Clinical Course of Small Subepithelial Tumors of the Small Bowel Detected on CT

PURPOSE: To investigate the clinical evolution of orthotopic small bowel transplantation in outbred rats. METHODS: Seventy-two outbred Wistar rats weighting from 250 to 300g were used as donor and recipient in 36 consecutives ortothopic small intestine transplantation without immunosuppression. The graft was transplanted into the recipient using end-to-side aortic and portacaval microvascular anastomosis. Procedure duration, animal clinical course and survival were evaluated. Survival shorter than four days was considered technical failure. Recipients were sacrificed with signs of severe graft rejection or survival longer than 120 days. Necropsies were performed in all recipients to access histopathological changes in the graft. RESULTS: Median time for the procedure was 107 minutes. Six recipients (16.7%) presented technical failure. Twenty-seven recipients were sacrificed due to rejection, being nineteen (52.7%) between 7th and 15th postoperative day and eight (22.2%) between 34th and 47th postoperative day. Graft histology confirmed severe acute cellular rejection in those recipients. Uneventful evolution and survival longer than 120 days without rejection were observed in three recipients (8.3%). CONCLUSION: Intestinal transplantation in outbred rats without immunosuppressant regiment accomplishes variable clinical evolution.

Download Full-text

CLINICAL COURSE, MORPHOLOGY, AND TREATMENT OF CHRONICALLY REJECTING SMALL BOWEL ALLOGRAFTS

Transplantation Journal ◽

10.1097/00007890-199302000-00002 ◽

1993 ◽

Vol 55 (2) ◽

pp. 242-250 ◽

Cited By ~ 31

Author(s):

JAN M. LANGREHR ◽

BARBARA BANNER ◽

KENNETH K. W. LEE ◽

WOLFGANG H. SCHRAUT

Keyword(s):

Small Bowel ◽

Clinical Course

Download Full-text

Capsule Endoscopy for Ileitis with Potential Involvement of Other Sections of the Small Bowel

Gastroenterology Research and Practice ◽

10.1155/2016/9804783 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Hyun Seok Lee ◽

Yun Jeong Lim

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Clinical Course ◽

Diagnostic Value ◽

Definitive Diagnosis ◽

Imaging Findings ◽

Terminal Ileitis ◽

Aphthous Ulcers ◽

Radiologic Imaging ◽

Inflammatory Drugs

Ileitis is defined as inflammation of the ileum. This condition includes ulcers, aphthous ulcers, erosions, and nodular or erythematous mucosa. Various etiologies are associated with ileitis. Crohn’s disease, ulcerative colitis, medications such as nonsteroidal anti-inflammatory drugs, infectious conditions, neoplasms, infiltrative disorders, vasculitides, spondyloarthritis, endometriosis, and radiation therapy-related conditions involve the ileum. However, the differential diagnosis of terminal ileitis can be difficult in many cases. Video capsule endoscopy (VCE) has become a useful tool for the diagnosis of a variety of small bowel lesions. This review describes each of the various conditions associated with ileitis and the diagnostic value of VCE for ileitis, which may help identify and evaluate these conditions in clinical practice. Based on the information provided by VCE, a definitive diagnosis could be made using the patients’ medical history, clinical course, laboratory and ileocolonoscopic findings, radiologic imaging findings, and histologic findings.

Download Full-text

Small Bowel Intussusception Due to a Primary Non-Hodgkin's Lymphoma. An Unusual Presentation and Clinical Course

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-010-9152-1 ◽

2010 ◽

Vol 41 (4) ◽

pp. 233-237 ◽

Cited By ~ 2

Author(s):

Nikolaos S. Salemis ◽

Evangelos Tsiambas ◽

Christos Liatsos ◽

Andreas Karameris ◽

Efstathios Tsohataridis

Keyword(s):

Small Bowel ◽

Hodgkin’S Lymphoma ◽

Clinical Course ◽

Unusual Presentation ◽

Hodgkin's Lymphoma ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Small Bowel Intussusception

Download Full-text

Peutz Jeghers Syndrome (PJS): Can Double Balloon Enteroscopy (DBE) Modify the Clinical Course and Complications Secondary to Small Bowel Polyps (SBP)?

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2009.03.425 ◽

2009 ◽

Vol 69 (5) ◽

pp. AB196

Author(s):

Oscar V. Hernández ◽

Juan Manuel Blancas Valencia ◽

Maria Luisa Hernandez Reyes ◽

Victor Manuel Paz Flores

Keyword(s):

Small Bowel ◽

Clinical Course ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Double Balloon ◽

Peutz Jeghers Syndrome

Download Full-text

Pouchitis

Mediators of Inflammation ◽

10.1080/09629359891117 ◽

1998 ◽

Vol 7 (3) ◽

pp. 175-181 ◽

Cited By ~ 16

Author(s):

W. R. Schouten

Keyword(s):

Ulcerative Colitis ◽

Small Bowel ◽

Chronic Inflammation ◽

Clinical Course ◽

Bacterial Overgrowth ◽

Ileoanal Pouch ◽

Continent Ileostomy ◽

Endoscopic Findings ◽

Ileoanal Pouch Anastomosis

Pouchitis is a major long-term complication of the continent ileostomy as well as the ileoanal pouch anastomosis. When diagnosed on the basis of clinical, endoscopic and histologic features, this syndrome has been demonstrated almost exclusively in patients with ulcerative colitis. The clinical course, the endoscopic findings and the histologic abnormalities resemble those of ulcerative colitis. The association with extra-intestinal manifestations further supports the hypothesis that pouchitis represents ulcerative colitis in the small bowel. All ileal reservoirs show bacterial overgrowth, especially of anaerobes. As a response to this altered intraluminal environment chronic inflammation and incomplete colonic metaplasia occur. The efficiency of metronidazole does suggest that bacteriological factors play an important role in the pathogenesis of pouchitis.

Download Full-text

A rare case of brain metastasis from poorly differentiated small bowel adenocarcinoma

Surgical Neurology International ◽

10.25259/sni_413_2019 ◽

2019 ◽

Vol 10 ◽

pp. 256

Author(s):

Erika Yamazawa ◽

Yoshitaka Honma ◽

Kaishi Satomi ◽

Hirokazu Taniguchi ◽

Masamichi Takahashi ◽

...

Keyword(s):

Brain Tumor ◽

Small Bowel ◽

Brain Metastasis ◽

Ct Scan ◽

Rare Case ◽

Clinical Course ◽

Small Bowel Adenocarcinoma ◽

Gastrointestinal Malignancies ◽

Abdominal Lymph Node ◽

Poorly Differentiated

Background: Small bowel adenocarcinoma (SBA) accounts for <2% of all gastrointestinal malignancies. The most common organs of SBA metastases are the abdominal lymph node, liver, and peritoneum. There have been almost no reports of brain metastases of SBA. Dabaja et al. reported 1 case of brain metastasis out of 217 SBA cases, but details of the clinical course of the case were unclear. Our case might be the first report covering the full clinical course, pathological findings, and genetic data. Here, we report a very rare case of brain metastasis from poorly differentiated SBA. Case Description: A 54-year-old man who suffered from abdominal pain and melena visited a nearby hospital. This patient had no risk factors for SBA. He underwent partial resection of the jejunum with regional lymphadenectomy and combined resection of the transverse colon. Pathological diagnosis was poorly differentiated adenocarcinoma, pT4N2M0 Stage IIIB (UICC-TNM: 8th edition). One month after curative surgery, liver metastasis was detected by a computed tomography (CT) scan, and then, palliative chemotherapy was started. During the third-line chemotherapy, a brain tumor on the left cerebellum was detected by the CT scan. Tumor resection was performed, and the histopathological features coincided with the primary jejunum tumor. Based on surgical, radiological, pathological, and genetic findings, this brain tumor was comprehensively diagnosed as a metastasis from poorly differentiated SBA. Conclusion: Here, we experienced a very rare case of brain metastasis from poorly differentiated SBA.

Download Full-text

Resected bowel syndrome: clinical course and treatment options

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.12.200452 ◽

2020 ◽

Vol 92 (12) ◽

pp. 36-42

Author(s):

I. E. Hatkov ◽

T. N. Kuzmina ◽

E. A. Sabelnikova ◽

A. I. Parfenov

Keyword(s):

Small Bowel ◽

Mixed Type ◽

Bowel Resection ◽

Clinical Course ◽

Abdominal Cavity ◽

Small Bowel Resection ◽

Nutritional Risk ◽

Protein Energy ◽

The Right ◽

Resected Bowel

The current concepts of the short bowel syndrome and malabsorption after intestinal surgery are generally accepted, but do not fully reflect the patients condition, making it difficult to diagnose and treat it. Aim.The purpose of the study is to analyze the clinical course of the patients after bowel resection, to create a classification based on the variants identified to allow for a differentiated treatment and to introduce the concept of the resected bowel syndrome. Materials and methods.We observed 239 patients (96 men and 143 women) aged 18 to 80 who underwent intestinal resection for 1 month to 16 years (from 2002 to 2018). The 1st group included 96 patients with small bowel resection (40 men and 56 women). The 2nd group included 39 men and 58 women with small bowel resection, including the resection of the ileocecal valve and the right-hand side of the colon (n=97). The 3rd group included 17 men and 29 women with the resection of the right-hand side of the colon or colectomy (n=46). The survey included the NRS-2002 (Nutritional Risk Screening 2002) screening test to identify nutritional risk, a clinical assessment of the symptoms that occurred after the surgery, instrumental methods (esophagogastroduodenoscopy, colonoscopy with biopsy, ultrasound of the abdominal cavity organs and the kidneys, a plain radiography of the abdominal cavity organs, an X-ray examination of the small intestine and the intestinal passage), serum citrulline and short-chain fatty acids in faeces. Results.Based on the analysis of the clinical symptoms and the nutritional status of the patients, a new concept is proposed the resected bowel syndrome with two variants of its progression: either with or without the development of nutritional insufficiency of three types: the dehydration type, the protein-energy insufficiency type and a mixed type. Type 1 requires the use of antimicrobials with the control of SCFA concentrations in faeces. Type 2 requires the introduction of an optimal amount of easily digestible protein to correct protein-energy deficit. The 3rd (most severe) mixed type requires prescription of a parenteral nutrition component with the control of citrulline concentration in the blood serum. Conclusion.The proposed concept the resected bowel syndrome makes it possible to improve its diagnosis, take into account the variants of its progression and allow for a differentiated treatment.

Download Full-text