scholarly journals Jejuno-Ileal tumors: a retrospective study

2021 ◽  
Vol 8 (10) ◽  
pp. 3109
Author(s):  
Mohim Thakur ◽  
Ravinder Vats ◽  
Deep Goel ◽  
Virandera P. Bhalla
Keyword(s):  
Small Bowel ◽  
Surgical Management ◽  
Malignant Tumors ◽  
Demographic Data ◽  
Laparoscopic Group ◽  
Early Recovery ◽  
Primary Tumors ◽  
Delay In Diagnosis ◽  
Radiologic Findings ◽  
Proximal Small Bowel

Background: Primary tumors of the jejunum and ileum are rare and this segment of gastrointestinal tract is relatively inaccessible to conventional endoscopy, leading to a delay in diagnosis. Due to its rarity, data of primary jejunoileal tumors is still scarce, especially in India where diagnostic modalities like capsule endoscopy is not widely available. Herein we aim to discuss the clinico-radiologic findings, pathology and surgical management of such tumors. Methods: Of the total 51 small bowel resections done in our institute during the period from year 2012 to 2015, 14 patients were identified who were diagnosed with jejunoileal benign/malignant jejunoileal tumors. Records were analysed with respect to patient demographic data, clinical features, radiologic findings, surgical management, histopathology and postoperative outcomes.Results: Jejunoileal tumors are more common in males (77%) and first presentation was intestinal obstruction (50%) in majority of patients. A definite preoperative diagnosis based on radiologic/endoscopic means was possible in six patients (46%). Patients were operated and laparoscopic group showed superior outcomes in terms of postoperative complications. Conclusions: Jejunoileal tumors are an infrequent finding in surgical practice. In our study malignant tumors were more common in proximal small bowel. Computed tomography (CT) enterography can detect small bowel lesions with low sensitivity but allows evaluation of lymphadenopathy/distant metastasis. Laparoscopic resection allows initial staging and has the advantage of early recovery, less wound infection rates and better cosmesis.

scholarly journals Small-Bowel Neoplasms: Role of MRI Enteroclysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Angela Faggian ◽  
Maria Rosaria Fracella ◽  
Grazia D’Alesio ◽  
Maria Eleonora Alabiso ◽  
Daniela Berritto ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Tumors ◽  
Delay In Diagnosis ◽  
Computed Tomographic ◽  
Radiologic Findings ◽  
Tissue Contrast ◽  
Magnetic Resonance Enteroclysis ◽  
Small Bowel Neoplasms ◽  
Bowel Neoplasm ◽  
Real Time Information

Small-bowel neoplasms are the 3%–6% of all gastrointestinal tract neoplasms. Due to the rarity of these lesions, the low index of clinical suspicion, and the inadequate radiologic examinations or incorrect interpretation of radiologic findings, a delay in diagnosis of 6–8 months from the first symptoms often occurs. Even if conventional enteroclysis and capsule endoscopy are the most common procedures used to accurately depict the bowel lumen and mucosal surface, their use in evaluating the mural and extramural extents of small-bowel tumors is limited. Instead multidetector computed tomographic enteroclysis and magnetic resonance enteroclysis have the potential to simultaneously depict intraluminal, mural, and extraintestinal abnormalities. In particular MR enteroclysis has an excellent soft tissue contrast resolution and multiplanar imaging capability. It can provide anatomic, functional, and real time information without the need of ionizing radiation. MR findings, appearances of the lesions, combined with the contrast-enhancement behavior and characteristic of the stenosis are important to differentiate small-bowel neoplasm from other nonneoplastic diseases.

EFFECTS OF SMOKING ON THE DISEASE PROGNOSIS IN CANCER PATIENTS

2019 ◽  
Vol 65 (3) ◽  
pp. 321-329
Author(s):  
David Zaridze ◽  
Anush Mukeriya
Keyword(s):  
Smoking Cessation ◽  
Cancer Patients ◽  
Malignant Tumors ◽  
Scientific Data ◽  
Second Primary ◽  
Primary Tumors ◽  
Smoking Intensity ◽  
Risk Of Death ◽  
Disease Prognosis ◽  
Increased Risk

Smoking not only increases the risk of the development of malignant tumors (MT), but affects the disease prognosis, mortality and survivability of cancer patients. The link between the smoking of cancer patients and increased risk of death by all diseases and oncological causes has been established. Mortality increases with the growth of the smoking intensity, i.e. the number of cigarettes, smoked per day. Smoking is associated with the worst general and oncological survivability. The statistically trend-line between the smoking intensity and survivability was observed: each additional unit of cigarette consumption (pack/year) leads to the Overall Survival Reduction by 1% (p = 0.002). The link between smoking and the risk of developing second primary tumors has been confirmed. Smoking increases the likelihood of side effects of the antitumor therapy both drug therapy and radiation therapy and reduces the treatment efficacy. The smoking cessation leads to a significant improvement in the prognosis of a cancer patient. Scientific data on the negative effect of smoking on the prognosis of cancer patients have a major clinical importance. The treatment program for cancer patients should include science-based methods for the smoking cessation. The latter is fundamentally important, taking into account that the smoking frequency among cancer patients is much higher than in the population.

scholarly journals A prospective study evaluating preoperative (clinical, imaging) and intraoperative predictors of suboptimal debulking in advanced epithelial ovarian cancer

2016 ◽  
Author(s):  
Anupama Rajanbabu ◽  
Kiran Bagul ◽  
Keyword(s):  
Ovarian Cancer ◽  
Small Bowel ◽  
Ct Scan ◽  
Epithelial Ovarian Cancer ◽  
Survival Benefit ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Imaging Results ◽  
Advanced Epithelial Ovarian Cancer ◽  
Optimal Debulking

Introduction: In advanced epithelial ovarian cancer, there is a survival benefit for patients who achieve optimalcytoreduction. Suboptimallycytoreduced patients are at risk of the increased morbidity of a surgery without associated survival benefit. Predicting which patients can undergo optimal cytoreduction represents a critical decision-making point. Present study analyses the predictors, pre operative (clinical and radiologic) and intraoperative of suboptimal debulking. Methods: This was a prospective observational study conducted at Amrita Institute of Medical Sciences from March 2013 to May 2015. All the patients with clinically (physical examination, laboratory and imaging results) diagnosed Stage IIIc epithelial ovarian, fallopian tube, or primary peritoneal carcinoma (PPC) who were planed for primary debulking surgery were included. The demographic data and details of tumor markers, radiological investigations including CT scan, intra operative findings and histopathologic details were collected. Statistical analysis was done using SPSS v20.0. Results: 36 patients fit the inclusion criteria. Gross ascites wasthe clinical parameter found to be associated with suboptimal debulking. CT scan had low sensitivity (35-53%) in diagnosing small bowel mesenteric and porta hepatis disease and high sensitivity in diagnosing diffuse peritoneal thickening, omental disease, diaphragmatic and nodal disease. On univariate analysis diffuse peritoneal thickening and small bowel serosa and mesenteric disease were significantly consistent with sub optimal debulking. Conclusion: Finding out disease at the sites which are associated with suboptimal debulking (diffuse peritoneal thickening, smallbowel mesenteric and serosal disease) pre operatively or at the beginning of surgery can predict optimal debulking and can help avoid un necessary surgery.

Sentinel bowel loop as a marker for primary segmental intestinal volvulus in extreme low birth weight neonates

2021 ◽  
pp. 1-5
Author(s):  
T. Zahouani ◽  
W.R. Carter ◽  
R.H. Jessel ◽  
D.E. El-Metwally ◽  
H.M. Crowley
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Surgical Management ◽  
Case Series ◽  
Extremely Low Birth Weight ◽  
Bowel Loop ◽  
Clinical Markers ◽  
Low Birth Weight Infants ◽  
Intestinal Volvulus ◽  
Delay In Diagnosis

Primary segmental intestinal volvulus is a rare condition that may affect neonates. This condition occurs when a loop of bowel torses around the axis of its mesentery without any other abnormality or malrotation. In the earlier stages, the diagnosis can be challenging due to the lack of specific clinical and radiographic signs. Prompt surgical management is critical as a delay in diagnosis may result in bowel loss or death. We present a series of three cases of extremely low birth weight infants with primary segmental volvulus. A sentinel bowel loop was critical in guiding each patient’s surgical management as there were no other clinical markers concerning a pending intra-abdominal catastrophe. This case series suggests that a sentinel bowel loop may be a radiographic marker for primary segmental intestinal volvulus in extremely low birth weight infants.

scholarly journals Measurement of hepatic insulin sensitivity early after the bypass of the proximal small bowel in humans

2016 ◽  
Vol 3 (1) ◽  
pp. 95-98 ◽  
Author(s):  
A. D. Miras ◽  
R. Herring ◽  
A. Vusirikala ◽  
F. Shojaee‐Moradi ◽  
N. C. Jackson ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Small Bowel ◽  
Hepatic Insulin Sensitivity ◽  
Proximal Small Bowel

Impact of Race on the Surgical Management of Adhesive Small Bowel Obstruction

2018 ◽  
Vol 226 (6) ◽  
pp. 968-976.e1 ◽  
Author(s):  
Alexander S. Chiu ◽  
Raymond A. Jean ◽  
Kimberly A. Davis ◽  
Kevin Y. Pei
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Adhesive Small Bowel Obstruction

1074 Gallstone Ileus: Two Decades After Cholecystectomy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Matwala ◽  
M R Iqbal ◽  
T Shakir ◽  
D W Chicken
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
Open Cholecystectomy ◽  
Gallstone Ileus ◽  
Proximal Small Bowel ◽  
Solid Diet ◽  
History Of ◽  
Ileocaecal Junction ◽  
Tomography Scan

Abstract Introduction Gallstone ileus is a rare complication of gallstones that occurs in 1%-4% of all cases of bowel obstruction. We present a surprising case of gallstone ileus causing small bowel obstruction 19 years after open cholecystectomy. Case Report A 77-year-old male presented with a 3-day history of abdominal pain, 4 episodes of vomiting and absolute constipation. He had a surgical background of an open cholecystectomy and open appendicectomy 19 years and 45 years ago respectively. Medically, he had well-controlled hypertension and experienced a TIA 5 years prior. Computed Tomography Scan of the abdomen and pelvis revealed features consistent with an obstructing, heterogenous opacity in the distal small bowel without pneumobilia. The patient subsequently underwent diagnostic laparoscopy. Intraoperatively, an obstructing gallstone, measuring 4 cm, was found 50cm proximal to the ileocaecal junction, with dilatation of the proximal small bowel and distal collapse. Enterotomy and removal of the stone was done. Post-operatively, this gentleman recovered without complications and was discharged home two days later after being able to tolerate a solid diet. Conclusions This is the second reported case of gallstone ileus in a patient with previous cholecystectomy about two decades ago, according to our literature search. Although extremely rare, absence of the gallbladder does not exclude the possibility of gallstone ileus.

Small intestinal motility in fasted and postprandial states: effect of transient vagosympathetic blockade

1987 ◽  
Vol 252 (3) ◽  
pp. G301-G308 ◽  
Author(s):  
S. A. Chung ◽  
N. E. Diamant
Keyword(s):  
Small Bowel ◽  
Intestinal Motility ◽  
Gastric Fundus ◽  
Phase Iii ◽  
Entire Small Bowel ◽  
Vagal Blockade ◽  
Small Intestinal Motility ◽  
Proximal Small Bowel ◽  
Small Intestinal ◽  
Gastric Contractions

We investigated vagal control of the migrating myoelectric complex (MMC) and postprandial pattern of the canine small intestine. Gastric and small intestinal motility were monitored in six conscious dogs. The vagosympathetic nerves, previously isolated in bilateral skin loops, were blocked by cooling. To feed, a meat-based liquid food was infused by tube into the gastric fundus. MMC phases I, II, III, and IV were observed in the fasted state. On feeding, the fed pattern appeared quickly in the proximal small bowel but was delayed distally. Vagal blockade abolished all gastric contractions and spiking activity as well as the small bowel fed pattern. During vagal blockade, the small bowel exhibited MMC-like migrating bursts of spikes in both the fasted and fed states. The migration and cycling of these bursts were not significantly different from the MMC, but the duodenal and jejunal phase II was absent or shortened. On termination of vagal blockade, normal fasting or fed activity reappeared but with a delay in the fed pattern distally. We conclude: the ileum is the least sensitive to vagal blockade; the fasting vagal influence is exerted primarily on phases I and II of the duodenal and jejunal MMC; the fed pattern throughout the entire small bowel is normally dependent upon vagal integrity; the phase III-like bursts of activity seen during vagal blockade likely represents the intrinsic small bowel MMC, which is vagally independent.

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