Pheochromocytoma

Pheochromocytoma

Definition

Pheochromocytoma are tumours arising from neuroectodermal cells of the adrenal medulla or extra adrenal sites they are found increased frequency in patients with hypertension MEN2a and MEN2b syndrome and von recklimghausen,s nerurofibromatosis

Read More!

TREATMENT OF CROHN,S DISEASE

 TREATMENT OF CROHN,S DISEASE

Medical treatment or Surgical treatment

Medical treatment

 as 1- 5- aminosalicylic acid - containing preparations may be of benefit , colitis responds better than small bowel disease however there are no proven benefits in reducing recurrence following resection 2- antibiotics particularly metronidazole and ciprofloxacin are effective though three months may need to be given 3- steroids are used in acute episodes though there is little to suggest that maintenance

Read More!

CROHN,S DISEASE

  

CROHN,S DISEASE

Definition

This is a chronic granulomatous inflammatory condition that

can involve any part of the gastrointestinal tract . it may occur at any age and the sex distribution is equal the most common site affected is the terminal ileum . this is involved in 70% of patients , giving rise to the soubriquet of (terminal ileitis) or (regional ileitis) the colon may also be involved and crohn,s colitis is the only manifestation of the disease in 20%of cases . multiple sites are common . crohn,s disease occurs in a discontinuous pattern within the bowel such that affected areas may be separated by quite normal bowel . these affected areas are termed skip-lesions 
Pathology

,Macroscopically the bowel wall becomes grossly thickened and enveloped in mesenteric fat (fat wrapping). the histological hallmark is non - caseating granuloma . this may not be found in up to 40%of specimens however . there is transmural chronic inflammation of the affected bowel with local lymphadenopathy . various aetiological theories exist , including genetic autoimmune viral and mycobacterial infections though a complex polygenic aetiology is the most likely . there appears to be strong relationship with smoking

Read More!

MANAGEMENT OF ACUTE PANCREATITIS

MANAGEMENT  OF ACUTE PANCREATITIS

non- operative management

repeated and careful clinical assessment of all patients during the first 25 hours is essential as the course of the disease is unpredictable during this time . a chest radiography is mandatory as is estimation of arterial blood gases daily for the first 48 hours and oxygen should be administered by mask if there is hypoxaemia . plain abdominal radiographs may show a sentinel loop, pancreatic calcification or calcified gall stones . vital signs and urine output should be monitored hourly . the severely affected patient should be managed on the intensive care unit . oral intake is withheld so adequate fluid replacement , especially of colloid is necessary . energetic fluid replacement is the single most important therapeutic measure since a large volume of protein rich fluid is sequestered in the

Read More!