Perfluorooctane sulfonate exerts inflammatory bowel disease-like intestinal injury in rats

Background Perfluorooctane sulfonate (PFOS), a type of perfluorinated compounds (PFCs), can induce various organ toxicity, including hepatomegaly, immunotoxicity, and gut microbiota disorder. PFCs have been associated with inflammatory bowel disease (IBD). Yet, whether PFOS exposure causes IBD-like disorder and the underlying mechanism remains undefined. Here, we investigated the influence of PFOS exposure on the development of IBD-like disorder in rats. Methods Sprague-Dawley rats were intraperitoneally injected with PFOS (1 or 10 mg/kg) or normal saline (NS) every other day for 15 days. Body weight, serum concentrations of serum amyloid A (SAA) and high sensitivity C reactive protein (hsCRP) were measured. Pathological assessments of villi height and crypt depth in the proximal duodenum and jejunum were performed using H&E staining. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was used to assay cell apoptosis in the jejunum. The infiltration of inflammatory cells and cytokines in the jejunum were detected by immunohistochemistry analysis. Results PFOS (10 mg/kg) significantly increased the body weight, SAA and hsCRP, whereas no significant differences were observed in PFOS 1 mg/kg group of rats. The villi height and crypt depth in the proximal duodenum and jejunum were significantly reduced upon PFOS exposure. PFOS induced higher histopathological score in intestinal tissues compared to NS. Notably, TUNEL-positive cells were significantly higher in the jejunum upon PFOS exposure. Further, neutrophil and macrophage accumulated, and inflammatory cytokines infiltration were also remarkably increased in rats exposed to PFOS. Conclusion PFOS induces IBD-like phenotypes in rats, with associated inflammatory infiltration to intestinal.

A CASE OF BRUNNERS GLAND HAMARTOMA CAUSING OBSTRUCTIVE JAUNDICE

Brunner’s gland hamartoma is a rare benign tumor of duodenum .We present a case of large pedunculated duodenal hamartoma causing obstructive jaundice and significant dilatation of intrahepatic biliary radicles. Duodenal polyp is a rare benign tumor formed from a proliferation of Brunner gland, typically forming polypoid growth in proximal duodenum and can extend up to 3rd part of duodenum. It may be incidental finding but can present in emergency with obstruction and hemorrhage requiring surgical endoscopic resection.

Anatomic Feasibility of Percutaneous Cholecystoenteric Fistula Creation and Stent Insertion in Acute Cholecystitis

Objective. To assess the prevalence of patients whose anatomy would be potentially amenable to percutaneous cholecystoenteric lumen-apposing metallic stents (LAMS) insertion from a population of acute cholecystitis patients. Methods. Contrast-enhanced abdominal computed tomography images in 100 consecutive adult patients with acute cholecystitis were reviewed retrospectively. Feasibility of LAMS placement percutaneously or with endoscopic ultrasound guidance was defined as the presence of a straight and unobstructed trajectory from the skin to the gallbladder, and between the gallbladder and the gastric antrum, or the proximal duodenum, measuring ≤2 cm, respectively. Results. The gallbladder was within 2 cm of the gastric antrum or proximal duodenum without intervening structures in 95 of 100 patients (95%). Percutaneous LAMS appeared anatomically feasible in 90 of 100 patients (90%). Mean ± SD shortest inner-inner wall distance between the gallbladder and the adjacent proximal gastrointestinal tract was 1.20 ± 0.43 cm. The closest location for percutaneous LAMS was between the gallbladder and duodenum in 87 of the feasible cases (97%). The percutaneous approach was transhepatic in 89.5%, and extrahepatic in 10.5%. Endoscopic ultrasound-guided LAMS appeared feasible in 95 of 100 patients, including 5 of the 10 percutaneously unfeasible cases. The other 5 patients appeared unfeasible due to colonic interposition or other intervening structures. Conclusions. LAMS appeared anatomically feasible percutaneously in 90% of acute cholecystitis patients. The shortest and most direct path for percutaneous LAMS was transhepatic and cholecystoduodenal. Percutaneously placed LAMS may be an attractive alternative to percutaneous cholecystostomy.

The use of a pedicalised gallbladder graft to repair a large duodenal defect: a case report and review of the literature.

<p>Large or complex duodenal defects are uncommon but can arise in a variety of clinical contexts and present a technical challenge to manage. We present the case of severe necrotising pancreatitis complicated by necrosis of the distal stomach and proximal duodenum. The resulting large duodenal defect was not amenable to closure with conventional methods but was successfully repaired with a novel technique of cholecystoduodenoplasty. To our knowledge, successful repair of a large duodenal defect using the gallbladder as a full thickness pedicled graft for acute duodenal necrosis has not been previously described in the literature.</p>