Should intestinal continuity be restored after massive intestinal resection?

1989 ◽  
Vol 158 (6) ◽  
pp. 577-580 ◽  
Author(s):  
Baolien T. Nguyen ◽  
Garnet J. Blatchford ◽  
Jon S. Thompson ◽  
Larry E. Bragg
Keyword(s):  
Intestinal Resection ◽  
Intestinal Continuity

Intestinal Structure and Function after Small Bowel by-Pass in the Rat

1972 ◽  
Vol 43 (6) ◽  
pp. 731-742 ◽  
Author(s):  
M. H. Gleeson ◽  
J. Cullen ◽  
R. H. Dowling
Keyword(s):  
Small Bowel ◽  
Migration Rate ◽  
Morphological Changes ◽  
Intestinal Resection ◽  
Glucose Absorption ◽  
Turnover Time ◽  
Structure And Function ◽  
Major Influence ◽  
Intestinal Continuity ◽  
And Function

1. To study further the influence of luminal nutrition on small bowel structure and function, segments of rat jejunum and ileum were completely excluded from intestinal continuity by Thiry-Vella by-pass operations. The effect of partial deprivation of luminal nutrition was also studied in jejunal segments that had been surgically transposed to a distal position in the intestinal tract. 2. Macroscopically, by-passed jejunum and ileum both became narrowed and atrophic, whereas the intestine in continuity showed hypertrophic changes similar to those seen after intestinal resection. 3. In by-passed intestine the pattern of villi changed from mucosal ridges to ‘fingers’ and ‘leaves’. Although villous height and total mucosal thickness were both reduced, light microscopy showed that even 6 months after exclusion from intestinal continuity villous morphology was still retained. 4. Epithelial-cell migration rate and turnover time were diminished in both jejunum and ileum after by-pass. In intestine in continuity the migration rate was increased, but the turnover time remained the same as in controls. 5. In by-passed jejunum, in vivo glucose absorption diminished progressively with time, but did not change in excluded ileal segments. 6. After ileo-jejunal transposition, the jejunum showed no major morphological changes, but glucose absorption became significantly depressed. 7. These results further support the concept that intraluminal nutrition exerts a major influence on cell turnover, villous morphology and absorptive function in the small intestine.

Experimental Massive Intestinal Resection

1970 ◽  
Vol 101 (5) ◽  
pp. 599 ◽  
Author(s):  
Harry M. Delany
Keyword(s):  
Intestinal Resection

scholarly journals Biodistribution of the radiophamarceutical sodium pertechnetate (Na99mTcO4) after massive small bowel resection in rats

2007 ◽  
Vol 22 (6) ◽  
pp. 430-435 ◽  
Author(s):  
Dâmaso de Araújo Chacon ◽  
Irami Araújo-Filho ◽  
Arthur Villarim-Neto ◽  
Amália Cínthia Meneses Rêgo ◽  
Ítalo Medeiros Azevedo ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Intestinal Mucosa ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Control Group ◽  
Short Bowel ◽  
Massive Resection ◽  
Mucosal Thickness ◽  
Misleading Interpretation

PURPOSE: To evaluate the biodistribution of sodium pertecnetate (Na99mTcO4) in organs and tissues, the morphometry of remnant intestinal mucosa and ponderal evolution in rats subjected to massive resection of the small intestine. METHODS: Twenty-one Wistar rats were randomly divided into three groups of 7 animals each. The short bowel (SB) group was subjected to massive resection of the small intestine; the control group (C) rats were not operated on, and soft intestinal handling was performed in sham rats. The animals were weighed weekly. On the 30th postoperative day, 0.l mL of Na99mTcO4, with mean activity of 0.66 MBq was injected intravenously into the orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The biopsies were washed with 0.9% NaCl.,The radioactivity was counted using Gama Counter WizardTM 1470, PerkinElmer. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated. Biopsies of the remaining jejunum were analysed by HE staining to obtain mucosal thickness. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. RESULTS: There were no significant differences in %ATI/g of the Na99mTcO4 in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05). CONCLUSION: In rats with experimentally-produced short bowel syndrome, an adaptive response by the intestinal mucosa reduced weight loss. The biodistribution of Na99mTcO4 was not affected by massive intestinal resection, suggesting that short bowel syndrome is not the cause of misleading interpretation, if an examination using this radiopharmaceutical is indicated.

Intestinal Resection and Calcium Absorption in the Rat

1980 ◽  
Vol 163 (4) ◽  
pp. 553-557 ◽  
Author(s):  
W. C. Eastin ◽  
H. D. Wilson ◽  
H. P. Schedl
Keyword(s):  
Calcium Absorption ◽  
Intestinal Resection

scholarly journals THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Soto Dopazo ◽  
E Pérez Prudencio ◽  
A Arango Bravo ◽  
C Nuño Iglesias ◽  
C Mateos Palacios ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Broad Ligament ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Exploratory Laparotomy ◽  
X Rays ◽  
Intestinal Necrosis ◽  
Urgent Surgery ◽  
Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

A rare encounter of obstructed direct inguinal hernia

2019 ◽  
Vol 22 (2) ◽  
pp. 41-43
Author(s):  
Amit Kumar Singh ◽  
Nripesh Rajbhandari ◽  
Balaram Malla ◽  
Gakul Bhatta
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Intestinal Obstruction ◽  
Intestinal Resection ◽  
Posterior Wall ◽  
Acute Intestinal Obstruction ◽  
University Hospital ◽  
Direct Inguinal Hernia ◽  
Direct Hernia ◽  
The Right

The direct inguinal hernia has a wider neck and thus usually doesn’t present as strangulation or incarceration in comparison to the indirect component. When direct inguinal hernias are untreated for a longer duration, they may get strangulated and incarcerated. Hence such long-standing direct hernias with features of intestinal obstruction and /or peritonism should be promptly seen and diagnosed to prevent massive and unwanted intestinal resection. We are reporting a case of 83-year-old male presented to Surgical Emergency Department of Dhulikhel Hospital, Kathmandu University hospital with complaints of swelling in the right inguinoscrotal region for 12 years and progressed to become irreducible and painful for 12 hours. Clinically he had an acute intestinal obstruction. Intra-operatively we found a direct hernia containing congested small bowel loops and toxic fluids. The toxic fluid was suctioned and after confirming viability, modified Bassini’s repair was done with reinforcement of the posterior wall. Even direct inguinal hernia of longer duration can cause acute or sub-acute intestinal obstruction with or without features of peritonism. This complication is more common in elderly patients.

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