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Results for “DUODENAL INTUBATION”

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At least 235 records · Page 13Linked to original sources

PubMed1991

[A comparative evaluation of the results of studies of multi-moment chromatic intubation and cholecystography].

These methods were employed in examinations of 55 patients with various gastrointestinal diseases. The findings of both methods coincided in assessment of gallbladder kinetic function in 36 (66%) patients. In 19 (34%) patients the results did not coincide, in 9 of them multi-moment chromatic duodenal intubation with xylite stimulation has yielded overstated results, and in the remaining 10 patients gallbladder hyperfunction was detected by x-ray examination after egg yolk stimulation. Individual reactions of the body may be responsible for this discrepancy; other explanations are unstable pathologic dysfunction of the gallbladder and the psychoemotional status of patients during the examination.

Adult↗

PubMed2000

Stimulation of gallbladder by intravenous infusion of amino acid: a new method to obtain duodenal bile for bile analyses.

Bile analysis is performed on duodenal bile obtained after stimulation of the gallbladder (GB) with cholecystokinin or its analog. Rapid amino acids (AA) infusion contracts the GB. Our objective was to assess qualitatively the adequacy of duodenal bile obtained following AA infusion. We prospectively studied 15 patients each with non ulcer dyspepsia (NUD) and gallstones (GS), and 17 patients with acute idiopathic pancreatitis (AIP). Duodenal bile was obtained after duodenal intubation and stimulation of GB by rapid AA infusion. The GB contractile response to AA infusion was assessed by functional ultrasonography. Bile was analyzed for lipids, nucleation time, cholesterol saturation index (CSI), and biliary crystals. Adequate duodenal bile could be collected in all but one patient with AIP and one with GS. The mean +/- SD percent ejection fraction of GB following AA infusion in patients with NUD, GS and AIP was 53.41 +/- 16.23, 52.06 +/- 16.07, and 43.37 +/- 14.16, respectively. Biliary microscopy showed the presence of cholesterol monohydrate crystals (CMC) in 7 of 16 patients with AIP, 12 of 14 patients with GS, and 1 of 15 patients with NUD. Mean CSIs in patients with NUD, GS, CMC-positive AIP, and CMC-negative AIP were 0.78, 1.97, 1.85, and 1.00, respectively. Nucleation time in patients with NUD and gallstones was 21.1 and 8.42 days. respectively. In conclusion, qualitatively adequate bile can be obtained for chemical and microscopic examination following rapid intravenous infusion of AA to stimulate the GB.

Acute Disease↗

PubMed2000

Effect of pyloric blockade and infusion of histamine or pentagastrin on gastric secretion in horses.

OBJECTIVE: To determine the origin of the nonacid (nonparietal) component of gastric secretions in horses induced by pentagastrin infusion. ANIMALS: 6 horses. PROCEDURE: A Latin square design was used, involving 6 horses, 3 treatments, and 2 duodenal intubation conditions (catheter with balloon to obstruct pylorus [B] or without balloon allowing movement of contents between stomach and duodenum [NB]). Each horse had an indwelling gastric cannula and a catheter positioned in the duodenum. Gastric and duodenal contents were collected during 15-minute periods. Each experiment consisted of serial collection periods: baseline; infusion of pyrilamine maleate (1 mg/kg of body weight, IV); not treated; and IV infusion of saline (0.9% NaCl) solution alone, saline solution containing pentagastrin (6 microg/kg x h), or saline solution containing histamine (30 microg/kg x h). Volume of samples was recorded, and electrolyte concentrations were measured. RESULTS: Pentagastrin and histamine stimulated maximal acid output; however, during NB conditions, pentagastrin-induced concentration of hydrogen ions was significantly less than during histamine or pentagastrin infusions during B conditions. The large volume produced in response to pentagastrin during NB conditions was accompanied by increased sodium ion output that was greater than for pentagastrin during B conditions, but both values were significantly greater than values for histamine during B or NB conditions. CONCLUSIONS AND CLINICAL RELEVANCE: Nonparietal secretions collected during IV infusion of pentagastrin are duodenal in origin. Reflux of duodenal contents into the stomach of horses is enhanced by pentagastrin. Flow of duodenal contents into the stomach could have implications in the pathogenesis of ulcers in horses.

Animals↗

PubMed1998

[The clinical significance of the new concept of basal and stimulated bile secretion].

Bilification during the interdigestive period of duodenal motility was studied together with basal and stimulated duodenal intubation in healthy subjects and patients with chronic noncalculous cholecystitis, with a mode of medicamentous stimulation of the gallbladder contractile function being developed. An adequate response to the standard cholekinetic was recordable during the second phase of duodenal motility, which fact permitted reaching a conclusion that it is necessary that cholekinetic be administered just during the second phase when the gallbladder is most ready to evacuate bile directly through a probe during the interdigestive period and one hour after a meal during the digestive period.

Bile↗

PubMed1984

[Double contrast studies of the small intestine. How, when, why].

The double contrast radiological technique involving duodenal intubation for the examination of the small intestine is described. The technical difficulties involved are discussed with ample illustration. This forms the basis for suggestions on the main indications for the technique in a correct diagnostic protocol.

Adult↗

PubMed1984

Influence of sex and body size on pancreatic bicarbonate and enzyme output.

The study was aimed both at defining normal values of pancreatic function and at looking at variables (age, sex, body weight, height, and body surface) which may influence the range of normality in 271 normal controls evaluated consecutively by duodenal intubation from 1974 to 1981. Frequency distribution of all functional values were consistent with a Gaussian curve. A positive, linear correlation was found between secretory parameters and both volume secretion and output values, while no correlation was detected with bicarbonate and enzymes values. Duodenal fluid secretion and both bicarbonate and enzymes output were approximately 20% higher in males than in females, the difference being statistically significant. Mean values of both bicarbonate and enzyme concentration were not statistically different between sexes. When related to body surface, both volume and outputs values in males were no more different from those observed in females. The study has shown that body size influences pancreatic functional values and, therefore, the values should be related to some parameters of body size as body surface. The difference between males and females in fluid secretion and output values is linked primarily to differences in body size. The normal distribution of all functional parameters implies that normal limits may be calculated with standard parametric statistical analysis.

Adult↗

PubMed1992

Inhibition of human exocrine pancreatic secretion by the long-acting somatostatin analogue octreotide (SMS 201-995).

The new long-acting somatostatin analogue octreotide (SMS 201-995) was investigated for its influence on secretagogue-stimulated human exocrine pancreatic secretion. Eighteen healthy volunteers participated in the study. During duodenal intubation with a background stimulation of either secretin 1 U.kg/h or secretin 1 U.kg/h + ceruletide, 120 ng.kg/h, octreotide was infused at doses of 5, 20 and 80 micrograms/h in a placebo-controlled randomized double-blind crossover trial. Duodenal juice samples were collected in 10-min intervals, and amylase, trypsin, chymotrypsin, and bicarbonate were measured in the individual fractions. During secretin stimulation, amylase was inhibited between 41 and 59%, trypsin between 28 and 72%, chymotrypsin between 55 and 70%, and bicarbonate between 0 and 31% with 5, 20 and 80 micrograms/h octreotide. During secretin and ceruletide stimulation, amylase was significantly inhibited by 84%, 78%, 81%, trypsin by 76%, 55%, 52%, chymotrypsin by 77%, 55%, 60%, and bicarbonate by 25%, 11%, 19% with 5, 20, and 80 micrograms/h octreotide, respectively (all decreases P less than 0.05). The long-acting somatostatin analogue octreotide was confirmed to be a potent inhibitor of stimulated human exocrine pancreatic secretion. The near maximal inhibitory potency of octreotide was achieved at a dose of only 5 micrograms/h. This finding may be of value in the planning of therapeutic studies with octreotide.

Adult↗

PubMedDate not supplied

Value of CA 19-9 assay in serum and duodenal juice in the differential diagnosis of pancreatic disease.

Levels of CA 19-9 in the serum and duodenal juice of nine patients with pancreatic adenocarcinoma (PC), ten patients with chronic calcifying pancreatitis (CCP) and ten healthy volunteers (C) were determined by immunoassay. Duodenal juice was obtained by duodenal intubation during the secretin caerulein test. Elevated CA 19-9 levels in the serum were significantly more frequent in PC than in CCP patients, but two PC patients gave levels only slightly above the cut-off value of 37 U/ml. CA 19-9 levels in duodenal juice were significantly higher in PC than in CCP patient, but there was some overlap between them; no overlapping was seen between PC or CCP group and controls. Two PC patients with duodenal juice CA 19-9 levels overlapping those of CCP were the same who showed only a slight rise in serum CA 19-9 levels. The CA 19-9 to total protein ratio in duodenal juice did not permit better discrimination between PC and CCP. We conclude that CA 19-9 assay in duodenal juice can differentiate healthy subjects from patients with pancreatic diseases, but it cannot improve the differential diagnosis between CCP and PC patients with a slight rise of CA 19-9 levels in serum.

Adenocarcinoma↗

PubMed1995

Evaluation and clinical application of the Enterotest for the determination of human biliary porphyrin composition.

The Enterotest string test is an easy and non-invasive method for sampling duodenal fluid, which has been successfully used for the analysis of duodenal microflora, as well as biliary bile acid and lipid composition. The method was evaluated for determination of porphyrins in duodenal bile in normal subjects and subjects with porphyria, following cholecystokinin induced gall bladder contraction; it is known that analysis of biliary porphyrins is more discriminatory for the diagnosis of asymptomatic porphyria than their analysis in faeces or urine. Moreover, serial analysis of bile from patients with erythropoietic protoporphyria may help in establishing their ability to secrete protoporphyrin in bile and to assess effects of treatment. The binding of various porphyrins to Enterotest strings was investigated by incubating pieces of the string in different human bile samples with low to very high porphyrin concentrations, followed by HPLC analysis of porphyrins both in the native bile and in extracts obtained from the strings. No differences between porphyrin composition in native bile and extracts were observed. Duodenal fluid obtained by means of the Enterotest from volunteers not receiving cholecystokinin showed large variations in porphyrin patterns not resembling those of native bile. Mesoporphyrin, a secondary porphyrin derived from protoporphyrin by bacteria, was often detectable. These data indicate that the duodenal content without cholecystokinin injection does not reflect biliary porphyrin composition. The presence of mesoporphyrin in the whole intestinal tract, but not in serum and bile, suggests that there is no enterohepatic circulation of secondary porphyrins. There was close agreement between the porphyrin ratios found with the standard duodenal intubation technique and the Enterotest, performed simultaneously in one healthy volunteer after induction of gall bladder contraction by cholecystokinin. From these experiments, it was concluded that fluid adsorbed to the Enterotest string after gall-bladder contraction can be used to determine biliary porphyrin composition. Since duodenal bile is diluted gall bladder bile, variable porphyrin concentrations were found when applying the Enterotest in combination with cholecystokinin in the same subject on successive days. However, porphyrin ratios, such as the protoporphyrin to coproporphyrin I ratio, were relatively constant. In subjects with symptomatic variegate porphyria, the Enterotest showed highly aberrant porphyrin patterns, with increased protoporphyrin to coproporphyrin I ratios and, in addition, the presence of some unknown porphyrins. A deviating biliary protoporphyrin/coproporphyrin I ratio in one patient appeared to be a useful diagnostic index for the presence of latent variegate porphyria (or variegate porphyria in remission).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1980

[Barium meal after pancreatic surgery (author's transl)].

After duodenopancreatectomy the roentgenpattern of the upper gastrointestinal tract resembles the pattern after Billroth I- or Billroth II- resection. A different aspect results after Y-Roux anastomosis. The follow-up of pseudocysts drained into the stomach poses no problems. The follow-up of pseudocysts drained into the small bowel demands a roentgenexamination with duodenal intubation. The use of hypotonia is advisable in the diagnosis of malignancy. Problems may arise in roentgendiagnostics after palliative operations.

Barium Sulfate↗

PubMed1976

Metoclopramide: a review of its pharmacological properties and clinical use.

Metoclopramide, 4-amino-5-chloro-2-methoxy-N-(2-diethyl-aminoethyl) benzamide, is advocated for use in gastro-intestinal diagnostics, and in treating various types of vomiting and a variety of functional and organic gastro-intestinal disorders. Published data have indicated that metoclopramide assists radiological identification of lesions in the small intestine, facilitates duodenal intubation and small intestine biopsy, and eases emergency endoscopy in upper gastro-intestinal haemorrhage. Metoclopramide reduces post-operative vomiting and radiation sickness, and ameliorates some types of drug-induced vomiting. It may provide symptomatic relief in dyspepsia and possibly in vertigo, reflux oesophagitis and hiccups, but further controlled trials are needed to confirm the efficacy of metoclopramide in these proposed areas of use. It promotes gastric emptying prior to anaesthesia. Its effects in healing gastric ulcer and preventing relapse of duodenal ulcer remain unproven. Side-effects are few and transient, though alarming extrapyramidal reactions can occur in a small proportion of patients receiving therapeutic doses but more usually following excessive doses in young subjects. They respond rapidly to withdrawal of the drug.

Animals↗

PubMed1994

Gut failure--predictor of or contributor to mortality in mechanically ventilated blunt trauma patients?

UNLABELLED: Thirty-seven ventilator-dependent blunt trauma patients (ISS 36 +/- 15) were randomized at 24 hours after injury to receive parenteral (TPN) (n = 15), enteral (TEN) (n = 12), or parenteral plus enteral (PN/EN) (n = 10) nutrition. The TEN and PN/EN patients had endoscopically placed transpyloric feeding tubes. Patients who had nutritional complications were two TPN (13%), three TEN (25%), and five PN/EN (50%). Enteral complications were tube occlusion (two), failed duodenal intubation (one), patient extubation of feeding tube (one), gastric reflux (two), and abdominal distention (two). Mortality rates were not different between the groups, but were significantly related to the nutrition-associated complications (p = 0.01): four deaths in ten (40%) with complications and one death in 27 (3.7%) without complications. All four deaths associated with complications occurred in the four with gastric reflux or abdominal distention. No deaths occurred in the other 18 TEN or PN/EN patients (p = 0.0001). Of the four deaths, three were associated with ARDS and respiratory infection (75%). CONCLUSIONS: In mechanically ventilated blunt trauma patients, endoscopic transpyloric tube placement and feeding has a substantial failure rate (36%). Intolerance to duodenal feeding has a remarkably high mortality (100%) in patients in whom gut dysfunction may be a manifestation of injury severity or directly affect survival.

Adult↗

PubMed1998

Intestinal, pancreatic and hepatic involvement in carbohydrate-deficient glycoprotein syndrome type I.

BACKGROUND: Children with carbohydrate-deficient glycoprotein syndrome type I during infancy have gastrointestinal symptoms and growth impairment, the cause of which is largely unknown. METHODS: Seven children were investigated with small intestinal biopsy, liver biopsy, duodenal intubation with determination of lipolytic and proteolytic activity, and test meal. Weight, length-height, and head circumference were recorded regularly. RESULTS: Growth was affected from early infancy, with an initial low rate of weight gain followed by impaired linear growth. Vomiting and diarrhea were dominant symptoms. Four of seven children had abnormal findings in light microscopic examination of small intestinal biopsy specimens, with short villi and increased inflammatory cells in the stroma, that did not respond to elimination of such food proteins as cow's milk or gluten. Electron microscopic study showed dilatation of smooth endoplasmic reticulum and abnormal inclusions containing lipids. The liver was abnormal in all. Besides steatosis and fibrosis or cirrhosis, there was a remarkable increase of inflammatory cells in portal zones. Activity of lipolytic enzymes in duodenal juice was low, except in one child, who no longer had growth problems or symptoms. Two of six had abnormal proteinolytic activity in duodenal juice. Digestion of triglycerides and absorption were within normal limits, as was the absorption of glucose and xylose. CONCLUSIONS: Inflammation of small intestine and liver may be the cause of gastrointestinal symptoms. In all likelihood, the growth failure was because of low caloric intake and increased losses related to vomiting. Growth and gastrointestinal symptoms improved spontaneously as time elapsed.

Biopsy↗

PubMed1976

Goblet cell density in Eustachian tube of children.

In 13 clinically normal infants and children between the ages of 9 days and 14 years, the entire mucosa from the Eustachian tube was dissected and stained by the PAS-Alcian blue whole-mount method, and the density of goblet cells was determined in 360 counting fields. This disclosed an extreme dispersion of median density in the various parts, due to a physiological increase through childhood, an increase in the osseous or cartilaginous part, and in the entire Eustachian tube due to pathologic actions such as tubal occlusion, recurrent or protracted catarrhal conditions, regurgitations, and duodenal intubation. After the pathologic stimulation has ceased, the density falls, presumably to the limit normal for the age concerned.

Adolescent↗

PubMed1983

Measurement of bile acid kinetics in human serum using stable isotope labeled chenodeoxycholic acid and capillary gas chromatography electron impact mass spectrometry.

A non invasive method for measurement of bile acid kinetics in serum using (24-13C)chenodeoxycholic acid has been developed. After oral administration of 50 mg (24-13C)chenodeoxycholic acid, the exponential decay of the 13C atom percent excess was measured in serum using capillary gas chromatography mass spectrometry. This required that isotope ratios were measured with high accuracy and coefficients of variation less than 1% by means of selected ion monitoring and scan averaging. The clinical applicability was tested by repeated determination of pool size, fractional turnover and synthesis rate of chenodeoxycholic acid in one healthy volunteer. This method permitted the determination of pool size, synthesis and conversion of chenodeoxycholic acid into lithocholic acid in man without the use of radioactive tracers and without repeated duodenal intubation.

Bile Acids and Salts↗

PubMed1992

Assessment of portosystemic shunting from superior mesenteric vein by duodenal administration of iodoamphetamine I123.

Portosystemic shunting (PSS) from the superior mesenteric vein (SMV) was evaluated with the duodenal administration of iodoamphetamine I123 (IMP) in patients with chronic hepatitis and liver cirrhosis. After duodenal intubation, IMP was administered through a tube, and then scintigraphy including the pulmonary and hepatic regions was performed. In all patients, images of the liver and/or lungs were observed within 10 min and became clear with time, due to a good absorption of IMP from the intestine. On the other hand, IMP appears not to be absorbed from the stomach. The portosystemic shunt index was calculated by dividing counts of lungs by counts of liver and lungs. The shunt index (mean +/- SE) was 1.5% +/- 0.8%, 12.6% +/- 3.7% and 28.3% +/- 4.5% in chronic hepatitis, compensated cirrhosis and decompensated cirrhosis, respectively. This index was significantly higher in cirrhosis, especially in decompensated cirrhosis. Therefore, transintestinal portal scintigraphy with IMP could be a useful method for the non-invasive and quantitative evaluation of PSS from the SMV in portal hypertension.

Amphetamines↗

PubMed1978

Prevalence of Giardiasis: a study at upper-gastrointestinal endoscopy.

The prevalence of giardiasis was assessed in 1000 consecutive adult patients undergoing upper-gastrointestinal endoscopy for the usually accepted indications. Patients with upper-gastrointestinal bleeding were excluded. The diagnosis was established by examination of duodenal aspirate and duodenal mucosal impression smears. In 21 patients (2.1%) trophozoites were detected both in the duodenal juice and stained mucosal impression smears. All were treated with metronidazole or tinidazole. In 14 of 16 patients who had subsequent duodenal intubation, eradication of the parasite was confirmed. In five patients previously existent abdominal pain disappeared with clearing of the parasite, and no other cause for their abdominal pain was discovered. A search for Giardia lamblia infestation may be a worthwhile additional procedure at the time of endoscopy when no other cause for abdominal pain is found.

Abdomen↗

PubMed1980

Cholangitis in a child due to biliary tract anomalies.

A 29-month-old child with persistent cholangitis and steatorrhea complicating congenital hepatic fibrosis underwent radiographic evaluation of the biliary tree. Communicating intrahepatic cavernous ectasias were demonstrated by percutaneous transhepatic cholangiography, a procedure deemed safe in children of this age group. Unlike most patients with cholangitis, he had documented steatorrhea and growth failure which resolved following successful treatment with trimethoprim-sulfamethoxazole. Bacteriologic diagnosis was made by direct culture of liver tissue combined with duodenal intubation.

Bile Ducts, Intrahepatic↗