Een laattijdige complicatie na het plaatsen van een PEG-sonde

Gastrocolocutaneous fistula as a complication of percutaneous endoscopic gastrostomy First described in 1980, percutaneous endoscopic gastrostomies (PEG) have become widely used to provide enteral nutritional support to patients unable to ingest solid or liquid foods. A 46-year-old man presented himself with a malodorous leakage near the insertion site after getting a PEG. The PEG had been placed 6 months earlier in the context of a swallowing disorder, caused by progressive chronic inflammatory demyelinating polyneuropathy. An additional CT scan showed no collection or abscess. Instead, the PEG tube appeared to have perforated the colon transversum, with the tip of the probe still located in the stomach. Damage of intra-abdominal organs after placement of a PEG is described in literature. While in the majority of described cases, damage was caused to large and small intestines, only damage to the liver or spleen was reported occasionally. An iatrogenic perforation of the bowel is more common in an older population due to increased laxity of the mesentery. Excessive insufflation of air into the stomach during the procedure is thought to cause gastric rotation, which can pull the transverse colon toward the stomach. Previous abdominal surgery, as also described in this case report, increases the risk of perforation. Perforation of an intra-abdominal organ usually presents immediately after placement of a PEG probe. This late complication is rare and demonstrates the importance of correct patient selection, periprocedural attention and early detection. When presenting a malodorous loss around the tube, a physician should always be contacted. Vigilance is therefore required, even months after placement.

Comparative Experimental Biomodelling of NSAID-induced Enterocolitis

Use of non-steroidal anti-inflammatory drugs (NSAIDs) is considered to be a factor in the development of gastrointestinal tract (GIT) diseases. Thus, enterocolitis is a frequent complication of NSAIDs. Experimental modelling of GIT diseases in laboratory animals, which describes the origin and mechanism of the corresponding disease in humans with maximal precision, is an urgent problem of modern medicine. This paper presents the results of comparative experimental biomodelling of NSAID-induced enterocolitis in laboratory rats. It was found that the intragastric administration of acetylsalicylic acid resulted mainly in stomach damage. The introduction of dexketoprofen — both orally and intramuscularly — causes erosive and ulcerative lesions of the stomach and intestines. The type of damage showed no correlation with the type of administration. For the first time, the results of enterocolitis biomodelling using dexketoprofen are presented.

MODULATION OF B-LYMPHOCYTES ACTIVITY BY CHOLINOTROPIC DRUGS BEFORE WATER-IMMERSION STRESS

The aim of the work was to study the effect of modulation of B-lymphocytes activity with cholinotropic drugs on the stomach damage caused by water-immersion stress (WIS). The work was performed on male Wistar rats. Atropine (2 mg/kg), methacin (2 mg/kg) and choline alfoscerat (90 mg/kg) were administered 14 days before the WIS which lasted for 5 hours. The number of antibody-producing cells (APC) in spleen and the content of immunoglobulins IgA, IgG, IgM in blood were determined. The rats injected with saline were served as the control. On day 14 after administration of methacin or choline alfoscerat, but not atropine, an increase in the APC content in the spleen was observed comparing with control. At the same time, there was a significant decrease in the number of gastric ulcers. Thus on the model of water-immersion stress (WIS), it has been shown that B-lymphocytes can serve as a new target for the action of cholinotropic drugs, and modulation of their activity can provide effective prevention against stress.

Gastroprotective Effect of Aqueous Extract of Azadirachta indica (Neem) on Ethanol Induced Gastric Lesion in Rats

The present study has been undertaken to find out the gastro-protective effect of aqueous extract of Azadirachta indica on ethanol induced gastric lesion in rats. To demonstrate this effect : some parameters of gastric damage -such as number of lesions, lesions length, lesions breadth, lesions area, lesions index and percent inhibition was chosen. In addition, histological features of rat stomach were also examined to confirm gastric damage and to determine the extent. The rats were provided with aqueous extract of Azadirachta indica (300mg /kg body wt) orally by gastric tube. After 12 hrs,1 ml absolute ethanol were orally administered to all groups by gastric tube. After 60 mins of administration, all rats were sacrificed. Rats pretreated with aqueous extract of Azadirachta indica (300mg /kg body wt) showed significant decrease in stomach damage both macroscopically and microscopically as compared to control. It is observed that aqueous extract of Azadirachta indica has gastroprotective effect. Therefore, aqueous extract of Azadirachta indica can be used to prevent gastric ulcer. DOI: http://dx.doi.org/10.3329/bjpp.v28i1-2.20074 Bangladesh J Physiol Pharmacol 2012; 28(1&2):10-14