Spontaneous pneumoperitoneum secondary to intestinal pneumatosis: an uncommon cause of acute abdomen

Intestinal pneumatosis is a rare entity characterized by gas accumulation in the submucosa and or subserosa of the intestinal tract wall and is generally associated with other diseases, the primary presentation is rare. Most of the cases are asymptomatic, being infrequent the presentation as an acute abdomen secondary to a spontaneous pneumoperitoneum. We report the case of a patient with systemic sclerosis, who presented to the emergency department with abdominal pain and intestinal obstruction, without improvement to conservative treatment and with progression to acute abdomen, for which surgical treatment was performed showing intestinal pneumatosis that compromised the entire small intestine.

Characteristics of myoelectrical activities along the small intestine and their responses to test meals of different glycemic index in rats

The purpose of this study was to characterize intestinal myoelectrical activity along the small intestine and investigate its responses to test meals with different glycemic index at different locations. Sixteen rats were implanted with electrodes in the serosal surface of the duodenum, jejunum, and ileum. Intestinal myoelectrical activities were recorded from these electrodes for 30 min in the fasting state and 3 h after four kinds of meals with different glycemic index, together with the assessment of blood glucose. The results were as follows: 1) in the fasting state, the percentage of normal intestinal slow waves (%NISW) showed no difference; however, the dominant frequency (DF), power (DP), and percentage of spike activity superimposed on the intestinal slow wave (NS/M) were progressively decreased along the entire small intestine; 2) regular solid meal and Ensure solicited no changes in any parameters of intestinal myoelectrical activity; whereas glucose and glucose + glucagon significantly altered the %NISW, DF, DP, and NS/M, and the effects on the proximal intestine were opposite to those in the distal intestine; and 3) postprandial blood glucose level was significantly correlated with %NISW along the entire small intestine. We found that that, in addition to the well-known frequency gradient, there is also a gradual decrease in the DP and spikes along the small intestine in the fasting state. Glucose and hyperglycemic meals inhibit myoelectrical activities in the proximal small intestine but result in enhanced but more dysrhythmic intestinal myoelectrical activities. There is a significant negative correlation between the normality of intestinal slow waves and blood glucose.

Acute mesenteric ischemia with necrosis of entire small intestine

The case study describes a case of a patient with acute mesenteric ischemia with necrosis of entire small intestine. In following text there is an overview of the incidence of acute mesenteric ischemia, its most common etiology, diagnostic methods and treatment of this severe disease.

Ginger Extract and [6]-Gingerol Inhibit Contraction of Rat Entire Small Intestine

This study aims to investigate the effect of oral administration and the direct action of ginger extract or [6]-gingerol on small intestinal contractility. The direct effect of 10 minutes preincubation of ginger ethanolic extract (10, 100 and 300 μg/mL) or [6]-gingerol (1, 30, and 100 μM) on 0.01 to 30 μM ACh-induced contractions of all parts of the small intestine isolated from normal rats was investigated using the organ bath technique. For in vivo study, the rats were orally administered with extract (10, 20, and 100 mg/kg/d) or [6]-gingerol (2 mg/kg/d) for 7 days, followed by determining the contractile responses to ACh of rat isolated duodenum, jejunum, and ileum and their histology were assessed. Direct application of the extract or [6]-gingerol attenuated ACh-induced contractions in each small intestinal segment, Emax was reduced by 40% to 80%, while EC50 increased 3- to 8-fold from control. Similarly, in the in vivo study ACh-induced contractions were reduced in all parts of the small intestine isolated from rats orally treated with ginger extract (20 and 100 mg/kg/d) or [6]-gingerol (2 mg/kg/d). Emax decreased 15% to 30%, while EC50 increased 1- to 3-fold compared to control. No discernable changes in the histology of intestinal segments were detectable. Thus, the results support the clinical application of ginger for disorders of gastrointestinal motility.

Toxicity from Intra-Abdominal Injection of Chlorfenapyr

Introduction. Chlorfenapyr is commonly used for food crops in Korea. However, chlorfenapyr toxicity in humans has not yet been studied.Case. A 74-year-old man was admitted to the emergency room after he intra-abdominally injected 20 mL of chlorfenapyr in an attempt to commit suicide. Emergency surgery was performed and accumulation of approximately 500 mL of reactive fluid in the abdomen was observed. The entire small intestine showed congestion. After surgery, additional surgery to drain the fluid was performed on POD 12. But immediately after administration of general anesthesia, flat rhythm was observed by electrocardiogram (ECG) monitoring, requiring cardiopulmonary resuscitation (CPR).Discussion. The color of the bowel was purple, indicating ischemic injury. This could be attributed to direct absorption of the substance through the peritoneum, leading to chemical injury to the small intestine serosa, unlike in the case of oral ingestion. This resulted in an ischemic change in the small intestine, eventually leading to sepsis.Conclusion. Only a few cases of chlorfenapyr toxicity have been reported in the literature, and death occurred in all cases, including our case. Therefore, careful and aggressive treatments are necessary. This is the first reported case of intra-abdominal injection of chlorfenapyr.

STORYBOARD OF WCE VIDEO EXTRACTION BASED ON FRAME DIFFERENCE

Wireless capsule endoscopy (WCE) is an imaging technology that enables close examination of the interior of the entire small intestine. A major problem associated with this new technology is that a large volume of video data need to be examined manually by clinicians. It is therefore useful to design a mechanism that allows the clinicians to gain certain evaluation of a video without watching the whole video. In this paper, a shot detection-based method is presented for automatically establishing the WCE video static storyboard, and then moving storyboard is extracted based on the selected representative frames under the supervision of clinicians. Experimental results show that most of the representative frames containing relevant features can be extracted from the original WCE video. The proposed method can significantly and safely reduce the number of frames that need to be examined by clinicians and thus speed up the diagnosis procedures.

DISEASES DETECTION IN WIRELESS CAPSULE ENDOSCOPY IMAGES WITH COLOR FEATURE

Due to a few great advantages such as viewing the entire small intestine with almost non-invasiveness and no sedation over traditional endoscopies and other imaging techniques for gastrointestinal tract diseases, the wireless capsule endoscopy invented by Given Imaging has found its gradually wide applications in hospitals. However, one major issue concerning this new technology is that too many images to be examined by naked eyes cause a huge burden to physicians, so it is very necessary to ease the physician if we can do diseases detection using computerized methods. In this paper, we develop a new method by making use of color feature, also a very important clue for diagnosis by physicians, to discriminate between normal region and abnormal region. Exploiting the color histogram of the image, we can get the distribution of the color in the image. Then we use the minimum distance classifier to judge the status of the regions. Experimental results on our present data prove promising performance of the proposed scheme in detecting bleeding and ulcers.