Gastroenterology International

Acute thrombosis of the celiac trunk is a very uncommon condition, unless diagnosed early can become a life threatening emergency. The clinical presentation is highly variable depending on the extent of the thrombus. We report a case of biliary peritonitis related to an acute thrombosis of the celiac trunk and isolated gangrene of the gall bladder. This case highlights the role of diagnostic laparoscopy in the diagnosis of acute upper abdominal pain. Keywords: Pain abdomen, mesenteric ischaemia, laparoscopy, gall bladder

COVID-19 Virus is mainly transmitted through drops generated when an infected person coughs, sneezes, or exhales. These droplets are too heavy to hang in the air, and quickly fall on floors or surfaces.1 The person might acquire infection very soon, if you are within close proximity of someone who has COVID-19, or by touching a contaminated surface and then your eyes, nose or mouth. The pandemic disease COVID-19 affects different people in different ways. Those who get infected will develop mild to moderate illness and recover without hospitalization.2 • Most common symptoms: • Fever • Dry cough • Tiredness • Less common symptoms: • Aches and pains • Sore throat • Diarrhea • Conjunctivitis • Headache • Loss of taste or smell Besides these symptoms the patient received in OPD/IPD with or without Fever history such as pain abdomen, loose stools and vomiting when tested found positive and managed accordingly. Totally patient received in OPD/IPD during the month of Mid March to Mid May totally screened patient with suspicion of COVID has been tested RT PCR Positive 58 patient out of total hospitalization and OPD footfall. Extra pulmonary features are common in COVID 19 and commonest being the gastrointestinal.3 Keywords: COVID, GIT, Extra Pulmonary, RT PCR.

Background: Cytomegalovirus is a common and self-limiting infection in general population, but in immunocompromised states it has been implicated in severe complications like pneumonia and colitis. It could also be an innocent bystander(coloniser) in colon. In Inflammatory bowel disease there has been an association with severe colitis and flares of disease,with a reported prevalence of 4.5–16.6%, and as high as 25% in patientsrequiring colectomy for severe colitis. The role of CMV in the deterioration of the IBD disease is still debatable. There is also no global consensus in defining this entity. The clinical relevance of the presence of CMV in IBD patients is our question-whether it is a bystander or clinically significant. Aim: To analyse the clinical relevance of Cytomegalovirus in patients with inflammatory bowel disease, including epidemiology, clinical features, diagnosis and management options. Methods: Literature search was made using Pubmed, EMBASE and the Cochrane resources with the search words: CMV in Inflammatory Bowel disease, cytomegalovirus colitis, CMV treatment. Results: Cytomegalovirus infection is common in patients with Inflammatory Bowel Disease. CMV disease and CMV reactivation is common in patients with severe colitis, with a prevalence of 4.5–16.6%, and upto 25% in patients with severe colitis requiring colectomy. The clinical outcome of patients with reactivation is poorer compared to those without reactivation. However, 71-86% of patients who underwent treatment with antivirals showed disease remission. Conclusions: From the literature review, we can infer that, testing for CMV should be considered in patients with flare of disease having moderate to severe activity, by doing biopsies for microscopic evidence of CMV activity, Immunohistochemistry, tissue for Real time Polymerase Chain reaction. Ganciclovir treatment showed good results in these group of patients. Key Words: Cytomegalovirus infection, Cytomegalovrus Disease, Inflammatory Bowel Disease, Flare, Severe Colitis, Steroid Refractory Colitis, Clinical relevance.