Ileocolic Intussusception as the Presenting Symptom of Primary Enteric Varicella-Zoster Virus Infection in a 7-Month-Old Infant

Ileocolic intussusception is the invagination of ileum into the colon. In a subset of patients, the disease is caused by mesenteric lymphadenopathy in response to (viral) infection. We present a case of an ileocolic intussusception necessitating surgery in a 7-month-old immunocompetent infant with concurrent primary wild-type varicella-zoster virus (VZV) infection, in whom chickenpox rash developed 2 days after surgery. Detailed in situ analyses of resected intestine for specific cell type markers and VZV RNA demonstrated VZV-infected lymphocytes and neurons in the gut wall and in ganglion cells of the myenteric plexus.

Resected Intestine Syndrome: Term Defining the Strategy for Nutritional Deficiency Management

Study Objective: to develop nutritional deficiency management approaches in patients with resected intestine syndrome. Study Design: observational study. Materials and Methods. We examined and treated 239 patients (143 women, mean age: 49.4 ± 6.5 years old; 96 men, mean age: 52.1 ± 15.6 years old) who underwent intestine resection to a various extent and level caused by various conditions. Small intestine was resected in 96 patients; a combined resection of small intestine and right half of large intestine was performed in 97 patients; and right hemicolectomy/colectomy was indicated in 46 cases. At least one month after surgery all patients underwent a screening to identify the nutrition risk as per the Screening of Nutritional Risk 2002 questionnaire. Study Results. It was found out that nutritional support was needed in 85.7% of cases, including 51% and 34.7% of cases with moderate and high risk of nutritional disorders, respectively. Various extent and levels of intestine resections are characterised by similar types of nutritional deficiency, most often it was a mixed type with signs on dehydration and protein-calorie deficiency. Following the results of a comprehensive nutritional deficiency assessment in our patients and taking into account the level and extent of intestine resection, as well as its causes and concomitant pathology, we propose a new term “resected intestine syndrome” and classification. Additional examinations using the proposed classification allowed adjusting the conventional nutritional therapy and modifying management. Conclusion. Data consolidation resulted in the need to introduce a new term “resected intestine syndrome” and to develop a classification which allows using differentiated correction of this condition and to make any forecasts. The term “resected intestine syndrome” we propose and a new classification of nutritional deficiency can help in identifying the potential risk as well as patients requiring nutritional correction and follow-up. Keywords: nutritional deficiency, resected intestine syndrome, therapy.

A Case of 2-Year-Old Child with Entero-Enteric Fistula Following Ingestion of 25 Magnets

Introduction: Magnet ingestion usually does not cause serious complications, but in case of multiple magnet ingestion or ingestion of magnet with other metal it could cause intestinal obstruction, fistula formation or even perforation. Case report: We report case of intestinal obstruction and fistula formation following ingestion of 25 magnets in a 2-year-old girl. Intraoperatively omega shaped intestinal loop with fistula caused by two magnetic balls was found. Intestine trapped with magnetic balls was edematous and inflamed. Resection of intestinal segment was performed, followed by entero-enteric anastomosis. A total of 25 magnets were removed from resected intestine. Conclusion: Single magnet ingestion is treated as non-magnetic foreign body. Multiple magnet ingestion should be closely monitored and surgical approach could be the best option to prevent or to cure its complications.

Transport of vitamin A in vitro across normal isolated rat intestine and intestine subjected to ‘partial’ resection

The transport of vitamin A across normal and resected intestine was studied in vitro by the method of Darlington and Quastel. The results showed that under aerobic conditions the rate of transport of vitamin A across normal and resected intestine was identical. In contrast, under anaerobic conditions transport was reduced 50% for resected intestine and totally inhibited for control intestine. These results were duplicated under aerobic conditions when 2, 4, dinitrophenol was added to the mucosal solution. Thus for the control intestine, transport is entirely dependent on DNP-sensitive phosphorylation mechanisms which require a wetting agent (polyoxyethylene sorbitan monooleate, ‘Tween 80’) as a solubilizer on the serosal side for the transport of vitamin A across the intestine. The DNP-insensitive mechanisms responsible for 50% of the total transport across the resected intestine were inhibited by iodoacetic acid and sodium fluoride. Chromatographic analysis of intestinal homogenates and mucosal solution at the end of the perfusion demonstrated that vitamin A palmitate is converted to the alcohol either in the lumen or on the surface of the epithelial cells and is then re-esterified in the intestinal mucosa. Transport of this vitamin is via ‘active’ energy-requiring mechanisms. In the normal intestine energy is supplied by oxidative phosphorylation, and in the resected intestine by oxidative as well as anaerobic glycolytic phosphorylation.