Crohn's disease in the city of Derby, 1951-85
Article Abstract:
Crohn's disease, a gastrointestinal disorder characterized by inflammation and/or constriction of portions of the intestinal tract, abdominal pain, and diarrhea, is prevalent worldwide. Numerous epidemiological surveys have been published of Crohn's disease incidence in England, but most recent reports come from coastal areas, and few are of long enough duration to show any trends in occurrence of the disease. A retrospective and prospective study was performed of Crohn's disease cases reported in an inland English city (Derby) covering the period from 1951 to 1985. Criteria for acceptance were chronic abdominal pain or diarrhea, radiological evidence of intestinal dysfunction, and microscopic verification. Not all criteria could be satisfied in the retrospective cases. Patients were classified according to sex, age, ethnic background, year of onset of symptoms, year of diagnosis, and several indications about the site of the disease. The disease was evenly distributed among men and women. The majority of patients reported involvement of both the large and small intestines, but older patients (60 to 79 years old) reported a greater incidence of large intestine involvement. The major trend seen was a general increase in overall incidence of the disease, from 0.7 cases per 100,000 between 1951 and 1955 to 6.67 cases per 100,000 from 1981 to 1985. The incidence of Crohn's disease reported among Asians was not different from that in the overall population. The incidence and prevalence of Crohn's disease in Derby are among the highest reported in the world, but this fact may reflect the more sensitive inclusion criteria applied in this study. The changes over time are similar in magnitude and direction to studies done in Cardiff and Nottingham, but differ from the reduction in Crohn's disease seen in Aberdeen over a similar period of time. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1990
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Future needs for ERCP: incidence of conditions leading to bile duct obstruction and requirements for diagnostic and therapeutic biliary procedures
Article Abstract:
The bile duct allows passage of bile (an important substance in the digestion of food) to flow from the liver to the intestine. Blockage of the bile duct, usually caused by gall stones or tumors, can result in jaundice, pain, and fever; if untreated, more severe complications may ensue. Prior to about 1974, the only treatment for bile duct blockade was surgery. More recently, a technique known as endoscopic retrograde cholangiopancreatography (ERCP) using a flexible device that is inserted into the biliary system from the intestine has been used to visualize and treat obstructions of the bile duct. In some areas, ERCP has largely replaced surgical modes of treatment; in other regions, hospitals are not equipped to perform this technique. To assess current and future requirements, an epidemiological study was carried out investigating the prevalence of bile duct obstruction in a selected region of the United Kingdom. The results of this survey were combined with an accounting of the number of actual surgical and endoscopic procedures performed on patients for biliary obstruction. From these two sources it was estimated that approximately 50 ERCP procedures per 100,000 population would be required in the foreseeable future. As the popularity of ERCP grows as an alternative to surgical therapies, this number may increase. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1990
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Carcinoid tumour of the common bile duct - a novel complication of von Hippel-Lindau syndrome
Article Abstract:
The von Hippel-Lindau syndrome is a disorder in which blood vessel tumors (angiomas) occur in the retina, brain, and some internal organs. A case is reported of a 30-year-old man who had a retinal angioma in childhood, who developed jaundice, itching, dark urine, and pale stools. The man's father and older brother had died from tumors. Tests showed that the bile duct of this patient was blocked by a cherry-sized tumor. The tumor was found to be carcinoid, a tumor that tends to spread, containing endocrine-like cells that secrete hormones. Further scanning of the patient showed cysts in both kidneys and the adrenal gland, and an angioma in the right eye. One kidney was subsequently removed and was found to contain an enlarging cancer. A tumor was located in the common bile duct, which is rare; the tumor also did not have the expected characteristics of tumors associated with von Hippel-Lindau syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1990
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