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At least 649 records · Page 36Linked to original sources
PubMed1988

Prolapse of gastrostomy tube resulting in entero-enteric fistula and intussusception.

A case is reported in which a surgical gastrostomy tube migrated into the duodenum and eroded through the jejunal wall into an adjacent loop of jejunum. This resulted in an entero-enteric fistula, small bowel obstruction and intussusception. Since the number of gastrostomy tubes being placed endoscopically and surgically is increasing, gastroenterologists and surgeons should be alerted to these and other potential complications.

Aged↗
PubMed1987

Intramural duodenal hematoma: an unusual complication of endoscopic small bowel biopsy.

We report a case of intestinal obstruction secondary to intramural duodenal hematoma after endoscopic small bowel biopsy. Review of the literature indicates that intramural duodenal hematoma occurs mainly in infants and children after trauma to the abdomen. The diagnosis can be made by upper gastrointestinal series and confirmed by computerized axial tomography of the abdomen. Conservative management in the form of nasogastric suction and total parenteral nutrition resulted in amelioration of obstructive symptoms within 10 days. Physicians should be alerted to the possibility of developing intramural duodenal hematoma after small bowel biopsy. This is the first report of such an unusual complication after endoscopic small bowel biopsy in children.

Biopsy↗
PubMed1982

Intragastric and intraduodenal investigations.

This review has detailed a method for the quantification of postprandial gastric secretion and emptying based on multiple marker dilution. The method can be applied to the physiologic study of antacid therapy, allowing measurement of the effects of the antacid on gastric secretion and emptying, as well as measurement of the efficiency of antacid utilization. In our laboratory, my colleagues and I have employed this method to characterize the fate of aluminum hydroxide and magnesium hydroxide under conditions closely resembling those existing in a usual therapeutic setting. Further studies are required to compare the behavior of this class of cationic antacid with other commercial preparations and to study other factors (concomitant administration of other drugs such as H2-blockers or anticholinergics, diet, schedule, and dose) that may have an important influence on antacid utilization and their acid-neutralizing effects.

Administration, Oral↗
PubMed1996

[Application of laparoscopic technique in gastrointestinal surgery].

OBJECTIVE: To evaluate the feasibility of gastrointestinal procedures guided by laparoscopy in 42 patients aged from 18 to 86 years. METHODS: We performed 10 Billroth II gastrectomies, 10 resections of gastric benign tumor, 11 repairs of duodenal perforation, 2 highly selective vagotomies, 5 resections of small bowel, 3 adhesiolyses of small bowel and 1 ileocolectomy. The operations were performed under general anesthesia with endotracheal intubation and through four portals (10mm). The omentum and mesentery were mobilized with an electrocautery and vessels controlled with either Endoclip or ELC. The reconstructions of the digestive tract were performed entirely intraabdominally with ELC. RESULTS: Except one patient receiving Billroth II gastrectomy complicated with postoperative bleeding had to be reoperated, the remaining 41 patients were successfully treated. All the 41 patients could walk and take fluids on the second postoperative day. The average length of hospitalization after operation was 7.5 days. CONCLUSIONS: Laparoscopic gastrointestinal procedures for selected cases can be carried out safely and effectively with decreased postoperative pain and rapid recovery. It may change the surgical management of some benign gastrointestinal diseases.

Adult↗
PubMed1996

Diagnosis of Cryptosporidium parvum in patients with severe diarrhea and AIDS.

The sensitivity of noninvasive stool microscopy and endoscopic biopsies from the upper and lower gastrointestinal tract in the diagnosis of Cryptosporidium parvum in patients with AIDS is not known. We evaluated 30 severely immunocompromised patients with AIDS and diarrhea caused by C. parvum. C. parvum was diagnosed by either stool microscopy, endoscopic biopsy, or both. Patients submitted a mean (+/-SEM) of 3.3 +/- 0.3 stool samples, each microscopically evaluated for ova and parasites. Upper and lower endoscopy were performed in all patients and endoscopic biopsies were taken throughout the gastrointestinal tract. Diarrhea had been present for a mean of 13.5 +/- 2.3 months and mean daily stool weight was 1224 +/- 127 g. Overall, individual stool samples were insensitive, as only 53% demonstrated C. parvum. When multiple stool samples were considered for each patient, 73% of subjects demonstrated C. parvum in at least one stool sample. The sensitivity of endoscopy with mucosal biopsy varied by anatomical location: stomach (11%), duodenum (53%), terminal ileum (91%), and colon (60%). The terminal ileum was significantly more likely than the duodenum to demonstrate C. parvum (P = 0.03). Thus, duodenal biopsies are much less sensitive than those from the terminal ileum in the diagnosis of C. parvum. In AIDS patients with diarrhea undergoing colonoscopy, intubation of the terminal ileum should be performed when feasible. Although individual stool samples are insensitive in detecting C. parvum, the diagnostic yield is improved by the collection of multiple samples.

AIDS-Related Opportunistic Infections↗
PubMed1985

Endoscopic decompression in partial small bowel obstruction.

Upper gastrointestinal endoscopy has been applied successfully in the management of patients with small bowel obstruction. In one group of patients after gastrectomy with a Roux-Y limb obstructed at the level of the transverse mesocolon, the endoscope was manipulated into this segment, and the tip was deflected in four directions with release of the kink. Conventional wisdom depends heavily on the interpretation of the upper gastrointestinal series, which in all five patients in this report proved to be incorrect. It was only through the endoscopic examination that the anastomoses were found to be patent, and the kinked segment of jejunum, once identified, could be released by endoscopic manipulation. Two patients required repeat endoscopy, and at last follow-up, all patients were eating well with no recurrence of symptoms. In the second group of patients with distal small bowel obstruction who normally would be considered for Miller-Abbott tube management, it was possible to decompress the stomach, duodenum, and upper jejunum endoscopically with immediate clinical and radiographic improvement. In addition, it was also possible to place the Miller-Abbott tube into the small bowel at the same time and thus avoid the 2 to 3 days of delay in advancing the tube beyond the pylorus. All patients had improvement and there were no complications. Although two required laparotomy several weeks later, they too were improved by the endoscopic procedures. The immediate decompression and rapid intubation represent significant advances in the management of patients with small bowel obstruction.

Aged↗
PubMed1994

Effect of iron deficiency on DMH-induced gastrointestinal tract tumors and occurrence of hepatocyte abnormalities in Fischer rats.

The relationship between iron deficiency and carcinogenesis was studied using the carcinogen dimethylhydrazine to induce gastrointestinal tumors in Fischer 344 control and iron-deficient rats. Dimethylhydrazine (30 mg/body wt) was administered by gastric intubation 10 times over nine weeks. After 32 weeks, rats were sacrificed, and tumor incidence was assessed. The overall incidence of gastrointestinal tract tumors (colonic and duodenal) was higher in the iron-deficient (66%) than in the control group (46%). Whereas the incidence of colonic tumors was identical in control and iron-deficient groups, the duodenal tumor incidence was significantly elevated in iron deficiency. Five of 15 rats, i.e., 33.3%, in the iron-deficient group developed duodenal tumors; in the control group, only 1 of 15 rats developed a tumor (i.e., 6.6%). Also, iron-deficient rats had multiple tumors. Histological examination of the colon and duodenum revealed that the tumors were adenocarcinomatous in nature. Another notable feature in the iron-deficient group was the presence of atypical cells in the livers of carcinogen-treated iron-deficient rats. This study thus suggests that there is a greater incidence of tumors in iron deficiency and that the proximal part of the intestines seems to be the preferred site. The presence of atypical cells in the liver suggests that in iron deficiency, besides gastrointestinal tract tumors, the liver may also be a favored site for abnormalities.

1,2-Dimethylhydrazine↗