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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 345:526-532 August 16, 2001 Number 7
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Case 25-2001— A 71-Year-Old Man with Gastric Ulcers and Ileocecal Thickening Eight Years after Renal Transplantation
Nezam H. Afdhal, M.D., and Rhonda K. Yantiss, M.D.

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Presentation of Case

First Admission

A 71-year-old man was admitted to the hospital because of diarrhea and abdominal pain.

The patient had a history of polycystic renal disease with hypertension and end-stage renal failure, for which cadaveric renal transplantation had been performed eight years before admission; his base-line creatinine level at the time of transplantation was 2.3 mg per deciliter (203 µmol per liter). In recent years, diabetes mellitus type 2 had developed; it was controlled with insulin but was complicated by painful peripheral neuropathy, which required narcotic medication. A myocardial infarction three years before admission was treated by quintuple coronary-artery bypass grafting. Shortly before . . . [Full Text of this Article]

Second Admission

Third Admission

Differential Diagnosis

Causes of Esophagogastric Ulceration

Differential Diagnosis of Ileocolonic Lesions

            Ischemic Ileocolitis

            Non-Hodgkin's Lymphoma

            Bacterial Ileocolitis

            Protozoal and Fungal Infections

            Viral Ileocolitis

Conclusions

Clinical Diagnosis

Dr. Nezam H. Afdhal's Diagnosis

Pathological Discussion

Anatomical Diagnoses

References




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