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Revista Espanola de Enfermedades... Mar 2021Plexiform fibromyxoma (PF) is an uncommon primary tumor of the gastrointestinal tract, with a mesenchymal origin and a benign behavior. Herein, we report a case and... (Review)
Review
Plexiform fibromyxoma (PF) is an uncommon primary tumor of the gastrointestinal tract, with a mesenchymal origin and a benign behavior. Herein, we report a case and provide a literature review. A 41-year-old male patient underwent surgery in our unit for a PF at the gastric antrum, after being admitted due to vomiting and weight loss. As illustrated by our case, the mean age at presentation is around 40 years, the antrum is the most common location and abdominal pain the most widely reported manifestation. None of the reviewed cases involved regional or distant spread.
Topics: Adult; Digestive System Neoplasms; Fibroma; Gastrointestinal Stromal Tumors; Humans; Male; Pyloric Antrum; Stomach Neoplasms
PubMed: 33213171
DOI: 10.17235/reed.2020.7048/2020 -
American Journal of Physiology.... Jan 2024Delayed gastric emptying (GE) has been associated with antral and pyloric dysmotility. We aimed to characterize differences in the antral, duodenal, and pyloric motility...
Delayed gastric emptying (GE) has been associated with antral and pyloric dysmotility. We aimed to characterize differences in the antral, duodenal, and pyloric motility profiles associated with delayed GE, using high-resolution antropyloroduodenal manometry (HR-ADM). Patients referred for HR-ADM for dyspeptic symptoms performed a concurrent GE breath test (NCT01519180 and NCT04918329). HR-ADM involved 36 sensors 1 cm apart, placed across the pylorus. Interdigestive and postprandial periods were identified. Antral, pyloric, and duodenal motor profiles were analyzed recording the frequency, amplitude, and propagative nature of contractions for each period. Plots of patients with normal and delayed GE were compared. Sixty patients underwent both HR-ADM and GE tests. Twenty-five and 35 patients had delayed and normal GE, respectively. Antral and duodenal motor profiles were not different between the two groups during the interdigestive period. During the postprandial period, a lower frequency of antral contractions was associated with delayed GE (2.22 vs. 1.39 contractions/min; = 0.002), but no difference in mean contraction amplitude was observed. The pyloric region was identified in all the patients and pylorospasms, defined as 3 min of repeated isolated pyloric contractions, were more frequent in patients with delayed GE (32.0% vs. 5.7%; = 0.02) during the postprandial period. No difference in duodenal contraction profiles was observed. Manometric profile alterations were observed in 72% of the patients with delayed GE, with 56% having a low frequency of antral contractions. Using HR-ADM, patients with delayed GE displayed different postprandial antropyloric motility as compared with patients with normal GE. High-resolution antropyloroduodenal manometry (HR-ADM) allows precise characterization of antral, pyloric, and duodenal motility, although its association with gastric emptying (GE) has been poorly investigated. Concurrent HR-ADM with GE measurement showed a lower frequency of antral postprandial contractions and an increased frequency of postprandial pylorospasms in patients with delayed GE. HR-ADM could, therefore, be useful in the future to better select patients for treatments targeting the pylorus.
Topics: Humans; Pyloric Antrum; Gastric Emptying; Pylorus; Duodenum; Manometry; Gastrointestinal Motility
PubMed: 37874655
DOI: 10.1152/ajpgi.00101.2023 -
Anesthesia and Analgesia Jul 2023High-flow nasal oxygen (HFNO) therapy is widely used in critical care obstetrics to improve oxygenation. Much of the benefit of HFNO is linked to the creation of modest...
BACKGROUND
High-flow nasal oxygen (HFNO) therapy is widely used in critical care obstetrics to improve oxygenation. Much of the benefit of HFNO is linked to the creation of modest levels of positive airway pressure. Pregnant women are generally considered to be at high risk of regurgitation and aspiration. It is unknown whether HFNO may cause gas insufflation into the stomach and further increase this risk. Therefore, this study aimed to systematically evaluate the possible safety effects of HFNO on gastric volume in healthy fasted parturients.
METHODS
Sixty fasted parturients scheduled for elective cesarean delivery were enrolled in an observer-blinded, prospective, interventional study. We used ultrasonography to assess changes of antral cross-sectional area (CSA) and gastric volume before and after a 20-minute treatment with HFNO at a rate of 50 L·min -1 . The primary outcome was the change in gastric volume from before to after HFNO therapy, and the secondary outcome was the distribution of antral grades.
RESULTS
In semirecumbent right lateral position, the antral CSA at baseline and after treatment with HFNO was 3.81 (3.01-4.72) cm 2 and 3.79 (3.03-4.54) cm 2 , respectively. The estimated fluid volume at baseline and after treatment with HFNO was 38.51 (33.39-54.62) mL and 39.71 (32.00-52.82) mL, respectively. All participants had either a grade 0 or grade 1 antrum, and most of them had a grade 0 antrum. There was no significant difference in gastric volume and distribution of antral grades before and after HFNO therapy. Gastric air distension was not shown in any of the parturients either at baseline or after treatment with HFNO.
CONCLUSIONS
Treatment with HFNO for 20 minutes at flow rates up to 50 L·min -1 did not increase gastric volume in term pregnant women breathing spontaneously when evaluated by gastric ultrasonography.
Topics: Humans; Female; Pregnancy; Pyloric Antrum; Prospective Studies; Oxygen; Stomach; Ultrasonography
PubMed: 36630297
DOI: 10.1213/ANE.0000000000006340 -
The Journal of Small Animal Practice Mar 2024A 6-year-old, female neutered Labrador retriever was presented with a chronic history of vomiting and anorexia. Abdominal ultrasound identified two large cavitated...
A 6-year-old, female neutered Labrador retriever was presented with a chronic history of vomiting and anorexia. Abdominal ultrasound identified two large cavitated structures with echogenic content in the gastric fundus and pyloric region. CT revealed the intraparietal nature of these structures, one in the greater curvature and another one extending from the lesser curvature to the pyloric antrum. Surgical exploration revealed two areas of thickened gastric wall with intramural purulent material. Debridement and partial resection of the abscess (deroofing) were performed via a routine gastrotomy approach. Histopathology of a gastric wall sample revealed neutrophilic inflammation with intralesional vegetal foreign body. The presence of intralesional foreign body with a positive bacterial culture and macroscopic absence of peritonitis may suggest an intramural migrating vegetal foreign body. Gastric wall abscess should be included in a differential diagnosis in dogs with a history of chronic vomiting and the presence of gastric wall cavitated structures. Surgical debridement through a routine gastrotomy opening alleviated the clinical signs related to the intramural gastric abscesses in this dog with no recurrence at 22 months.
PubMed: 38441150
DOI: 10.1111/jsap.13713 -
Annals of African Medicine 2021Helicobacter pylori (H. pylori) is a Gram-negative, helically shaped flagellated bacterium. Major diseases associated with H. pylori infection include peptic ulcer,... (Review)
Review
Helicobacter pylori (H. pylori) is a Gram-negative, helically shaped flagellated bacterium. Major diseases associated with H. pylori infection include peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. The incidence of H. pylori in the anatomotopographic regions of the stomach, such as antrum, corpus, fundus, and incisura angularis, has been investigated. Do the rates of H. pylori in the settlements change over time according to the age ranges of the hosts? Does this change affect the diseases caused by or related to H. pylori? It is estimated that the outcomes, which have been obtained, may provide a new perspective in terms of understanding the etiopathogenesis of H. pylori-induced diseases. A comprehensive literature search of PubMed/MEDLINE databases had been conducted using a combination of terms, "Helicobacter pylori," "Sydney System," "stomach," "pyloric antrum," "gastric corpus," "stomach cancer," and "Helicobacter pylori and age." There are very few articles examining the relationship between the topographic locations of H. pylori and host age range in the English language literature. Therefore, it is also purposed to emphasize the outcomes of our current research about the mentioned topic. In our opinion, similar studies should reveal the settlement and age range in the different geographic locations and societies as in our study. We believe that these findings will contribute to the efforts for understanding overtly of H. pylori-induced disease of the stomach.
Topics: Adenocarcinoma; Adolescent; Adult; Age Factors; Aged; Biopsy; Duodenal Ulcer; Endoscopy; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Stomach; Stomach Neoplasms; Stomach Ulcer; Young Adult
PubMed: 33727504
DOI: 10.4103/aam.aam_69_19 -
World Journal of Gastroenterology Feb 2021Interdigestive migrating motor complexes (MMC) produce periodic contractions in the gastrointestinal tract, but the exact mechanism of action still remains unclear....
BACKGROUND
Interdigestive migrating motor complexes (MMC) produce periodic contractions in the gastrointestinal tract, but the exact mechanism of action still remains unclear. Intramuscular interstitial cells of Cajal (ICC-IM) participate in gastrointestinal hormone and neuromodulation, but the correlation between ICC-IM and MMC is also unclear. We found that xiangbinfang granules (XBF) mediated the phase III contraction of MMC. Here, the effects of XBF on gastric antrum motility in mice and the effects of ICC-IM on gastric antrum MMC are reported.
AIM
To observe the effects of ICC-IM on gastric antrum motility and to establish the mechanism of XBF in promoting gastric antrum motility.
METHODS
The density of c-kit-positive ICC myenteric plexus (ICC-MP) and ICC-IM in the antral muscularis of and wild-type (WT) mice was examined by confocal microscopy. The effects of XBF on gastric antrum slow waves in and WT mice were recorded by intracellular amplification recording. Micro-strain-gauge force transducers were implanted into the gastric antrum to monitor the MMC and the effect of XBF on gastric antrum motility in conscious and WT mice.
RESULTS
In the gastric antrum of mice, c-kit immunoreactivity was significantly reduced, and no ICC-IM network was observed. Spontaneous rhythmic slow waves also appeared in the antrum of mice, but the amplitude of the antrum slow wave decreased significantly in mice (22.62 ± 2.23 mV 2.92 ± 0.52 mV, < 0.0001). MMCs were found in 7 of the 8 WT mice but no complete MMC cycle was found in mice. The contractile frequency and amplitude index of the gastric antrum were significantly increased in conscious WT compared to mice (frequency, 3.53 ± 0.18 cpm 1.28 ± 0.12 cpm; amplitude index, 23014.26 ± 1798.65 mV·20 min 3782.16 ± 407.13 mV·20 min; < 0.0001). XBF depolarized smooth muscle cells of the gastric antrum in WT and mice in a dose-dependent manner. Similarly, the gastric antrum motility in WT mice was significantly increased after treatment with XBF 5 mg ( < 0.05). Atropine (0.1 mg/kg) blocked the enhancement of XBF in WT and mice completely, while tetrodotoxin (0.05 mg/kg) partially inhibited the enhancement by XBF.
CONCLUSION
ICC-IM participates in the regulation of gastric antrum MMC in mice. XBF induces MMC III-like contractions that enhance gastric antrum motility ICC-IM in mice.
Topics: Animals; Gastrointestinal Motility; Interstitial Cells of Cajal; Mice; Myenteric Plexus; Pyloric Antrum; Tetrodotoxin
PubMed: 33642830
DOI: 10.3748/wjg.v27.i7.576 -
BioRxiv : the Preprint Server For... Dec 2023Gastric cancer is the fifth most diagnosed cancer in the world. Infection by the bacteria (HP) is associated with approximately 75% of gastric cancer cases. HP...
BACKGROUND
Gastric cancer is the fifth most diagnosed cancer in the world. Infection by the bacteria (HP) is associated with approximately 75% of gastric cancer cases. HP infection induces chronic gastric inflammation, damaging the stomach and fostering carcinogenesis. Most mechanistic studies on induced gastric cancer initiation are performed in mice and utilize either mouse-adapted strains of HP or the natural mouse pathogen (HF). Each of these infection models is associated with strengths and weaknesses. Here, we identified the differences in immunogenicity and gastric pathological changes associated with HP and HF infection in mice.
MATERIAL AND METHODS
PMSS1 HP strain or with the CS1 HF strain were co-cultured with mouse peritoneal macrophages to assess their immunostimulatory effects. C57BL/6J mice were infected with HP or HF, and gastric inflammation, atrophy, and metaplasia development were assessed 2 months post-infection.
RESULTS
HP and HF induced similar cytokine production from cultured mouse peritoneal macrophages. HP-infected mice caused modest inflammation within both the gastric corpus and antrum and did not induce significant atrophy within the gastric corpus. In contrast, HF induced significant inflammation throughout the gastric corpus and antrum. Moreover, HF infection was associated with significant atrophy of the chief and parietal cell compartments and induced expression of pyloric metaplasia markers.
CONCLUSIONS
HP is poorly immunogenic compared to HF. HF induces dramatic CD4+ T cell activation, which is associated with increased gastric cancer risk in humans. Thus, HP studies in mice are better suited for studies on colonization, while HF is more strongly suited for pathogenesis and cancer initiation studies.
PubMed: 38187587
DOI: 10.1101/2023.12.22.573128 -
Indian Journal of Anaesthesia Aug 2022Point-of-care ultrasonography (USG) of the gastric antrum can help to evaluate the aspiration risk and improve the safety of anaesthesia. The aim was to assess the...
BACKGROUND AND AIMS
Point-of-care ultrasonography (USG) of the gastric antrum can help to evaluate the aspiration risk and improve the safety of anaesthesia. The aim was to assess the gastric antrum in term parturients scheduled for elective caesarean section using bedside USG.
METHODS
After obtaining institutional ethics committee approval and written informed consent, 250 term parturients (≥36 weeks gestational age) with body mass index 18.5-30 kg/m, and scheduled for elective caesarean delivery were included in this study. The parturients were instructed to follow standard fasting guidelines. In the preoperative area, ultrasonographic examinations were performed 15 min before the scheduled time of the caesarean section. The primary outcome was the qualitative assessment (grade 0-2) of the gastric antrum, and the secondary outcome was the quantitative assessment (antral cross-sectional area [CSA]) of gastric antrum in supine and right lateral decubitus (RLD) position. Data analysis was done using Statistical Package for Social Sciences Software (version 19).
RESULTS
Among the 234 parturients who completed the study, 191 exhibited grade 0 antrum, 42 had grade 1 antrum, and one parturient had grade 2 antrum. Overall, 83% of participants had an antral CSA ≤4.25 cm [95% confidence interval (CI), 2.52-5.67 cm] in the RLD position, equivalent to an estimated gastric volume of ≤43 ml (95% CI, 32-68 mL) or ≤1.5 ml/kg (95% CI, 0.49-1.23 ml/kg).
CONCLUSION
Majority of fasted term parturients scheduled for elective caesarean section had a grade 1 gastric antrum on bedside USG. This study also establishes cutoff values of antral CSA and gastric volume in both supine and RLD position for fasted term parturients.
PubMed: 36262725
DOI: 10.4103/ija.ija_727_21 -
Archives of Iranian Medicine Oct 2022Ectopic opening of the common bile duct (CBD) is extremely rare, and its importance has not been adequately defined. The aim of our study is to present the...
BACKGROUND
Ectopic opening of the common bile duct (CBD) is extremely rare, and its importance has not been adequately defined. The aim of our study is to present the characteristics of patients with this abnormality.
METHODS
This retrospective study was conducted in a tertiary center in Dicle University Hospital, Diyarbakır, Turkey, between October 2008 and December 2020. We present clinical, laboratory, endoscopic and cholangiographic features as well as the success rate of therapeutic interventions of consecutive patients with this abnormality undergoing endoscopic retrograde cholangiopancreatography (ERCP).
RESULTS
Ectopic opening of the CBD was identified in 29 (21 men; mean age 62) out of 3872 (0.74%) patients. There was a history of cholecystectomy in 14 (48%) and recurrent acute cholangitis in 20 (69%) patients. We found peptic ulcer in 13 (45%) and duodenal deformity associated with apical stenosis in 21 (72%) patients. Opening site was seen as abnormal in all patients, and it opened into the antrum in 2 (6.8%) and into the first part of the duodenum in 27 (93%) patients. Copious amount of bile and/ or bile sediment in the stomach were seen in all patients. We observed dilatation in both intrahepatic and extrahepatic bile ducts together with tapered narrowing and a hook-shaped distal end of CBD in all patients. There was bile stone in 26 (89%) and sludge in 3 (10%) patients. Sphincterotomy was not performed in any patients because there was not enough incision distance. Balloon dilatation was performed for extraction of stone and sludge in all patients. Complete stone extraction was achieved in only 7 out of 26 (27%) patients.
CONCLUSION
Ectopic opening of CBD is usually associated with gastroduodenal and bile ducts disease. Endoscopic treatment is unsatisfactory in most patients with this abnormality.
Topics: Male; Humans; Middle Aged; Pyloric Antrum; Retrospective Studies; Sewage; Common Bile Duct; Duodenum; Cholangiopancreatography, Endoscopic Retrograde; Sphincterotomy, Endoscopic; Treatment Outcome
PubMed: 37542403
DOI: 10.34172/aim.2022.110 -
Cellular Oncology (Dordrecht) Jun 2021The purpose of this study was to characterize alterations in mucosa-associated microbiota in different anatomical locations of the stomach during gastric cancer...
PURPOSE
The purpose of this study was to characterize alterations in mucosa-associated microbiota in different anatomical locations of the stomach during gastric cancer progression and to identify associations between Helicobacter pylori infection and gastric microbial changes in patients with gastric cancer.
METHODS
Twenty-five H. pylori negative subjects with chronic gastritis and thirty-four subjects with gastric cancer were recruited, including H. pylori negative and positive patients with tumors in the antrum and the corpus. Gastric mucosa-associated microbiota were determined by 16S ribosomal RNA gene sequencing using a 454 sequencing platform.
RESULTS
We found that individuals with chronic gastritis from three different anatomical sites exhibited different microbiota compositions, although the microbial alpha diversity, richness and beta diversity were similar. Compared to patients with chronic gastritis, the gastric microbiota compositions were significantly different at the order level in the antrum and the corpus of patients with gastric cancer, which was dependent on the H. pylori infection status. Microbial alpha diversity and species richness, however, were similar between chronic gastritis and gastric cancer cases and independent of H. pylori status. The microbial community structure in patients with gastric cancer was distinct from that in patients with chronic gastritis. In addition, we found that the presence of H. pylori markedly altered the structure in gastric corpus cancer, but only mildly affected the antrum.
CONCLUSION
Our data revealed distinct niche-specific microbiota alterations during the progression from gastritis to gastric cancer. These alterations may reflect adaptions of the microbiota to the diverse specific environmental habitats in the stomach, and may play an important, as yet undetermined, role in gastric carcinogenesis.
Topics: Aged; Cardia; Disease Progression; Female; Gastric Mucosa; Gastritis; Gastrointestinal Microbiome; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Pyloric Antrum; Stomach Neoplasms
PubMed: 33770413
DOI: 10.1007/s13402-021-00596-y