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At least 19 recordsLinked to original sources

PubMed1978

[Morphofunctional stateof the cholinergic nervous apparatus of the normal duodenum and the duodenum after subdiaphragmatic vagotomy].

Histochemical study of the intramural nervous apparatus of the duodenum was carried out under normal conditions and following bilateral subphrenic vagotomy. Morphometric and microspectrofluorimetric methods gave informations on the reduction of the number of the cholinergic nervous fibers and of the acetylcholinesterase activity in them after a brief increase of these indices during the first 24 hours after vagotomy, with their subsequent return to the initial values.

Acetylcholinesterase↗

PubMed1979

[The effects of sphincteroplasty on manometric profile of common bile duct and the duodenum (author's transl)].

A simultaneous manometric monitoring of the common bile duct (CBD) and the duodenum were performed 2 weeks after choledocholithotomy on 15 patients whose common bile ducts were explored without sphincteroplasty and 30 patients with sphincteroplasty. These manometric studies were carried out by open-tip catheters intubated into the CBD and duodenum through the T-tube at the operation. In patients without sphincteroplasty, no effects of the duodenal pressure on a CBD pressure profile were recognized, while a synchronized pressure profile of the CBD and the duodenum was obtained in patients with sphincteroplasty. By stimulation with morphine (Morphine sulfate; 0.17 mg/Kg iv bolus), waxing and waning of the pressured in the CBD without sphincteroplasty were observed with 20 cmH2O in maximum at about 13 minutes after injection. However, in the CBD with sphincteroplasty, scale-over increase of the pressure curve was seen immediately after duodenal contraction caused by morphine stimulation. A direct infusion of 5 ml of 0.1 N hydrochloride to the duodenum causes hyperperistalsis of the duodenum, which made a synchronized pressure profile in the CBD with sphincteroplasty but made no remarkable change in a pressure profile of the CBD without sphincteroplasty. These findings conclude that the sphincter of Oddi plays an important role as a "pressure barrier" between the CBD and the duodenum, and that with the destruction of this sphincter by sphincteroplasty, a pressure profile of the CBD becomes close to that of the duodenum. This simultaneous manometric study of the CBD and the duodenum might be one of most valuable methods for evaluation of completeness of the sphincteroplasty.

Ampulla of Vater↗

PubMed1976

[Rupture of the duodenum due to blunt injury].

Injuries of the duodenum, although rare, have increased in frequency of occurence during the past ten years. Careful attention must be given to them, especially if the injury was brought about by a blunt blow of the abdominal, and lower thoracic regions. X-rays are the most important means used in diagnosing such cases. Injuries of the duodenum often occur along with injuries of other related structures, especially in polytraumatized patients. Early diagnosis, and surgical treatment are conditio sine qua non for successful results. During the operation itself, a compete inspection of the entire duodenum, both intra and extraperitoneal parts, careful placement of sutures about the perforation and an exact drainage are of utmost importance in the prevention of postoperative complications. In cases in which the duodenal wall has lost its vitality for accepting suture, a gastrojejunal, duodenojejunal anastomisi, or gastrostomia are performed, the content of the duodenum is aspirated, the duodenum is decompressed and adequate drainage of the peritoneal cavity is established. In cases of accompanying injury of the pancreas, or choledochus, a drainage of the extrahepatic bile duct is recommended. The authors discuss one case with a ruptured duodenum, resulting from blunt trauma, in which all of the above mentioned procedures were used; they insist that any suspicion of a duodenum's rupture indicates an immediate laparotomy.

Duodenum↗

PubMed1978

Effects of some gastrointestinal hormones on two muscle layers of duodenum.

The duodenums of opossums and cats were cut into strips 2 mm wide and 2-2.5 cm long. Strips cut in the oral-caudal axis were called longitudinal strips; those cut at 90 degrees to that axis were called circular strips. Cholecystokinin (CCK) and cerulein stimulated phasic contractions of circular muscle of opossum duodenum, but had no effect on the longitudinal muscle. The effect of CCK was not blocked by tetrodotoxin (10(-7)M), indicating a direct muscle stimulation. CCK had no effect of both muscle layers of the cat duodenum. Vasoactive intestinal peptide raised tension in longitudinal muscle, but reduced tension in circular muscle of opossum duodenum. Glucagon slightly reduced tension in both longitudinal and circular muscle of opossum duodenum. It also inhibited contractions of circular muscle caused by acetylcholine. Pentagastrin and secretin had no effect on either muscle layer in either species. These findings suggest that the circular and longitudinal muscle layers of the duodenum respond differently to at least some gastrointestinal hormones. Also, there is species variation in response to gastrointestinal hormones.

Animals↗

PubMedDate not supplied

[Treatment of injuries of the duodenum and pancreas].

The authors study 84 patients that had damages of the duodenum and or pancreas and underwent different types of surgery. In 39 patients who had damage only in the duodenum; there were 2 (4.0%) duodenal fistulas, and 3 (6.0%) intraperitoneal abscess. In 38 patients who had injuries only in the pancreas; there were 6 (13.1%) acute pancreatities, pancreatic fistulas and 1 (2.2%) pancreatic pseudocyst. In 7 cases, injuries were found to both pancreas and duodenum. The author reports 1 case of duodenal fistula (14.3%) 1 case of acute pancreatitis (14.3%) and 3 cases of pancreatic fistula (43.0%). Only 7 patients died (8.3%), and of these 2 died for reasons not directly related to the operatory technic used. A simple suture can be performed in those cases where a complete section of the duodenum is unnecessary and there is no injury to the duodenal papilla. A burying suture of the stomas associated with a side-to-side duodenojejunal anastomosis should be preferred in the complete section of the duodenum localized beyond the ampulla of Vater. In all superficial wounds of small extension a suture of the pancreas should be performed. Distal pancreatectomy of body or tail should be made in the wounds with a possible lesion to the Wirsung duct and when there is an extensive glandular lesion. The associate wounds of duodenum and pancreas should be treated as if they were isolated lesions.

Abdominal Injuries↗

PubMed1978

Retrograde movement of digesta in the duodenum of the chick: extent, frequency, and nutritional implications.

Movement of digesta from the duodenum to the gizzard of chicks was assessed by injection of 99mTc-diethyl-triamino-pentaacetic acid via an indwelling cannula in the hepatic bile duct. The change in location of isotope with time was followed with a Gamma Camera. About 40% of the injected isotope refluxed to the gizzard within 2 minutes of injection. Clearance of the isotope from the gizzard had a T1/2 of some 20 minutes. Some possible implications of retrograde movement of digesta were examined. Cholesterol, bile salts and pancreatic enzymes were found in the gizzard at 10% to 20% of duodenal concentrations. The proteolysis and lipolysis in the gizzard and duodenum were determined in chicks fed a duet containing 91Y as a non-absorbed reference substance. Thirty percent of the feed triglycerides were found hydrolysed in the gizzard as compared to 50% to 60% in the duodenum. Proteins were 30% to 50% trichloroacetic acid soluble in the gizzard reaching almost 70% in the duodenum. A small net secretion of both fatty acids and protein was observed in the gizzard, probably due to reflux of endogenous secretions from the duodenum. The nutritional significance of these results is discussed.

Animal Nutritional Physiological Phenomena↗

PubMed1975

Villous tumors of the duodenum.

Villous tumors of the duodenum are rare, but treatment may be problematic because of their association with invasive adenocarcinoma. Two cases of villous tumor of the duodenum are described and 39 other reported cases are reviewed. Presenting symptoms were bleeding 27%; obstruction 24%; jaundice 22% and vague dyspepsia 20%. Diagnosis may be made by radiographic barium contrast evaluation of the duodenum, especially with the addition of air contrast hypotonic studies and by fibro-optic endoscopy. Twenty-seven per cent of villous tumors of the duodenum are associated with adenocarcinoma. Invasive tumor is more common in patients over 50 years old (35%), in tumors of the third and fourth portions of the duodenum (44%) and in tumors over 4 cm in diameter (30%). Local excision is the treatment of choice for benign lesions. Pancreatico-duodenectomy is recommended for tumors which include invasive carcinoma in patients without distal metastases.

Adenocarcinoma↗

PubMed1979

[Decrease of ACh response in isolated duodenum from SART stressed (repeated cold stressed) mice (author's transl)].

ACh response in the isolated duodenum from SART stressed (repeated cold stressed) mice was remarkably decreased in comparison to normal mice 5 days after onset of loading SART stress, and maximal contraction in SART stress mice duodenum was about 37% of that in non-stressed mice. Pilocarpine and KCl responses were also considerably decreased, but BaCl2 response was much the same as in the controls. Thus, the contraction system of the muscle is apparently not damaged by SART stress. Though body weights decreased, the daily intake of food incressed in SART stressed mice. Length of small intestine from SART stressed mice was much the same as in controls, but wet weights of small intestines were larger than in controls. Autonomic agonists, antagonists, tranquilizers and other drugs were given intraperitoneally to mice once daily during SART stress, and the ACh responses in the isolated duodenum were investigated. Pretreatment with adrenergic and anticholinergic drugs inhibited the decrease of ACh response, but antiadrenergic and cholinergic drugs had no effects. Pretreatment with tranquilizers such as reserpine, chlorpromazine, carpipramine and imipramine inhibited the decrease of ACh response in the isolated duodenum, but diazepam, meprobamate and benadryl had no influence. Pretreatment of neurotropin, a neurosedative had good inhibitory effects. Our results suggest that SART stressed mice may be in a state of unbalance regarding sympathetic and parasympathetic nerves, particularly with regard to abnormal tension in the parasympathetic nervous system, in part of duodenum. Pretreatment with most of the above drugs had no influence on loss of body weight in SART stressed mice while pretreatment with neurotropin inhibited body weight to a considerable extent.

Acetylcholine↗

PubMed1978

Site of emetic action of oral copper sulfate in dogs. (II) Importance of lower duodenum.

Sensitivities of the stomach and duodenum to oral copper sulfate emesis were compared in dogs. 1) Dogs equipped with a stainless stell cannula in the middle of the duodenum were challenged to the oral threshold emetic dose of copper sulfate administered by a gastric tube. When the cannulas were opened, the oral thresholds were not effective to elicit vomiting in the most cases (1/13). Fairly rapid and high rate recoveries of copper through the open cannula were noted. With the closed cannulas, the thresholds were highly effective (16/16). 2)In the dogs with a cannula at the upper part of the jejunum, the oral threshold doses were always effective whether the canula was opened (9/9) or closed (11/11). Recovery rates of copper from the cannula were usually poor. 3) The oral thresholds administered into the proximal end or the middle of the duodenum through a PVC tubing were equally effective. 4) Although copper sulfate might irritate the stomach and upper duodenum to evoke vomiting, these results suggested a higher sensitivity of the lower duodenum.

Administration, Oral↗

PubMed1975

[Comparison of drug effects on the isolated rat colon and duodenum].

Adrenaline and isoproterenol elicited nearly maximal relaxation of the colon even in small doses, whereas increase in the doses caused greater relaxation in the duodenum. In the colon, these drugs prevented, to a great extent the contraction induced by acetylcholine (ACh) and serotonin but in the duodenum were totally ineffective. Dibenamine and propranolol reduced adrenaline- and isoproterenol-induced relaxation in the duodenum, though propranolol decreased the relaxation caused by isoproterenol. Atropine prevented ACh-induced contraction in both the colon and duodenum in the same way. After 2-bromolysergic acid diethylamide, duodenal contraction caused by ACh or serotonin decreased by over 70%; however, the contraction of the colon was not significantly inhibited. Methysergide had similar effects, but to a lesser degree. In calcium-free bathing fluid without addition of Na2EDTA, ACh and prostaglandin E1 elicited contraction in the colon, but not in the duodenum.

Acetylcholine↗

PubMed1977

The suspensory muscle of the duodenum and its nerve supply.

The gross anatomy, microscopic structure and nerve supply of the suspensory muscle of the duodenum and Hilfsmuskel have been studied in cadavers of 88 adults, 5 children, 1 infant and 6 neonates. The suspensory muscle of the duodenum, consisting of plain muscle fibres, arose from the connective tissue around the stems of the coeliac and superior mementeric arteries. It was inserted into the third and fourth parts of the duodenum in 53%, and into the duodeno-jejunal flexure in addition in 40%. It was innervated by non-myelinated fibres arising from the coeliac and superior mesenteric plexuses. Although both the longitudinal and circular muscle coats of the duodenum extended into the suspensory muscle, it was not supplied by Auerbach's plexus. The Halfsmuskel, which is a slip of the diaphragm is attached above to the margin of the oesophageal hiatus and below to the connective tissue in the region of the stem of the coeliac artery, sometimes extending to the stem of the superior mesenteric artery. The Hilfmuskel and the suspensory muscle of the duodenum are separate entities.

Adult↗

PubMed1976

Primary neoplasms of the duodenum.

The records of 12 patients with primary malignant neoplasms of the duodenum, excluding ampullary lesions, have been studied. There were eight adenocarcinomas and four leiomyosarcomas. The second portion of the duodenum was the most common site for these neoplasms. Common symptoms were epigastric pain; obstructive symptoms, such as nausea and vomiting; obstructive jaundice, and hematemesis. Hematemesis is the most common symptom in leiomyosarcoma of the duodenum. The mean duration of symptoms was six months for leiomyosarcoma and 3.2 months for adenocarcinoma. In five patients, excision of the tumor was carried out more frequently for those in the distal portion of the duodenum. More radical procedures, such as pancreaticoduodenectomy, are the treatment of choice in neoplasms of the second portion of the duodenum. A bypass procedure is done for palliation of intestinal obstruction. Three patients with leiomyosarcomas that were resected had a mean survival time of 51 months. On the other hand, patients with adenocarcinomas that were resected had a mean survival time of nine months, while patients with unresectable tumors had a mean survival time of 2.3 months.

Adenocarcinoma↗

PubMed1977

Invasion of the duodenum by carcinoma of the stomach.

It has frequently been stated that extension to the duodenum occurs commonly in patients with gastric lymphoma but almost never in those with carcinoma of the stomach. We found radiographically detectable invasion of the duodenum in six of 111 consecutive patients (5%) with gastric carcinoma. The duodenum was involved microscopically in 18%. Radiographic abnormalities in the duodenum in 11 patients with proven transpyloric spread of tumor varied from irregularity of the base of the bulb narrowing and distortion extending well into the second portion of the duodenum. On the basis of these data and the reported frequency of transpyloric extension in gastric lymphoma, carcinoma appears to be the more likely diagnosis in a patient with duodenal involvement by an antral tumor.

Adenocarcinoma↗

PubMed1975

Concurrent studies of the flow of digesta in the duodenum and of exocrine pancreatic secretion of calves. 3. Further studies on the addition of fat to skim milk and the use of non-milk proteins in milk-substitute diets.

1. The flow of digesta through the duodenum and the concurrent secretion of the pancreas were studied in four Friesian calves given four milk-substitute diets. The diets were: reconstituted, "mildly" pre-heated, spray-dried skim-milk powder with (SKF) or without (SK) margarine fat or with 5o percent of the skim-milk powder in diet SKF replaced by soya-bean flour (ASKF) or fish-protein concentrate (BSKF), together with dried whey. The diets were given ad lib. twice daily from 13 to 37 d of age, each diet being given for 6 consecutive days. Collections of duodenal digesta and pancreatic secretions, from cannulas, were made for 12 h after feeding the 6th and 12th meals ("experimental" meals) for each diet. 2. The diets fed as "experimental" meals contained polyethylene glycol (PEG) as a fluid (whey) marker and goat's milk containing (3H)lysine as a marker for total protein; beta-carotene was added as a lipid marker to the three diets containing margarine fat. 3. Over the 12 h postprandial period, the patterns of duodenal digesta flow and secretion of pancreatic fluid did not differ markedly between the four diets. The abomasal outflow of both nitrogen and lipid in a 12 h postprandial period was related to their intakes from the "penultimate" (5th and 11th) meals for diets SKF and SK BUT TO THEIR INTAKES AT THE "EXPERIMENTAL MEALS" FOR DIETS ASKF and BSKF. Secretion of pancreatic enzyme activity was highest during the 1st hour after feeding but the main outflow from the abomasum of total N and lipid occurred 5-10 h after feeding. 4. The time required for all the whey marker (PEG) to pass through the duodenum was similar for diets SKF and SK, but only 53 and 42 percent respectively of the ingested protein marker passed through the duodenum in the 12 h after feeding. More acid appeared to be secreted by the abomasum when diet SK was given; also less undigested protein passed out of the abomasum after giving this diet. It is concluded that the physical absence of fat globules in the abomasal clot increases the degree of proteolysis. 5. The secretions of pancreatic fluid and pancreatic enzyme activity were all markedly lower for diet SK than for diet SKF. 6. With diets containing non-milk proteins (ASKF and BSKF), abomasal proteolysis was less efficient and the ingested protein passed out of the abomasum more rapidly than for diet SKF. There was no difference in the rate of abomasal outflow of the whey fluids between diets SKF, ASKF and BSKF. 7. In comparison with diet SKF, diets ASKF and BSKF tended to induce less pancreatic enzyme secretion over a 12 h postprandial period, with the exception of lipase. 8. There appeared to be no direct relationship between the quantities of any of the pancreatic enzymes secreted during a postprandial period and either the concurrent flow of duodenal digesta or the total quantities of dietary constituents passing through the duodenum.

Animal Nutritional Physiological Phenomena↗

PubMed1977

Concurrent studies of the flow of digesta in the duodenum and of exocrine pancreatic secretion in calves. 5. The effect of giving milk once and twice daily, and of weaning.

1. The effects of giving milk once or twice daily (Expt 1) and of weaning (Expt 2) on the flow rate of digesta through the duodenum and on pancreatic secretion were studied in four and two Ayrshire calves respectively. The calves were prepared with duodenal re-entrant and pancreatic sac cannulas. 2. In Expt 1, when whole milk was offered ad lib. once daily, the calves ingested 141 g/kg live weight (46 g dry matter (DM)/kg live weight 0.75) at a single meal. The subsequent pattern of flow and total recovery of polyethylene glycol from the duodenum suggested that none of the ingested milk passed into the rumeno-reticulum. As the total daily quantity of milk ingested when the calves were fed once and twice daily was similar, it was concluded that abomasal distension is unlikely to be the sole factor limiting milk intake in the preruminant calf. 3. With twice-daily feeding, there were no differences in the pattern or total flow of fluid, electrolytes, nitrogen or fat through the duodenum of the calves following the 09.00 and 21.00 hours meals. The pattern of flow of duodenal and pancreatic fluids and the concentration of electrolytes, N and fat were markedly different when the calves were fed once or twice daily. The patterns of flow of fluid and the concentration of electrolytes in the duodenal digesta reflected the frequency of feeding and the size of the meal and the consequent balance between feed and endogenous components of the digesta. The quantity of the apparent endogenous secretion and pancreatic secretion was markedly less when the calves were fed once daily. 4. In Expt 2, the two Ayshire calves were given whole milk twice daily (diet MM), whole milk once daily with concentrates (diet MC), concentrates alone (diet CC) or dried grass alone (diet DG). The calves consumed 46, 49, 45 and 51 g DM/kg live weight 0.75 when given diets MM, MC, CC and DG respectively. 5. The twice-daily fluctuations in the flow and concentration of fluid, electrolytes, N and fat in the duodenal digesta and the pancreatic fluid observed when diet MM was given were replaced by relatively constant flow rates and composition when diet CC or DG was given. 6. Over the 24 h experimental period 97, 70, 50 and 58% of the DM and 112, 98, 99 and 84% of the N in the feed passed through the duodenum of calves when given diets MM, MC, CC and DG respectively. 7. When dry food was given, the rate of pancreatic fluid secretion was markedly lower (11.3 and 13.5 ml/kg live weight for diets CC and DG respectively) than when diet MM (19.7 ml/kg live weight) was given.

Animal Nutritional Physiological Phenomena↗

PubMed1975

Traumatic injuries to the duodenum: a report of 98 patients.

Data of 98 patients who had sustained traumatic injuries to the duodenum during a recent 7-year period is reviewed. The overall mortality was 23.5%; that of the blunt injury group was 35%, that of the penetrating injury group was 20%. However, after the establishment of a trauma unit, the mortality for duodenal injuries fell from 32% to 12%. Death from duodenal wounds may be reduced by earlier hospitalization, earlier diagnosis and consequently earlier surgical repair. Vigorous treatment of shock is essential. A specialized trauma unit with personnel experienced in the management of shock and trauma problems provides a better environment to carry out the preoperative and postoperative care of the acutely injured patient. Adequate surgical treatment of the blunt injury and missile injury of the duodenum should consist of the following procedures: 1) repair of the duodenal wall utilizing conventional techniques; 2) internal decompression of the repair by afferent jejunostomy; 3) efferent jejunostomy for postoperative feeding; 4) temporary gastrostomy; and 5) external drainage of the repair. In certain selected instances, the simple stab wound of the duodenum may be treated by conventional repair without decompression, but a loop of jujunum should be sutured over the repair to prevent delayed disruption. The majority of patients with injuries to the duodenum have associated organs injured which also require considered surgical judgment and action.

Adolescent↗

PubMed1977

Effects of cholecystokinin on the motility of the distal duodenum and the proximal jujunum in man.

Electrical spike potentials and intraluminal pressure variations were recorded in the distal part of the duodenum and proximal part of the jejunum in 5 normal human subjects before and after a bolus injection of cholecystokinin. A considerable increase in activity was observed in the jejunum after the hormone, whereas there was no response in the distal duodenum. Absence of reaction in the proximal duodenum and an increase in the motility in the distal ileum has previously been demonstrated after cholecystokinin administration. It is concluded that the human duodenum differs from the rest of the small intestine in its reaction to cholecystokinin. The change in reaction appears to occur on a level with the ligament of Treitz.

Cholecystokinin↗

PubMed1977

Malrotation of the duodenum. Frequency in a radiographic control group.

In a prospective radiographic study, abnormal configurations with kinking and torsion (malrotation) of the duodenum were found in 41% of 150 non-dyspeptic subjects. Malrotation of the duodenum (MD) was more frequent before the age of 30, and in the entire series the frequency decreased significantly with age from approximately 60% at 20 years to approximately 25% in individual aged 35 years or more. It should be considered whether the same radiographic configuration as in MD up to the age of 30--35 years is merely due to uncompleted disposition and fixation of the duodenum, so that the diagnosis of MD cannot be definitely established until after that age. In the presence of MD, the luminal diameter of the duodenum was larger than normal, and there was a greater tendency to gastric retention at 4 hours after the barium meal.

Adolescent↗