Esetismertetés / Case report
Lipoma of the coecum with secondary changes of the surface
Our endoscopically and histopathologically well documented case report is about a lipoma of the colon, which is a relatively rare benign mesenchymal tumor found in the large intestine. The lipoma was characterized as a pedunculated polyp in the cecum, intermittently translocating into terminal ileum and obstructing Bauhin's valve, resulting in clinical symptoms. During patient examination, lipomas present with differential diagnosis challenges due to their close resemble to other disorders, which might occur much more commonly are more probable to be malignant. Furthermore, bigger lipomas can also harbour secondary changes, such as erosion, ulceration, bleeding and necrosis. Although endoscopic and imaging techniques offer assistance in characterizing lipomas, the final diagnosis still relies heavily on the resecting and histologic examination of the entire polypoid/tumor-like outgrowth of the mucosa. Superficial sampling might also lead to misdiagnosis. Our case had inflammatory, erosive and also hyperplastic surface which could have been concluded as a hyperplastic polyp of colon, a much more common occurrence.
Összefoglaló közlemények / Reviews
Efficacy of fecal transplantation and presumed mechanisms of action
Therapeutic application of faces is not a new issue, since the Chinese applied the “yellow soup” already in the 4th century to treat prolonged diarrhea. It is also a routinely used method in the veterinary practice. It is acknowledged as an alternative and effective treatment option in human health care in the last 10 years for refractory Clostridiodes difficile infection, which caused pandemic and high health care cost. This method showed efficacy in many other conditions since that time. The effective agents are not exactly known due to the complex composition of stool. The current knowledge is shortly reviewed here about the mode of application, indications and the microbial and metabolic changes after fecal microbiota transplantation. Keywords: Clostridioides difficile, ulcerative colitis, Crohn’s disease, fecal microbiota transplantation
Összefoglaló közlemények / Reviews
Surgery of IBD
Gastroenterological medical treatment is more and more effective but contrary to the wide spread of biologic the surgical interventions remain indispensable therapeutic approach in the treatment of inflammatory bowel disease. Due to effect of improving medical treatment, the number of surgical procedures for colitis ulcerosa is decreasing but this cannot be stated for Crohn’s disease. Successful surgery for colitis ulcerosa may reach complete recovery, but it is not true for Crohn’s disease. After total proctocolectomy, perineal ileal pouch, with ileoanal anastomosis can preserve the fecal continence on acceptable level. At Crohn’s disease with small bowel involvement the “sparing” surgical technique, stricture plasty and limited resection become typical. At Crohn’s disease with large intestine involvement more liberal resection become accepted but preservation of the rectum, has to keep in mind to have a chance to perform ileorectal anastomosis. At the treatment of anal pathology, moderate surgical activity is characteristic. Anal sphincter apparatus without function may indicate to perform definitive stoma.
Orvostörténet / History in medicine
History of breath tests in gastroenterology
Although apparently simple both for patients and for physicians and nurses, the history of breath tests is as long as the medicine itself. The first knowledge on the role of air and its composition occurred in antiquity. Understanding the mechanism of respiration and tests for lung functions developed in the second half of the 19th century. Due to progress in basic sciences and medical technology, there have been many developments (labeled isotope tests, chromatography, mass spectrometry and combinations thereof, ion-selective sensors, electronic nose): some of these discoveries were awarded by Nobel Prize and later incorporated in the modern equipment’s. Consequently, today’s gastroenterology became enriched with accurate breath tests, which are complementary to or even replace invasive examinations.