Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause sym...Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan.展开更多
Hepatitis E is the fifth known form of human viral hepatitis.Although not very common in our clinical practice,the incidence in Western countries is increasing.Infection with the hepatitis E virus(HEV)may be related t...Hepatitis E is the fifth known form of human viral hepatitis.Although not very common in our clinical practice,the incidence in Western countries is increasing.Infection with the hepatitis E virus(HEV)may be related to acute illness,liver failure,chronic hepatitis and cirrhosis.HEV itself is an RNA virus,with eight described genotypes(HEV 1-8),four of which more commonly affect humans and have,thus,been better studied.Besides liver manifestations,genotype 3 is also related to extra-hepatic manifestations,such as neurological,renal and rheumatological.Evolution to chronic disease occurs especially in patients who underwent transplantation,have hematological malignancies requiring chemotherapy,or have infection with the human immunodeficiency virus.The diagnosis may be difficult because of the low availability of tests and due to low sensibility and specificity.The acute form of illness does not have to be treated,but the chronic one does.We present here a literature review of hepatitis E and the relation between chronic hepatitis E and transplantation.展开更多
文摘Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan.
文摘Hepatitis E is the fifth known form of human viral hepatitis.Although not very common in our clinical practice,the incidence in Western countries is increasing.Infection with the hepatitis E virus(HEV)may be related to acute illness,liver failure,chronic hepatitis and cirrhosis.HEV itself is an RNA virus,with eight described genotypes(HEV 1-8),four of which more commonly affect humans and have,thus,been better studied.Besides liver manifestations,genotype 3 is also related to extra-hepatic manifestations,such as neurological,renal and rheumatological.Evolution to chronic disease occurs especially in patients who underwent transplantation,have hematological malignancies requiring chemotherapy,or have infection with the human immunodeficiency virus.The diagnosis may be difficult because of the low availability of tests and due to low sensibility and specificity.The acute form of illness does not have to be treated,but the chronic one does.We present here a literature review of hepatitis E and the relation between chronic hepatitis E and transplantation.
