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Volume 76 - 2013 - Fasc.2 - Letters

Perianal abscess as a complication of intravesical administration of Bacillus Calmette-Guerin for bladder cancer

Most of the anorectal abscesses result from acute in- fection of the anal glands extending from the anal crypts. Approximately 10% are due to other causes such as Crohn's disease, trauma, hematologic malignancies, human immunodeficiency virus, tuberculosis, actinomy- cosis, sexually transmitted diseases, radiation therapy, foreign body or anal surgery. Herein we present a rare case of perianal abscess developing as a complication of intracavitary administration of Bacillus Calmette-Guerin (BCG) for bladder cancer.

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An unusual cause of abdominal pain

A 44-year-old man was referred for acute abdominal pain of the upper left quadrant. His medical history was unremarkable and he was taking no medicine. On exami- nation, the abdomen was soft and tender to palpation at the left costovertebral angle. Cardiac auscultation re- vealed a grade 3/6 pansystolic murmur over the left low- er sternal border. The white-cell count was 12.000 per cubic millimetre, the C-reactive protein was 20 mg/L and the LDH 500 U/L. Liver and pancreatic enzymes were normal. While the patient was in the emergency depart- ment narcotic analgesia was administered intravenously to control pain. Computer tomography of the abdomen showed multiple wedge-shaped areas of hypoenhase- ment in the spleen, consistent with splenic infarcts (Fig. 1).

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Garlic induced esophagitis

A 54-year-old man with history of hypertension admitted to our clinic with complaints of acute onset odynophagia and retrosternal pain in the preceding 12 hours. Endoscopy revealed a garlic at the upper part of esophagus (Fig. 1). Garlic pushed into the stomach with endoscopy. oedematous, fragile mucosal area with superficial erosion at the upper of esophagus was detect- ed. Longitudinal length of the lesion was nearly 2,5 cm (Fig. 2). The detailed history revealed that he had been in the habit of swallowing garlic with a little amount of water for an alternative treatment in controlling hyper- tensive attack.

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Characteristic CT findings of mesenteric panniculit

Mesenteric panniculitis is a disorder characterized by a chronic nonspecific inflammation involving the adipose tissue of the bowel mesentery. Mesenteric panniculitis is an uncommon disease of unknown etiology (1). The eti- ology and pathogenesis of the disease are very obscure. Various factors such as blunt abdominal trauma or prior surgery, cold, different drugs, vasculitis, vitamin defi- ciency, autoimmune processes and allergic disease have been suggested as possible causes (2). The disease has a 2-3 :1 male predilection and is seen more frequently in patients over 50 years old (3).

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Successfully multiple pregnancies in Crohn's disease under long-term treatment with adalimumab

It is well known that anti-TNF-a antibodies may be safe for patients suffering from Crohn's disease (CD) and in pregnancy (1,2). Successful pregnancies of women under treatment with adalimumab (ADA) have been re- ported (3), but no data are available about what may hap- pen when patients under long-term ADA treatment go through multiple pregnancies.

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Campylobacter data from a Turkish University hospital laboratory

Campylobacter spp. are primarily zoonotic, with a variety of animals implicated as reservoirs for human infection. Campylobacteriosis is common in both devel- oped and nondeveloped countries. Definitive diagnosis requires isolation of bacterium in culture (i.e. "gold stan- dard"). Due to underdiagnosis and underreporting, actual incidence of infection in any country is substantially greater than reported incidence (1).

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