Browsing by Author "Ristić, Nina (57194832760)"

Introduction Chronic intestinal pseudo-obstruction represents a group of rare disorders characterized by impaired gastrointestinal motility in the absence of mechanical bowel obstruction. These disorders can be primary or secondary, with autoimmune intestinal leiomyositis falling into the latter category. This condition is observed in adolescence and adulthood but is very rarely seen in children, especially in infancy. Case outline A nine-month-old male infant was hospitalized due to persistent vomiting, abdominal bloating, and distension. After diagnostic evaluations and failure of conservative treatment measures, surgical formation of an ileostomy was performed. During the procedure, intestinal samples were obtained, revealing T lymphocyte infiltration of the intestine. Immunological blood analyses showed elevated serum immunoglobulins and smooth muscle autoantibodies. Combined with histological findings and elevated inflammatory markers, a diagnosis of autoimmune intestinal leiomyositis was established. Immunosuppressive therapy was initiated, leading to normalization of inflammatory markers and resolution of clinical symptoms. After four years of immunomodulatory therapy, the ileostomy was closed, and intestinal biopsies showed no inflammatory infiltrates. Five years later, the boy remains free of gastrointestinal symptoms, with normal growth and development. Conclusion Although a rare condition, autoimmune intestinal leiomyositis is an important differential diagnostic entity in chronic intestinal pseudo-obstruction. Early disease recognition with intestinal biopsies, coupled with prompt and aggressive immunosuppressive therapy, enables favorable therapeutic outcomes. © 2025, Serbia Medical Society. All rights reserved.

“Refeeding syndrome” is described in the literature as a range of metabolic and electrolyte disorders that result from starting nutritional rehabilitation in malnourished patients. Without a universally accepted definition, data on “refeeding syndrome” incidence are heterogeneous. In most cases, a clinician will subjectively identify “refeeding syndrome,” many authors have developed their purposes and criteria for it in their studies. Using the PubMed database and the appropriate filters (“refeeding syndrome”-related terms: refeeding syndrome, pediatrics, child, nutrition support, nutrition assessment, malnutrition), a search of the published literature was conducted. The American Society for Parenteral and Enteral Nutrition’s 2020 recommendations are the only guidelines for identifying children with or at risk for “refeeding syndrome”. High-quality scientific evidence regarding the clinical syndrome is absent, so we need further research in all “refeeding syndrome”-related areas, from validation to better identification of risk factors, definitions of “refeeding syndrome,” and standardization of treatment protocols. For now, clinicians must remain vigilant to protect patients from the potentially devastating consequences of the “refeeding syndrome.”. © 2024, Serbia Medical Society. All rights reserved.

Crohn’s disease (CD) is a chronic inflammatory bowel condition with increasing global incidence. Diagnosing CD is challenging and requires close collaboration between clinicians and pathologists due to the lack of specific diagnostic criteria. Histologically, CD is characterized by transmural inflammation, crypt distortion, metaplasia, and granulomas, although granulomas are not always present. Schaumann bodies (SB), initially described in sarcoidosis, are rare in CD but have been reported in about 10% of cases. This case report presents a 4-year-old female with chronic hemorrhagic diarrhea, severe anemia, and elevated inflammatory markers. Endoscopic and histological evaluations suggested CD, with the presence of SB in the gastric mucosa. Further investigations ruled out sarcoidosis, confirming a diagnosis of multi-segmental, very early onset CD with atypical histological features. SB are inclusions composed of calcium carbonate crystals and conchoid bodies, typically found within giant cells. The presence of SB in the mucosa is rare, limiting their diagnostic significance in endoscopic biopsies. Differential diagnosis should exclude other granulomatous diseases such as intestinal tuberculosis and sarcoidosis. This case highlights the importance of considering SB in the diagnosis of CD, particularly in pediatric patients. © 2024 by the authors.