Colonoscopic findings and management of patients with outbreak typhoid fever presenting with lower gastrointestinal bleeding.

Published on May 24, 2013in Indian Journal of Gastroenterology
· DOI :10.1007/S12664-013-0337-Y
Mohammad A. R. Shaikhani1
Estimated H-index: 1
Hiwa A. B. Husein1
Estimated H-index: 1
+ 1 AuthorsMohamed Abdulrahman Mohamed1
Estimated H-index: 1
Lower gastrointestinal bleeding (LGIB) along with intestinal perforation is a well-known complication of typhoid fever. Reports of colonoscopic appearance and intervention of typhoid perforation involve only few cases. This series reports the colonoscopic findings and the role of colonoscopic hemostatic interventions in controlling the bleeding ileocolonic lesions. During the typhoid fever outbreak in Sulaymaniyah City in Iraqi Kurdistan Region, we received 52 patients with LGIB manifesting as fresh bleeding per rectum or melena. We performed total colonoscopy with ileal intubation for all cases. The findings were recorded and endoscopic hemostatic intervention with adrenaline–saline injection and argon plasma coagulation was applied to actively bleeding lesion. These patients were young, 11–30 years of age, with female preponderance. Blood culture was positive in 50 %. Colonoscopic findings were mostly located in the ileocecal region, although other areas of the colon were involved in many cases. Twenty-four percent of the cases required endoscopic hemostatic intervention by adrenaline injection with argon plasma coagulation which was effective in all patients except one who died in spite of surgical intervention in addition of endoscopic hemostasis. Dual endoscopic hemostatic intervention can be a safe and effective management option for patients with LGIB due to typhoid fever.
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#1Agung Budi Sutiono (University of Electro-Communications)H-Index: 7
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Last. Toshizumi Ohta (University of Electro-Communications)H-Index: 8
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Background Although typhoid transmitted by food and water is a common problem in daily life, its characteristics and risk factors may differ in disaster-affected areas, which reinforces the need for rapid public health intervention. Surveys were carried out post-tsunami in Banda Aceh, post-earthquake in Yogyakarta, and under normal conditions in Bandung, Indonesia. Logistic regression analysis was used to assess the risk factors with the dependent variable of typhoid fever, with or without compl...
#1António MurinelloH-Index: 3
#2A MorbeyH-Index: 2
Last. J. NettaH-Index: 1
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A febre tifoide e uma infeccao intestinal causada pela Salmonella typhi, manifestada por quadro septicemico, ocorrendo incidencia elevada de casos em regioes com deficientes condicoes sanitarias, atraves do consumo de agua e alimentos contaminados por fezes de individuos doentes ou portadores assintomaticos. Em paises desenvolvidos os casos verificados sao geralmente “importados”. A observacao endoscopica das ulceracoes da ileocolite tifica tem sido raramente descrita, nao havendo referencias pr...
#1Turan BuzganH-Index: 13
#2Ömer Evirgen (Yüzüncü Yıl University)H-Index: 11
Last. Hayrettin AkdenizH-Index: 16
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An 18-year old female patient was admitted to the Emergency Department with complaints of fever and fatigue beginning 15 days ago associated with headache, weakness, palpitation, abdominal pain, and diarrhea a week later. The patient who apathic confused and discordant was transferred to the Department of Infectious Diseases. There was also hypocalcemia, hypopotassemia, pancytopenia, intestinal hemorrhage, and hepatic involvement. S. typhi was grown in the blood culture. The patient was discharg...
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#2Eli Schwartz (Sheba Medical Center)H-Index: 57
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Abstract Background. Intestinal bleeding in patients with typhoid fever usually occurs in the ileum. However, endoscopic findings in such patients are not well established. We examined the colonoscopic manifestations of intestinal lesions with bleeding in patients with typhoid fever. Patients and methods. The colonoscopic findings of seven patients who presented with haematochezia due to typhoid fever were reviewed retrospectively. Typhoid fever was diagnosed when the Salmonella typhi was isolat...
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The small intestine is an uncommon site of gastro-intestinal (GI) bleeding; however it is the commonest cause of obscure GI bleeding. It may require multiple blood transfusions, diagnostic procedures and repeated hospitalizations. Angiodysplasia is the commonest cause of obscure GI bleeding, particularly in the elderly. Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients. Capsule endoscopy and deep enteroscopy have improved our ability to invest...
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