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Small bowel

F Y Lee, L Limi, T Gee
Epithelioid sarcoma (ES) of the small bowel is a rare gastrointestinal tumour. We report a case of gastrointestinal bleeding secondary to small bowel ES in a 55-year-old gentleman. After gastroscopy and colonoscopy failed to identify the source of bleeding, we proceeded with computed tomography angiogram of the mesentery, which revealed intraluminal blood clot in the distal jejunum with features of obstruction. This is a rare cause of obscure gastrointestinal bleeding and emphasises the need for additional evaluation in the presence of negative endoscopic findings...
August 2016: Medical Journal of Malaysia
Jeong-Eun Rah, Gwe-Ya Kim, Do Hoon Oh, Tae Hyun Kim, Jong Won Kim, Dae Yong Kim, Sung Yong Park, Dongho Shin
BACKGROUND: The purpose of this study is to evaluate the dosimetric benefits of a proton arc technique for treating tumors of the para-aortic lymph nodes (PALN). METHOD: In nine patients, a proton arc therapy (PAT) technique was compared with intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) techniques with respect to the planning target volume (PTV) and organs at risk (OAR). PTV coverage, conformity index (CI), homogeneity index (HI) and OAR doses were compared...
October 21, 2016: Radiation Oncology
Yaohong Wang, Sudeep P George, Swati Roy, Eric Pham, Amin Esmaeilniakooshkghazi, Seema Khurana
In the small intestine, epithelial cells are derived from stem cells in the crypts, migrate up the villus as they differentiate and are ultimately shed from the villus tips. This process of proliferation and shedding is tightly regulated to maintain the intestinal architecture and tissue homeostasis. Apoptosis regulates both the number of stem cells in the crypts as well as the sloughing of cells from the villus tips. Previously, we have shown that villin, an epithelial cell-specific actin-binding protein functions as an anti-apoptotic protein in the gastrointestinal epithelium...
October 21, 2016: Scientific Reports
Ajm Dingemans, Hjj van der Steeg, R Rassouli-Kirchmeier, M W Linssen, Ialm van Rooij, I de Blaauw
INTRODUCTION: Although surgery is effective in most patients with Hirschsprung's disease (HD), some have persistent obstructive symptoms. Additional medical treatment is generally sufficient, but a small fraction of these patients needs secondary surgery. Series on redo surgery are scarce. Aim of this study is to evaluate complications and clinical outcome of patients in need of redo surgery for HD. MATERIALS AND METHODS: Sixteen patients underwent redo endorectal pull-through surgery in our center between 2007 and 2015...
September 23, 2016: Journal of Pediatric Surgery
Vivek Subbiah, Oliver Holmes, Kyle Gowen, Daniel Spritz, Behrang Amini, Wei-Lien Wang, Alexa B Schrock, Funda Meric-Bernstam, Ralph Zinner, Sarina Piha-Paul, Maria Zarzour, Julia A Elvin, Rachel L Erlich, David L Stockman, Jo-Anne Vergilio, James H Suh, Philip J Stephens, Vincent Miller, Jeffrey S Ross, Siraj M Ali
Malignant gastrointestinal neuroectodermal tumor (GNET) is an aggressive rare tumor, primarily occurring in young adults with frequent local-regional metastases and recurrence after local control. The tumor is characterized by the presence of EWSR1-ATF1 or EWSR1-CREB1 and immunohistochemical positivity for S-100 protein without melanocytic marker positivity. Due to poor responses to standard sarcoma regimens, GNET has a poor prognosis, and development of effective systemic therapy is desperately needed to treat these patients...
October 21, 2016: Oncology
Gerard Adams, Matthew Foote, Simon Brown, Bryan Burmeister
Radiotherapy after lymph node dissection is recommended in high-risk melanoma cases. The aim of this study is to assess whether intensity-modulated radiotherapy (IMRT) offers advantages over three-dimensional conformal radiotherapy (3DCRT) in the groin nodal basin. Fifteen consecutively treated patients (5 3DCRT and 10 IMRT) were selected. Optimized theoretical plans using the other modality were created - enabling direct comparisons of 3DCRT and IMRT. Target volume and organs at risk constraints were assessed as achieved or as having minor (≤5%) or major (>5%) deviations...
October 19, 2016: Melanoma Research
S Shreshtha
A 70 year old lady presented to surgery emergency with small bowel obstruction without any obvious etiology. On exploration she was found to have an obstructed obturator hernia, which is a rare pelvic hernia with an incidence of 0.07-1.4% of all intra-abdominal hernias. Diagnosis is often delayed until laparotomy for bowel obstruction. Strangulation is frequent and mortality remains high (25%). Early diagnosis and surgical treatment contributes greatly to reduce the mortality and morbidity rates. A variety of techniques have been described, however surgical repair has not been standardized...
October 2016: Journal of Postgraduate Medicine
Jin Sil Kim, Hyun Jin Kim, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Hyun Kwon Ha
OBJECTIVES: To evaluate the CT features of ruptured GISTs and factors that might be predictive of rupture through comparison with CTs taken prior to rupture and CTs of non-ruptured GIST. METHODS: Forty-nine patients with ruptured GIST and forty-nine patients with non-ruptured GIST matched by age, gender and location were included. Clinical data including pharmacotherapy were reviewed. The imaging features were analyzed. Prior CT obtained before rupture were evaluated...
October 19, 2016: European Radiology
Betül Emine Derinkuyu, Mohammad Reza Affrancheh, Didem Sönmez, Meltem Bingöl Koloğlu, Suat Fitoz
BACKGROUND: The canal of Nuck is a fold of peritoneum that invaginates into the inguinal canal and closes at or just before birth. If the canal of Nuck remains open in female infants, herniation of the uterus, adnexa and/or bowel loops may arise through the inguinal canal into the labia majora. CASE REPORT: The present case is a 12-week-old female infant with complaints of left groin swelling and discomfort. Ultrasonographic examination revealed a left inguinal hernia containing both adnexa (ovaries and fallopian tubes), uterus and small bowel loops with fluid...
September 2016: Balkan Medical Journal
Kelsey Bourm, Cory Pfeifer, Adam Zarchan
Small bowel perforation is a rare complication of ventriculoperitoneal (VP) shunt placement. When seen, it most commonly affects the stomach or colon. We describe a case and image findings of an 8-year-old female who presented with sepsis and erosion of the VP shunt into the small bowel. The imaging findings were confirmed surgically. We also provide an overview of the current literature discussing previously reported cases, clinical features, and treatment.
June 2016: Journal of Radiology Case Reports
Nancy Sharma, Boris G Naraev, Eric G Engelman, M Bridget Zimmerman, David L Bushnell, Thomas M OʼDorisio, M Sue OʼDorisio, Yusuf Menda, Jan Müller-Brand, James R Howe, Thorvardur R Halfdanarson
OBJECTIVES: The objective of this study was to describe the outcomes of patients in the University of Iowa Neuroendocrine Tumor (NET) Database treated with peptide receptor radionuclide therapy (PRRT). METHODS: One hundred thirty-five patients from the University of Iowa NET Database who received PRRT were analyzed, their characteristics were described, and survival was calculated. RESULTS: The median age at diagnosis was 51 years, and 64% were men...
October 18, 2016: Pancreas
Wen-Guo Chen, Guo-Dong Shan, Hong Zhang, Ming Yang, Lin L, Min Yue, Guang-Wu Chen, Qing Gu, Hua-Tuo Zhu, Guo-Qiang Xu, Li-Hua Chen
The aim of the study was to evaluate the diagnostic and therapeutic value of double-balloon entoroscopy (DBE) in small bowel diseases (SBDs) in China.A retrospective review of 674 consecutive patients who underwent DBE between January 2007 and November 2015 was conducted. Patients were divided into 3 groups by age, young group (<45 years), middle-aged group (45-65 years), and elderly group (>65 years). Data were collected with regard to demographics, clinical, endoscopic findings, complications, diagnostic yield, and management...
October 2016: Medicine (Baltimore)
Andrew Scrima, Meghan G Lubner, Scott King, Gregory Kennedy, Perry J Pickhardt
OBJECTIVE: To compare performance of junior (JR)/senior (SR) abdominal radiologists using multidetector computed tomography (MDCT) to predict surgical intervention, bowel resection, and presence of bowel ischemia in patients with suspected small-bowel obstruction (SBO). METHODS: Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, blinded, independent review of MDCT studies for suspected SBO in 179 adults (mean age, 55...
October 18, 2016: Journal of Computer Assisted Tomography
Ashish Gupta, Karikal Chakaravarthi, Bramhadatta Pattnaik, Lileswar Kaman
Duplication cysts occur because of congenital aberration during gut development. They are commonly diagnosed during infancy and rarely during adulthood. We present an adult male who presented to surgical emergency with acute intestinal obstruction. Intraoperatively, this patient was found to have a non-communicating duplication cyst of ileum causing proximal obstruction. The involved segment of the small bowel was resected and a divided loop ileostomy was created.
October 6, 2016: BMJ Case Reports
S A Taylor, F Avni, C G Cronin, C Hoeffel, S H Kim, A Laghi, M Napolitano, P Petit, J Rimola, D J Tolan, M R Torkzad, M Zappa, G Bhatnagar, C A J Puylaert, J Stoker
OBJECTIVES: To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease. METHODS: An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols...
October 18, 2016: European Radiology
Sungmun Lee, Yeu-Chun Kim, Ji-Ho Park
Reactive oxygen species (ROS) play an important role in the development of inflammatory bowel diseases. Superoxide dismutase (SOD) has a great therapeutic potential by scavenging superoxide that is one of ROS; however, in vivo application is limited especially when it is orally administered. SOD is easily degraded in vivo by the harsh conditions of gastrointestinal tract. Here, we design a zein-alginate based oral drug delivery system that protects SOD from the harsh conditions of gastrointestinal tract and releases it in the environment of the small intestine...
October 15, 2016: International Journal of Pharmaceutics
Yaron Niv, Eyal Gal, Violeta Gabovitz, Marcela Hershkovitz, Lev Lichtenstein, Irit Avni
BACKGROUND AND THE STUDY AIM: Crohn's disease (CD) is a chronic inflammatory disorder defined as a transmural inflammation of the bowel wall, affecting the small and large intestine. The Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score) was devised to measure mucosal disease activity. We extended the Niv score to the colon and have a comprehensive view of the whole intestine. METHODS: We evaluated 3 parameters of intestinal pathology: A, Inflammation; B, Extent of disease; C, Presence of strictures...
October 7, 2016: Journal of Clinical Gastroenterology
Jun-Feng Wang, Hui Li, Hua Xiong, He Huang, Yan-Mei Zou
The influence of the position and radiation technique on the organs at risk (OARs) in radiotherapy of rectal cancer was evaluated. The relationship between the volume of irradiated small bowel (VSB) and acute bowel toxicity was determined. A total of 97 cases of rectal cancer were retrospectively randomized to receive radiotherapy with the designated treatment positions and radiation plans. Among 64 patients in the supine position, 32 patients were given three-dimensional conformal radiotherapy (3DCR) and 32 patients were subjected to intensity-modulated radiation therapy (IMRT) respectively...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Ahmed E Othman, Thomas K Eigentler, Georg Bier, Christina Pfannenberg, Hans Bösmüller, Christian Thiel, Claus Garbe, Konstantin Nikolaou, Bernhard Klumpp
OBJECTIVE: To assess the appearance of gastrointestinal melanoma metastases on CT and PET/CT and evaluate the diagnostic value of CT and PET/CT compared with surgery and histopathology. METHODS: We retrospectively included 41 consecutive patients (aged 56.1 ± 13.5 years) with gastrointestinal melanoma metastases who underwent preoperative imaging (CT: all, PET/CT: n = 24) and metastasectomy. Two blinded radiologists assessed CT and PET/CT for gastrointestinal metastases and complications...
October 17, 2016: European Radiology
Michael J Alfonzo, Carl R Baum
Magnets are inherently attractive to young children, but present a risk when ingested. If consumed alone, small, smooth magnetic foreign bodies are likely to pass without significant event; however, ingestion of multiple magnets may have catastrophic consequences, including bowel perforation, obstruction, peritonitis, and death. Increasing reports of morbidity and mortality in recent years from the US National Electronic Injury Surveillance System has led to numerous safety statements from the American Academy of Pediatrics and the Centers for Disease Control and Prevention, as well as several product recalls from the Consumer Product Safety Commission...
October 2016: Pediatric Emergency Care
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