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The Journal of the Kentucky Medical... Nov 1965
Topics: Adult; Humans; Jejunum; Middle Aged; Peptic Ulcer; Postgastrectomy Syndromes; Vagotomy
PubMed: 5831026
DOI: No ID Found -
Journal of Pediatric Gastroenterology... Apr 2000
Review
Topics: Adolescent; Anastomosis, Surgical; Colon; Colonic Diseases; Gastrointestinal Hemorrhage; Humans; Ileal Diseases; Ileostomy; Ileum; Jejunal Diseases; Male; Recurrence; Ulcer
PubMed: 10776961
DOI: 10.1097/00005176-200004000-00020 -
Journal of the Medical Association of... Apr 1946
Topics: Humans; Intestinal Diseases; Jejunum; Peptic Ulcer; Ulcer
PubMed: 21066554
DOI: No ID Found -
Langenbecks Archiv Fur Chirurgie 1983The results of isoperistaltic jejunal interposition in reconstructive ulcer surgery are demonstrated on the basis of 62 patients, operated one and a half to nine years...
The results of isoperistaltic jejunal interposition in reconstructive ulcer surgery are demonstrated on the basis of 62 patients, operated one and a half to nine years ago. The operations had been done because of dumping, reflux gastritis and afferent loop syndrome. Now 38 (65.5%) of the followed-up patients had a Visick I or II grading, 16 (27.5%) were Visick III. The endoscopical gastric mucosal biopsy showed normal mucosa as well as superficial gastritis or atrophic gastritis in different patients. By comparison with the preoperative biopsies no protective effect of the bile diversion on the gastric mucosa could be demonstrated. On the contrary 12 of 58 patients (20.5%) developed stomal ulcerations, which were often asymptomatic, mostly superficial and in 8 cases had to be operated in the meantime. The gastric acidity analysis showed a low gastric output with low pH values (pH 2.7--3.4). The incidence of stomal ulceration in jejunal interposition seemed to correlate with the reflux preventive effect. The longer the segment and the better the reflux preventive effect were, the higher was the ulcer risk. The parallelity of reflux preventive ulcer surgery and the ulcer provocation by the Mann-Williamson experiment is demonstrated. Therefore reflux preventive surgery should be used very carefully and in reconstructive procedures only. Using the jejunal interposition the segment should not be longer than 12--15 cm and a vagotomy has always to be added.
Topics: Adult; Afferent Loop Syndrome; Dumping Syndrome; Duodenogastric Reflux; Female; Follow-Up Studies; Gastrectomy; Gastric Mucosa; Gastroenterostomy; Humans; Jejunum; Male; Middle Aged; Peptic Ulcer; Risk; Stomach Ulcer; Vagotomy
PubMed: 6645729
DOI: 10.1007/BF01259234 -
Alimentary Pharmacology & Therapeutics Dec 1994We investigated the effect of dexamethasone on indomethacin-induced ulceration in the rat.
AIM
We investigated the effect of dexamethasone on indomethacin-induced ulceration in the rat.
METHODS
Groups of four rats received oral indomethacin (15 mg/kg) and the jejunal mucosa was examined 24 h later for mucosal ulceration. Three of the groups received oral dexamethasone (1, 3 and 6 mg/kg) 0.5 h prior to indomethacin, while the fourth received vehicle. Haematological evaluation was performed and ulcers were assessed both histologically and immunohistochemically.
RESULTS
Indomethacin caused multifocal jejunal ulceration that was reduced only by the highest dose of dexamethasone (6 mg/kg). Indomethacin caused a significant fall in the blood haemoglobin concentration that was prevented by dexamethasone at all doses. The ulcers induced by indomethacin alone were deep, punched-out and haemorrhagic while the ulcers arising in rats pre-treated with dexamethasone (all doses) were 'plugged' by a white fibrino-purulent exudate. Histologically, the dexamethasone ulcer exudate was composed of bacteria, fibrin, mucus and a significant increase in the numbers of neutrophils. Dexamethasone alone had no significant pathological effect on the small intestine.
CONCLUSIONS
We report the observation that dexamethasone at high doses inhibits indomethacin-induced jejunal ulceration in the rat while at low doses it promotes 'plugging' of ulcers with bacteria, fibrin, mucus and neutrophils that probably reduces haemorrhage from the ulcer base.
Topics: Animals; Dexamethasone; Enteritis; Fibrin; Hematologic Tests; Indomethacin; Intestinal Mucosa; Jejunal Diseases; Male; Mucus; Neutrophils; Rats; Rats, Sprague-Dawley; Ulcer
PubMed: 7696448
DOI: 10.1111/j.1365-2036.1994.tb00336.x -
Plastic and Reconstructive Surgery Jul 1994Reconstruction of the upper aerodigestive tract with free jejunal flaps is now an accepted alternative to more conventional techniques. Success rates for microsurgical...
Reconstruction of the upper aerodigestive tract with free jejunal flaps is now an accepted alternative to more conventional techniques. Success rates for microsurgical transfer approach 100 percent; however, complications following this technique are reported despite technical success, ischemia being implicated as an important etiologic factor. A histologic analysis of canine jejunum subjected to progressively increasing normothermic ischemic periods was undertaken. One hundred canine jejunal flaps were randomly assigned ischemia times between 0 and 12 hours and evaluated 48 hours after reperfusion. Results indicate that (1) isolation of a segment of jejunum on a single pedicle results in no light microscopic changes, (2) histologic changes are evident after 30 minutes of warm ischemia, but gross changes are not evident until greater than 2 hours of ischemia, (3) histologic changes that occur with ischemic insults are progressive and cumulative, (4) mucosal ulcerations are evident at 3 hours, (5) partial-thickness muscle necrosis occurs in all segments at 4 hours, (6) 5 hours of ischemia results in spotty full-thickness necrosis of the bowel wall in 80 percent of the flaps, and (7) by 6 hours, full-thickness myonecrosis is present in all segments. Ischemic periods greater than 6 hours result in increasing histologic disarray.
Topics: Animals; Dogs; Ischemia; Jejunum; Surgical Flaps; Time Factors
PubMed: 8016230
DOI: 10.1097/00006534-199407000-00019 -
Canadian Journal of Surgery. Journal... Oct 2012Obesity has become a major health concern in Canada. This has resulted in a steady rise in the number of bariatric surgical procedures being performed nationwide. The... (Review)
Review
Obesity has become a major health concern in Canada. This has resulted in a steady rise in the number of bariatric surgical procedures being performed nationwide. The laparoscopic Roux-en-Y gastric bypass (LRYGB) is not only the most common bariatric procedure, but also the gold standard to which all others are compared. With this in mind, it is imperative that all gastrointestinal surgeons understand the LRYGB and have a working knowledge of the common postoperative complications and their management. Early postoperative complications following LRYGB that demand immediate recognition include anastomotic or staple line leak, postoperative hemorrhage, bowel obstruction and incorrect Roux limb reconstructions. Later complications may be challenging to differentiate from other gastrointestinal disorders and include anastomotic stricture, marginal ulceration, fistula formation, weight gain and nutritional deficiencies. We discuss the principles involved in the management of each complication and the timing of referral to specialist bariatric centres.
Topics: Adult; Anastomotic Leak; Canada; Constriction, Pathologic; Evidence-Based Medicine; Female; Gastric Bypass; Gastrointestinal Hemorrhage; Humans; Intestinal Fistula; Intestinal Obstruction; Jejunum; Laparoscopy; Length of Stay; Male; Malnutrition; Middle Aged; Obesity, Morbid; Postoperative Complications; Surgical Stapling; Ulcer; Weight Gain
PubMed: 22854113
DOI: 10.1503/cjs.002011 -
Chirurgia (Bucharest, Romania : 1990) 2011We present a female patient of 70 years, admitted in emergency department for signs of high bowel obstruction. After preoperative intensive care, surgical intervention...
We present a female patient of 70 years, admitted in emergency department for signs of high bowel obstruction. After preoperative intensive care, surgical intervention was performed. A complete stenosis of the bowel lumen was found about 15 cm from the duodenojejunal angle, due to a process of sclerosis. Segmental enterectomy was performed with lateroterminal enteroenteralanastomosys, with poor outcome due to a lung infection, which occurred amid COPD. The patient died in intensive care unit requiring mechanical ventilation postoperative. Jejunal ulcer diagnosis was established after pathological examination. Particular issues in discussion are: etiological, clinical, diagnostic and therapeutic ones, that this rare condition posed in practical care.
Topics: Aged; Anastomosis, Surgical; Critical Care; Diagnosis, Differential; Fatal Outcome; Female; Humans; Intestinal Obstruction; Jejunal Diseases; Prognosis; Pulmonary Disease, Chronic Obstructive; Ulcer
PubMed: 21991878
DOI: No ID Found -
Nihon Shokakibyo Gakkai Zasshi = the... Apr 2016A 56-year-old man was admitted to our hospital with appetite loss, palpitations, orthostatic syncope, and hematochezia. Contrast-enhanced abdominal computed tomography...
A 56-year-old man was admitted to our hospital with appetite loss, palpitations, orthostatic syncope, and hematochezia. Contrast-enhanced abdominal computed tomography (CT) revealed a proximal jejunal diverticulum with contrast extravasation. We immediately performed transoral double balloon enteroscopy (DBE) to treat the bleed in the jejunum, and this revealed a small ulcer with an exposed vessel at the opening of the jejunal diverticulum. Hemostasis was achieved endoscopically with argon plasma coagulation (APC) and hemoclips. During subsequent surgery, the diverticulum was found on the mesenteric side of the jejunum. We performed laparoscopy-assisted partial resection of the jejunum, and pathological examination showed that the diverticulum shared a common proper muscle layer with the jejunum and was covered by jejunal mucosa with no ectopic mucosa. Therefore, we diagnosed jejunal duplication. After hospital discharge, the patient had no recurrence of hematochezia or anemia. We report a rare case of jejunal duplication presenting with hematochezia, which was diagnosed as jejunal diverticular bleeding by CT and DBE before surgery. Pathological analysis confirmed jejunal duplication after surgery. We suggest that intestinal diverticular bleeding, as well as duplication of the gastrointestinal tract, should be considered as part of the differential diagnosis of obscure gastrointestinal bleeding.
Topics: Gastrointestinal Hemorrhage; Humans; Jejunum; Male; Middle Aged; Radiography
PubMed: 27052396
DOI: 10.11405/nisshoshi.113.662 -
Fetal Diagnosis and Therapy 2010
Review
Topics: Duodenal Obstruction; Female; Hospitals, Pediatric; Humans; Incidence; Intestinal Atresia; Japan; Jejunum; Male; Pregnancy; Pregnancy Outcome; Ulcer; Umbilical Cord
PubMed: 20881370
DOI: 10.1159/000320327