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Case Reports in Hematology 2021The portal vein could be occluded by blood clots partially or completely causing portal vein thrombosis (PVT). The acute episode may be asymptomatic or manifested by...
The portal vein could be occluded by blood clots partially or completely causing portal vein thrombosis (PVT). The acute episode may be asymptomatic or manifested by abdominal pain, increasing body temperature, and unspecific dyspeptic symptoms. The main causes of PVT are categorized into local, acquired, and genetic thrombophilic factors. To our knowledge, this is the 2 recognized case of PVT following colectomy for colonic inertia successfully treated with an effective anticoagulation therapy. The patient received unfractionated heparin as soon the diagnosis was implemented. The patient was a 34-year-old lady with chief complaint of severe abdominal pain, nausea, vomiting, and anorexia 10 days after the first hospital admission for subtotal colectomy due to colonic inertia. Spiral abdominal CT scan with intravenous (IV) contrast showed thrombosis in main portal vein with its extension to right and left intrahepatic branches. Our case showed that we should keep in mind PVT in patients who present with upper gastrointestinal symptoms several days after a major surgery (open colectomy) as a risk factor and oral contraceptive pills (OCP) usage, postpregnancy, and immobility as other risk factors, that the protein C, S, and FVL deficiencies were secondary, and that the PVT can be managed by low molecular weight heparin plus oral warfarin therapy in the continue.
PubMed: 33532102
DOI: 10.1155/2021/8895206 -
Journal of Agricultural and Food... Jan 2021In this work, spiral dextrin/resveratrol (SD/Res) crystal, a new colon-specific drug-delivery system, was established by a novel method of encapsulation and...
In this work, spiral dextrin/resveratrol (SD/Res) crystal, a new colon-specific drug-delivery system, was established by a novel method of encapsulation and cocrystallization to improve the antidigestion ability compared with the SD/Res inclusion complex (SD/Res IC) prepared by encapsulation and coprecipitation. X-ray diffraction (XRD) and scanning electron microscopy (SEM) revealed that the SD/Res crystal formed a more regular and perfect crystallite than SD/Res IC. Moreover, the encapsulation ability and thermostability of the SD/Res crystal were enhanced as the chain length of SD was increased. digestion indicated that SD/Res IC merely achieved small intestine-targeted release of resveratrol, while the SD/Res crystal could act as a colon-specific delivery system to protect resveratrol from degradation by gastric acid and pancreatic enzymes. The SD-1/Res crystal presented much higher thermal stability and stronger gastrointestinal stability than other SD/Res crystals and SD/Res ICs, which facilitated its application as a novel colon-target delivery system for resveratrol.
Topics: Colon; Dextrins; Drug Compounding; Drug Delivery Systems; Drug Liberation; Humans; Particle Size; Plant Extracts; Resveratrol; X-Ray Diffraction; Zea mays
PubMed: 33372794
DOI: 10.1021/acs.jafc.0c05668 -
Medicine Dec 2020Colon cancer is a common malignant tumor of the gastrointestinal tract. Therefore, a clear diagnosis is particularly important for the treatment of colon cancer....
BACKGROUND
Colon cancer is a common malignant tumor of the gastrointestinal tract. Therefore, a clear diagnosis is particularly important for the treatment of colon cancer. Ultrasound and spiral computed tomography (CT) can both be used in the diagnosis, but each has its own advantages and disadvantages, which could cause confusion in clinical choice. The purpose of this study was to systematically evaluate the practicability of spiral CT and ultrasound in the diagnosis of colon cancer.
METHODS
A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of diagnostic experimental study of ultrasound and spiral CT in the diagnosis of Colon Cancer. The retrieval time limit was from the establishment of the database to October 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using Meta Disc1.4 and RevMan5.3 software.
RESULTS
Sensitivity, specificity, positive Likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were used to determine the diagnostic efficacy of ultrasonography and helical CT in colorectal cancer.
CONCLUSIONS
This study will compare the practicability of CT and ultrasound in the diagnosis of colon cancer and provide reliable evidence-based basis for clinicians to choose the appropriate or best evidence-based basis.
ETHICS AND DISSEMINATION
The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.
OSF REGISTRATION NUMBER
DOI 10.17605/OSF.IO/WAJHQ.
Topics: Colonic Neoplasms; Humans; Likelihood Functions; Meta-Analysis as Topic; Odds Ratio; Research Design; Sensitivity and Specificity; Systematic Reviews as Topic; Tomography, Spiral Computed; Ultrasonography
PubMed: 33327262
DOI: 10.1097/MD.0000000000023381 -
VideoGIE : An Official Video Journal of... Nov 2020The small bowel has, to date, remained a difficult area to access via endoscopy. The novel motorized power spiral enteroscopy, recently introduced, has more depth of...
BACKGROUND AND AIMS
The small bowel has, to date, remained a difficult area to access via endoscopy. The novel motorized power spiral enteroscopy, recently introduced, has more depth of insertion and is of shorter duration. Presented here is a case series of motorized spiral enteroscopies.
METHODS
Motorized spiral enteroscopy is indicated for patients requiring deep enteroscopy (eg, for a diagnosis of obscure GI bleeding, suspected inflammatory bowel disorder) and for therapeutic interventions, such as polypectomy, hemostasis, or stricture dilatation. It is contraindicated in patients who are not eligible for general anesthesia, with perforation, or with coagulopathy and in the pediatric population. The contraindications for the anterograde route are gastroesophageal varices, foregut stenosis, eosinophilic esophagitis, and so on. The retrograde approach is contraindicated in active colitis, anal stenosis, or colonic stricture. Informed consent was sought from all the patients.
RESULTS
The procedure was successful in 13 of 14 (92.8%) in that the target site was reached or panenteroscopy was confirmed. The diagnoses were stricture and ulcers of the jejunum or ileum. The procedures performed were argon plasma coagulation and stricture dilation. The average duration of anterograde enteroscopy was 61.1 minutes and retrograde enteroscopy was 90 minutes. The major adverse events were hypothermia (3 of 14) and pancreatitis (1 of 14), from which the patients recovered fully.
CONCLUSIONS
Novel motorized power spiral enteroscopy is a great tool in small-bowel diagnostics and therapeutics. Speed and ease add to the attractiveness of the procedure.
PubMed: 33204928
DOI: 10.1016/j.vgie.2020.08.001 -
Frontiers in Physiology 2020Cotton rats are one of the experimental rodents used for testing different infectious and non-infectious diseases, including gastrointestinal tract pathology. However,...
Cotton rats are one of the experimental rodents used for testing different infectious and non-infectious diseases, including gastrointestinal tract pathology. However, their intestinal morphological characteristics are still poorly understood. Here, we clarified the anatomical and histological characteristics of the cecum and ascending colon (AC) of young (1-3-month old), adult (4-6-month old), and old (10-12-month old) cotton rats. The large intestine (LI) in cotton rats is composed of the cecum, AC, transverse and descending colons, and rectum, and is similar to that of other mammals. The AC begins with a double or triple spiral loop-like flexure (SLLF) and ends with a coupled horseshoe-like flexure (HSLF). A single longitudinal mucosal fold (SLMF) was found at the beginning of the AC along the mesentery line and developed with age. Furthermore, the SLMF contained several lymphatic nodules (LNs), indicating their role in digestive and immunological functions. Small and large protuberant LNs were found in the cecum and SLLF, respectively, whereas thin and flat LNs were observed in the HSLF and transverse colon, respectively. Regarding sex-related differences, adult females had a significantly longer AC with a higher number of SLLFs compared to males. The SLMF length and LN number were also longer and higher, respectively, in adult females compared to adult males. These are crucial findings, indicating the presence of sex-related differences in the morphology of the LI in cotton rats, and ours is the first study to discover a sex difference in the mammalian LI lining. Our study clarified the unique morphology of the LI in cotton rats, which could serve as the principal model for elucidating species-specific digestive tract functions and gastrointestinal disorders.
PubMed: 33192600
DOI: 10.3389/fphys.2020.587214 -
Journal of Biomedical Physics &... Oct 2020Adhesive intestinal obstruction is a common and potentially lethal complication after surgical interventions in the abdomen. Radiologic imaging is the main diagnostic...
BACKGROUND
Adhesive intestinal obstruction is a common and potentially lethal complication after surgical interventions in the abdomen. Radiologic imaging is the main diagnostic method.
OBJECTIVE
This study aims to analyse the diagnostic value of spiral computed tomography with a novel method (n = 54).
MATERIAL AND METHODS
In this multidirectional cohort study, we present the data with non-parallel (historical) control. This study included the analysis of results of patients with a diagnosis of intestinal obstruction (n = 54) who were admitted to the surgical departments of the City Clinical Hospitals (Ufa city) from 2013 to 2019; the patients' examination methods included computed tomography with conventional enhancement. The proposed novel enhancement method was implemented by ingesting a mixture containing 50 ml of the contrast Unigexol (300 mg) in 1.0 L cold mineral carbonated water, and Computed tomography (CT) was performed during 40 min after ingesting the contrast meal. Further, the patients with suspected obstruction in the colon were administered a pre-prepared contrast enema with a decoction of leaves of smoke-tree (100 g), chamomile flowers (100 g) and calendula flowers (100 g). Additionally, CT was performed.
RESULTS
Obstruction was conservatively stopped in 24 (44.4%) patients of the main group. Remaining 30 (55.6%) patients from the main group were operated with minimal surgical access in the early stages.
CONCLUSION
Owing to early diagnosis of intestinal obstruction and application of the phytocomposition during the examination, exerting various effects such as antispasmodic, analgesic, disinfectant, bactericidal, cicatrising, choleretic, tanning and decongestant, unnecessary surgical interventions were prevented.
PubMed: 33134220
DOI: 10.31661/jbpe.v0i0.1912-1032 -
European Urology Jun 2021To allow patients with bladder and bowel dysfunctions to achieve social continence, continent catheterizable channels (CCCs) are effective alternatives to intermittent...
BACKGROUND
To allow patients with bladder and bowel dysfunctions to achieve social continence, continent catheterizable channels (CCCs) are effective alternatives to intermittent self-catheterization and enema.
OBJECTIVE
We aimed to describe our progressive advancement from open to robotic construction of CCCs, reporting outcomes and comparing the two approaches.
DESIGN, SETTING, AND PARTICIPANTS
We retrospectively reviewed electronic medical records of pediatric patients who underwent construction of CCCs between 2008 and 2019. The inclusion criteria were age ≤18 yr, and CCCs with or without bladder augmentation or bladder neck surgery. We compared open versus robotic approaches for demographics, and intra- and postoperative outcomes; operative time was calculated as incision-to-closure time.
SURGICAL PROCEDURE
Channels performed were appendicovesicostomy (APV), Monti with tapered ileum, and antegrade colonic enema (ACE). A Monti channel with tapered ileum was preferred to a spiral Monti or double Monti, as it has more robust blood supply and it was performed only with an open approach.
MEASUREMENTS
The primary outcome was success rate, defined as postoperative stomal continence. Stomal incontinence was defined as the presence of urine leakage noted by caregivers or patients and confirmed by the surgeon. Secondary outcomes were stomal stenosis (supra- and subfascial), incontinence, need for surgical revision, and surgical site infection.
RESULTS AND LIMITATIONS
A total of 69 patients were included in the study, with 35 open and 34 robotic procedures. The robotic approach showed a significant decrease in length of hospital stay (LOS) compared with the open approach. Six primary subfascial revisions were performed in five patients--three Monti, two ACE, and one APV. Continence rates were 91.4% and 91.2% for open and robotic approaches, respectively.
CONCLUSIONS
Robotic surgery for CCCs showed acceptable postoperative functional outcomes and complication rates, which are comparable with those of the traditional open approach. Additionally, due to its minimally invasive nature, it offers advantages such as decreased postoperative pain, LOS, and time to full diet, and better cosmesis.
PATIENT SUMMARY
Robotic surgery for continent catheterizable channels showed acceptable postoperative functional outcomes and complication rates, which are comparable with those of the traditional open approach.
Topics: Child; Follow-Up Studies; Humans; Retrospective Studies; Robotic Surgical Procedures; Urinary Catheterization; Urinary Incontinence; Urinary Reservoirs, Continent
PubMed: 32868139
DOI: 10.1016/j.eururo.2020.08.013 -
Journal of Zoo and Wildlife Medicine :... Jun 2020Gastrointestinal (GI) pathology is common in elasmobranchs; however, information regarding normal GI transit time and the effect of therapeutics on GI motility is...
RADIOGRAPHIC DETERMINATION OF GASTRIC EMPTYING AND GASTROINTESTINAL TRANSIT TIME IN COWNOSE RAYS () AND WHITESPOTTED BAMBOO SHARKS () AND THE EFFECT OF METOCLOPRAMIDE ON GASTROINTESTINAL MOTILITY.
Gastrointestinal (GI) pathology is common in elasmobranchs; however, information regarding normal GI transit time and the effect of therapeutics on GI motility is lacking. The objective of this study was to determine baseline gastric emptying and GI transit times in cownose rays () and whitespotted bamboo sharks () via radiographic barium sulfate contrast studies. Additionally, a pilot study was undertaken to determine the effect of metoclopramide on GI transit time in whitespotted bamboo sharks. Eight cownose rays and eight whitespotted bamboo sharks were administered a 98% w/w barium sulfate suspension at 8 ml/kg via orogastric tube. Post-contrast radiographs were obtained at 2 min, 3, 6, 12, and 23 hr for rays; and 2 min, 3, 6, 9, 12, 16, 25, 30, 36, and every 12 hr until complete gastric emptying occurred for sharks. In cownose rays, the mean and standard error were established for time of initial spiral colon filling (3.4 ± 0.4 hr), complete spiral colon opacification (12 ± 0 hr), initial spiral colon emptying (21.6 ± 1.4 hr), and complete gastric emptying (23 ± 0 hr). In bamboo sharks, the mean and standard error were established for time of initial spiral colon filling (5.3 ± 0.5 hr), complete spiral colon opacification (12.4 ± 1.3 hr), initial spiral colon emptying (22.5 ± 2.7 hr), and complete gastric emptying (39.9 ± 3.3 hr). Cownose rays had a significantly shorter time to spiral colon filling and complete gastric emptying compared with bamboo sharks ( < 0.05). Whitespotted bamboo sharks ( = 8) were administered metoclopramide (0.4 mg/kg orally once daily for 10 days) and the barium series was repeated. Complete gastric emptying time was significantly shorter in treated sharks compared with control ( < 0.05), suggesting that metoclopramide may be a useful therapeutic for GI motility disorders in elasmobranchs.
Topics: Animals; Antiemetics; Female; Gastric Emptying; Gastrointestinal Motility; Gastrointestinal Tract; Gastrointestinal Transit; Male; Metoclopramide; Pilot Projects; Sharks; Skates, Fish; Species Specificity
PubMed: 32549562
DOI: 10.1638/2019-0015 -
Journal of the Mechanical Behavior of... Feb 2020For colonic stents design, the interaction with colonic tissue is essential in order to characterize the appropriate radial stiffness which provides a minimum lumen for...
For colonic stents design, the interaction with colonic tissue is essential in order to characterize the appropriate radial stiffness which provides a minimum lumen for intestinal transit to be maintained. It is therefore important to develop suitable constitutive models allowing the mechanical behavior of the colon tissue to be characterized. The present work investigates the biomechanical behavior of colonic tissue by means of biaxial tests carried out on different parts of the colonic tract taken from several porcine specimens. Samples from the colonic tract were quasi-statically tensioned using a load-controlled protocol with different tension ratios between the circumferential and the axial directions. Fitting techniques were then used to adjust specific hyperelastic models accounting for the multilayered conformation of the colonic wall and the fiber-reinforced configuration of the corresponding tissues. It was found that the porcine colon changed from a more isotropic to a more anisotropic tissue and became progressively more flexible and compliant in circumferential direction depending on the position along the duct as it approaches the rectum. The best predictive capability of mechanical behavior corresponds to the Four Fiber Family model showing mean values of coefficient of determination R=0.97, and a normalized root mean square error of ε=0.0814 for proximal spiral samples, and R=0.89 , ε=0.1600 and R=0.94 , ε=0.1227 for distal spiral and descending colon samples, respectively. The other analyzed models provide good results for proximal spiral colon specimens, which have a lower degree of anisotropy. The analyzed models with the fitted elastic parameters can be used for more realistic and reliable FE simulations, providing the appropriate framework for the design of optimal devices for the treatment of colonic diseases.
Topics: Animals; Anisotropy; Biomechanical Phenomena; Colon; Computer Simulation; Stress, Mechanical; Swine; Tensile Strength
PubMed: 31877516
DOI: 10.1016/j.jmbbm.2019.103507 -
Journal of Gastrointestinal Surgery :... Dec 2020To evaluate the clinical value of CT angiography (CTA), CT colonography (CTC), and image fusion in the preoperative evaluation of laparoscopic complete mesocolic... (Randomized Controlled Trial)
Randomized Controlled Trial
Clinical Value of Multi-Slice Spiral CT Angiography, Colon Imaging, and Image Fusion in the Preoperative Evaluation of Laparoscopic Complete Mesocolic Excision for Right Colon Cancer: a Prospective Randomized Trial.
PURPOSE
To evaluate the clinical value of CT angiography (CTA), CT colonography (CTC), and image fusion in the preoperative evaluation of laparoscopic complete mesocolic excision (CME) for right colon cancer.
METHODS
In this randomized prospective study, 80 patients undergoing laparoscopic CME for right colon cancer were randomly divided into two groups: image fusion [the original images were reconstructed using CTA and CTC, then fused into three-dimensional images of the blood vessels and intestines (n = 40)] and control (without CTA and CTC reconstruction before surgery). All patients underwent plain and enhanced abdominal CT before surgery.
RESULTS
In the image fusion group, the gastrocolic trunk of Henle was present in 33 cases, and its branches originated from the colon vein, right gastroepiploic vein, and superior anterior pancreaticoduodenal vein. Among these patients, 5 exhibited the right gastroepiploic vein and superior anterior pancreaticoduodenal vein; 21 exhibited a gastrointestinal trunk consisting of 2 or 3 branches of the right gastroepiploic vein, right colon vein, and middle colon vein; and 7 exhibited 3 or 4 gastro-pancreatic and colon trunks consisting of the right colon vein, middle colon vein, right gastroepiploic vein, and superior anterior pancreaticoduodenal vein. The correspondence with the anatomy actually observed during surgery was 100%. Compared with the conventional CT group, the duration of the operation in the image fusion group was shorter, with reduced intraoperative bleeding, and more lymph node dissection. There were no significant differences in the incidence of complications and length of hospital stay between the two groups (p > 0.05).
CONCLUSIONS
For laparoscopic CME for right colon cancer, CTA, CTC, and image fusion were effective preoperative evaluation methods, which avoided some unseen dangers in the operation process and led to better therapeutic outcomes.
Topics: Colectomy; Colonic Neoplasms; Computed Tomography Angiography; Humans; Laparoscopy; Lymph Node Excision; Mesocolon; Prospective Studies
PubMed: 31845142
DOI: 10.1007/s11605-019-04460-1