BACKGROUND Enteric-coated medications are supposed to pass intact through the gastric environment and to release the drug content into the small intestine or the colon.Before dissolution of the enteric coating,they ma...BACKGROUND Enteric-coated medications are supposed to pass intact through the gastric environment and to release the drug content into the small intestine or the colon.Before dissolution of the enteric coating,they may appear hyperdense on computed tomography(CT).Unfortunately,few reports have been published on this topic so far.In this case report,the hyperdense appearance on contrastenhanced CT of an enteric-coated mesalamine tablet was initially misinterpreted as a jejunal gastrointestinal stromal tumor(GIST).CASE SUMMARY An asymptomatic 81-year-old male patient,who had undergone laparoscopic right nephrectomy four years earlier for stage 1 renal carcinoma,was diagnosed with a jejunal GIST at the 4-year follow-up thoraco-abdominal CT scan.He was referred to our hub hospital for gastroenterological evaluation,and subsequently underwent 18-fluorodeoxyglucose positron emission tomography,abdominal magnetic resonance imaging,and video capsule endoscopy.None of these examinations detected any lesion of the small intestine.After reviewing all the CT images in a multidisciplinary setting,the panel estimated that the hyperdense jejunal image was consistent with a tablet rather than a GIST.The tablet was an 800 mg delayed-release enteric-coated oral mesalamine tablet(Asacol®),which had been prescribed for non-specific colitis,while not informing the hospital physicians.CONCLUSION Delayed-release oral mesalamine(Asacol®),like other enteric-coated medications,can appear as a hyperdense image on a CT scan,mimicking a small intestinal GIST.Therefore,adetailed knowledge of the patients’medications and a multidisciplinary review of the images areessential.展开更多
Dear Editor,Appendectomy is usually performed to treat acute appendicitis although it may also be conducted in the absence of appendicitis when patients suffer from chronic abdominal pain.Resection is also known to mi...Dear Editor,Appendectomy is usually performed to treat acute appendicitis although it may also be conducted in the absence of appendicitis when patients suffer from chronic abdominal pain.Resection is also known to mitigate the risk of ulcerative colitis[1],a risk factor for colorectal cancer.The impact of appendectomy on colorectal cancer risk,particularly in the long term,is unclear.The procedurewas initially hypothesized to increase colorectal cancer risk due to decreased immunocompetency.展开更多
文摘BACKGROUND Enteric-coated medications are supposed to pass intact through the gastric environment and to release the drug content into the small intestine or the colon.Before dissolution of the enteric coating,they may appear hyperdense on computed tomography(CT).Unfortunately,few reports have been published on this topic so far.In this case report,the hyperdense appearance on contrastenhanced CT of an enteric-coated mesalamine tablet was initially misinterpreted as a jejunal gastrointestinal stromal tumor(GIST).CASE SUMMARY An asymptomatic 81-year-old male patient,who had undergone laparoscopic right nephrectomy four years earlier for stage 1 renal carcinoma,was diagnosed with a jejunal GIST at the 4-year follow-up thoraco-abdominal CT scan.He was referred to our hub hospital for gastroenterological evaluation,and subsequently underwent 18-fluorodeoxyglucose positron emission tomography,abdominal magnetic resonance imaging,and video capsule endoscopy.None of these examinations detected any lesion of the small intestine.After reviewing all the CT images in a multidisciplinary setting,the panel estimated that the hyperdense jejunal image was consistent with a tablet rather than a GIST.The tablet was an 800 mg delayed-release enteric-coated oral mesalamine tablet(Asacol®),which had been prescribed for non-specific colitis,while not informing the hospital physicians.CONCLUSION Delayed-release oral mesalamine(Asacol®),like other enteric-coated medications,can appear as a hyperdense image on a CT scan,mimicking a small intestinal GIST.Therefore,adetailed knowledge of the patients’medications and a multidisciplinary review of the images areessential.
基金The French E3N cohort is maintained with the support of the Mutuelle Générale de l’Education Nationale(MGEN),Gustave Roussy and the French League against Cancer(LNCC).E3N-E4N is also supported by the French National Research Agency(ANR)under the Investment for the future Program(PIA)(ANR-10-COHO-0006)by the French Ministry of Higher Education,Research and Innovation(subsidy#2102918823).
文摘Dear Editor,Appendectomy is usually performed to treat acute appendicitis although it may also be conducted in the absence of appendicitis when patients suffer from chronic abdominal pain.Resection is also known to mitigate the risk of ulcerative colitis[1],a risk factor for colorectal cancer.The impact of appendectomy on colorectal cancer risk,particularly in the long term,is unclear.The procedurewas initially hypothesized to increase colorectal cancer risk due to decreased immunocompetency.
