Type B congenital pyloric atresia: a case report

This is a case of congenital pyloric atresia type B not associated with any other anomaly rare condition, seen as an isolated anomaly with excellent prognosis) of two days female child presenting with vomiting since birth. X-ray abdomen showed only stomach air bubble, sonography showed distended stomach with echoes and on barium meal no passage of contrast was seen beyond pyloric antrum even after 24 hours. Patient underwent Heineke-Mikulicz pyloroplasty and postoperative recovery was uneventful.

Pyloric Obstruction Caused by an Inflammatory Fibroid Polyp

This is a case report of a 57-year-old woman who presented with abdominal pain and vomiting over a period of two months. Upper gastrointestinal endoscopies and biopsies were inconclusive, while abdomen computed tomography (CT) scan revealed a large mass arising from the pyloric antrum measuring about 6×4.8 cm imitating gastrointestinal stromal tumor (GIST). The patient underwent a laparotomy, and the tumor was totally resected with well-defined borders. The histopathological analysis revealed the mass to be an inflammatory fibroid polyp (IFP).

Ovine small bowel “minute rhythm” intensity related to feeding and phase of migrating myoelectric complex

The presented study was performed to characterize further the ‘minute rhythm’ in the ovine small bowel, notably to assess the role of fasting and feeding as well as of the phase of the MMC upon the number and amplitude of the MR-containing spike bursts. In eight rams the electrodes were attached to the pyloric antrum, duodenal bulb, duodenum and upper jejunum. In the course of chronic experiments, the myoelectrical recordings were conducted in fasted and non-fasted rams, before and after feeding offered during phase 2a or 2b of the MMC. The phases of the MMC and the MR episodes were identified and the MR frequency, the number of the spike bursts in one MR episode and their amplitudes were calculated. 74 per cent of the MR episodes exhibited the propagated character. At the beginning of phase 2a, the MR often arrived exclusively in the duodenal bulb and was disorganized, while at the end of phase 2b of the MMC, the MR-related spike bursts were most prominent and propulsive. In the duodenal bulb, the giant-like spike bursts forming the pattern were observed occasionally. The MR episodes contained usually 1-2 spike bursts. The number of the MR episodes, each containing one spike burst was smaller after feeding mostly in the duodenum and jejunum and it was lower during phase 2b than during phase 2a of the MMC in the duodenal bulb, duodenum and jejunum. The number of the spike bursts in one MR episode increased after feeding and during phase 2b of the migrating myoelectric complex and it was the highest in the jejunum. The spike burst amplitudes of the MR episodes were the highest in the duodenal bulb. Feeding during phase 2b of the MMC decreased the amplitude of the MR-related spike bursts both in the duodenum and the jejunum. It is concluded that the intensity of the MR in the ovine small bowel is related to feeding and to the phase of the MMC and the high variability of the pattern comprises its character and strength that are apparently related to the intraluminal influences affecting the controlling mechanisms.

Clinical Assessment and Prognostic Evaluation of Tumor Markers in Patients with Gastric Cancer

Aim To investigate the relationship between the serum levels of CEA, CA19-9, CA24-2, CA72-4, and AFP in patients with gastric cancer (GC) and their clinicopathological characteristics; to analyze the efficacy of these tumor markers in evaluating the prognosis of GC. Methods Overall, 389 patients with GC either located in the gastric cardia (132), the pyloric antrum (112) or the body of the stomach (145) were included in the study. Serum levels of CEA, CA19-9, CA72-4, and AFP were detected with the ECLIA method, while CA24-2 was measured with ELISA. Results First, the serum level of CEA in GC patients with a cardia-located cancer was significantly higher than in patients with pyloric antrum-located cancer (p=0.050). CA72-4 level in patients with GC located in the gastric body was significantly higher than in patients with cardia and pyloric antrum-located cancers (p=0.042 and p=0.039, respectively). Secondly, serum CA19-9 and CA24-2 levels in females with cardia-located GC were significantly higher than those in males with the same type of tumor (p=0.037 and p=0.033, respectively). Additionally, for females with gastric body-located GC the levels of CEA and CA72-4 were significantly higher than those in male patients with the same type of tumor (p=0.047 and p=0.048, respectively). Conversely, in female GC patients with pyloric antrum-located cancer the serum levels of CA19-9 and CA24-2 were significantly lower than those in male patients with the same type of cancer (p=0.013 and p=0.007, respectively). Moreover, CEA, CA19-9, CA24-2, and CA72-4 levels were strongly related to TNM grade and histological anatomy stage, whereas CEA and CA72-4 levels were strongly related to lymph node stage (p=0.000 and p=0.042, respectively). Patients with vascular embolism had higher serum levels of CEA, CA19-9, CA24-2, and CA72-4 compared with patients without vascular embolism (p=0.005, p=0.031, p=0.007, and p=0.014, respectively). In patients with distant metastases and ascites the levels of CEA, CA19-9, and CA24-2 were higher than in patients without these conditions (p=0.003, p=0.001, p=0.001, p=0.016, p= 0.011, and p=0.030, respectively). Serum CEA, CA19-9, and CA24-2 levels showed correlations with tumor invasive depth and growth types (p=0.001, p=0.040, and p=0.035, respectively). Patients with lump and catheter tumor growth types had significantly higher AFP levels than patients with invasion and anabrosis growth types (p=0.034 and p=0.005, respectively). Tumor size was correlated with the preoperative serum levels of CEA, AFP, and CA72-4 (p=0.007, p=0.020, and p=0.008, respectively). Additionally multiple linear regression analysis showed that preoperative levels of CEA and CA72-4 were correlated to TNM stages, CA19-9 and CA24-2 levels were correlated to both gender and distant metastasis, and AFP was correlated only to ascites. During follow-up there were 115 deaths. Median survival time for GC patients with negative preoperative CEA was 18.07 months, and was 10.97 months for patients with preoperative CEA positive levels (p=0.0005). Similarly, the median survival time for GC patients with negative preoperative CA72-4 was 33.60, and was 16.03 months for patients with preoperative CA72-4 positive levels (p=0.0041). Conclusions The preoperative levels of CEA, CA19-9, CA24-2, CA72-4, and AFP were closely related to TNM grade, gender, distant metastasis and ascites. These makers seem to play important roles in predicting recurrence and metastasis, and in evaluating prognosis.