Effect of vascular occlusion on small-bowel intraluminal pressures in dogs

Background: Small bowel adenocarcinoma are relatively rare tumors of the digestive system. Due to the lack of specific screening methods, patients are often diagnosed at an advanced stage. At present, there is no specific surgical guidance and chemotherapy regimen for small bowel adenocarcinoma. Here, we report a rare small bowel adenocarcinoma case with mesenteric vascular embolization and microsatellite instability, in which palliative surgery combined with chemotherapy and anti-Programmed cell death protein 1(PD-1) therapy resulted in complete remission.Case Presentation: The patient was a 55-year-old man who was admitted for suspected small bowel adenocarcinoma combined with incomplete ileus, mesenteric vascular occlusion and distant metastasis. We performed palliative surgery to remove adenocarcinoma as well as relieve obstruction. Then according to the pathological and immunohistochemical results (Stage IV and microsatellite instability), we used XELOX regimen combined with anti-PD-1 therapy. In last 2 years follow up, this patient achieved complete remission.Conclusions: The possibility of small intestinal tumor should be considered in patients with mesenteric vascular obstruction. PD-1 blockade is an effective therapy for small bowel adenocarcinoma with microsatellite instability.

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Meconium Ileus: A New Roentgen Sign

PEDIATRICS ◽

10.1542/peds.18.2.253 ◽

1956 ◽

Vol 18 (2) ◽

pp. 253-253

Keyword(s):

Small Bowel ◽

Proteolytic Enzymes ◽

Present Report ◽

Vascular Occlusion ◽

Upright Position ◽

Meconium Ileus ◽

Uncomplicated Case ◽

Diagnostic Sign ◽

Fluid Levels ◽

Mucosal Secretions

Neuhauser described a "bubble" appearance in roentgenograms of the abdomen, apparently due to air mixed with thick meconium, as a diagnostic sign of meconium ileus. It was present in 40% of cases but has subsequently been found not to be specific, as it occurs in cases of imperforate anus. In the present report the author states that, in six uncomplicated cases of meconium ileus, fluid levels were not observed in the dilated loops of small bowel in films taken in the upright position. The lack of fluid levels in the roentgenogram is attributed to a paucity of mucosal secretions in the uncomplicated case of meconium ileus. This is contrary to the usual findings in intestinal obstruction in the newborn. This diagnostic sign is not seen in the presence of complications such as volvulus, gangrene, and peritonitis. In the complicated cases fluid levels appear probably because of the release of proteolytic enzymes by infection and vascular occlusion, the meconium being rendered more fluid by these released enzymes. This appears to be an additional valuable sign to be observed in the diagnosis of meconium ileus by roentgenograms.

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