Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders.Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting,but pati...Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders.Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting,but patients tend not to seek medical attention due to embarrassment or fear of cancer.As a result,patients frequently present with advanced disease after experiencing significant decreases in quality of life.A number of patients with anorectal complaints are referred to gastroenterologists.However,gastroenterologists' knowledge and experience in approaching these conditions may not be sufficient.This article can serve as a guide to gastroenterologists to recognize,evaluate,and manage medically or non-surgically common benign anorectal disorders,and to identify when surgical referrals are most prudent.A review of the current literature is performed to evaluate comprehensive clinical pearls and management guidelines for each topic.Topics reviewed include hemorrhoids,anal fissures,anorectal fistulas and abscesses,and pruritus ani.展开更多
Eosinophilic ascites(EA)is a rare disorder of unknown etiology that has been reported in both adult and pediatric patients.It is a part of the syndrome of eosinophilic gastroenteritis,which is characterized by eosinop...Eosinophilic ascites(EA)is a rare disorder of unknown etiology that has been reported in both adult and pediatric patients.It is a part of the syndrome of eosinophilic gastroenteritis,which is characterized by eosinophilic infiltration of any or all layers of the gut wall and may involve any segment of the gastrointestinal tract.Peripheral eosinophilia may or may not be present.We report a case of EA that developed post partum.展开更多
Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requi...Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage B.Thalidomide and dexamethasone were initiated.The patient developed a continuous increase in bilirubin that led to severe cholestasis.A liver biopsy revealed plasma cell infiltration.He then rapidly progressed to liver failure and died.Treatment options are limited in MM with significant liver dysfunction.espite new drug therapies in MM,those patients with rapidly progressive liver failure appear to have a dismal outcome.展开更多
文摘Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders.Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting,but patients tend not to seek medical attention due to embarrassment or fear of cancer.As a result,patients frequently present with advanced disease after experiencing significant decreases in quality of life.A number of patients with anorectal complaints are referred to gastroenterologists.However,gastroenterologists' knowledge and experience in approaching these conditions may not be sufficient.This article can serve as a guide to gastroenterologists to recognize,evaluate,and manage medically or non-surgically common benign anorectal disorders,and to identify when surgical referrals are most prudent.A review of the current literature is performed to evaluate comprehensive clinical pearls and management guidelines for each topic.Topics reviewed include hemorrhoids,anal fissures,anorectal fistulas and abscesses,and pruritus ani.
文摘Eosinophilic ascites(EA)is a rare disorder of unknown etiology that has been reported in both adult and pediatric patients.It is a part of the syndrome of eosinophilic gastroenteritis,which is characterized by eosinophilic infiltration of any or all layers of the gut wall and may involve any segment of the gastrointestinal tract.Peripheral eosinophilia may or may not be present.We report a case of EA that developed post partum.
文摘Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage B.Thalidomide and dexamethasone were initiated.The patient developed a continuous increase in bilirubin that led to severe cholestasis.A liver biopsy revealed plasma cell infiltration.He then rapidly progressed to liver failure and died.Treatment options are limited in MM with significant liver dysfunction.espite new drug therapies in MM,those patients with rapidly progressive liver failure appear to have a dismal outcome.
