A MASSIVE RESECTION OF THE SMALL INTESTINE FROM FIFTEEN CENTIMETERS DISTAL TO THE LIGAMENT OF TREITZ TO WITHIN SIX CENTIMETERS OF THE ILEOCECAL VALVE—WITH A FOUR YEAR FOLLOW-UP

Short bowel syndrome refers to the malabsorptive state caused by loss of significant portions of the small intestine, whose clinical framework is characterized by malnutrition, diarrhea, dehydration, weight loss, and low-weight-related symptoms/signs. These clinical conditions seem to be related to the length of resection. Twenty-one years ago we reported the clinical case of an infant, who underwent a massive resection of the loops of the small intestine, of the cecum and of part of the ascending colon, due to intestinal malrotation with volvulus. The residual small intestine measured just 11 cm and consisted of the duodenum and a small part of jejunum, in the absence of the ileocecal valve, configuring the case of a <em>ultra-short bowel syndrome</em>. In this report, we update the case, reporting the patient succeeded to obtain a good weight gain and to conduct a quite normal lifestyle, despite the long-term consequences of such resection.

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Massive resection of the small intestine: A six year follow-up study

The American Journal of Digestive Diseases ◽

10.1007/bf02881311 ◽

1953 ◽

Vol 20 (6) ◽

pp. 152-156 ◽

Cited By ~ 7

Author(s):

Jacob K. Berman ◽

Elmer D. Habegger ◽

Elmer Billings

Keyword(s):

Small Intestine ◽

Follow Up Study ◽

Massive Resection

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Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses

Journal of the American Veterinary Medical Association ◽

10.2460/javma.20.10.0577 ◽

2021 ◽

pp. 1-7

Author(s):

Marco Gandini ◽

Gessica Giusto

Keyword(s):

Small Intestine ◽

Ileocecal Valve ◽

Exploratory Laparotomy ◽

Clinical Findings ◽

Long Term Effects ◽

Short Term ◽

Small Intestinal ◽

End To End

Abstract CASE DESCRIPTION 7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. CLINICAL FINDINGS All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the small intestine. TREATMENT AND OUTCOME All horses underwent emergency exploratory laparotomy, in which the affected aborad portion of the jejunum and orad portion of the ileum were resected; in 5 horses, a hand-sewn end-to-end jejuno-ileal anastomosis was combined with a hand-sewn incomplete ileocecal bypass to produce a hybrid jejuno-ileo-cecal anastomosis. In 2 horses, the hand-sewn end-to-end jejuno-ileal anastomosis was combined with a half-stapled, half–hand-sewn incomplete ileocecal bypass. The procedures restored continuity of the small intestine with partial bypass of the ileocecal valve. All horses survived to hospital discharge, and none developed colic or ileus during the postoperative period. Follow-up revealed that 6 horses were living and had no subsequent signs of colic (4 to 17 months after surgery), and 1 was euthanized because of colic 17 months after surgery. CLINICAL RELEVANCE Results for these horses suggested the hybrid jejuno-ileo-cecal anastomosis could be considered as an option for the resolution of small intestinal strangulating lesions involving the orad portion of the ileum. Studies are needed to assess short-term and long-term effects of the procedure in horses.

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Digestion and Absorption After Massive Resection of the Small Intestine

Gastroenterology ◽

10.1016/s0016-5085(19)36599-0 ◽

1950 ◽

Vol 16 (1) ◽

pp. 126-139 ◽

Cited By ~ 70

Author(s):

T.L. Althausen ◽

R.K. Doig ◽

Kahn Uyeyama ◽

S. Weiden

Keyword(s):

Small Intestine ◽

Massive Resection

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

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502007000600003 ◽

2007 ◽

Vol 22 (6) ◽

pp. 430-435 ◽

Cited By ~ 13

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.

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A long-term survivor of clear cell sarcoma-like tumor of the gastrointestinal tract with liver metastasis: a case report

Surgical Case Reports ◽

10.1186/s40792-020-01028-z ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Takuhisa Okada ◽

Yasumitsu Hirano ◽

Shintaro Ishikawa ◽

Hiroka Kondo ◽

Toshimasa Ishii ◽

...

Keyword(s):

Small Intestine ◽

Lymph Node ◽

Gastrointestinal Tract ◽

Liver Metastasis ◽

Surgical Resection ◽

Clear Cell ◽

Clear Cell Sarcoma ◽

Cell Sarcoma

Abstract Background Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLTGT) is extremely rare. It is a mesenchymal neoplasm that usually forms in the small intestine of adolescents and young adults, is prone to local recurrence and metastasis, and has a high mortality rate. We report a patient with CCSLTGT with lymph node- and liver metastases, who continues to survive 6 years after initial surgical resection. Case presentation A 38-year-old woman presented with lightheadedness. Laboratory analysis revealed anemia (hemoglobin, 6.7 g/dL), and enhanced computed tomography (CT) demonstrated a mass in the small intestine, about 6 cm in diameter, with swelling of 2 regional lymph nodes. Double-balloon small intestine endoscopic examination revealed a tumor accompanied by an ulcer; the biopsy findings suggested a primary cancer of the small intestine. She was admitted, and we then performed a laparotomy for partial resection of the small intestine with lymph node dissection. Pathologic examination revealed CCSLTGT with regional lymph node metastases. About 3 years later, follow-up CT revealed a single liver metastasis. Consequently, she underwent a laparoscopic partial liver resection. Histopathologic examination confirmed that the liver metastasis was consistent with CCSLTGT. It has now been 3 years without a recurrence. Conclusion Repeated radical surgical resection with close follow-up may be the only way to achieve long-term survival in patients with CCLSTGT.

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Arginine becomes an essential amino acid after massive resection of rat small intestine.

Journal of Biological Chemistry ◽

10.1016/s0021-9258(18)31686-7 ◽

1994 ◽

Vol 269 (51) ◽

pp. 32667-32671

Author(s):

Y. Wakabayashi ◽

E. Yamada ◽

T. Yoshida ◽

H. Takahashi

Keyword(s):

Small Intestine ◽

Amino Acid ◽

Essential Amino Acid ◽

Rat Small Intestine ◽

Massive Resection

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Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

BMC Gastroenterology ◽

10.1186/s12876-021-01627-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhicheng Zhang ◽

Xiaowei Huang ◽

Qian Chen ◽

Demin Li ◽

Qi Zhou ◽

...

Keyword(s):

Small Intestine ◽

Case Report ◽

Literature Review ◽

Ct Scan ◽

Duplication Cyst ◽

Abdominal Ct ◽

Case Presentation ◽

Abdominal Ct Scan ◽

Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

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