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A fecalith mimicking a bladder calculus secondary to an appendicovesical fistula: a case report
Gonzalez-Urquijo Mauricio,Romero-Davila, Andrea,Mendoza-Silva MaryCarmen,Treviño Antonio Nassim Halun,Rodarte-Shade Mario,Gil-Galindo Gerardo 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.4
An appendicovesical fistula is defined as an abnormal communication between the appendix and the urinary bladder, with only a few cases reported in the literature. It is very challenging to make an early diagnosis, due to the inability of conventional imaging modalities to detect this unique pathology. The symptoms are often mild, and there are not any specific signs or symptoms that might suggest this type of anomalous communication. We report a case of a 27-year-old male patient who presented difficulty for initiating urination, dysuria, and persistent urinary tract infections. An abdominal x-ray showed a large calculus inside the bladder. A cystoscopy was performed, where the tip of the appendix was seen protruding inside the bladder with a large fecalith adhered to the bladder wall. An appendectomy and partial cystectomy with primary repair were auspiciously achieved. A review of the literature is also presented.
( Marta Perez De Lis Novo ),( Alexandre Perez Gonzalez ),( Melania Estevez Gil ),( Emma Filgueira Davila ),( Julian Fernandez Martin ),( Roberto Perez Alvarez ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: To analyse the epidemiological, clinical, diagnostic and therapeutic features related to the development of spondylodiscitis in a cohort of Spanish patients. Methods: A retrospective analysis of 75 cases of infectious spondylodiscitis diagnosed in university hospital between 2000 and 2013. Results: We studied 75 patients with a mean age of 63 + / - 20 years, of which 67% were male. Time average evolution of disease prior to consultation was 4.2 months. The main symptom was back pain or back pain (90%) The most frequent location was the lumbar spondylodiscitis (74%), 60% of patients had one or more associated diseases (Diabetes:20%; COPD: 18%; tumors: 17%). Furthermore, 50% of them suffered from heart disease, being the most frequently hypertensive. 23% of patients carried immunosuppressive therapy, mainly corticosteroids (90%). In 53 patients (70%) could be performed a certain diagnosis, with Staphylococcus aureus the most frequent (41%) followed by S. epidermidis (17%), and Streptococcus (15%). Blood cultures were positive in 60% of cases and surgical biopsy was performed in 37% of the patients. 8 cases had endocarditis criteria, 6 of which were fulfi lled by S. aureus. MRI was performed in 75% cases, being in all cases, pathological. The average length of treatment was 12 weeks, with the most commonly used antibiotics cloxacillin, vancomycin and ceftriaxone. 18% of patients underwent surgery, performed laminectomy and drainage of abscesses. During evolution 6 patients died. 10 patients (8%) had sequelae neurological. Conclusions: Spondylodiscitis is a rare disease in adults, but with high morbidity and mortality due to the diffi culty of diagnosis. Insidious development and the lack of specifi city of the symptoms it interferes with the diagnosis and treatment early, so a high index of suspicion is essential.
Castro-Perez, B.I.,Garzon-Proano, J.S.,Lopez-Soto, M.A.,Barreras, A.,Gonzalez, V.M.,Plascencia, Alejandro,Estrada-Angulo, A.,Davila-Ramos, H.,Rios-Rincon, F.G.,Zinn, R.A. Asian Australasian Association of Animal Productio 2013 Animal Bioscience Vol.26 No.8
Four male lambs (Katahdin; average live weight $25.9{\pm}2.9$ kg) with "T" type cannulas in the rumen and proximal duodenum were used in a $4{\times}4$ Latin square experiment to evaluate the influence of supplemental dry distillers grain with solubles (DDGS) levels (0, 10, 20 and 30%, dry matter basis) in substitution for dry-rolled (DR) corn on characteristics of digestive function and digestible energy (DE) of diet. Treatments did not influence ruminal pH. Substitution of DR corn with DDGS increased ruminal neutral detergent fiber (NDF) digestion (quadratic effect, p<0.01), but decreased ruminal organic matter (OM) digestion (linear effect, p<0.01). Replacing corn with DDGS increased (linear, $p{\leq}0.02$) duodenal flow of lipids, NDF and feed N. But there were no treatment effects on flow to the small intestine of microbial nitrogen (MN) or microbial N efficiency. The estimated UIP value of DDGS was 44%. Postruminal digestion of OM, starch, lipids and nitrogen (N) were not affected by treatments. Total tract digestion of N increased (linear, p = 0.04) as the DDGS level increased, but DDGS substitution tended to decrease total tract digestion of OM (p = 0.06) and digestion of gross energy (p = 0.08). However, it did not affect the dietary digestible energy (DE, MJ/kg), reflecting the greater gross energy content of DDGS versus DR corn in the replacements. The comparative DE value of DDGS may be considered similar to the DE value of the DR corn it replaced up to 30% in the finishing diets fed to lambs.