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Neurogastroenterology and Motility Mar 2018Upper gastrointestinal symptoms in children are common and motility disorders are considered in the differential diagnosis. High resolution esophageal manometry (HRM)... (Review)
Review
BACKGROUND
Upper gastrointestinal symptoms in children are common and motility disorders are considered in the differential diagnosis. High resolution esophageal manometry (HRM) has revolutionized the study of esophageal physiology, and the addition of impedance has provided new insights into esophageal function. Antroduodenal motility has provided insight into gastric and small bowel function.
PURPOSE
This review highlights some of the recent advances in pediatric esophageal and antroduodenal motility testing including indications, preparation, performance, and interpretation of the tests. This update is the second part of a two part series on manometry studies in children (first part was on anorectal and colonic manometry [Neurogastroenterol Motil. 2016;29:e12944]), and has been endorsed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the American Neurogastroenterology and Motility Society (ANMS).
Topics: Consensus; Duodenal Diseases; Esophageal Motility Disorders; Gastrointestinal Motility; Humans; Manometry
PubMed: 29178261
DOI: 10.1111/nmo.13239 -
Alimentary Pharmacology & Therapeutics Apr 2014Study of the upper gastrointestinal microbiome has shown that other bacteria besides Helicobacter pylori flourish despite the hostile environment. Whilst H. pylori is... (Review)
Review
BACKGROUND
Study of the upper gastrointestinal microbiome has shown that other bacteria besides Helicobacter pylori flourish despite the hostile environment. Whilst H. pylori is the most studied bacteria in this region with a defined role in inflammation and neoplasia, it is apparent that other bacteria may contribute to UGI disease.
AIM
To review current knowledge of bacteria inhabiting the oesophagus, stomach and duodenum.
METHODS
Published studies on the upper gastrointestinal microbiome (extracted from PubMed during the last 20 years).
RESULTS
The stomach is a hostile environment for bacteria; however, recent studies categorising the microbiota have shown surprising results. Helicobacter pylori has been intensively studied since 1984 and recent sequencing analysis of other gastric microbiota shows that H. pylori is not alone. Composition can be influenced by acid suppression, gastritis and abundance of H. pylori. Eradication of H. pylori, whilst decreasing gastric cancer is associated with an increase in asthma, reflux and obesity. A future approach may be to selectively eradicate bacteria which predispose to inflammation and cancer as opposed to a comprehensive knockout policy. In the oesophagus, viridans streptococci are the most common bacteria influenced by both oral and gastric bacteria. Oesophagitis and Barrett's oesophagus are characterised by a significant decrease in Gram-positive bacteria and an increase in Gram-negative bacteria. An inverse association of H. pylori and oesophageal adenocarcinoma is described. The duodenal microbiome has been shown to influence small intestinal bacterial overgrowth, irritable bowel syndrome and coeliac disease. The numbers of bacteria recoverable by culture are variable in the stomach mucosa and gastric juice, typically 10(2) -10(4) colony-forming units (CFU)/g or mL and in the oesophagus, up to 10(4) bacteria per mm(2) mucosal surface. In the small bowel, in health, 10(3) CFU/mL are normal.
CONCLUSION
This review highlights current knowledge of upper gastrointestinal bacteria and associations with disease.
Topics: Bacteria; Duodenal Diseases; Esophageal Diseases; Gastrointestinal Neoplasms; Helicobacter Infections; Helicobacter pylori; Humans; Inflammation; Stomach Diseases
PubMed: 24612362
DOI: 10.1111/apt.12666 -
American Family Physician Mar 2012Upper gastrointestinal bleeding causes significant morbidity and mortality in the United States, and has been associated with increasing nonsteroidal anti-inflammatory... (Review)
Review
Upper gastrointestinal bleeding causes significant morbidity and mortality in the United States, and has been associated with increasing nonsteroidal anti-inflammatory drug use and the high prevalence of Helicobacter pylori infection in patients with peptic ulcer bleeding. Rapid assessment and resuscitation should precede the diagnostic evaluation in unstable patients with severe bleeding. Risk stratification is based on clinical assessment and endoscopic findings. Early upper endoscopy (within 24 hours of presentation) is recommended in most patients because it confirms the diagnosis and allows for targeted endoscopic treatment, including epinephrine injection, thermocoagulation, application of clips, and banding. Endoscopic therapy results in reduced morbidity, hospital stays, risk of recurrent bleeding, and need for surgery. Although administration of proton pump inhibitors does not decrease mortality, risk of rebleeding, or need for surgery, it reduces stigmata of recent hemorrhage and the need for endoscopic therapy. Despite successful endoscopic therapy, rebleeding can occur in 10 to 20 percent of patients; a second attempt at endoscopic therapy is recommended in these patients. Arteriography with embolization or surgery may be needed if there is persistent and severe bleeding.
Topics: Duodenal Diseases; Endoscopy, Gastrointestinal; Esophageal Diseases; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Medical History Taking; Peptic Ulcer Hemorrhage; Physical Examination; Recurrence; Stomach Diseases
PubMed: 22534226
DOI: No ID Found -
European Journal of Vascular and... Dec 2022
Topics: Humans; Endovascular Aneurysm Repair; Intestinal Fistula; Duodenal Diseases; Aortic Diseases; Gastrointestinal Hemorrhage
PubMed: 36209965
DOI: 10.1016/j.ejvs.2022.10.012 -
Acta Medica Portuguesa 2011Duodenocaval fistula is a type of digestive fistula rarely described in the literature. It usually manifests by sepsis associated with gastrointestinal bleeding. The...
Duodenocaval fistula is a type of digestive fistula rarely described in the literature. It usually manifests by sepsis associated with gastrointestinal bleeding. The treatment is surgical and the prognosis usually not favorable. We describe the case of a woman admitted to our hospital with sepsis, having been diagnosed with a duodenocaval fistula secondary to perforation of the digestive tract by a foreign body. Surprisingly, the fistula sealed by itself, without the need of surgery, and with a favorable evolution.
Topics: Duodenal Diseases; Female; Humans; Intestinal Fistula; Intestinal Perforation; Middle Aged; Vascular Fistula; Vena Cava, Inferior
PubMed: 22525640
DOI: No ID Found -
Arquivos Brasileiros de Cirurgia... 2021
Topics: Duodenal Diseases; Humans; Intestinal Fistula; Tuberculosis
PubMed: 34008711
DOI: 10.1590/0102-672020190004e1570 -
Journal of Clinical Pathology Nov 2006The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the... (Review)
Review
The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis.
Topics: Algorithms; Biopsy; Celiac Disease; Diagnosis, Differential; Duodenal Diseases; Duodenitis; Duodenum; Humans; Infections; Intestinal Mucosa
PubMed: 16679353
DOI: 10.1136/jcp.2005.031260 -
Postgraduate Medical Journal Aug 1994
Review
Topics: Anti-Bacterial Agents; Duodenal Diseases; Gastrointestinal Diseases; Gastroscopy; Helicobacter pylori; Humans; Lymphoma, B-Cell; Peptic Ulcer; Stomach Neoplasms; Ultrasonography
PubMed: 7937449
DOI: 10.1136/pgmj.70.826.561 -
The Medical Journal of Malaysia Aug 2003Primary aorto-duodenal fistula is a rare and life-threatening cause of upper gastro-intestinal bleed. In this case report, a patient presented acutely with several...
Primary aorto-duodenal fistula is a rare and life-threatening cause of upper gastro-intestinal bleed. In this case report, a patient presented acutely with several episodes of haematochezia and pulseless lower limbs bilaterally. Primary aorto-duodenal fistula with peripheral vascular disease was diagnosed after an urgent CT angiogram was performed. She underwent left axillo-bifemoral bypass, resection of the fistula, Rouxen-Y gastro-jejunostomy, pyloric exclusion and controlled duodenal fistula the following day.
Topics: Aged; Aortic Diseases; Duodenal Diseases; Female; Humans; Intestinal Fistula
PubMed: 14750389
DOI: No ID Found -
World Journal of Gastroenterology Jan 2008Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. We report the first case of a man with...
Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting. Computed tomography scan showed in the third duodenal segment the presence of inflammatory tissue with air bubbles between the duodenum and prosthesis, adherent to the duodenum. The patient was submitted to surgery, during which the prosthesis was detached from the duodenum, the intestine failed to close and a gastro-jejunal anastomosis was performed. The post-operative course was simple, secondary ADF was a complication (0.3%-2%) of aortic surgery. Mechanical erosion of the prosthetic material into the bowel was due to the lack of interposed retroperitoneal tissue or the excessive pulsation of redundantly placed grafts or septic procedures. The third or fourth duodenal segment was most frequently involved. Diagnosis of ADF was difficult. Surgical treatment is always recommended by explorative laparotomy. ADF must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained obstructive syndrome. Rarely the clinical picture of ADF is subtle presenting as an obstructive syndrome and in these cases the principal goal is to effectively relieve the mechanical bowel obstruction.
Topics: Aortic Diseases; Blood Vessel Prosthesis; Diagnosis, Differential; Duodenal Diseases; Humans; Intestinal Fistula; Male; Middle Aged; Prosthesis Failure
PubMed: 18200675
DOI: 10.3748/wjg.14.484