.
We report a new type of retroperitoneal internal hernia with hepatodiaphragmatic interposition of the stomach and colon. The hernia neck was formed in the lesser omentum, and the hernia sac consisted of the lesser omentum and retroperitoneum. The herniated organs (the stomach and colon) were incarcerated in the right extraperitoneal subphrenic space from the left dorsal side of the sulcus vena cava. This is the first reported case of this type.
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Am. J. Gastroenterol. · Jul 1989
Case ReportsAcute pancreatitis as a complication of Crohn's disease.
Two cases of Crohn's disease coincidental with acute pancreatitis are described. Both patients were diagnosed as suffering from acute pancreatitis by hyperamlasemia and ultrasonography. Both had received a previous diagnosis of Crohn's ileocolitis. ⋯ We also review other cases of Crohn's disease accompanied with pancreatitis that have been reported previously in the literature. In six cases, no cause was established for the pancreatitis, other than the Crohn's disease itself. We assume that pancreatitis, although rare, may be one of the extra-intestinal complications of Crohn's disease.
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Am. J. Gastroenterol. · Mar 1989
Case ReportsPortal and mesenteric venous thrombosis as a complication of endoscopic sclerotherapy.
We report on the occurrence of portal and mesenteric venous thrombosis in two patients who underwent endoscopic injection sclerotherapy (EIS) for bleeding esophageal varices. One patient was diagnosed at autopsy, and portal and mesenteric venous thrombosis was not suspected during life. The second patient was suspected on ultrasound examination and was diagnosed by angiography. ⋯ The venous phase of the superior mesenteric arteriogram 1 month after surgery revealed an organized thrombosis in the right intrahepatic portal branches. No other thrombi were seen. This patient is the first reported who has survived portal and mesenteric venous thrombosis after sclerotherapy.