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Gastric by pass

Zhe Wang, Feng Cao, Diangang Liu, Yu Fang, Fei Li
Trichobezoars are hairballs or hair-like fibers formed by chewing and swallowing hair or any other indigestible materials. Trichobezoars usually form in the gastric body and are thus prepyloric. However, trichobezoars may rarely pass through the pylorus into the duodenum, jejunum, ileum, and even the colon, in a condition referred to as Rapunzel syndrome. Here, we present a case of a 13-year-old girl with this rare syndrome and discuss the diagnosis and treatment of the disease.
November 2016: Acta Radiologica Open
Andrew M Bellinger, Mousa Jafari, Tyler M Grant, Shiyi Zhang, Hannah C Slater, Edward A Wenger, Stacy Mo, Young-Ah Lucy Lee, Hormoz Mazdiyasni, Lawrence Kogan, Ross Barman, Cody Cleveland, Lucas Booth, Taylor Bensel, Daniel Minahan, Haley M Hurowitz, Tammy Tai, Johanna Daily, Boris Nikolic, Lowell Wood, Philip A Eckhoff, Robert Langer, Giovanni Traverso
Efforts at elimination of scourges, such as malaria, are limited by the logistic challenges of reaching large rural populations and ensuring patient adherence to adequate pharmacologic treatment. We have developed an oral, ultra-long-acting capsule that dissolves in the stomach and deploys a star-shaped dosage form that releases drug while assuming a geometry that prevents passage through the pylorus yet allows passage of food, enabling prolonged gastric residence. This gastric-resident, drug delivery dosage form releases small-molecule drugs for days to weeks and potentially longer...
November 16, 2016: Science Translational Medicine
Per M Hellström, Panu Hendolin, Pertti Kaihovaara, Leif Kronberg, Axel Meierjohann, Anders Millerhovf, Lea Paloheimo, Heidi Sundelin, Kari Syrjänen, Dominic-Luc Webb, Mikko Salaspuro
INTRODUCTION: Helicobacter-induced atrophic gastritis with a hypochlorhydric milieu is a risk factor for gastric cancer. Microbes colonising acid-free stomach oxidise ethanol to acetaldehyde, a recognised group 1 carcinogen. OBJECTIVE: To assess gastric production of acetaldehyde and its inert condensation product, non-toxic 2-methyl-1,3-thiazolidine-4-carboxylic acid (MTCA), after alcohol intake under treatment with slow-release L-cysteine or placebo. METHODS: Seven patients with biopsy-confirmed atrophic gastritis, low serum pepsinogen and high gastrin-17 were studied in a cross-over single-blinded design...
November 3, 2016: Scandinavian Journal of Gastroenterology
Hirotsugu Hashimoto, Masahiro Yanagiya, Masashi Kusakabe, Atsushi Kurata, Sayaka Ohara, Yoshio Suzuki, Jun Matsumoto, Hajime Horiuchi
Vascular changes observed in intralobar pulmonary sequestration (PS) have been reported to be similar to those observed in pulmonary hypertension (PH). However, atherosclerosis in the pulmonary artery, which is one of the characteristic arterial changes of PH, has scarcely been reported in PS. Here, we report this unique manifestation in a 66-year-old man, in whom an intralobar PS fed by an aberrant artery branching from the left gastric artery had been identified 10 years earlier, and who was diagnosed with pneumonia after having symptoms of fever and cough...
October 5, 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Yoshinori Sato, Takashi Fujino, Akira Kasagawa, Ryo Morita, Shun-Ichiro Ozawa, Yasumasa Matsuo, Tadateru Maehata, Hiroshi Yasuda, Masayuki Takagi, Fumio Itoh
A 77-year-old woman underwent an upper gastrointestinal (UGI) endoscopy screening examination, and a 10-mm reddish, submucosal tumor-like lesion was found on the posterior wall of the fornix. Biopsy was performed, but there was no evidence of malignancy, so annual follow-up by UGI endoscopy was decided upon. After 12 years, examination of another biopsy specimen revealed an adenocarcinoma of the fundic gland type. There had been no significant change in the size or shape of the lesion over the long follow-up period...
December 2016: Clinical Journal of Gastroenterology
Shuangshuang Zhang, Hongxiang Yan, Panpan Yu, Yulong Xia, Wenli Zhang, Jianping Liu
The present study was aimed to develope a proliposomal formulation to decrease the hepatic first-pass metabolism of protocatechualdehyde (PD), followed by pellet coating to modify the drug release for angina chronotherapy. PD proliposomes were prepared by depositing PD-phospholipid complex on mannitol powders to improve the drug encapsulation. Afterwards, the PD proliposomes were prepared into pellet cores via extrusion-spheronization using 10% κ-carrageenan as pelletization aid prior to the development of PD sustained-release pellets (PD-SRPs)...
October 10, 2016: European Journal of Pharmaceutical Sciences
Sang Won Lee, Hyun Seok Lee
Gastric mucormycosis is a rare and life-threatening fungal disease, caused by fungus in the order Mucorales. While rhino-cerebral and pulmonary forms are common, gastric mucormycosis is an uncommon site for the disease. We diagnosed gastric mucormycosis in a 41-year-old female who had severe multiple trauma, including cardiac rupture, due to a traffic accident. Eighteen days after hospitalization, she passed 800 mL of melena over one day. We performed upper esophagogastroduodenoscopy (EGD) and found a huge gastric ulcer with bleeding...
August 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Masaya Uesato, Tomohide Tamachi, Naoyuki Hanari, Yorihiko Muto, Akiko Kagaya, Ryuma Urahama, Yukiko Ogura, Hiroshi Suito, Akira Nakano, Mizuho Aikawa, Takashi Oide, Hisahiro Matsubara
BACKGROUND AND AIMS: EUS-guided FNA biopsy has been widely performed to aid in the diagnosis of submucosal tumors (SMTs). However, in cases of small tumors, the diagnostic yield of EUS-FNA is poor. Therefore, it is necessary to develop a new needle for the diagnosis. We developed a device with a new mechanism that we refer to as a drill needle aspiration biopsy (DNAB). The aim of this study was to evaluate the use of DNAB in resected gastric SMT specimens. METHODS: A drill needle with a sharp tip and wide ditch was inserted into a catheter for angiography...
August 16, 2016: Gastric Cancer
Aleksandra Iljin, Bogusław Antoszewski, Adam Durczyński, Edward Lewandowicz, Janusz Strzelczyk
UNLABELLED: The aim of the study was evaluation of long-term results after simultaneous incisional hernia repair and abdominoplasty in patients following RYGB (Roux-en-Y Gastric By-pass) and estimation of quality of life before and after this complex operation. MATERIAL AND METHODS: We analyzed long-term results in 18 patients who underwent complex anterior abdominal wall surgery after massive weight loss, following previous RYGB. The patients were followed-up for at least 8 years...
May 1, 2016: Polski Przeglad Chirurgiczny
Rodolfo J Oviedo, Chase W Sofiak, Bruce M Dixon
INTRODUCTION: Achalasia is a condition that occurs when the lower esophageal sphincter (LES) fails to properly relax, combined with slowing/failure of esophageal peristalsis. This is seen clinically by not allowing solids and liquids to pass easily into the stomach. Achalasia is not historically associated with morbid obesity, yet dual treatment of morbid obesity and achalasia is becoming more prominent due to the worldwide obesity epidemic. PRESENTATION OF CASE: Achalasia is typically a disease that affects non-obese adults over the age of 55, which makes the discussion of this case report unique in that our patient is a 23 year-old woman who successfully underwent per-oral endoscopic myotomy (POEM) in preparation for a future laparoscopic sleeve gastrectomy...
2016: International Journal of Surgery Case Reports
Jae Pil Han, Tae Hee Lee, Su Jin Hong, Hee Kyung Kim, Hyung Min Noh, Yun Nah Lee, Hyun Jong Choi
OBJECTIVE: Adequate tissue acquisition for immunohistochemical (IHC) analysis is important in the differential diagnosis of subepithelial tumors (SETs). We compared the diagnostic yield from IHC analysis between endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and EUS-guided fine needle biopsy (EUS-FNB) after on-site cytologic evaluation for cellularity in gastric SETs. METHODS: In 22 patients with gastric SET, EUS-guided tissue sampling was performed on the same of SETs in a randomized sequence with EUS-FNA followed by EUS-FNB, or vice versa...
July 16, 2016: Journal of Digestive Diseases
Swati Agrawal, Sandeep Arora, Nishi Sharma
Ingestion of foreign bodies is a common pediatric problem. The majority of ingested foreign bodies pass spontaneously. Oesophageal foreign bodies should be urgently removed because of their potential to cause complications. Ingested batteries that lodge in the oesophagus, sharp or pointed foreign bodies in the oesophageal or gastric tract, and ingestion of multiple magnets all require urgent endoscopic removal. A 4-year-old boy ingested a sharp magnetic foreign body, which was removed via rigid oesophagoscopy without complication...
August 2016: International Journal of Pediatric Otorhinolaryngology
Deepanshu Jain, Nirav Thosani, Shashideep Singhal
Gastrointestinal bleeding can range from grossly visible blood in stool or vomitus to microscopic bleed. However, any kind of bleeding can lead to potential life-threatening consequences. A small proportion of patients with gastrointestinal bleeding remain refractory to initial endoscopic hemostasis. While some are successfully managed by repeat endoscopic intervention, a few fail to respond or are not amenable to endoscopic hemostasis. As of now, the next level of intervention is passed on to either surgeons or interventional radiologists...
July 2016: Therapeutic Advances in Gastroenterology
Sophie Geboers, Jef Stappaerts, Jan Tack, Pieter Annaert, Patrick Augustijns
Simvastatin (SV) is marketed as a lactone ester prodrug which is hydrolyzed to the active simvastatin hydroxyacid (SVA). SV is characterized by a low solubility and undergoes extensive first-pass metabolism. In this study, the influence of the upper gastrointestinal environment on the intraluminal behavior of simvastatin was investigated by a series of in vitro experiments. Dissolution, stability and two-stage dissolution tests were performed using simulated and human gastrointestinal fluids. The dissolution studies revealed a relatively slow dissolution of SV as well as conversion of SV to SVA...
August 20, 2016: International Journal of Pharmaceutics
Hisashi Gunji, Daisuke Horibe, Masaya Uesato, Masayuki Kano, Kouichi Hayano, Naoyuki Hanari, Hiroshi Kawahira, Hideki Hayashi, Hisashiro Matsubara
BACKGROUND/AIMS: Totally laparoscopic distal gastrectomy (TLDG) has become a feasible and safe surgical option for early gastric cancer. However, determining the transection line of the stomach without palpation is still difficult. This study aimed to assess the efficacy of TLDG for gastric resection under retroflexed endoscopic guidance (GRREG) in patients with gastric cancer in the middle third of the stomach. METHODS: Fifteen patients with gastric cancer underwent TLDG using GRREG...
2017: Digestive Surgery
Marianne Grønnebæk Rhode, Mads Partridge Vandborg, Vibeke Bladt, Leif Rognås
BACKGROUND: Pre-hospital endotracheal intubation is challenging and repeated endotracheal intubation is associated with increased morbidity and mortality. We investigated whether the introduction of the McGrath MAC video laryngoscope as the primary device for pre-hospital endotracheal intubation could improve first-pass success rate in our anaesthesiologist-staffed pre-hospital critical care services. We also investigated the incidence of failed pre-hospital endotracheal intubation, the use of airway adjuncts and back-up devices and problems encountered using the McGrath MAC video laryngoscope...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
V Y P Jacob, A Stallmach, J Felber
BACKGROUND: Changes in gastric and small bowel motility are a common clinical problem. Currently diagnostic options are limited because each method harbors certain disadvantages. It has been shown that the high-resolution three-dimensional magnetic detector system 3D-MAGMA is capable of reliably measuring gastric and small intestine motor activity. This system allows precise localization of a small magnetic marker and determination of its three-dimensional orientation inside a human body...
June 2016: Zeitschrift Für Gastroenterologie
P Kocián, M Bocková, J Schwarz
UNLABELLED: Bouveret syndrome is a gastric outlet obstruction caused by impaction of a gallstone that passes through a cholecystoduodenal or cholecystogastric fistula. It is a rare disease, most common in elderly women with multiple comorbidities and high surgical risk. The diagnosis can be made either radiologically or endoscopically. Endoscopic extraction is the preferred therapeutic option. Surgical intervention is indicated when endoscopic methods fail. We describe a case of Bouveret syndrome in a 79 years old woman...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Luis Franco-Avilés, Héctor Tonalli Arce-Guridi, Ulises Mercado
BACKGROUND: Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a gallstone which passes into the duodenal bulb through a cholecystoduodenal fistula. CLINICAL CASE: We reported the case of a 46-year-old woman who presented intermittent epigastric pain, nausea, vomiting, and weight loss of 2-months duration. The patient admitted alcohol and methamphetamine abuse. She had not fever, dehydration or jaundice. Amylase, electrolytes, enzymes, and creatinine level were within normal limits...
July 2016: Revista Médica del Instituto Mexicano del Seguro Social
Shunsuke Saima, Takashi Asai, Yasuhisa Okuda
An obese patient was scheduled for shoulder joint surgery under general anesthesia. After induction of anesthesia and tracheal intubation, insertion of a gastric tube was difficult. A new tracheal tube was prepared, the connecter was removed, and the tube was cut longitudinally. The tube was inserted orally into the esophagus. A gastric tube was passed through the nose, and its tip was taken out of the mouth. The tip of the gastric tube was passed through the tracheal tube, and its correct position in the stomach was confirmed by auscultation of the epigastrium...
April 2016: Masui. the Japanese Journal of Anesthesiology
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