scholarly journals Small Intestinal Amyloidosis: A Rare Cause of Diverticular Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Gabriel M. Groisman ◽  
Hector I. Cohen
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Diverticular Disease ◽  
Additional Case ◽  
Systemic Amyloidosis ◽  
Small Intestinal

Systemic amyloidosis frequently involves the small intestine. However, its association with diverticular disease has been seldom reported to date. To draw attention to this rare but potentially harmful association, we herein present an additional case of small bowel diverticular disease associated with amyloidosis.

scholarly journals Update in Small Bowel Physiology: Part 1

1990 ◽  
Vol 4 (6) ◽  
pp. 243-254
Author(s):  
RJ Fingerote ◽  
S Churnratanakul ◽  
M Keelan ◽  
K Madsen ◽  
ABR Thomson
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Human Disease ◽  
Intestinal Function ◽  
The Past ◽  
Recent Advances ◽  
Small Intestinal ◽  
Clinical Advances

The recent advances in clinically important diseases of the small intestine have been reviewed; however, the basis for many of these clinical advances rests with important observations on alterations in the physiology of the small intestine, as well as mechanistic observations of alterations in small intestinal function in models of human disease. In this review a summary of the past year's literature is presented which will draw attention to the considerable areas of progress in small bowel physiology which will soon be translated into an improved understanding of the pathophysiology of a variety of intestinal disorders.

scholarly journals The small bowel microbiome changes significantly with age and aspects of the ageing process

2022 ◽  
Vol 9 (1) ◽  
pp. 21-23
Author(s):  
Gabriela Leite ◽  
Mark Pimentel ◽  
Gillian M. Barlow ◽  
Ruchi Mathur
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Microbiome ◽  
Ageing Process ◽  
Age Related ◽  
Human Ageing ◽  
Stool Samples ◽  
Older Subjects ◽  
Small Intestinal ◽  
Host Metabolism

Gut microbiome changes have been associated with human ageing and implicated in age-related diseases including Alzheimer’s disease and Parkinson’s disease. However, studies to date have used stool samples, which do not represent the entire gut. Although more challenging to access, the small intestine plays critical roles in host metabolism and immune function. In this paper (Leite et al. (2021), Cell Reports, doi: 10.1016/j.celrep.2021.109765), we demonstrate significant differences in the small intestinal microbiome in older subjects, using duodenal aspirates from 251 subjects aged 18-80 years. Differences included significantly decreased microbial diversity in older subjects, driven by increased relative abundance of phylum Proteobacteria, particularly family Enterobacteriaceae and coliform genera Escherichia and Klebsiella. Moreover, while this decreased diversity was associated with the ‘ageing process’ (comprising chronologic age, number of medications, and number of concomitant diseases), changes in certain taxa were found to be associated with number of medications alone (Klebsiella), number of diseases alone (Clostridium, Bilophila), or chronologic age alone (Escherichia, Lactobacillus, Enterococcus). Lastly, many taxa associated with increasing chronologic age were anaerobes. These changes may contribute to changes in human health that occur during the ageing process.

scholarly journals Endoscopic Evaluation of the Small Intestine

2002 ◽  
Vol 16 (3) ◽  
pp. 178-185 ◽  
Author(s):  
Steven J Shields ◽  
Jacques van Dam
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Bleeding ◽  
Endoscopic Evaluation ◽  
Design And Development ◽  
Intestinal Pathology ◽  
Small Intestinal ◽  
Small Bowel Endoscopy

Technological achievements in the area of endoscope design and development have resulted in instruments capable of advancing beyond the reach of simple gastroscopes. Such instruments, known as enteroscopes, form the bases of small bowel endoscopy. Recent widespread use of enteroscopes have contributed significantly to the understanding of small intestinal pathology and improved the ability to diagnose and treat patients with intestinal bleeding sources.

Small Intestinal Perforation Secondary to Necrotizing Enteritis—An Under-Recognized Complication of Crohn’s Disease

2022 ◽  
pp. 000313482110545
Author(s):  
Carlos Theodore Huerta ◽  
Antoine J. Ribieras ◽  
Karishma Kodia ◽  
D. Dante Yeh ◽  
David Kerman ◽  
...  
Keyword(s):  
Small Intestine ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Intestinal Perforation ◽  
Bowel Perforation ◽  
Case Fatality ◽  
Regional Enteritis ◽  
Small Bowel Perforation ◽  
Small Intestinal

Small bowel perforation is an uncommon but severe event in the natural history of Crohn’s disease with fewer than 100 cases reported. We review Crohn’s disease cases with necrotizing enteritis and share a case of a 26-year-old female who presented with a recurrent episode of small intestinal perforation. A PubMed literature review of case reports and series was conducted using keywords and combinations of “Crohn’s disease,” “small intestine perforation,” “small bowel perforation,” “free perforation,” “regional enteritis,” and “necrotizing enteritis.” Data extracted included demographic data, pre- or postoperative steroid administration, medical or surgical management, and case fatality. Nineteen reports from 1935 to 2021 qualified for inclusion. There were 43 patients: 20 males and 23 females with a mean age of 36 ± 15 years old. 75 total perforations were described: 56 ileal (74.6%), 15 jejunal (20.0%), 2 cecal (2.7%), and 1 small intestine non-specified (2.7%). 38 of 43 patients were managed surgically by primary repair (11), ostomy creation (21), or an anastomosis (11). Of 11 case fatalities, medical management alone was associated with higher mortality (5/5; 100% mortality) compared to those treated surgically (6/38; 15.8% mortality; P < .001). Patient sex, disease history, acute abdomen, and pre- or postoperative steroid use did not significantly correlate with mortality. Jejunal perforation was significantly ( P = .028) associated with event mortality while ileal was not ( P = .45). Although uncommon, necrotizing enteritis should be considered in Crohn’s patients who present with small intestinal perforation. These cases often require urgent surgical intervention and may progress to fulminant sepsis and fatality if not adequately treated.

scholarly journals Paneth cell–derived growth factors support tumorigenesis in the small intestine

2020 ◽  
Vol 4 (3) ◽  
pp. e202000934
Author(s):  
Qing Chen ◽  
Kohei Suzuki ◽  
Luis Sifuentes-Dominguez ◽  
Naoteru Miyata ◽  
Jie Song ◽  
...  
Keyword(s):  
Small Intestine ◽  
Growth Factors ◽  
Small Bowel ◽  
Genetic Model ◽  
Paneth Cell ◽  
Tumor Formation ◽  
Intestinal Epithelial ◽  
Α Subunit ◽  
Conditional Expression ◽  
Small Intestinal

Paneth cells (PCs) are small intestinal epithelial cells that secrete antimicrobial peptides and growth factors, such as Wnt ligands. Intriguingly, the context in which PC-derived Wnt secretion is relevant in vivo remains unknown as intestinal epithelial ablation of Wnt does not affect homeostatic proliferation or restitution after irradiation injury. Considering the importance of growth factors in tumor development, we explored here the role of PCs in intestinal carcinogenesis using a genetic model of PC depletion through conditional expression of diphtheria toxin-α subunit. PC depletion in ApcMin mice impaired adenoma development in the small intestine and led to decreased Wnt3 expression in small bowel adenomas. To determine if PC-derived Wnt3 was required for adenoma development, we examined tumor formation after PC-specific ablation of Wnt3. We found that this was sufficient to decrease small intestinal adenoma formation; moreover, organoids derived from these tumors displayed slower growth capacity. Overall, we report that PC-derived Wnt3 is required to sustain early tumorigenesis in the small bowel and identify a clear role for PC-derived Wnt production in intestinal pathology.

Histological examination of rat small intestine after surgical removal of obturation small bowel obstruction and peptide stimulation of lymph flow

2018 ◽  
pp. 157-162
Author(s):  
А.А. Коваленко ◽  
Г.П. Титова ◽  
В.К. Хугаева
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Small Bowel ◽  
Goblet Cells ◽  
Intestinal Wall ◽  
Structure And Function ◽  
Lymph Flow ◽  
Intestinal Lumen ◽  
And Function

Оперативное лечение различных заболеваний кишечника сопровождается осложнениями в виде нарушений микроциркуляции в области анастомоза кишки. Ранее нами показана способность лимфостимуляторов пептидной природы восстанавливать нарушенную микроциркуляцию, что послужило основой для настоящего исследования. Цель работы - оценка влияния стимуляции лимфотока в стенке кишки на процессы восстановления микроциркуляции, структуры и функции тонкой кишки в области оперативного вмешательства. Методика. В экспериментах на наркотизированных крысах (хлоралгидрат в дозе 0,6 г/кг в 0,9% растворе NaCl) моделировали различные поражения тонкой кишки (наложение лигатуры, перевязка 1-3 брыжеечных артерий, перекрут петли кишки вокруг оси брыжейки, сочетание нескольких видов повреждений). Резекция поврежденного участка через 1 сут. с последующим созданием тонкокишечного анастомоза завершалась орошением операционного поля раствором пептида-стимулятора лимфотока (40 мкг/кг массы животного в 1 мл 0,9% раствора NaCl). На 7-е сут. после операции проводили гистологическое исследование фрагмента кишки в области анастомоза. Результаты. На 7-е сут. после резекции у выживших животных (летальность вследствие кишечной непроходимости составляла 30%) имеют место морфологические признаки острых сосудистых нарушений стенки кишки, изменений кровеносных и лимфатических микрососудов, интерстициальный отек всех слоев стенки кишки, дилатация просвета кишки, повреждение всасывающего эпителия ворсин с истончением щеточной каемки клеток, морфологические признаки гиперфункции бокаловидных клеток. Использование лимфостимулятора пептидной природы после операции увеличивало выживаемость животных на 24%. У части животных отмечалось уменьшение расширения просвета кишки, у других практически полная его нормализация. Восстанавливалась форма кишечных ворсин и распределение бокаловидных клеток. Отсутствовали признаки внутриклеточного и межмышечного отека. Отмечено умеренное полнокровие венул. Заключение. Использование лимфостимулятора при хирургическом лечении кишечной непроходимости увеличивает выживаемость животных на 24% по сравнению с контролем, способствует более раннему восстановлению структуры и функции тонкой кишки. Полученные результаты свидетельствуют о перспективности использования стимуляции лимфотока при операциях на кишечнике. Surgical treatment of bowel diseases is associated with complications that cause microcirculatory disturbances in the anastomosis area and may lead to a fatal outcome. This study was based on our previous finding that peptide-type lymphatic stimulators are able to restore impaired microcirculation. The aim of this work was stimulating the lymph flow in the intestinal wall to facilitate recovery of microcirculation, structure and function of the small intestine in the area of surgical intervention. Methods. In experiments on anesthetized rats (0.6 g/kg chloral hydrate in 0.9% NaCl), various small bowel lesions were modeled (bowel ligation, ligation of 1-3 mesenteric arteries, gut torsion, combination of several lesion types). In 24 h, the damaged area was resected, and a small intestine anastomosis was creased. The surgery was completed with irrigation of the operative field with a solution of lymph flow stimulating peptide (40 мg/kg body weight in 1 ml of 0.9% NaCl). A gut fragment from the anastomosis area was examined histologically on day 7 after the surgery. Results. On the 7th day after removing the intestinal obstruction, the surviving animals (lethality 30%) had morphological signs of acute vascular disorders in the intestinal wall; changes in blood and lymphatic microvessels; interstitial edema of all intestinal wall layers; dilatation of the intestinal lumen; damage to the absorptive epithelium of villi with thinning of the brush border, and hyperfunction of mucous (goblet) cells. The use of the peptide after surgery increased the survival rate of animals by 24% and provided a smaller dilatation of the intestinal lumen in some animals. In other animals, the lumen recovered. The shape of intestinal villi and distribution of goblet cells were restored. Signs of intracellular and intermuscular edema were absent. Moderate venular congestion was noticed. Conclusion. Using the lymphatic stimulator in surgical treatment of intestinal obstruction increases the survival rate of animals by 24% compared to the control, facilitates earlier restoration of the small intestine structure and function. The obtained results indicated the effectiveness of lymphatic stimulation in intestinal surgery.

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

scholarly journals Bowel obstruction and perforation secondary to barbed suture after minimally invasive inguinal hernia repair: report of two cases and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Liming Wang ◽  
Taku Maejima ◽  
Susumu Fukahori ◽  
Shoji Nishihara ◽  
Daitaro Yoshikawa ◽  
...  
Keyword(s):  
Small Intestine ◽  
Inguinal Hernia ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Perforation ◽  
Barbed Suture ◽  
Small Bowel Perforation ◽  
Peritoneal Closure ◽  
Pubmed Database

Abstract Background Laparoscopic transabdominal preperitoneal patch (TAPP) is now commonly used in the repair of inguinal hernia. Barbed suture can be a fast and effective method of peritoneal closure. We report two rare cases of small bowel obstruction and perforation caused by barbed suture after TAPP. Cases Patient 1 is a 45-year-old man who underwent laparoscopic repair of a right inguinal hernia. Barbed suture was used to close the peritoneal defect. At 47 days after the operation, he was diagnosed with a small bowel obstruction caused by an elongated tail of the barbed suture. Emergency laparoscopic exploration was performed for removal of the embedded suture and detorsion of the volvulus. The second patient is a 50-year-old man who was admitted with a small bowel perforation one week after TAPP herniorrhaphy. Emergency exploration revealed that the tail of the barbed suture had pierced the small intestine, causing a tiny perforation. After cutting and releasing the redundant tail of the barbed suture, the serosal and muscular defect was closed with 2 absorbable single-knot sutures. Both patients have recovered well. Finally, we searched the PubMed database and reviewed the literature on the effectiveness and safety of barbed suture for TAPP. Conclusions Surgeons should understand the characteristics of barbed suture and master the technique of peritoneum closure during TAPP in order to reduce the risk of bowel obstruction and perforation.

Application of a dynamic mechanistic model of small intestinal starch digestion in the dairy cow

2002 ◽  
Vol 2002 ◽  
pp. 104-104
Author(s):  
J. A. N. Mills ◽  
E. Kebreab ◽  
L. A. Crompton ◽  
J. Dijkstra ◽  
J. France
Keyword(s):  
Experimental Data ◽  
Small Intestine ◽  
Dairy Cow ◽  
Energy Recovery ◽  
Mechanistic Model ◽  
Biological Knowledge ◽  
Dietary Energy ◽  
Starch Digestion ◽  
High Contribution ◽  
Small Intestinal

The high contribution of postruminal starch digestion (>50%) to total tract starch digestion on certain energy dense diets (Mills et al. 1999) demands that limitations to small intestinal starch digestion are identified. Therefore, a dynamic mechanistic model of the small intestine was constructed and evaluated against published experimental data for abomasal carbohydrate infusions in the dairy cow. The mechanistic structure of the model allowed the current biological knowledge to be integrated into a system capable of identifying restrictions to dietary energy recovery from postruminal starch delivery.

scholarly journals Jejunal diverticular disease: a report of three cases

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Richard Ghandour ◽  
Georges Khalifeh ◽  
Nasr Bou Orm ◽  
Mohamad Rakka ◽  
Samer Dbouk ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Diverticular Disease ◽  
Bowel Obstruction ◽  
Giant Diverticulum ◽  
Medical Entity ◽  
Adequate Management

Abstract Jejunal diverticula (JD) are a rare medical entity. They are often unnoticed, until complications occur. We report herein three cases of such diverticula, analyzed retrospectively, and depicting some of these complications: small bowel obstruction due to enterolith in a giant diverticulum treated surgically, incidental intraoperative finding on an anastomotic jejunal limb affecting the surgical plan and diverticulitis with anemia. In all three cases, the diagnosis of JD was unexpected, which illustrates the importance of being familiar with this disease for adequate management.

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