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Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

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Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The...
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Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal...
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Polyarteritis nodosa presenting as profuse gastrointestinal bleeding.

Gaurang Nandkishor Vaidya1, Arman Khorasani-Zadeh, Savio John

  • 1Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.

BMJ Case Reports
|February 8, 2014
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Summary
This summary is machine-generated.

Polyarteritis nodosa (PAN) can present with severe gastrointestinal bleeding, often without other symptoms. Early diagnosis and immunosuppressive treatment are crucial for managing this rare but serious manifestation of PAN.

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Area of Science:

  • Vascular Medicine
  • Gastroenterology
  • Rheumatology

Background:

  • Polyarteritis nodosa (PAN) is a systemic vasculitis that can affect medium-sized arteries.
  • Gastrointestinal bleeding is an uncommon presenting symptom of PAN, making early diagnosis challenging.

Observation:

  • A 70-year-old male presented with acute, profuse rectal bleeding.
  • Colonoscopy revealed diffuse colonic and distal ileal blood but no definitive source.
  • Visceral arteriography identified pseudoaneurysms in the superior mesenteric and left gastric arteries.

Findings:

  • The patient's bleeding resolved spontaneously.
  • The underlying cause of the pseudoaneurysms and bleeding was diagnosed as polyarteritis nodosa (PAN).
  • This case highlights gastrointestinal hemorrhage as a rare sole presenting manifestation of PAN.

Implications:

  • Prompt diagnosis of PAN in patients with significant gastrointestinal bleeding is vital.
  • Initiation of immunosuppressive therapy, including pulsed steroids, can prevent relapses.
  • This case underscores the importance of considering PAN in unexplained gastrointestinal bleeding.