-
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Oct 2021At present, there are many studies on Crohn's disease of terminal ileum and colon, but few studies on Crohn's disease of small intestine alone. This study aims to...
OBJECTIVES
At present, there are many studies on Crohn's disease of terminal ileum and colon, but few studies on Crohn's disease of small intestine alone. This study aims to analyze the clinical features and therapeutic effect of small bowel in adult patients with Crohn's disease so as to strengthen the diagnosis and treatment for this disease.
METHODS
From July 1, 2015 to October 31, 2018, patients with small bowel Crohn's disease at Department of Gastroenterology, Third Xiangya Hospital of Central South University, were enrolled. At the same time, patients' demographics and clinical data were collected.
RESULTS
A total of 44 patients were small bowel Crohn's disease. Among them, 40 patients were male. The age at diagnosis was (35.8±10.3) years old and disease duration was (35.2±59.5) months. The subtypes included 29(65.9%) of ileum, 7(15.9%) of jejunum, 8(18.2%) of ileum with jejunum. There were 27(61.4%) of stricture behavior, 4(9.1%) of penetrating behavior, and 13(29.5%) of non-stricture and non-penetrating behavior. Endoscopic visible stricture (29/85, 34.1%) was common, followed by longitudinal ulcers (27/85, 31.8%). Non-caseate granulomatous were found in 2 cases (4.5%). The score of Crohn's disease activity index was correlated to hemoglobin, hematocrit, and erythrocyte sedimentation rate (all <0.05). Among the most common symptom of abdominal pain (34/44, 77.3%), 11 patients (25.0%) developed complications (eg. intestinal obstruction) during the follow-up, and 66.7% of patients treated with mesalazine had complications.
CONCLUSIONS
Patients with ileum account for a large proportion in patients with small bowel Crohn's disease. Stricture is more common in small bowel Crohn's disease. Stricture and longitudinal ulcer are more common under enteroscopy. Crohn's disease activity index is correlated to hemoglobin, red blood cell specific volume, and erythrocyte sedimentation rate. The most common complication is intestinal obstruction. Mesalazine is less effective on small bowel Crohn's disease.
Topics: Adult; Crohn Disease; Endoscopy, Gastrointestinal; Humans; Ileum; Intestinal Obstruction; Intestine, Small; Male; Middle Aged
PubMed: 34911841
DOI: 10.11817/j.issn.1672-7347.2021.190732 -
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 -
Cellular and Molecular Gastroenterology... 2018After esophagojejunostomy, rodents develop reflux esophagitis and a columnar-lined esophagus with features of Barrett's metaplasia. This rodent columnar-lined esophagus...
BACKGROUND & AIMS
After esophagojejunostomy, rodents develop reflux esophagitis and a columnar-lined esophagus with features of Barrett's metaplasia. This rodent columnar-lined esophagus has been proposed to develop from cellular reprogramming of progenitor cells, but studies on early columnar-lined esophagus development are lacking. We performed a systematic, histologic, and immunophenotypic analysis of columnar-lined esophagus development in rats after esophagojejunostomy.
METHODS
At various times after esophagojejunostomy in 52 rats, the esophagus was removed and tissue sections were evaluated for type, location, and length of columnar lining. Molecular characteristics were evaluated by immunohistochemistry and immunofluorescence.
RESULTS
At week 2, ulceration was seen in esophageal squamous epithelium, starting distally at the esophagojejunostomy anastomosis. Re-epithelialization of the distal ulcer segment occurred via proliferation and expansion of immature-appearing glands budding directly off jejunal crypts, characteristic of wound healing. The columnar-lined esophagus's immunoprofile was similar to jejunal crypt epithelium, and columnar-lined esophagus length increased significantly from 0.15 mm (±0.1 SEM) at 2 weeks to 5.22 mm (±0.37) at 32 weeks. Neoglands were found within esophageal ulcer beds, and spindle-shaped cells expressing epithelial-mesenchymal transition markers were found at the columnar-lined esophagus's leading edge. Only proliferative squamous epithelium was found at the proximal ulcer border.
CONCLUSIONS
After esophagojejunostomy in rats, metaplastic columnar-lined esophagus develops via a wound healing process that does not appear to involve cellular reprogramming of progenitor cells. This process involves EMT-associated migration of jejunal cells into the esophagus, where they likely have a competitive advantage over squamous cells in the setting of ongoing gastroesophageal reflux disease.
Topics: Anastomosis, Surgical; Animals; Biomarkers; Cell Differentiation; Cell Proliferation; Doublecortin Protein; Epithelial Cells; Epithelial-Mesenchymal Transition; Epithelium; Esophagitis, Peptic; Esophagus; Homeodomain Proteins; Ki-67 Antigen; Models, Anatomic; Rats, Sprague-Dawley; SOX9 Transcription Factor; Stem Cells; Time Factors; Trans-Activators; Ulcer; Wound Healing
PubMed: 30186929
DOI: 10.1016/j.jcmgh.2018.06.007 -
Case Reports in Medicine 2018We report a case of septicemia in a patient presenting with a bleeding ulcer of a jejunal interposition.
INTRODUCTION
We report a case of septicemia in a patient presenting with a bleeding ulcer of a jejunal interposition.
CASE PRESENTATION
An 81-year-old female patient was acutely admitted to our hospital due to hematemesis and melena. She had a history of metastatic gastrointestinal stromal tumor, for which she was receiving second line treatment with sunitinib. She had also undergone a Merendino procedure 4 years prior to presentation. The patient underwent emergency gastroscopy, which revealed a bleeding ulcer in the jejunal interposition. Despite initial endoscopic control of the bleeding and transfusion of blood products, the hemoglobin level continued to drop, and the patient was treated for an assumed hemolytic transfusion reaction. The patient died 3 days following admission, and the results of blood cultures later confirmed a septicemia. The postmortem examination revealed a diffuse spread of to multiple organs.
CONCLUSION
This case is a reminder of the importance of considering septicemia, particularly in association with , as a potential cause of hemolysis. It also demonstrates the extent of organ involvement in a case of diffuse clostridial myonecrosis.
PubMed: 29560007
DOI: 10.1155/2018/4278904 -
Postgraduate Medical Journal Jun 1945
PubMed: 21313449
DOI: 10.1136/pgmj.21.236.196 -
Case Reports in Gastrointestinal... 2019Intestinal schistosomiasis can be caused by the trematodes that mainly exists in East Asia or the in Africa and South America. The adult worms of live in the...
Intestinal schistosomiasis can be caused by the trematodes that mainly exists in East Asia or the in Africa and South America. The adult worms of live in the mesenteric veins and excrete eggs that circulate to the liver and colon; the eggs migrate through the intestinal wall and pass out with the stool. Here, we report a case of jejunal ulcer caused by the infection of . A 63-year-old woman from Wuhan, China, was admitted with left quadrant abdominal pain and weight loss for more than 6 months. The patient's computerized tomography reported cirrhotic liver changes, jejunal wall edema, and narrowed lumen; the upper enteroscopy corroborated these findings with the presence of several jejunal ulcers and edema. The pathology report showed chronic inflammation with ulcerative changes and eggs deposition. Schistosomiasis is one of the neglected tropical diseases that affect the poorest. Although a great improvement has been made to control it, there is a lot of work that remains to be fulfilled.
PubMed: 31049231
DOI: 10.1155/2019/8356438 -
ACG Case Reports Journal Mar 2023
PubMed: 37021279
DOI: 10.14309/crj.0000000000000969 -
Case Reports in Oncology 2021A 66-year-old man with vomiting and weight loss was referred to our hospital. Abdominal computed tomography showed small bowel obstruction caused by a presumed small...
A 66-year-old man with vomiting and weight loss was referred to our hospital. Abdominal computed tomography showed small bowel obstruction caused by a presumed small intestinal tumor. Single-balloon endoscopy showed an ulcerated tumor and marked stenosis of the jejunum. Immunohistochemical staining suggested the tumor to be poorly differentiated or undifferentiated carcinoma. The patient underwent open surgical resection of the jejunal tumor and regional lymph nodes both to improve the quality of life of the patient and to possibly get a cure of the presumed jejunal carcinoma. Pathological examination of the excised tumor and lymph nodes including para-aortic lymph nodes showed large-sized tumor cells and massive lymphocyte infiltrates. Immunostaining showed the tumor cells to be OCT3/4, AE1/AE3, CD117, and D2-40 positive, leading to the diagnosis of metastatic seminoma. With the preoperative diagnosis of a presumed burned-out tumor of the testis, the patient underwent left high orchiectomy. Pathological examination of the left testis showed marked scar tissue, no teratoma elements, and no residual tumor cells. Under the final diagnosis of regressed seminoma, the patient has received combination chemotherapy using bleomycin, etoposide, and cisplatin as adjuvant chemotherapy. Surgical oncologists should take regressed seminoma into their differential diagnosis when the biopsy specimens of the presumed intestinal malignancy show poorly differentiated or undifferentiated atypical cells with massive lymphocyte infiltrates, especially in postpubertal men. Confirmation of a malignant noninvasive component should be another important clue to the appropriate differential diagnosis when choosing between metastatic seminoma and poorly differentiated or undifferentiated intestinal primary malignancies.
PubMed: 33776737
DOI: 10.1159/000513027 -
Gut Oct 1968
Topics: Adult; Aged; Biopsy; Celiac Disease; Deficiency Diseases; Dietary Fats; Feces; Female; Humans; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Pancreatic Diseases; Pancreatin; Peptic Ulcer; Postgastrectomy Syndromes
PubMed: 5717108
DOI: 10.1136/gut.9.5.576 -
Edinburgh Medical Journal Sep 1948
Topics: Gastrointestinal Diseases; Gastrointestinal Tract; Humans; Peptic Ulcer; Ulcer
PubMed: 18100508
DOI: No ID Found