THE MORPHOFUNCTIONAL CONDITIONS OF THE ORGANS OF THE ABDOMINAL CAVITY DUE TO REPERFUSION OF THE SMALL INTESTINE FOLLOWING ITS ACUTE OBSTRUCTION IN AN EXPERIMENT

2013 ◽  
Vol 12 (1) ◽  
pp. 17-20
Author(s):  
L. V. Shkrobot ◽  
I. Ye. Herasymiuk
Keyword(s):  
Small Intestine ◽  
Abdominal Cavity ◽  
Acute Obstruction

Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

Providing Comfort or Prolonging Death for a Baby with “Dead Gut Syndrome”?

1999 ◽  
Vol 8 (4) ◽  
pp. 538-538 ◽  
Author(s):  
MARK G. KUCZEWSKI
Keyword(s):  
Small Intestine ◽  
Prenatal Diagnosis ◽  
Abdominal Cavity ◽  
Length Of Gestation

The patient was born at 29 weeks gestation. There was a prenatal diagnosis that the child's small intestine had developed outside of the abdominal cavity. The length of gestation had made the initial prognosis good. But after birth, surgery to place the intestine back into the abdominal cavity found that the baby actually had very little small intestine and a diagnosis of “dead gut syndrome” was made. The amount of small intestine was not compatible with survival. The transplant service saw the baby twice and each time said the baby's profile did not meet the transplant protocol.

scholarly journals Application of a temporary intestinal storage device in a small intestine gunshot wound dog model

2021 ◽  
Author(s):  
Weihang Wu ◽  
Mingwei Wang ◽  
Weikang Zhou ◽  
Yuewen Zhu ◽  
Tianyu Lin ◽  
...  
Keyword(s):  
Small Intestine ◽  
Gunshot Wound ◽  
Inflammatory Cell ◽  
Treatment Time ◽  
Abdominal Cavity ◽  
First Aid ◽  
Storage Device ◽  
Wound Model ◽  
Transmission Electron ◽  
Normal Intestine

Abstract Background: We aimed to verify the feasibility of a novel temporary intestinal storage device (TISD) using a simple intestinal gunshot wound model. Methods: Ten female beagle dogs were fasted for 12 hours and anesthetized. An incision protector was inserted into a 10-cm abdominal incision. The small intestine was exposed to the body by natural drooping. An automatic rifle was used to shoot the intestine from a distance of 25 meters to introduce a simple intestinal gunshot wound. The three phases of first aid for war injuries were followed: Care Under Fire, Tactical Field Care, and Tactical Evacuation Care. For Tactical Field Care, a novel TISD was used to reconstruct the ruptured intestine, and necrotic intestinal tissue was stored. The abdominal cavity was temporarily closed, and the abdomen was opened for exploration 4 hours after surgery. Treatment time was observed during Care Under Fire, transfer time was observed from Tactical Field Care to Tactical Evacuation Care, rescue was observed during Tactical Evacuation Care, and the treatment time of each intestinal segment was measured. After 4 hours, intestinal vitality was observed, and the heart, liver, spleen, lung, kidney, stomach, normal intestine, and necrotic intestine were examined before and 4 hours after surgery by light microscopy. The broken ends of the intestine were connected to the intestinal reconstruction device before and 4 hours after surgery and were examined by transmission electron microscopy. Results: The processing time of Care Under Fire was 41.55 ± 10.46 seconds, which is shorter than the maximum time limit of the battlefield first aid principle. Transit time from Care Under Fire to Tactical Field Care transit was 60.78 ± 15.95 seconds, which is shorter than the battlefield first aid principle. The treatment time of Tactical Field Care was 29.75 ± 5.13 minutes, and the reconstruction time of each intestinal segment was 4.44 ± 0.31 minutes. One dog died of anesthetic overdose, two died of splenic bleeding, and the rest completed all phases. The abdominal cavity was explored 4 hours after surgery, and the TISD was positioned. Intestinal tract reconstruction was normal, and no obvious necrosis was observed. Necrotic intestine had the same vitality as before storage. With light microscopy, the heart, liver, spleen, lung, kidney, and stomach showed no obvious necrosis, inflammatory cell infiltration, or necrosis of normal intestine before and after surgery. Before and 4 hours after surgery, intestinal necrosis involved local necrosis of villi and tissues, and marked inflammatory cell infiltration. Transmission electron microscopy showed that the villi of the intestinal stump connected to the TISD before surgery were intact, and no obvious necrosis was observed. The villi of the intestinal stump were moderately damaged after surgery, and focal necrosis was observed. Conclusions: The novel TISD can be used in the emergency treatment of simple small intestine gunshot wounds in beagle dogs and can prevent further deterioration after intestinal injury. Background: We aimed to verify the feasibility of a novel temporary intestinal storage device (TISD) using a simple intestinal gunshot wound model.

The Impact of Minimally Invasive Colostomy on the Microbial Infection of the Abdominal Cavity and the Development of Intoxication Syndrome in Patients with Rectal Cancer Complicated by Acute Obstruction

10.12737/7265 ◽  
2014 ◽  
Vol 21 (4) ◽  
pp. 38-40
Author(s):  
Тотиков ◽  
Z. Totikov ◽  
Тотиков ◽  
V. Totikov
Keyword(s):  
Rectal Cancer ◽  
Acute Phase ◽  
Microbial Contamination ◽  
Acute Phase Proteins ◽  
Abdominal Cavity ◽  
Minimal Access ◽  
Acute Obstruction ◽  
Microbial Infection ◽  
Proximal Colostomy ◽  
The Impact

The article studies the influence of proximal colostomy formed through minimal access for microbial contamination of the abdominal cavity during the radical phase of treatment and the dynamics of the inflammatory changes and intoxication syndrome in patients with rectal cancer complicated by acute obstruction. The research on microbial contamination of the abdominal cavity was made in 32 patients, including 15 patients in whom obstruction was resolved conservatively and 17 patients in whom was made a proximal colostomy through mini-invasive access to eliminate acute obstruction. In 30 patients were investigated acute phase proteins and determined the level of toxemia available by calculation leukocyte index of intoxication. Blood sampling was carried out in patients with acute intestinal obstruction directly before applying the proximal colostomy, and before the second - a radical step treatment in 7-10 days. Found that the imposition of the proximal colostomy through minimal access does not lead to an increase in microbial contamination of the abdomen; helps reduce the level of acute phase proteins, the level of general toxemia and reduces the risk of postoperative inflammatory complications before performing radical phase of treatment.

scholarly journals The Study of the Gastrocolicomentum Influence on the Healing of the Intestinal Anastomosis in a Blood Supply Disorders of the Small Intestine

2017 ◽  
Vol 10 (4) ◽  
pp. 288-292
Author(s):  
S A Markos`yan ◽  
N M Lysyakov ◽  
M U Belyaeva
Keyword(s):  
Small Intestine ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Blood Viscosity ◽  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Protein Loss ◽  
Ischemic Area ◽  
Erythrocyte Sedimentation ◽  
Gastrocolic Omentum

Topicality. Currently, the problem of intestinal anastomosis reliability remains one of the most important, especially when the volume of surgical interventions is associated with significant disturbance of the blood supply to the intestine. According to the literature, the incidence of intestinal anastomosis incompetence after intestinal resection remains high and ranges from 4 to 10.2%. The aim of the study is experimental assessment of the efficiency of omentoenteropexy application for prophylaxis of intestinal anastomosis incompetence. Materials and methods. Experiments were carried out on 20 dogs divided into 2 groups. The first group consists of animals which were formed intestinal anastomosis and ligated mesenteric vessels, the second group is the animals, which in addition to the aforesaid activities were realized omentoenteropexy. Of the venous vessel, directly adjacent to the ischemic area of the small intestine, within 25 minutes after the formation of intestinal anastomosis was performed blood sampling, followed by the study of a number of indicators hemomicrocirculatory: сapillary filtrate, plasma protein loss, blood viscosity, coefficient deformation erythrocytes, erythrocyte sedimentation rate. In addition, the blood flow in the vessels of the small bowel mesentery, adjacent to the zone of ischemia, was investigated. During the postoperative period pathomorphological changes were estimated in the peritoneal cavity, mechanical strength of the junctions and stricture formation index were defined. Results. Capillary filtrate and plasma protein loss in the ischemic area of the small intestine with the anastomosis increase by 6.4 times (p <0.01) and 250% (p<0.05). Blood viscosity increased by 30.6% (p <0.01), erythrocyte sedimentation rate decreased by 30.9% (p <0.01). The number of functioning capillaries is equal to 48.5+1.8% (P <0.01). In 1 case pneumopressia test revealed intestinal anastomosis incompetence. The postsurgical period was accompanied by a significant development of adhesions in the abdominal cavity. In the study hemomicrocirculatory rates in the ischemic area of the small intestine with anastomosis, covered the greater omentum, we didn't detect reliable differences to those of the first group of animals. In all cases intestinal anastomoses were competence and adhesions in the abdominal cavity was represented by single commissures. Discussion. The paper presents the results of an experimental research on the morphological and functional changes in the ischemic area of the small intestine with the anastomosis in absense of omentoenteropexy and after covering the ischemic part organ with anastomosis by dint of the gastrocolic omentum and subsequent suturing it to the avascular part of the bowel mesentery. Performed research determined significant change of hemomicrocirculatory rates in the ischemic area of the small intestine with anastomosis in flowing venous blood from it and in the mesentery of the small intestine, directly adjacent to the avascular area. Postoperative relaparotomy showed pronounced morphological disturbances in the ischemic area of the small intestine with the anastomosis, the presence of significant adhesions in the abdominal cavity. Intestinal anastomosis incompetence was diagnosed in 1 case. Covering explored part of the small intestine by dint of the gastrocolic omentum has contributed to a more favorable regeneration flow without the development of postoperative complications in the intestinal anastomosis. There was an insignificant adhesion in the abdominal cavity in most cases. Conclusion. Thus, covering the ischemic area of the small intestine with anastomosis by dint of the gastrocolic omentum and suturing it to the avascular part of the mesentery resulted in a significant improvement in the regeneration of the intestinal anastomosis and reduction of intraperitoneal adhesions.

scholarly journals Intramural hematoma in the jejunum as a cause of colics in horses

2017 ◽  
Vol 73 (10) ◽  
pp. 671-674
Author(s):  
Bernard Turek ◽  
Roma Buczkowska ◽  
Bartłomiej Obrochta ◽  
Kamil Górski ◽  
Olga Drewnowska
Keyword(s):  
Small Intestine ◽  
Antibiotic Therapy ◽  
Fluid Therapy ◽  
Abdominal Cavity ◽  
Intramural Hematoma ◽  
Physiological Solution ◽  
Postoperative Treatment ◽  
Full Health ◽  
Life Threatening ◽  
Severity Of The Disease

Colics in horses are a common problem, which can be life-threatening for the animal, depending on the type and severity of the disease. The case described in this article concerns surgically treated intramural hematoma of the jejunum in a 3-year-old Arabian mare. Medial laparotomy was performed in dorsal recumbency under general anesthesia. During the exploration of the abdominal cavity, highly filled intestinal loops were found along with intramural hematoma located in the jejunum. A resection of the intestinal part with extravasation was performed, and the content of the small intestine was evacuated. The postoperative treatment consisted of intravenous and general antibiotic therapy as well as intensive fluid therapy for the next 5 days. The abdominal cavity was flushed two times a day with a warm physiological solution containing heparin. After 3 days the drain was removed. After the treatment the mare returned to full health.

scholarly journals A case of volvulus of the small intestine during eight months of pregnancy

2021 ◽  
Vol 32 (8-9) ◽  
pp. 760-762
Author(s):  
V. N. Vasiliev
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Acute Obstruction ◽  
The Subject

Intestinal obstruction is one of the chapters of modern surgery, where not all questions have yet been clarified and developed, which can be seen at least from the fact that this topic is the subject of discussion at the congresses and does not leave the pages of the surgical press. One thing is certain that the therapy of acute obstruction is exclusively surgical.

scholarly journals MORPHOLOGICAL CHANGES IN THE SMALL INTESTINE OF RATS WITH ACUTE GENERALIZED PERITONITIS

2019 ◽  
pp. 110-113
Author(s):  
I. Ya. Dzyubanovsky ◽  
B. M. Vervega ◽  
S. R. Pіdruchna ◽  
N. A. Melnyk
Keyword(s):  
Endothelial Cells ◽  
Small Intestine ◽  
Mucous Membrane ◽  
Morphological Changes ◽  
Histological Study ◽  
Abdominal Cavity ◽  
Inflammatory Infiltration ◽  
Generalized Peritonitis ◽  
White Rats ◽  
Fecal Suspension

The main cause of mortality in acute generalized peritonitis (AGP) is the development of multiple organ insufficiency. The intestine is the organ where the first changes develop in this pathology. The aim of the study – to research and evaluate the morphological changes in the small intestine wall of animals with experimental AGP. Materials and Methods. 32 white rats were used in this study. Acute peritonitis was modeled by introduction of 10 % fecal suspension in the dosage of 0.5 ml per 100 g of the animal's weight into the abdominal cavity of rats by puncture. The terms of observation: the 1st, 3rd and the 7th days from the beginning of the peritonitis modeling. For histological study the intestinal tissue was taken. The resulting pieces of the organ were fixed in a 10 % neutral formalin solution, which were then stained with hematoxylin and eosin. Results and Discussion. On the 3rd day of the experiment in animals with a modeled AGP, vascular changes were manifested first of all by the rounding (retraction) of endothelial cells or their desquamation and the appearance of defects, that allow plasma proteins and the formed elements of blood to leave circulation boundaries of the vascular bed. On the 7 th day in animals with a modeled AGP increased vascular permeability of the mucous membrane of the small intestine was accompanied by a significant edema of the stroma of the villi and by focal hemorrhages. Conclusion. Consequently, the distinct inflammatory changes in all terms of the injury were seen in the wall of the small intestine at the simulated AGP. The significant expansion of the capillaries and venules against the background of inflammatory infiltration in the stroma of the glandular component of the small intestine was noted on the 1st day from the beginning of the experiment. An increase in the height of intestinal villus and a crypt with retraction and desquamation of endothelial cells in the wall of vessels, which caused platelet adhesion in the areas of destruction was observed on the 3rd day. The areas of focal necrosis of the superficial epithelium, which were accompanied by multiple hemorrhages per diapedesis in the perivascular space of the mucous membrane, were seen in the wall of the small intestine of animals with a simulated AGP on the 7th day.

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