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At least 397 records · Page 22Linked to original sources
PubMed1978

[Trouble after cholecystectomy (author's transl)].

Unsatisfactory results after cholecystectomy are mostly due to complications of the disease not realised under surgery and to technical blunders. Only intraoperative cholangiography, exploration of the common bile duct and inspection by choledochoscopy build the sound basis for an adequate surgical procedure.

Blind Loop Syndrome↗
PubMed1979

[II. Etiological classification of the small bowel diseases (author's transl)].

A new classification of the small bowel diseases is proposed according to - the physiopathology; - the anatomo-pathology; - the etiology. In this second part, the ethiological classification is developed. One may distinguish the post-surgical lesions, congenital defects, the side-effects of drugs and the vascular lesions. Allergy and infection are especially studied. The main problems which may be solved in a next future are: the mechanism of chronic infections, the biochemical pathology and especially the normal and pathological immunology.

Blind Loop Syndrome↗
PubMed1976

Malabsorption following gastric resection.

We have tried to stress the complexity of the bacterial ecology that may exist in the intestine of patients and experimental animals with small intestinal bacterial overgrowth. The multiplicity of organisms often makes the management of these patients quite frustrating. A number of metabolic derangements of varying severity may occur in any given patient. Although many of the observed abnormalities are secondary to disturbed events with the luminal environment of the small intestine, the significance of direct damage to the small intestinal epithelium has been emphasized. Since intestinal cultures are both cumbersome and difficult to perform on a routine basis, the use of labeled substrate breath tests will allow guided, outpatient therapy more easily than in the past. Since full correction of the malabsorption is seldom achieved with antibiotic therapy, nutritional supplementation deserves more attention than it has previously received.

Animals↗
PubMed1978

Intestinal atresia.

Forty-five patients with intestinal atresia, including 20 with duodenal, 21 with jejunoileal, and 3 with colonic obstruction, were encountered at the Yale-New Haven Hospital between 1970 and 1976. The overall survival rate in the 43 operated cases was 93 per cent. The major reasons for the excellent operative survival with this malformation include: (1) the care received in a regional neonatal center; (2) the early recognition and appropriate case selection, denying operation unless mandated in babies with duodenal atresia and trisomy 21; (3) primary repair using modern surgical techniques which minimize anastomotic complications and the "blind-loop" and "short gut syndrome"; and (4) the use of uncomplicated long-term total parenteral nutrition in approximately one-half of operated cases.

Abnormalities, Multiple↗
PubMed1969

Intestinal bacteria. The role they play in normal physiology, pathologic physiology, and infection.

Anaerobic bacteria predominate in the normal human fecal flora, out-numbering aerobes at least 100 to one. The two most prevalent organisms are Bacteroides fragilis and Bifidobacterium. Ileostomy flora is, on the other hand, chiefly aerobic and the total count is lower (10(8) per ml of fluid, compared to 10(10) per gram for feces). In normal people, small bowel bacterial counts are generally 10(5) per ml or less. The upper small bowel consists primarily of Gram-positive aerobes in small numbers. In the terminal ileum, counts are higher and aerobes and anaerobes are present in equal numbers. In the presence of acute obstruction and certain bowel stasis or other syndromes, the small bowel flora may become relatively profuse and fecal in type. The stomach normally has less than 10(3) organisms per ml but counts are higher in gastric samples with pH above 4.0. Intestinal bacteria are important in such processes as conversion of bilirubin to urobilinogen, supply of vitamin K to the host, defense against infection, bile acid deconjugation and conversion, infections related to the bowel, the malabsorption of blind loop and other bacterial overgrowth syndromes, and hepatic coma.

Adult↗
PubMed1975

Short chain fatty acids in rats with jejunal blind loops. I. Analysis of SCFA in small intestine, cecum, feces, and plasma.

The luminal and plasma levels of short chain fatty acids (SCFA), products of bacterial fermentation, were measured in rats with surgically produced, self-filling blind loops located in the proximal small intestine. High levels of acetic, propionic, and butyric acids were detected in the blind loop segment and in the distal small bowel, regions which in normal and sham-operated rats contain no SCFA. Isobutyric, isovaleric, and valeric acids were also present. Feeding or fasting made little difference in the amount or composition of luminal SCFA. Although the amount of SCFA in each animal varied, the ratio of these acids was relatively constant. The ceca of the blind loop rats had relatively less acetic acid (48% of total SCFA) than did normal rats (64%) and proportionately more isobutryic, isovaleric, and valeric acids. The concentrations of SCFA increased in the feces of blind loop rats. The acetic acid concentration was 50% higher in blind loop rat feces; propionic, isobutryic, and isovaleric acids were elevated to a greater extent. The total output of most of the SCFA was also of acetic acid (137 +/- 32 mug per ml), the rest being isovaleric (5.2 +/- 2.6 mug per ml) and isobutyric (1.4 +/- 0.7 mug per ml) acids. Blind loop animals had nearly twice the concentration of acetic acid in the plasma (240 +/- 29 mug per ml) as normal animals, while the other acids were unchanged. The present study suggests that endogenous substances may be important substrates for the production of SCFA in the intestinal lumen. The high levels of SCFA in the small intestine and in feces and the substantial increase in the concentration of acetic acid in thvergrowth syndrome if the same relationships were found in man.

Animals↗
PubMed1980

[Surgical management of sequelae from duodenal stenosis and atresia in the neonate (author's transl)].

Surgical sequelae from duodenal atresia treated by gastrojejunostomy or duodenojejunostomy are rarely encountered. They usually appear in the late course of gastrojejunostomies. They are related at the duodenal distension above the stenoses which constitute a poorly drained "blind-loop" usually developed from a side to side anastomosis as observed in the small bowel. The following complications, related to the duodenal pouch have been reported in the literature: peptic ulcer, duodenitis or gastritis, abdominal pain, dumping syndrom and malnutrition. One patient developed a gangrenous calculous cholecystitis at 10 years of age. 3 patients under went revision of their previous surgery because of sequelae. One had duodenal atresia above the ampulla, one had an anular pancreas: in one the duodenal atresia was at the ligament of Treitz. All patients had a revision according to our technic described in Annales de Chirurgie Infantile, consisting in: --calibration of the duodenal pouch --end to end or end to side duodeno-duodenal anastomonsis --suppression of previous anastomosis. A good result was obtained in all 3 cases.

Blind Loop Syndrome↗
PubMedDate not supplied

[Infected bowel syndrome].

Colonization of the gut by intestinal bacteria begins at birth and progresses rapidly in the immediate postnatal period. Host defense mechanisms that mediate enteric colonization include gastric acidity and intestinal motility. The small bowell overgrowth syndrome is a condition characterized by large numbers of bacteria, often anaerobes, in the upper intestine. Steatorrea, carbohydrate malabsorption and abdominal pain are frequently present. Predisposing conditions are localized anatomic disorders (surgical blind loops, small bowel strictures caused by surgery or Crohn's disease, short-gut syndrome without ileocaecal valve), motility derangements or reduction of gastric acidity. Diagnosis of the overgrowth syndrome is often difficult and quantitative cultures of jejunal-aspirated fluid is the best diagnostic test. Antimicrobial therapy directed against anaerobes is often successful, but the best therapeutic approach is the correction of predisposing conditions, if present.

Anti-Bacterial Agents↗
PubMed2004

Renal sodium handling study in an atypical case of Bartter's syndrome associated with mitochondriopathy and sensorineural blindness.

Bartter's syndrome is a disorder that has been linked to mutations in one of three ion transporter proteins: NKCC2 (type I), ROMK (type II) and CCLNKB (type III), which affects a final common pathway that participates in ion transport by thick ascending limb cells. We present an atypical case of mitochondriopathy combined with tubule functional disturbances compatible with Bartter's syndrome and definitive sensorineural blindness. Our patient had a peculiar clinical presentation with signs of salt and volume depletion, low blood pressure and secondary hyperaldosteronism, associated with hypokalemic metabolic alkalosis, hypocalcemia and severe hypomagnesemia, uncommon in genetic forms of Bartter's syndrome. The enhanced absolute and fractional sodium excretion in our patient compared to volunteers was accompanied by increased post-proximal sodium rejection, suggesting a striking ion transport dysfunction in these nephron segments. These findings lead to the Bartter's syndrome diagnosis, accompanied by a suppose mitochondrial tick ascending loop of Henle epithelium dysfunction that may reflect the high energy supplied by mitochondria electron transport chain, required for this nephron segment to maintain normal ion transport.

Alkalosis↗