Duodenal perforation as a complication of routine endoscopic nasoenteral feeding tube placement.
Explore the source record for details and available documents.
Burns↗
SEARCH · PubMed Health
Results for “DUODENAL INTUBATION”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Application of laparoscopic technologies in the treatment of peritonitis, caused by duodenal ulcer perforation].
Results of treatment of 105 patients suffering peritonitis, caused by duodenal ulcer perforation, using laparoscopic technologies were studied up. In terms up to 6 hours from the perforation occurrence 68 (64.8%) patients were admitted to the hospital, from 6 to 12 hours--23 (21.9%), from 12 to 24 hours--14 (13.3%). Local peritonitis was diagnosed in 12 (11.4%) patients, extended one--in 71 (67.6%), general--in 22 (21%). Serous peritoneal exudate was revealed in 65 (61.9%) observations, serofibrinous one--in 27 (25.7%), fibrinopurulent--in 13 (12.4%). The peritoneal cavity sanation, depending on the inflammation character and extension, was performed using from 1 to 91 of antiseptic solution and assistance of irrigation-aspiration system. Necessity to perform conversion have occurred in 3 (2.8%) patients in presence of intestinal paresis, necessitating the intestinal intubation performance. In 7 (6.7%) patients, admitted to hospital in terms later than 12 hours from the ulcer perforation moment, in 12-24 hours after laparoscopic operation performance the elective videolaparoscopic sanation of peritoneal cavity was done.
Adolescent↗
Trefoil factor family (TFF) peptides of normal human Vater's ampulla.
Vater's ampulla is of great clinical relevance with regard to the influx of chyme, ascending inflammation, intubation during diagnostic and therapeutic endoscopic maneuvers, therapeutic papillotomy and, especially, the formation of malignancies. Little is known about the distribution of trefoil factor family (TFF) peptides in the ampulla. We have therefore examined TFF peptide distribution in the normal ampulla of Vater and compared it with that in duodenal mucosa and Brunner's glands. Expression and synthesis of TFF peptides in Vater's ampulla and duodenum was investigated by reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry. The samples studied originated from 30 autopsy cases with short postmortem intervals. TFF3 was expressed in the ampulla of Vater. mRNA expression of TFF1 was detected in only approximately 25% of the investigated samples. Western blot revealed the production of TFF3 and immunohistochemistry showed that TFF3 was the product of goblet cells. TFF peptide composition of Vater's ampulla varied in comparison with that in the duodenum regarding TFF2 expression. The ampulla of Vater thus has a unique profile of TFF peptide production, supporting the hypothesis that the ampulla is an autonomous organ. The observed differences in the TFF peptide distribution between the duodenum and Vater's ampulla favour the investigation of TFF peptides as prognostic markers in the classification of ampullary carcinomas.
Adult↗
Gastric emptying and secretion of bile acids, cholesterol, and pancreatic enzymes during digestion. Duodenal perfusion studies in healthy subjects.
Explore the source record for details and available documents.
Adult↗
Drinking in the rhesus monkey: peripheral factors.
Rhesus monkeys prepared with chronic cannulae implanted in the stomach and duodenum were water deprived for 22.5 hr. With both cannulae closed, a mean of 137 ml was drunk within a 60-min period. When ingested water drained freely from an open gastric cannula, continuous drinking far in excess (878 ml mean intake) of normal occurred. Sham drinking also exceeded (634 ml mean intake) normal when ingested water drained through an open duodenal cannula. This pattern of continuous sham drinking indicates that oropharyngeal stimulation is not sufficient alone, or together with the passage of water through the stomach and the initial part of the duodenum, to terminate drinking. Duodenal infusions of water (25-100 ml) slowed or stopped gastric sham drinking in a dose-dependent fashion, but equivalent infusions of isotonic saline were without effect. Thus, pre- or postabsorptive signals at or beyond the level of the intestine distal to the site of the duodenal cannula are probably important for the termination of drinking in the rhesus monkey.
Animals↗
Effect of cholestyramine on composition of duodenal bile in obese human subjects.
Explore the source record for details and available documents.
Administration, Oral↗
Anaesthetic management of a patient with pemphigus vulgaris for emergency laparotomy.
A 45-year-old man with a long-standing history of duodenal ulcer presented with symptoms and signs of perforation peritonitis. He also had lesions of pemphigus vulgaris throughout the body, involving both skin and mucous membranes. Care was taken to avoid pressure and friction during placement of monitoring devices, intravenous and arterial lines. Since the patient had to undergo exploratory laparotomy, intubation was performed in an atraumatic manner after rapid sequence induction. However, there was minor bleeding from the mucous lesions of the oral cavity, which was controlled by a saline adrenaline throat pack. The patient was extubated at the end of the surgery and steroids were continued in the peri-operative period.
Anesthesia, General↗
Gastric and duodenal features of meals mediate controls of liquid gastric emptying during fill in rhesus monkeys.
To study the dynamics of liquid gastric emptying in rhesus monkeys under conditions that simulated gastric fill during a meal, we measured the gastric emptying of liquid glucose at various concentrations and volumes when administered intragastrically at rates ranging from 12.5 to 37.5 ml/min. Glucose gastric emptying was faster during than following the period of gastric fill. At a single glucose concentration, volume infused rather than the rate of filling determined the volume emptied. Lower glucose concentrations emptied more slowly than physiological saline. As glucose concentration increased, emptying during fill slowed. Duodenal glucose infusions greatly slowed the rate of saline emptying during fill, demonstrating duodenal feedback control. Although casein hydrolosate emptied more rapidly than glucose, the dynamics of volume and concentration dependency and the role of duodenal feedback were similar. These data reveal that both gastric volume and duodenal negative feedback controls important in gastric emptying following stomach filling also contribute to its control during fill.
Animals↗
[Replacement of the extra-hepatic common bile duct in the dog by an elastomere silicone prosthesis. Its possible application in biliary surgery].
From an experimental study of the prosthetic replacement of the common bile duct in the dog by an silicone elestomere prothesis, according to the technic of double intubation with a 2 1/2 year follow up in the oldest cases, and complete reconstitution of a well-structured new bile duct, the author propose using a similar prosthesis in biliary surgery: --firstly, the carcinoma of the bile ducts, using an internal prosthesis hepatico-gastric, hepatico-jejunal or duodenal, which is eliminated internally; --secondly, in stenosis or operative wounds of the bile ducts, using either removable tutor prosthesis, or segmental prostheses lost internally.
Animals↗
[Effect of various therapeutic schedules of antacids on the pH of gastric contents in patients with duodenal ulcer].
Ten patients with uncomplicated duodenal ulcer were given three different therapeutic regimens of antacid experiments II, III and IV, and a control regimen, without antacid, named experiment I. Experiment I consisted of a normal diet with three meals a day; experiment II, III and IV consisted of a diet as in experiment I plus 132,06 mEq, 265,92 mEq or 396,88 mEq respectively of antacid divided in six equal doses given one and three hours after breakfast, lunch and dinner. Having been carefully instructed, the patients were intubated with a gastric tube, which was kept in for five days, receiving in each day one of the aforementioned regimens, in a sequential order. The fifth day was reserved for the augmented Histalog test. Each hour from 8 a.m. to 10 p.m., in the first four days, a sample of the gastric juice was aspirated for pH measurement. The statistical evaluation of the acidity of the samples at different times showed that experiment III (265,92 mEq antacid/day) was able to keep the pH over 3 for longer periods of time when compared with experiments I and II and not different from experiment IV. The present investigation emphasize the necessity of clinical trials comparing therapeutic regimens of antacid with different neutralizing capacity, in order to find the most effective dose in the treatment of duodenal ulcer.
Adult↗
Novel approach to quantify duodenogastric reflux in healthy volunteers and in patients with type I gastric ulcer.
A new method is described which allows simultaneous measurement of gastric emptying and duodenogastric reflux and avoids transpyloric intubation. After intragastric instillation of a liquid lipid meal in six healthy volunteers the fractional gastric emptying rate was 2.9 +/- 0.3 in the upright and 2.5 +/- 0.6 SEM X 10(-2)/min in the supine position, respectively (p greater than 0.5). The duodenogastric reflux rate (expressed as fraction of the intraduodenal amount of duodenal marker) was 0.30 (range 0.03-0.81) and 0.22 (0.01-0.55) X 10(-2)/min, respectively (p greater than 0.2). Atropine (40 micrograms/kg) decreased the supine gastric emptying rate to 1.1 +/- 0.2 (p less than 0.05) and increased the supine duodenogastric reflux rate to 2.74 (0.04-9.80) X 10(-2)/min (p less than 0.05). Fasting duodenogastric reflux rate was similar in the supine and upright position, 0.49 (0.04-0.89) and 0.42 (0.06-0.97) X 10(-2)/min, respectively (p greater than 0.5). Fractional gastric emptying rate was similar in 10 volunteers and 17 patients with type I gastric ulcer (2.1 +/- 0.4 vs 1.7 +/- 0.2 SEM X 10(-2)/min, p greater than 0.2). Their duodenogastric reflux rates were also similar, 0.65 (0.01-5.24) vs 1.10 (0.01-10.83) X 10(-2)/min (p greater than 0.5). We conclude therefore that (1) gastric emptying and both fasting and postprandial duodenogastric reflux are independent of the posture; (2) fasting and postprandial reflux are of similar magnitude; (3) atropine shows gastric emptying and increases duodenogastric reflux; and (4) patients with type I gastric ulcer have neither slowed gastric emptying nor increased duodenogastric reflux.
Adult↗
Stimulation of secretory IgA and secretory component of immunoglobulins in small intestine of rats treated with Saccharomyces boulardii.
Saccharomyces boulardii (S.b.) is largely used in Western European countries for the treatment of acute infectious enteritis and antibiotic-induced gastrointestinal disorders. To study the mechanisms of the protective effect of S.b. against enteral pathogen infection, we assessed the response of the intestinal secretion of secretory IgA (s-IgA) and of the secretory component of immunoglobulins (SC) to oral administration of high doses (0.5 mg/g body weight, three times per day) of S.b. cells in growing rats. S.b. cells (biological activity: 2.8 x 10(9) viable cells/100 mg) were administered daily by gastric intubation to weanling rats from day 14 until day 22 postpartum. Control groups received either 0.9% saline or ovalbumin following the same schedule. Expressed per milligram of cell protein, SC content was significantly increased in crypt cells isolated from the jejunum (48.5% vs saline controls, P less than 0.05) as it was in the duodenal fluid (62.8% vs saline controls, P less than 0.01) of rats treated with S.b. Oral treatment with S.b. had no effect on the secretion of SC by the liver. In the duodenal fluid of rats treated with S.b. cells, the mean concentration of s-IgA was increased by 56.9% (P less than 0.01) over the concentration of s-IgA measured in saline controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
The Lundh test: a review of its clinical use in the diagnosis of pancreatic disease.
The clinical value of the Lundh test in the diagnosis of pancreatic disorders was reviewed retrospectively for 139 patients with proven pancreatic disease (15 acute and 72 chronic pancreatitis, 51 carcinoma of the pancreas and one partial pancreatectomy). There was a good separation between patients with pancreatic disease and those with other gastrointestinal disorders who presented with similar symptoms. The test was most helpful in patients with chronic pancreatitis (diagnostic rate 89%, mean tryptic activity (MTA) less than 7 U), more particularly in those presenting with jaundice or steatorrhoea (100%) than pain (86%), but less successful (diagnostic rate 68%) in carcinoma of the pancreas (steatorrhoea 100%; jaundice 64%; pain 55%). Complete absence of bile from duodenal juice in jaundiced patients usually indicated pancreatic or hepatobiliary carcinoma. An abnormal but not diagnostic MTA (7 to less than 10 U) was seen in 7% of patients with chronic pancreatitis, 13% with carcinoma of the pancreas and 11% with non-pancreatic disorders and suggested the need for further pancreatic investigation. Cytological examination of duodenal juice increased the usefulness of the test. Although malignant cells were rarely seen, characteristic (degenerate) cells were found in 22 of 44 (50%) patients with, but only five of 85 (6%) without pancreatic disease, even when the MTA was normal. The Lundh test can be conveniently combined with a jejunal biopsy at the same intubation for the investigation of diarrhoea or steatorrhoea.
Biopsy↗
Pharmacokinetics of serum glycerol and changes of ICP: comparison of gastric and duodenal administration.
To investigate the more effective route of oral administration of glycerol to decrease the raised ICP, two different routes were employed in the clinical practice. The one was through a Naso-Gastric tube, and the other was through an Entero-Duodenal tube. Pharmacokinetics of glycerol in relation to the decrease of ICP, and the changes of other parameters which could influence the serum osmotic pressure were sequentially monitored for initial 30 minutes. In the group of Entero-Duodenal route, the time to reach to the maximum glycerol concentration (Tmax) was faster, the maximum concentration of glycerol (Cmas) was higher, and ICP reduction rate was greater than these in the group of Naso-Gastric route. Other parameters (Na, K, BUN and Glucose) showed no significant difference between the two routes. It can be concluded that the Entero-Duodenal administration of glycerol is the more effective route to decrease the raised ICP, when it is administered orally.
Brain Injuries↗
Duodenal diversion of percutaneous biliary drain through a percutaneous endoscopic gastrostomy: report of a case.
Occasionally, percutaneous biliary drainage is the only possible form of treatment in a patient with a malignant obstruction at the porta hepatis. We report on a case of gallbladder carcinoma with a complete block at the porta hepatis, which was palliated with a percutaneous biliary drain. Enteral reinfusion of bile was accomplished through a duodenal tube placed through a percutaneous endoscopic gastrostomy.
Adenoma, Bile Duct↗
Continuous duodenal infusions of levodopa: plasma concentrations and motor fluctuations in Parkinson's disease.
Four parkinsonian patients received continuous duodenal infusions of levodopa (LD) for severe "on-off" phenomena associated with Sinemet (carbidopa/levodopa) therapy. All patients had marked decreases in motor fluctuations on the infusions compared with tablets. Two factors that appear related to this improvement are the ability of duodenal infusions to produce steadier plasma LD concentrations and/or to maintain LD concentrations above a minimum threshold needed to achieve the "on" state.
Adult↗
Premedication, preparation, and surveillance.
Once again the staggering variation in IV sedation practice between different countries is highlighted. This year the "to sedate or not sedate" debate focuses on colonoscopy. Several papers on the use of Propofol are reviewed. It remains this authors' opinion that propofol is an anaesthetic agent to be used by (or at least in the presence of) an anaesthetist. Informed consent and the question of what to do if a patient withdraws consent halfway through the procedure are discussed. Predictably further recent papers on the relative merits of midazolam and diazepam are presented plus another report on the use of flumazenil in the recovery period. The use of 3% hydrogen peroxide solution to aid the visualization of acutely bleeding gastro-duodenal lesions is presented in two papers along with a discussion of its possible mode of action. The use of antispasmodics to aid colonoscopy is further discussed: this year concentrating on the use of hyoscyamine sulphate (as opposed to hyoscine butylbromide, the preferred agent in the UK). The patients receiving hyoscyamine sulphate had significantly shorter caecal intubation times, better sedation and easier colonic insertion. The "downside" was drug-induced tachycardia and the authors caution against the widespread use of this drug until this situation is further clarified. The subject of hypoxaemia at the time of gastroscopy, colonoscopy and ERCP was reviewed last year and further papers are presented in which the incidence of various levels of hypoxia are given. In anaesthetic circles it would be considered totally unacceptable to allow a patient's oxygen saturation to fall below 85 %, and yet we continue to have papers reporting its incidence. This level of desaturation is potential dangerous and the routine use of supplemental oxygen would greatly reduce this unneccessary risk to patients.
Procedural Sedation↗
Surgery offers the best palliation for carcinoma of the pancreas.
This debate discusses the palliative management of pancreatic cancer. The arguments in favour of surgical palliation are that this approach allows all symptoms to be treated or prevented, the diagnosis can be confirmed histologically and a final assessment of resectability can be made. The arguments against the use of surgery are that survival is short and that effective alternative therapies are available: endoscopic intubation, percutaneous coeliac plexus block and pancreatic enzyme supplements. The most appropriate policy, however, is to tailor the management plan to suit the individual patient.
Aged↗