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

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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Clinical case and short review of extreme short bowel syndrome: an update 21 years after

Italian Journal of Medicine ◽

10.4081/itjm.2016.543 ◽

2016 ◽

Vol 10 (1) ◽

pp. 45

Author(s):

Pasquale Mansueto ◽

Aurelio Seidita ◽

Salvatore Iacono ◽

Antonio Carroccio

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Clinical Case ◽

Ileocecal Valve ◽

Short Review ◽

Short Bowel ◽

Massive Resection ◽

Low Weight ◽

Clinical Conditions

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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Short Bowel Syndrome

10.2310/gastro.5448 ◽

2015 ◽

Author(s):

Robert Burakoff ◽

Alison Goldin

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Average Length ◽

Intestinal Failure ◽

Clinical Manifestations ◽

Intestinal Resection ◽

Intestinal Atresia ◽

Congenital Defects ◽

Short Bowel ◽

Vascular Insufficiency

Short bowel syndrome (SBS) is a state of malabsorption resulting from physical or functional loss of large portions of the small intestine, and is the most common cause of intestinal failure. The average length of a human’s small intestine is between 3 and 8 m, depending on the type of measurements made (surgical, radiologic, or autopsy); SBS occurs when less than 200 cm of small bowel remains. SBS may be congenital (intestinal atresia) or acquired. Physical losses usually occur from surgical resection for Crohn disease (CD), vascular insufficiency, radiation, malignancy, trauma, or volvulus. The site of intestinal resection helps to determine the degree of intestinal capacity. Functional losses, on the other hand, are less common and occur in the setting of a nonfunctioning, but intact, small intestine. Examples include radiation enteritis, congenital defects, and inflammatory bowel disease (IBD). This review addresses the epidemiology, pathophysiology and pathogenesis, clinical manifestations, treatment, complications, and prognosis of SBS. A figure shows sites of intestinal nutrient absorption. A table lists potential complications of SBS in patients receiving parenteral nutrition (PN). This review contains 1 highly rendered figure, 1 table, and 67 references.

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Short Bowel Syndrome after Massive Small Bowel Resection for Primary Volvulus of the Small Intestine in a 90-year-old Patient—A Case Report—

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.76.525 ◽

2015 ◽

Vol 76 (3) ◽

pp. 525-528

Author(s):

Atsushi SUGA ◽

Atsushi SEYAMA ◽

Yuki SUEHIRO ◽

Toshihiro INOKUCHI ◽

Takashi INOUE ◽

...

Keyword(s):

Small Intestine ◽

Case Report ◽

Small Bowel ◽

Short Bowel Syndrome ◽

Bowel Resection ◽

Small Bowel Resection ◽

Short Bowel ◽

Massive Small Bowel Resection

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Does resection enhance the response of the intestine to urogastrone-epidermal growth factor in the rat?

Clinical Science ◽

10.1042/cs0750121 ◽

1988 ◽

Vol 75 (2) ◽

pp. 121-126 ◽

Cited By ~ 31

Author(s):

R. A. Goodlad ◽

A. P. Savage ◽

W. Lenton ◽

M. A. Ghatei ◽

H. Gregory ◽

...

Keyword(s):

Small Intestine ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Intestinal Resection ◽

Small Bowel Resection ◽

Control Group ◽

Positive Interaction ◽

Proliferative Effect ◽

Small Rise ◽

Epidermal Growth

1. The objective of this study was to see whether another proliferative stimulus could modify the marked proliferative effect of human epidermal growth factor (urogastrone-epidermal growth factor, URO-EGF) on the gastrointestinal epithelium. 2. The response of the gastrointestinal tract to URO-EGF was investigated in rats maintained on total parenteral nutrition (TPN) with or without 75% small bowel resection. 3. Continuous infusion of 60 μg of recombinant β-urogastrone/day per rat increased proliferation in the stomach by over four times (P < 0.01), doubled proliferation in the small intestine (P < 0.001) and increased it by four and a half times in the colon (P < 0.001) in the control group. No significant effect of urogastrone was observed in the stomach of the resected groups, but proliferation was also increased in the small intestine by one and a half times (P < 0.001) and by nearly four times in the colon (P < 0.001). 4. Two-way analysis of variance showed that resection had a significant effect (P < 0.01) on proliferation below the anastamosis and in the ileum. However, the response of the ileum was only half that observed in orally fed rats, which confirms the importance of ‘luminal nutrition’ in the response to resection. 5. Intestinal resection in the TPN rat was associated with a small rise in plasma enteroglucagon levels, suggesting that this hormone may be implicated in the adaptive response of the small intestine to resection. However, the proliferative effects of URO-EGF were not associated with increased plasma enteroglucagon and thus the two agents probably exert their proliferative effects via separate mechanisms. 6. There was no evidence for a significant positive interaction between the effects of URO-EGF and resection. Thus loss of intestinal mass had no influence on the susceptibility of the intestine to the effects of URO-EGF. Although URO-EGF significantly increased intestinal epithelial cell proliferation, it could not entirely compensate for the lack of luminal contents.

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MORPHOLOGICAL CHANGES IN THE MUSCLE LAYERS OF SMALL INTESTINE IN THE SHORT BOWEL SYNDROME IN EXPERIMENT

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-4-176-180 ◽

2019 ◽

Vol 23 (4) ◽

pp. 176-180

Author(s):

R. R. Khasanov ◽

D. Svoboda ◽

M. Kohl ◽

Aytbai А. Gumerov ◽

V. S. Vagapova ◽

...

Keyword(s):

Small Intestine ◽

Short Bowel Syndrome ◽

Morphological Changes ◽

Intestinal Adaptation ◽

Circular Muscle ◽

Muscle Layer ◽

Control Group ◽

Longitudinal Muscle Layer ◽

Short Bowel ◽

Intestinal Functions

Introduction. Patients with the short bowel syndrome often have intestinal dilatation which impairs intestinal functions. Changes in the muscle intestinal layers, which cause this condition, are not studied well yet. Purpose. To study the role of small intestine muscle layers in the intestinal adaptation and dilatation in the short bowel syndrome. Materials and methods. 22 rats were taken into the experimental trial; short bowel syndrome was modelled in 12 of them; 10 other rats which had only laparotomy were in the control group. The diameter and thickness of muscle layers in the small intestine and ileum were studied. Results. In the short bowel syndrome, one can observe a significant dilatation of the small intestine and ileum. Thickness of longitudinal and circular layers of the small intestine was significantly larger in rats with the short bowel syndrome in comparison to the control group. In the ileum, only the circular muscle layer was hypertrophied; there was no difference in the thickness of longitudinal muscle layer in rats with the short bowel syndrome and in rats from the control group. Conclusion. In rats with the short bowel syndrome, morphological changes occur not only in the mucous layer, but also in muscle layers of the small intestine what is manifested by the intestinal dilatation and hypertrophy of muscle layers. These changes are results of intestinal adaptation and are pathophysiological for the short bowel syndrome.

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COPPER AND MAGNESIUM DEFICIENCIES IN PATIENTS WITH SHORT BOWEL SYNDROME RECEIVING PARENTERAL NUTRITION OR ORAL FEEDING

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000200004 ◽

2015 ◽

Vol 52 (2) ◽

pp. 94-99 ◽

Cited By ~ 8

Author(s):

Camila Bitu Moreno BRAGA ◽

Iahel Manon de Lima FERREIRA ◽

Júlio Sérgio MARCHINI ◽

Selma Freire de Carvalho da CUNHA

Keyword(s):

Parenteral Nutrition ◽

Short Bowel Syndrome ◽

Intestinal Resection ◽

Oral Feeding ◽

Control Group ◽

Sodium Potassium ◽

Short Bowel ◽

Electrolyte Disturbances ◽

Feeding Methods ◽

And Gender

Background Patients with short bowel syndrome have significant fluid and electrolytes loss. Objective Evaluate the mineral and electrolyte status in short bowel syndrome patients receiving intermittent parenteral nutrition or oral feeding. Methods Twenty two adults with short bowel syndrome, of whom 11 were parenteral nutrition dependent (PN group), and the 11 remaining had been weaned off parenteral nutrition for at least 1 year and received all nutrients by oral feeding (OF group). The study also included 14 healthy volunteers paired by age and gender (control group). Food ingestion, anthropometry, serum or plasma levels of sodium, potassium, phosphorus, magnesium, calcium, zinc, iron and copper were evaluated. PN group subjects were evaluated before starting a new parenteral nutrition cycle. Results The levels of sodium, potassium, phosphorus, calcium and zinc were similar between the groups. The magnesium value was lower in the PN group (1.0 ± 0.4 mEq /L) than other groups. Furthermore, this electrolyte was lower in the OF group (1.4 ± 0.3 mEq /L) when compared to the Control group (1.8 ± 0.1 mEq/L). Lower values of copper (69±24 vs 73±26 vs 109±16 µg/dL) were documented, respectively, for the PN and OF groups when compared to the control group. Conclusion Hypomagnesemia and hypocupremia are electrolyte disturbances commonly observed in short bowel syndrome. Patients with massive intestinal resection require monitoring and supplementation in order to prevent magnesium and copper deficiencies.

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The impact of intestinal resection on the immune function of short bowel syndrome patients

Human Immunology ◽

10.1016/j.humimm.2016.07.237 ◽

2016 ◽

Vol 77 (12) ◽

pp. 1202-1208 ◽

Cited By ~ 4

Author(s):

Walter Miguel Turato ◽

Helioswilton Sales-Campos ◽

Camila Bitu Moreno Braga ◽

Selma Freire Carvalho Cunha ◽

José Henrique Silvah ◽

...

Keyword(s):

Immune Function ◽

Short Bowel Syndrome ◽

Intestinal Resection ◽

Short Bowel ◽

The Impact

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RARE CASE OF SHORT BOWEL SYNDROME

TSMU COLLECTION OF SCIENTIFIC WORKS ◽

10.52340/csw.v49i0.137 ◽

2019 ◽

Vol 49 ◽

pp. 6-8

Author(s):

Azmaiparashvili G. აზმაიფარაშვილი გ. ◽

Tomadze G. თომაძე გ. ◽

Megreladze A. მეგრელაძე ა.

Keyword(s):

Small Intestine ◽

Small Bowel ◽

Parenteral Nutrition ◽

Short Bowel Syndrome ◽

Rare Case ◽

Postoperative Management ◽

Hepatic Flexure ◽

Postoperative Treatment ◽

Extensive Resection ◽

Short Bowel

Short bowel syndrome is characterized by malabsorption following extensive resection of the small bowel. It may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel remains. Successful postoperative management of short bowel syndrome has been discussed. Patient was operated because of cancer of hepatic flexure of large bowel with invasion in stomach, pancreas, retroperitoneal space, mesentery of small bowel. Right sided colectomy and excessive resection of small bowel with limphodissection was performed and only 80 cm of small bowel was left together with the left part of the colon. Ileotransversoanastomosis was performed. After the adequate course of chemotherapy and partial parenteral nutrition patient’s general condition became satisfactory. Patient started to gain weight. Adequate postoperative treatment determined postoperative period without surgical and nutritional complication.

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