BACKGROUND Ileum adenocarcinoma(IA),a type of small bowel adenocarcinoma,is a rather uncommon factor associated with obstruction in small bowel.Owing to its location and indefinite clinical symptoms,the diagnosis of I...BACKGROUND Ileum adenocarcinoma(IA),a type of small bowel adenocarcinoma,is a rather uncommon factor associated with obstruction in small bowel.Owing to its location and indefinite clinical symptoms,the diagnosis of IA is difficult,and survival is usually poor.With respect to the rarity of this disease,very few studies have reported such cases to provide a reference for treatment.CASE SUMMARY In this manuscript,a case of a 48-year-old man presented with chronic right lower abdominal pain and distention,queasiness and emesis.A computed tomography scan revealed intestinal wall thickening and an intestinal obstruction in the terminal ileum.He was diagnosed with inflammatory bowel disease.However,his symptoms were not relieved after conservative treatment.The patient sub-sequently underwent exploratory laparotomy,and a tumour in the ileum measuring approximately 2.0 cm×2.0 cm that was located 20 cm from the ileocolic valve was discovered incidentally and was operatively resected along with the enlarged lymph nodes.Pathological examination revealed a stage IIA(T3N0M0)ulcerative IA.Along with imaging examinations,a diagnosis of primary IA with no lymph or distant metastases was considered.The patient was discharged and recovered well as of the writing of this manuscript.CONCLUSION IA should be considered as a differential diagnosis in cases of intestinal obstruction,and the recommended method for local disease treatment is surgery.展开更多
BACKGROUND Appendiceal signet-ring cell carcinoma(SRCC)with terminal ileum metastasis is extremely rare.There have been no reported cases in domestic and foreign literature.CASE SUMMARY In this case report,we present ...BACKGROUND Appendiceal signet-ring cell carcinoma(SRCC)with terminal ileum metastasis is extremely rare.There have been no reported cases in domestic and foreign literature.CASE SUMMARY In this case report,we present an 88-year-old man with appendiceal SRCC with terminal ileum metastasis.The tumour stage was stage pT4bN2M1bG3 IVB,and the Tumour,Node,Metastasis staging system was used.The patient was admitted to our hospital on 12 July,2022 and underwent laparoscopic appendectomy under general anaesthesia after the examination.The pathological examination that took place 1 week after the operation showed that SRCC of the appendix invaded the whole layer,vessels and nerves of the appendix wall.It was suggested that the primary appendix should be considered after excluding metastasis.Based on the postoperative pathology findings,the patient underwent a secondary surgery on 2 August,2022.The second pathological examination showed residual SRCC in the appendiceal area of the ileocecal region,which infiltrated the serosal fibres and adipose tissue of the ileocecal region to the surface mesothelium.The tumour infiltrated the whole layer of the ileum wall,serosa fibres,adipose tissue and the surface mesothelium.Postoperative follow-up showed no signs of tumour recurrence or metastasis.CONCLUSION In clinical practice,a heightened awareness of rare diseases,coupled with thorough intraoperative exploration and rapid pathological examination,enables more accurate judgments,potentially sparing patients from unnecessary secondary surgery and ensuring optimal treatment.展开更多
Background Intrauterine growth retardation(IUGR)affects intestinal growth,morphology,and function,which leads to poor growth performance and high mortality.The present study explored whether maternal dietary methyl do...Background Intrauterine growth retardation(IUGR)affects intestinal growth,morphology,and function,which leads to poor growth performance and high mortality.The present study explored whether maternal dietary methyl donor(MET)supplementation alleviates IUGR and enhances offspring’s growth performance by improving intestinal growth,function,and DNA methylation of the ileum in a porcine IUGR model.Methods Forty multiparous sows were allocated to the control or MET diet groups from mating until delivery.After farrowing,8 pairs of IUGR and normal birth weight piglets from 8 litters were selected for sampling before suckling colostrum.Results The results showed that maternal MET supplementation tended to decrease the IUGR incidence and increased the average weaning weight of piglets.Moreover,maternal MET supplementation significantly reduced the plasma concentrations of isoleucine,cysteine,urea,and total amino acids in sows and newborn pig-lets.It also increased lactase and sucrase activity in the jejunum of newborn piglets.MET addition resulted in lower ileal methionine synthase activity and increased betaine homocysteine S-methyltransferase activity in the ileum of newborn piglets.DNA methylation analysis of the ileum showed that MET supplementation increased the methyla-tion level of DNA CpG sites in the ileum of newborn piglets.Down-regulated differentially methylated genes were enriched in folic acid binding,insulin receptor signaling pathway,and endothelial cell proliferation.In contrast,up-regulated methylated genes were enriched in growth hormone receptor signaling pathway and nitric oxide biosyn-thetic process.Conclusions Maternal MET supplementation can reduce the incidence of IUGR and increase the weaning litter weight of piglets,which may be associated with better intestinal function and methylation status.展开更多
Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbi...Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.展开更多
N-(3′,4′,5′-Trimethoxycinnamoyl)ortho-aminobenzoic acid(TOA),at the concentration of 80μg/ml,significantly inhibited the antigen-induced contraction of ileum isolated from the actively sensitized guinea-pig.At the...N-(3′,4′,5′-Trimethoxycinnamoyl)ortho-aminobenzoic acid(TOA),at the concentration of 80μg/ml,significantly inhibited the antigen-induced contraction of ileum isolated from the actively sensitized guinea-pig.At the concentrations of 25 and 50μg/ml, TOA inhibited homocytotropic antibody-mediated degranulation of mast cells in the rat mesentery,and also inhibited anaphylactic histamine release from rat peritoneal mast cells.展开更多
BACKGROUND The digestive tract is the maximal immunizing tissue in the body, and mucosal integrity and functional status of the gut is very important to maintain a healthy organism. Severe infection is one of the most...BACKGROUND The digestive tract is the maximal immunizing tissue in the body, and mucosal integrity and functional status of the gut is very important to maintain a healthy organism. Severe infection is one of the most common causes of gastrointestinal dysfunction, and the pathogenesis is closely related to endotoxemia and intestinal barrier injury. Bifidobacterium is one of the main probiotics in the human body that is involved in digestion, absorption, metabolism, nutrition, and immunity.Bifidobacterium plays an important role in maintaining the intestinal mucosal barrier integrity. This study investigated the protective mechanism of Bifidobacterium during ileal injury in rats.AIM To investigate the effects of Bifidobacterium on cytokine-induced neutrophil chemoattractant(CINC) and insulin-like growth factor 1(IGF-1) in the ileum of rats with endotoxin injury.METHODS Preweaning rats were randomly divided into three groups: Control(group C),model(group E) and treatment(group T). Group E was intraperitoneally injected with lipopolysaccharide(LPS) to create an animal model of intestinal injury.Group T was intragastrically administered Bifidobacterium suspension 7 d before LPS. Group C was intraperitoneally injected with normal saline. The rats were killed at 2, 6 or 12 h after LPS or physiological saline injection to collect ilealtissue samples. The expression of ileal CINC mRNA was evaluated by reverse transcription-polymerase chain reaction(RT-PCR), and expression of ileal IGF-1 protein and mRNA was detected by immunohistochemistry and RT-PCR,respectively.RESULTS The ileum of rats in Group C did not express CINC mRNA, ileums from Group E expressed high levels, which was then significantly decreased in Group T(F =23.947, P < 0.05). There was no significant difference in CINC mRNA expression at different times(F = 0.665, P > 0.05). There was a high level of IGF-1 brown granules in ileal crypts and epithelial cells in Group C, sparse staining in Group E, and dark, dense brown staining in Group T. There was a significant difference between Groups C and E and Groups E and T(P < 0.05). There was no significant difference in IGF-1 protein expression at different times(F = 1.269, P > 0.05). IGF-1 mRNA expression was significantly different among the three groups(P < 0.05),though not at different times(F = 0.086, P > 0.05).CONCLUSION Expression of CINC mRNA increased in the ileum of preweaning rats with endotoxin injury, and exogenous administration of Bifidobacterium reduced CINC m RNA expression. IGF-1 protein and mRNA expression decreased in the ileum of preweaning rats with endotoxin injury, and exogenous administration of Bifidobacterium prevented the decrease in IGF-1 expression. Bifidobacterium may increase IGF-1 expression and enhance intestinal immune barrier function in rats with endotoxin injury.展开更多
AIM： To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyp...AIM： To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyperdynamic peritonitis.METHODS： Spontaneous contractions of isolated ileum muscle segments from sham operated rats and those exposed to peritonitis, were studied in vitro. The amplitude and the frequency of spontaneous contractions of ileum muscle segments were studied after adding dexmetetomidine, propofoi, and midazolam to the organ bath in a cumulative manner.RESULTS： Both amplitude （85.2 ± 6.6 vs 47.4 ± 7.1） and frequency （32.8 ± 4.6 vs 20.2 ± 3.9） of spontaneous contractions in ileum smooth muscle segments were decreased significantly in the peritonitis group compared to the control group （P 〈 0.05）. Dexmedetomidine significantly increased the amplitude of spontaneous contractions （85.2 ± 6.6 vs 152.0 ± 5.4, P 〈 0.05） whereas, propofol （85.2 ± 6.6 vs 49.6 ± 4.8, P 〈 0.05） and midazolam （85.2 ± 6.6 vs 39.2 ± 4.5, P 〈 0.05） decreased it in both control and peritonitis groups. The frequency of spontaneous contractions were significantly decreased by propofol in both control （32.8 ± 4.6 vs 18.2 ± 3.4, P 〈 0.05） and peritonitis groups 20.2 ± 3.9 vs 11.6 ± 3.2, P 〈 0.05）. Dexmedetomidine and midazolam did not cause significant changes in the number of spontaneous contractions in both control and the peritonitis groups （P 〉 0.05）.CONCLUSION： Propofol, midazolam and dexmede- tomidine have various in vitro effects on spontaneous contractions of the rat ileum. While dexmedetomidine augments the spontaneous contraction of the rat ileum, propofol attenuates it. However, the effects of these compounds were parallel in both control and peritonitis groups.展开更多
BACKGROUND The activity staging of Crohn’s disease(CD)in the terminal ileum is critical in developing an accurate clinical treatment plan.The activity of terminal ileum CD is associated with the microcirculation of i...BACKGROUND The activity staging of Crohn’s disease(CD)in the terminal ileum is critical in developing an accurate clinical treatment plan.The activity of terminal ileum CD is associated with the microcirculation of involved bowel walls.Dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusionweighted imaging(DWI)can reflect perfusion and permeability of bowel walls by providing microcirculation information.As such,we hypothesize that DCE-MRI and DWI parameters can assess terminal ileum CD,thereby providing an opportunity to stage CD activity.AIM To evaluate the value of DCE-MRI and DWI in assessing activity of terminal ileum CD.METHODS Forty-eight patients with CD who underwent DCE-MRI and DWI were enrolled.The patients’activity was graded as remission,mild and moderate-severe.The transfer constant(Ktrans),wash-out constant(Kep),and extravascular extracellular volume fraction(Ve)were calculated from DCE-MRI and the apparent diffusion coefficient(ADC)was obtained from DWI.Magnetic Resonance Index of Activity(MaRIA)was calculated from magnetic resonance enterography.Differences in these quantitative parameters were compared between normal ileal loop(NIL)and inflamed terminal ileum(ITI)and among different activity grades.The correlations between these parameters,MaRIA,the Crohn’s Disease Activity Index(CDAI),and Crohn’s Disease Endoscopic Index of Severity(CDEIS)were examined.Receiver operating characteristic curve analyses were used to determine the diagnostic performance of these parameters in differentiating between CD activity levels.RESULTS Higher Ktrans(0.07±0.04 vs 0.01±0.01),Kep(0.24±0.11 vs 0.15±0.05)and Ve(0.27±0.07 vs 0.08±0.03),but lower ADC(1.41±0.26 vs 2.41±0.30)values were found in ITI than in NIL(all P<0.001).The Ktrans,Kep,Ve and MaRIA increased with disease activity,whereas the ADC decreased(all P<0.001).The Ktrans,Kep,Ve and MaRIA showed positive correlations with the CDAI(r=0.866 for Ktrans,0.870 for Kep,0.858 for Ve,0.890 for MaRIA,all P<0.001)and CDEIS(r=0.563 for Ktrans,0.567 for Kep,0.571 for Ve,0.842 for MaRIA,all P<0.001),while the ADC showed negative correlations with the CDAI(r=-0.857,P<0.001)and CDEIS(r=-0.536,P<0.001).The areas under the curve(AUC)for the Ktrans,Kep,Ve,ADC and MaRIA values ranged from 0.68 to 0.91 for differentiating inactive CD(CD remission)from active CD(mild to severe CD).The AUC when combining the Ktrans,Kep and Ve was 0.80,while combining DCE-MRI parameters and ADC values yielded the highest AUC of 0.95.CONCLUSION DCE-MRI and DWI parameters all serve as measures to stage CD activity.When they are combined,the assessment performance is improved and better than MaRIA.展开更多
Crohn’s disease(CD)is an inflammatory bowel disease characterized by immunemediated flares affecting any region of the intestine alternating with remission periods.In CD,the ileum is frequently affected and about one...Crohn’s disease(CD)is an inflammatory bowel disease characterized by immunemediated flares affecting any region of the intestine alternating with remission periods.In CD,the ileum is frequently affected and about one third of patients presents with a pure ileal type.Moreover,the ileal type of CD presents epidemiological specificities like a younger age at onset and often a strong link with smoking and genetic susceptibility genes.Most of these genes are associated with Paneth cell dysfunction,a cell type found in the intestinal crypts of the ileum.Besides,a Western-type diet is associated in epidemiological studies with CD onset and increasing evidence shows that diet can modulate the composition of bile acids and gut microbiota,which in turn modulates the susceptibility of the ileum to inflammation.Thus,the interplay between environmental factors and the histological and anatomical features of the ileum is thought to explain the specific transcriptome profile observed in CD ileitis.Indeed,both immune response and cellular healing processes harbour differences between ileal and non-ileal CD.Taken together,these findings advocate for a dedicated therapeutic approach to managing ileal CD.Currently,interventional pharmacological studies have failed to clearly demonstrate distinct response profiles according to disease site.However,the high rate of stricturing disease in ileal CD requires the identification of new therapeutic targets to significantly change the natural history of this debilitating disease.展开更多
AIM: To evaluate the effect of thienorphine on small intestinal transit in vivo and on guinea-pig ileum (GPI) contraction in vitro . METHODS: The effects of thienorphine on intestinal transit were examined in mice and...AIM: To evaluate the effect of thienorphine on small intestinal transit in vivo and on guinea-pig ileum (GPI) contraction in vitro . METHODS: The effects of thienorphine on intestinal transit were examined in mice and in isolated GPI. Buprenorphine and morphine served as controls. The distance traveled by the head of the charchol and the total length of the intestine were measured in vivo . Gastrointestinal transit was expressed as a percentage of the distance traveled by the head of the marker relative to the total length of the small intestine. The isolated GPI preparations were connected to an isotonic force transducer and equilibrated for at least 1 h before exposure to drugs. Acetylcholine was used for muscle stimulation. RESULTS: Thienorphine (0.005-1.0 mg/kg, ig ) or bu-prenorphine (0.005-1.0 mg/kg, sc ) dose-dependently significantly inhibited gut transit compared with saline. Thienorphine inhibited gut transit less than buprenorphine. The maximum inhibition by thienorphine on the intestinal transit was 50%-60%, whereas the maximum inhibition by morphine on gut transit was about 100%. Thienorphine also exhibited less inhibition on acetylcholine-induced contraction of GPI, with a maximum inhibition of 65%, compared with 93% inhibition by buprenorphine and 100% inhibition by morphine. Thienorphine induced a concentration-dependent decrease in the basal tonus of spontaneous movement of the GPI, the effect of which was weaker than that with buprenorphine. The duration of the effect of thienorphine on the GPI was longer than that with buprenorphine. CONCLUSION: Thienorphine had less influence, but a longer duration of action on GPI contraction and moderately inhibited intestinal transit.展开更多
Objective:To investigate Petroselinum crispum Latifolum(parsley) for treating stomach and intestinal disorders in Iran.Methods:An 80%ethanol extract was prepared from parsley seeds, and its antispasmodic activity asse...Objective:To investigate Petroselinum crispum Latifolum(parsley) for treating stomach and intestinal disorders in Iran.Methods:An 80%ethanol extract was prepared from parsley seeds, and its antispasmodic activity assessed by measuring contractions of isolated ilea induced by 60 mM potassium chloride(KG).A piece of ileum from an adult male Wistar rat was dissected and mounted in an organ bath containing Tyrode’s solution,and ileum contractions were recorded by an isotonic transducer under one gram resting tension.The effect of parsley extract was measured in the presence of two antagonists’ of a - and(5-adrenoceptors.Results:These experiments showed that parsley extract inhibited the response to 60 mM KC1 in a concentration-dependent manner(P【0.01,n=7).The spasmolytic effect of parsley extract was unaffected by 1μM phentolamine or 1μM propranolol.Conclusions:This study shows that parsley seed extract is a relaxant of isolated rat ileum and the relaxation effect of extract does not involved adrenergic receptors.展开更多
Type Ⅳ paraesophageal hernia(PEH) is very rare, and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a 78-year-old woman who presented at ou...Type Ⅳ paraesophageal hernia(PEH) is very rare, and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a 78-year-old woman who presented at our emergency department because of epigastric pain that she had experienced over the past 24 h. On the day after admission, her pain became severe and was accompanied by right chest pain and dyspnea. Chest radiography revealed an intrathoracic intestinal gas bubble occupying the right lower lung field. Emergency explorative laparotomy identified a type Ⅳ PEH with herniation of only the terminal ileum through a hiatal defect into the right thoracic cavity. In this report, we also present a review of similar cases in the literature published between 1980 and 2015 in Pub Med. There were four published cases of small bowel herniation into the thoracic cavity during this period. Our patient represents a rare case of an individual diagnosed with type Ⅳ PEH with incarceration of only the terminal ileum.展开更多
AIM： To investigate their expression and activity in the rat ileum after exposure to ionizing radiation along with that of the cellular effectors and molecular mediators involved in the regulation of MMPs. METHODS： ...AIM： To investigate their expression and activity in the rat ileum after exposure to ionizing radiation along with that of the cellular effectors and molecular mediators involved in the regulation of MMPs. METHODS： Rats were exposed to a single 10-Gy dose of X-rays delivered to the abdomen. A combination of methods, such as zymography, immunohistochemistry and real time reverse transcriptase-polymerase chain reaction, were used to localize and quantify MMPs and the molecules involved in MMP activating and inhibitory pathways （plasmin/ plasminogen, TIMPs）, CD^8＋, as well as inflammatory （interleukin （IL）-1β, IL-8, tumor necrosis factor-s, TNF-α） and fibrogenic mediators （transforming growth factor- β1-3） within ileal tissue at 1, 3, and 7 d after irradiation. RESULTS： A marked increase in MMP-2 and -14 mRNA and protein levels associated with an increased activity of MMP-2 was observed in irradiated ileal tissue. MMP-2 and -14 expression was mainly observed in inflammatory, epithelial, and mesenchymal cells, whereas a slight increase in MMP-3 expression was detected in the few infiltrating macrophages at d i after irradiation. Conversely, MMP-1, -7, and -9 mRNA levels were not found to be affected by abdominal irradiation. Irradiation was found to induce disappearance of CD^8＋ cells. Furthermore, we have observed that TNF-α and IL-1β protein levels increased 6 h after irradiation, whereas those of IL-8 only increased after 3 d and was concomitant with neutrophil infiltration. In addition, the expressions of molecules involved in MMP activating and inhibitory pathways （urokinase-type plasminogen activator andtissue-type plasminogen activator; TIMP-1, TIMP-2, and plasminogen activator-inhibitor-i） were found to be increased after abdominal irradiation. CONCLUSION： This study showed that abdominal irradiation induces an acute remodeling of the ileum associated with an increased expression of MMPs and TIMPs that do not involve CD^8＋ T cells but involve mesenchymal and epithelial cells, although to a lesser extent, and probably even soluble inflammatory and fibrogenic mediators.展开更多
We presented a 20-year-old patient with Crohn's disease (CD).Colonoscopy revealed longitudinal ulceration in the terminal ileum and rectal aphtoid ulcers.After treatment with mesalamine and total parenteral nutrit...We presented a 20-year-old patient with Crohn's disease (CD).Colonoscopy revealed longitudinal ulceration in the terminal ileum and rectal aphtoid ulcers.After treatment with mesalamine and total parenteral nutrition,repeat colonoscopy revealed a granular elevated area in the terminal ileum,which appeared as an irregular dome-like elevation with irregularly arranged villi on magnifying endoscopy.Biopsy specimens taken from the region showed microgranulomas and lymphoid hyperplasia,Scanning electron microscopy revealed the presence of M cells,confirming that the area corresponded to Peyer's patches.Peyer's patches by magnifying endoscopy and electron microscopy may provide insights into the pathogenesis of CD.展开更多
BACKGROUND The P2X7 receptor is expressed by enteric neurons and enteric glial cells.Studies have demonstrated that administration of a P2X7 receptor antagonist,brilliant blue G(BBG),prevents neuronal loss.AIM To repo...BACKGROUND The P2X7 receptor is expressed by enteric neurons and enteric glial cells.Studies have demonstrated that administration of a P2X7 receptor antagonist,brilliant blue G(BBG),prevents neuronal loss.AIM To report the effects of BBG in ileum enteric neurons immunoreactive(ir)following experimental ulcerative colitis in Rattus norvegicus albinus.METHODS 2,4,6-trinitrobenzene sulfonic acid(TNBS group,n=5)was injected into the distal colon.BBG(50 mg/kg,BBG group,n=5)or vehicle(sham group,n=5)was given subcutaneously 1 h after TNBS.The animals were euthanized after 24 h,and the ileum was removed.Immunohistochemistry was performed on the myenteric plexus to evaluate immunoreactivity for P2X7 receptor,neuronal nitric oxide synthase(nNOS),choline acetyltransferase(ChAT),HuC/D and glial fibrillary acidic protein.RESULTS The numbers of nNOS-,ChAT-,HuC/D-ir neurons and glial fibrillary acidic protein-ir glial cells were decreased in the TNBS group and recovered in the BBG group.The neuronal profile area(μm^2)demonstrated that nNOS-ir neurons decreased in the TNBS group and recovered in the BBG group.There were no differences in the profile areas of ChAT-and HuC/D-ir neurons.CONCLUSION Our data conclude that ileum myenteric neurons and glial cells were affected by ulcerative colitis and that treatment with BBG had a neuroprotective effect.Thus,these results demonstrate that the P2X7 receptor may be an important target in therapeutic strategies.展开更多
BACKGROUND Small intestinal cavernous hemangioma is a rare disease,especially in the ileum.It is difficult to accurately diagnose due to its hidden location and nonspecific clinical symptoms.Here,we reported a case of...BACKGROUND Small intestinal cavernous hemangioma is a rare disease,especially in the ileum.It is difficult to accurately diagnose due to its hidden location and nonspecific clinical symptoms.Here,we reported a case of ileal cavernous hemangioma with chronic hemorrhage in a 20-year-old man and review the literature to gain a better understanding of this disease.CASE SUMMARY The patient complained of intermittent melena and hematochezia for > 3 mo.The lowest hemoglobin level revealed by laboratory testing was 3.4 g/d L(normal range:12-16 g/dL).However,the gastroscopy,colonoscopy and peroral doubleballoon enteroscopy(DBE) showed no signs of bleeding.The transanal DBE detected a lesion at about 340 cm proximal to the ileocecal valve.Thus,we performed an exploratory laparoscopy and the lesion was resected.After the operation,the patient had no melena.Finally,the pathological examination identified the neoplasm as an ileal cavernous hemangioma,thereby resulting in gastrointestinal hemorrhage.CONCLUSION This report might improve the diagnosis and treatment of ileal cavernous hemangioma.展开更多
Accidentally ingested foreign bodies, for the most part, pass through the gastrointestinal tract, but can cause several complications. Perforation is rare, but can occur in any segment of the gastrointestinal tract. I...Accidentally ingested foreign bodies, for the most part, pass through the gastrointestinal tract, but can cause several complications. Perforation is rare, but can occur in any segment of the gastrointestinal tract. Intestinal perforations due to foreign bodies are rarely diagnosed preoperatively as clinical symptoms are non-specific and they can mimic other abdominal conditions. We describe a case of a 48-year-old patient who was admitted to the emergency room because of severe abdominal pain of 5 d duration. A computed tomography scan showed an undefined liquid collection involving a linear image 35 mm in size, suggestive of a foreign body. On laparotomy, an abscess containing a fish bone was resected. As fish bone ingestion is usually not remembered by the patient, the diagnosis can be delayed. The preoperative diagnosis is frequently acute abdomen of unknown cause. A low threshold of suspicion along with a good clinical history and radiologicalstudies are extremely important in order to make a correct diagnosis.展开更多
The occurrence of adult intussusception from small intestinal lymphoma is quite rare.We present an82-year-old man with a two-month history of intermittent abdominal pain,nausea and fatigue.Clinical symptoms included m...The occurrence of adult intussusception from small intestinal lymphoma is quite rare.We present an82-year-old man with a two-month history of intermittent abdominal pain,nausea and fatigue.Clinical symptoms included moderate abdominal tenderness in the right lower abdomen.Computed tomography scan of the abdomen revealed a mass in the terminal ileum with the sign of"bowel within bowel"which was suspicious of ileo-ileum intussusception.The patient underwent laparoscopic segmental ileal resection.Pathologic evaluation revealed a diffuse large B cell non-Hodgkin’s lymphoma of the ileum.The postoperative course was uneventful.展开更多
Intussusception is a rare condition in the adult population.However,in contrast to its presentation in children,an identifiable etiology is found in the majority of cases.Clinical manifestations of adult intussuscepti...Intussusception is a rare condition in the adult population.However,in contrast to its presentation in children,an identifiable etiology is found in the majority of cases.Clinical manifestations of adult intussusception are non-specific and patients may present with acute,intermittent or chronic symptoms,predominantly those of intestinal obstruction.A 27-year-old male patient with recurrent abdominal pain secondary to intussusception is herein reported.The clinical presentation and ultrasonographic findings led to the diagnosis.At laparotomy,an ileal hamartoma was found as the lead point of the intussusception.Surgical management and histopathologic studies are described.A recurrent intestinal obstruction and classic ultrasound findings may lead to the diagnosis of intussusception but surgical exploration remains essential.The principle of resection without reduction is well established.展开更多
文摘BACKGROUND Ileum adenocarcinoma(IA),a type of small bowel adenocarcinoma,is a rather uncommon factor associated with obstruction in small bowel.Owing to its location and indefinite clinical symptoms,the diagnosis of IA is difficult,and survival is usually poor.With respect to the rarity of this disease,very few studies have reported such cases to provide a reference for treatment.CASE SUMMARY In this manuscript,a case of a 48-year-old man presented with chronic right lower abdominal pain and distention,queasiness and emesis.A computed tomography scan revealed intestinal wall thickening and an intestinal obstruction in the terminal ileum.He was diagnosed with inflammatory bowel disease.However,his symptoms were not relieved after conservative treatment.The patient sub-sequently underwent exploratory laparotomy,and a tumour in the ileum measuring approximately 2.0 cm×2.0 cm that was located 20 cm from the ileocolic valve was discovered incidentally and was operatively resected along with the enlarged lymph nodes.Pathological examination revealed a stage IIA(T3N0M0)ulcerative IA.Along with imaging examinations,a diagnosis of primary IA with no lymph or distant metastases was considered.The patient was discharged and recovered well as of the writing of this manuscript.CONCLUSION IA should be considered as a differential diagnosis in cases of intestinal obstruction,and the recommended method for local disease treatment is surgery.
文摘BACKGROUND Appendiceal signet-ring cell carcinoma(SRCC)with terminal ileum metastasis is extremely rare.There have been no reported cases in domestic and foreign literature.CASE SUMMARY In this case report,we present an 88-year-old man with appendiceal SRCC with terminal ileum metastasis.The tumour stage was stage pT4bN2M1bG3 IVB,and the Tumour,Node,Metastasis staging system was used.The patient was admitted to our hospital on 12 July,2022 and underwent laparoscopic appendectomy under general anaesthesia after the examination.The pathological examination that took place 1 week after the operation showed that SRCC of the appendix invaded the whole layer,vessels and nerves of the appendix wall.It was suggested that the primary appendix should be considered after excluding metastasis.Based on the postoperative pathology findings,the patient underwent a secondary surgery on 2 August,2022.The second pathological examination showed residual SRCC in the appendiceal area of the ileocecal region,which infiltrated the serosal fibres and adipose tissue of the ileocecal region to the surface mesothelium.The tumour infiltrated the whole layer of the ileum wall,serosa fibres,adipose tissue and the surface mesothelium.Postoperative follow-up showed no signs of tumour recurrence or metastasis.CONCLUSION In clinical practice,a heightened awareness of rare diseases,coupled with thorough intraoperative exploration and rapid pathological examination,enables more accurate judgments,potentially sparing patients from unnecessary secondary surgery and ensuring optimal treatment.
基金This work was supported by Sichuan Provincial Science Fund for Distinguished Young Scholars(Grant No.2020JDJQ0041)CARS-35 and Sichuan Key Science and Technology Project(NO.2021ZDZX0009).
文摘Background Intrauterine growth retardation(IUGR)affects intestinal growth,morphology,and function,which leads to poor growth performance and high mortality.The present study explored whether maternal dietary methyl donor(MET)supplementation alleviates IUGR and enhances offspring’s growth performance by improving intestinal growth,function,and DNA methylation of the ileum in a porcine IUGR model.Methods Forty multiparous sows were allocated to the control or MET diet groups from mating until delivery.After farrowing,8 pairs of IUGR and normal birth weight piglets from 8 litters were selected for sampling before suckling colostrum.Results The results showed that maternal MET supplementation tended to decrease the IUGR incidence and increased the average weaning weight of piglets.Moreover,maternal MET supplementation significantly reduced the plasma concentrations of isoleucine,cysteine,urea,and total amino acids in sows and newborn pig-lets.It also increased lactase and sucrase activity in the jejunum of newborn piglets.MET addition resulted in lower ileal methionine synthase activity and increased betaine homocysteine S-methyltransferase activity in the ileum of newborn piglets.DNA methylation analysis of the ileum showed that MET supplementation increased the methyla-tion level of DNA CpG sites in the ileum of newborn piglets.Down-regulated differentially methylated genes were enriched in folic acid binding,insulin receptor signaling pathway,and endothelial cell proliferation.In contrast,up-regulated methylated genes were enriched in growth hormone receptor signaling pathway and nitric oxide biosyn-thetic process.Conclusions Maternal MET supplementation can reduce the incidence of IUGR and increase the weaning litter weight of piglets,which may be associated with better intestinal function and methylation status.
文摘Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.
文摘N-(3′,4′,5′-Trimethoxycinnamoyl)ortho-aminobenzoic acid(TOA),at the concentration of 80μg/ml,significantly inhibited the antigen-induced contraction of ileum isolated from the actively sensitized guinea-pig.At the concentrations of 25 and 50μg/ml, TOA inhibited homocytotropic antibody-mediated degranulation of mast cells in the rat mesentery,and also inhibited anaphylactic histamine release from rat peritoneal mast cells.
基金Supported by the Education Department of Heilongjiang Province,China,No.11521124
文摘BACKGROUND The digestive tract is the maximal immunizing tissue in the body, and mucosal integrity and functional status of the gut is very important to maintain a healthy organism. Severe infection is one of the most common causes of gastrointestinal dysfunction, and the pathogenesis is closely related to endotoxemia and intestinal barrier injury. Bifidobacterium is one of the main probiotics in the human body that is involved in digestion, absorption, metabolism, nutrition, and immunity.Bifidobacterium plays an important role in maintaining the intestinal mucosal barrier integrity. This study investigated the protective mechanism of Bifidobacterium during ileal injury in rats.AIM To investigate the effects of Bifidobacterium on cytokine-induced neutrophil chemoattractant(CINC) and insulin-like growth factor 1(IGF-1) in the ileum of rats with endotoxin injury.METHODS Preweaning rats were randomly divided into three groups: Control(group C),model(group E) and treatment(group T). Group E was intraperitoneally injected with lipopolysaccharide(LPS) to create an animal model of intestinal injury.Group T was intragastrically administered Bifidobacterium suspension 7 d before LPS. Group C was intraperitoneally injected with normal saline. The rats were killed at 2, 6 or 12 h after LPS or physiological saline injection to collect ilealtissue samples. The expression of ileal CINC mRNA was evaluated by reverse transcription-polymerase chain reaction(RT-PCR), and expression of ileal IGF-1 protein and mRNA was detected by immunohistochemistry and RT-PCR,respectively.RESULTS The ileum of rats in Group C did not express CINC mRNA, ileums from Group E expressed high levels, which was then significantly decreased in Group T(F =23.947, P < 0.05). There was no significant difference in CINC mRNA expression at different times(F = 0.665, P > 0.05). There was a high level of IGF-1 brown granules in ileal crypts and epithelial cells in Group C, sparse staining in Group E, and dark, dense brown staining in Group T. There was a significant difference between Groups C and E and Groups E and T(P < 0.05). There was no significant difference in IGF-1 protein expression at different times(F = 1.269, P > 0.05). IGF-1 mRNA expression was significantly different among the three groups(P < 0.05),though not at different times(F = 0.086, P > 0.05).CONCLUSION Expression of CINC mRNA increased in the ileum of preweaning rats with endotoxin injury, and exogenous administration of Bifidobacterium reduced CINC m RNA expression. IGF-1 protein and mRNA expression decreased in the ileum of preweaning rats with endotoxin injury, and exogenous administration of Bifidobacterium prevented the decrease in IGF-1 expression. Bifidobacterium may increase IGF-1 expression and enhance intestinal immune barrier function in rats with endotoxin injury.
文摘AIM： To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyperdynamic peritonitis.METHODS： Spontaneous contractions of isolated ileum muscle segments from sham operated rats and those exposed to peritonitis, were studied in vitro. The amplitude and the frequency of spontaneous contractions of ileum muscle segments were studied after adding dexmetetomidine, propofoi, and midazolam to the organ bath in a cumulative manner.RESULTS： Both amplitude （85.2 ± 6.6 vs 47.4 ± 7.1） and frequency （32.8 ± 4.6 vs 20.2 ± 3.9） of spontaneous contractions in ileum smooth muscle segments were decreased significantly in the peritonitis group compared to the control group （P 〈 0.05）. Dexmedetomidine significantly increased the amplitude of spontaneous contractions （85.2 ± 6.6 vs 152.0 ± 5.4, P 〈 0.05） whereas, propofol （85.2 ± 6.6 vs 49.6 ± 4.8, P 〈 0.05） and midazolam （85.2 ± 6.6 vs 39.2 ± 4.5, P 〈 0.05） decreased it in both control and peritonitis groups. The frequency of spontaneous contractions were significantly decreased by propofol in both control （32.8 ± 4.6 vs 18.2 ± 3.4, P 〈 0.05） and peritonitis groups 20.2 ± 3.9 vs 11.6 ± 3.2, P 〈 0.05）. Dexmedetomidine and midazolam did not cause significant changes in the number of spontaneous contractions in both control and the peritonitis groups （P 〉 0.05）.CONCLUSION： Propofol, midazolam and dexmede- tomidine have various in vitro effects on spontaneous contractions of the rat ileum. While dexmedetomidine augments the spontaneous contraction of the rat ileum, propofol attenuates it. However, the effects of these compounds were parallel in both control and peritonitis groups.
基金Medical Innovation Program of Fujian Province,No.2018-CX-30Startup Fund for Scientific Research of Fujian Medical University,No.2018QH1054.
文摘BACKGROUND The activity staging of Crohn’s disease(CD)in the terminal ileum is critical in developing an accurate clinical treatment plan.The activity of terminal ileum CD is associated with the microcirculation of involved bowel walls.Dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusionweighted imaging(DWI)can reflect perfusion and permeability of bowel walls by providing microcirculation information.As such,we hypothesize that DCE-MRI and DWI parameters can assess terminal ileum CD,thereby providing an opportunity to stage CD activity.AIM To evaluate the value of DCE-MRI and DWI in assessing activity of terminal ileum CD.METHODS Forty-eight patients with CD who underwent DCE-MRI and DWI were enrolled.The patients’activity was graded as remission,mild and moderate-severe.The transfer constant(Ktrans),wash-out constant(Kep),and extravascular extracellular volume fraction(Ve)were calculated from DCE-MRI and the apparent diffusion coefficient(ADC)was obtained from DWI.Magnetic Resonance Index of Activity(MaRIA)was calculated from magnetic resonance enterography.Differences in these quantitative parameters were compared between normal ileal loop(NIL)and inflamed terminal ileum(ITI)and among different activity grades.The correlations between these parameters,MaRIA,the Crohn’s Disease Activity Index(CDAI),and Crohn’s Disease Endoscopic Index of Severity(CDEIS)were examined.Receiver operating characteristic curve analyses were used to determine the diagnostic performance of these parameters in differentiating between CD activity levels.RESULTS Higher Ktrans(0.07±0.04 vs 0.01±0.01),Kep(0.24±0.11 vs 0.15±0.05)and Ve(0.27±0.07 vs 0.08±0.03),but lower ADC(1.41±0.26 vs 2.41±0.30)values were found in ITI than in NIL(all P<0.001).The Ktrans,Kep,Ve and MaRIA increased with disease activity,whereas the ADC decreased(all P<0.001).The Ktrans,Kep,Ve and MaRIA showed positive correlations with the CDAI(r=0.866 for Ktrans,0.870 for Kep,0.858 for Ve,0.890 for MaRIA,all P<0.001)and CDEIS(r=0.563 for Ktrans,0.567 for Kep,0.571 for Ve,0.842 for MaRIA,all P<0.001),while the ADC showed negative correlations with the CDAI(r=-0.857,P<0.001)and CDEIS(r=-0.536,P<0.001).The areas under the curve(AUC)for the Ktrans,Kep,Ve,ADC and MaRIA values ranged from 0.68 to 0.91 for differentiating inactive CD(CD remission)from active CD(mild to severe CD).The AUC when combining the Ktrans,Kep and Ve was 0.80,while combining DCE-MRI parameters and ADC values yielded the highest AUC of 0.95.CONCLUSION DCE-MRI and DWI parameters all serve as measures to stage CD activity.When they are combined,the assessment performance is improved and better than MaRIA.
文摘Crohn’s disease(CD)is an inflammatory bowel disease characterized by immunemediated flares affecting any region of the intestine alternating with remission periods.In CD,the ileum is frequently affected and about one third of patients presents with a pure ileal type.Moreover,the ileal type of CD presents epidemiological specificities like a younger age at onset and often a strong link with smoking and genetic susceptibility genes.Most of these genes are associated with Paneth cell dysfunction,a cell type found in the intestinal crypts of the ileum.Besides,a Western-type diet is associated in epidemiological studies with CD onset and increasing evidence shows that diet can modulate the composition of bile acids and gut microbiota,which in turn modulates the susceptibility of the ileum to inflammation.Thus,the interplay between environmental factors and the histological and anatomical features of the ileum is thought to explain the specific transcriptome profile observed in CD ileitis.Indeed,both immune response and cellular healing processes harbour differences between ileal and non-ileal CD.Taken together,these findings advocate for a dedicated therapeutic approach to managing ileal CD.Currently,interventional pharmacological studies have failed to clearly demonstrate distinct response profiles according to disease site.However,the high rate of stricturing disease in ileal CD requires the identification of new therapeutic targets to significantly change the natural history of this debilitating disease.
基金Supported by National New Drugs Foundation of China, No.2011ZX09101-005-01"Integrated Drug Discovery Technology Plat form" of National Science and Technology Major Projects for "Major New Drugs Innovation and Development", No.2012ZX09301003-001
文摘AIM: To evaluate the effect of thienorphine on small intestinal transit in vivo and on guinea-pig ileum (GPI) contraction in vitro . METHODS: The effects of thienorphine on intestinal transit were examined in mice and in isolated GPI. Buprenorphine and morphine served as controls. The distance traveled by the head of the charchol and the total length of the intestine were measured in vivo . Gastrointestinal transit was expressed as a percentage of the distance traveled by the head of the marker relative to the total length of the small intestine. The isolated GPI preparations were connected to an isotonic force transducer and equilibrated for at least 1 h before exposure to drugs. Acetylcholine was used for muscle stimulation. RESULTS: Thienorphine (0.005-1.0 mg/kg, ig ) or bu-prenorphine (0.005-1.0 mg/kg, sc ) dose-dependently significantly inhibited gut transit compared with saline. Thienorphine inhibited gut transit less than buprenorphine. The maximum inhibition by thienorphine on the intestinal transit was 50%-60%, whereas the maximum inhibition by morphine on gut transit was about 100%. Thienorphine also exhibited less inhibition on acetylcholine-induced contraction of GPI, with a maximum inhibition of 65%, compared with 93% inhibition by buprenorphine and 100% inhibition by morphine. Thienorphine induced a concentration-dependent decrease in the basal tonus of spontaneous movement of the GPI, the effect of which was weaker than that with buprenorphine. The duration of the effect of thienorphine on the GPI was longer than that with buprenorphine. CONCLUSION: Thienorphine had less influence, but a longer duration of action on GPI contraction and moderately inhibited intestinal transit.
基金supported by the Department of Biology,Shahid Chamran University,Ahwaz,Iran
文摘Objective:To investigate Petroselinum crispum Latifolum(parsley) for treating stomach and intestinal disorders in Iran.Methods:An 80%ethanol extract was prepared from parsley seeds, and its antispasmodic activity assessed by measuring contractions of isolated ilea induced by 60 mM potassium chloride(KG).A piece of ileum from an adult male Wistar rat was dissected and mounted in an organ bath containing Tyrode’s solution,and ileum contractions were recorded by an isotonic transducer under one gram resting tension.The effect of parsley extract was measured in the presence of two antagonists’ of a - and(5-adrenoceptors.Results:These experiments showed that parsley extract inhibited the response to 60 mM KC1 in a concentration-dependent manner(P【0.01,n=7).The spasmolytic effect of parsley extract was unaffected by 1μM phentolamine or 1μM propranolol.Conclusions:This study shows that parsley seed extract is a relaxant of isolated rat ileum and the relaxation effect of extract does not involved adrenergic receptors.
基金Supported by Taoyuan Armed Forces General Hospital
文摘Type Ⅳ paraesophageal hernia(PEH) is very rare, and is characterized by the intrathoracic herniation of the abdominal viscera other than the stomach into the chest. We describe a 78-year-old woman who presented at our emergency department because of epigastric pain that she had experienced over the past 24 h. On the day after admission, her pain became severe and was accompanied by right chest pain and dyspnea. Chest radiography revealed an intrathoracic intestinal gas bubble occupying the right lower lung field. Emergency explorative laparotomy identified a type Ⅳ PEH with herniation of only the terminal ileum through a hiatal defect into the right thoracic cavity. In this report, we also present a review of similar cases in the literature published between 1980 and 2015 in Pub Med. There were four published cases of small bowel herniation into the thoracic cavity during this period. Our patient represents a rare case of an individual diagnosed with type Ⅳ PEH with incarceration of only the terminal ileum.
文摘AIM： To investigate their expression and activity in the rat ileum after exposure to ionizing radiation along with that of the cellular effectors and molecular mediators involved in the regulation of MMPs. METHODS： Rats were exposed to a single 10-Gy dose of X-rays delivered to the abdomen. A combination of methods, such as zymography, immunohistochemistry and real time reverse transcriptase-polymerase chain reaction, were used to localize and quantify MMPs and the molecules involved in MMP activating and inhibitory pathways （plasmin/ plasminogen, TIMPs）, CD^8＋, as well as inflammatory （interleukin （IL）-1β, IL-8, tumor necrosis factor-s, TNF-α） and fibrogenic mediators （transforming growth factor- β1-3） within ileal tissue at 1, 3, and 7 d after irradiation. RESULTS： A marked increase in MMP-2 and -14 mRNA and protein levels associated with an increased activity of MMP-2 was observed in irradiated ileal tissue. MMP-2 and -14 expression was mainly observed in inflammatory, epithelial, and mesenchymal cells, whereas a slight increase in MMP-3 expression was detected in the few infiltrating macrophages at d i after irradiation. Conversely, MMP-1, -7, and -9 mRNA levels were not found to be affected by abdominal irradiation. Irradiation was found to induce disappearance of CD^8＋ cells. Furthermore, we have observed that TNF-α and IL-1β protein levels increased 6 h after irradiation, whereas those of IL-8 only increased after 3 d and was concomitant with neutrophil infiltration. In addition, the expressions of molecules involved in MMP activating and inhibitory pathways （urokinase-type plasminogen activator andtissue-type plasminogen activator; TIMP-1, TIMP-2, and plasminogen activator-inhibitor-i） were found to be increased after abdominal irradiation. CONCLUSION： This study showed that abdominal irradiation induces an acute remodeling of the ileum associated with an increased expression of MMPs and TIMPs that do not involve CD^8＋ T cells but involve mesenchymal and epithelial cells, although to a lesser extent, and probably even soluble inflammatory and fibrogenic mediators.
文摘We presented a 20-year-old patient with Crohn's disease (CD).Colonoscopy revealed longitudinal ulceration in the terminal ileum and rectal aphtoid ulcers.After treatment with mesalamine and total parenteral nutrition,repeat colonoscopy revealed a granular elevated area in the terminal ileum,which appeared as an irregular dome-like elevation with irregularly arranged villi on magnifying endoscopy.Biopsy specimens taken from the region showed microgranulomas and lymphoid hyperplasia,Scanning electron microscopy revealed the presence of M cells,confirming that the area corresponded to Peyer's patches.Peyer's patches by magnifying endoscopy and electron microscopy may provide insights into the pathogenesis of CD.
基金Supported by Foundation Sao Paulo Research,No.2014/25927-2 and No.2018/07862-1Coordenacao de Aperfeicoamento de Pessoal de Nível SuperiorConselho Nacional de Desenvolvimento Científico e Tecnológico。
文摘BACKGROUND The P2X7 receptor is expressed by enteric neurons and enteric glial cells.Studies have demonstrated that administration of a P2X7 receptor antagonist,brilliant blue G(BBG),prevents neuronal loss.AIM To report the effects of BBG in ileum enteric neurons immunoreactive(ir)following experimental ulcerative colitis in Rattus norvegicus albinus.METHODS 2,4,6-trinitrobenzene sulfonic acid(TNBS group,n=5)was injected into the distal colon.BBG(50 mg/kg,BBG group,n=5)or vehicle(sham group,n=5)was given subcutaneously 1 h after TNBS.The animals were euthanized after 24 h,and the ileum was removed.Immunohistochemistry was performed on the myenteric plexus to evaluate immunoreactivity for P2X7 receptor,neuronal nitric oxide synthase(nNOS),choline acetyltransferase(ChAT),HuC/D and glial fibrillary acidic protein.RESULTS The numbers of nNOS-,ChAT-,HuC/D-ir neurons and glial fibrillary acidic protein-ir glial cells were decreased in the TNBS group and recovered in the BBG group.The neuronal profile area(μm^2)demonstrated that nNOS-ir neurons decreased in the TNBS group and recovered in the BBG group.There were no differences in the profile areas of ChAT-and HuC/D-ir neurons.CONCLUSION Our data conclude that ileum myenteric neurons and glial cells were affected by ulcerative colitis and that treatment with BBG had a neuroprotective effect.Thus,these results demonstrate that the P2X7 receptor may be an important target in therapeutic strategies.
文摘BACKGROUND Small intestinal cavernous hemangioma is a rare disease,especially in the ileum.It is difficult to accurately diagnose due to its hidden location and nonspecific clinical symptoms.Here,we reported a case of ileal cavernous hemangioma with chronic hemorrhage in a 20-year-old man and review the literature to gain a better understanding of this disease.CASE SUMMARY The patient complained of intermittent melena and hematochezia for > 3 mo.The lowest hemoglobin level revealed by laboratory testing was 3.4 g/d L(normal range:12-16 g/dL).However,the gastroscopy,colonoscopy and peroral doubleballoon enteroscopy(DBE) showed no signs of bleeding.The transanal DBE detected a lesion at about 340 cm proximal to the ileocecal valve.Thus,we performed an exploratory laparoscopy and the lesion was resected.After the operation,the patient had no melena.Finally,the pathological examination identified the neoplasm as an ileal cavernous hemangioma,thereby resulting in gastrointestinal hemorrhage.CONCLUSION This report might improve the diagnosis and treatment of ileal cavernous hemangioma.
文摘Accidentally ingested foreign bodies, for the most part, pass through the gastrointestinal tract, but can cause several complications. Perforation is rare, but can occur in any segment of the gastrointestinal tract. Intestinal perforations due to foreign bodies are rarely diagnosed preoperatively as clinical symptoms are non-specific and they can mimic other abdominal conditions. We describe a case of a 48-year-old patient who was admitted to the emergency room because of severe abdominal pain of 5 d duration. A computed tomography scan showed an undefined liquid collection involving a linear image 35 mm in size, suggestive of a foreign body. On laparotomy, an abscess containing a fish bone was resected. As fish bone ingestion is usually not remembered by the patient, the diagnosis can be delayed. The preoperative diagnosis is frequently acute abdomen of unknown cause. A low threshold of suspicion along with a good clinical history and radiologicalstudies are extremely important in order to make a correct diagnosis.
文摘The occurrence of adult intussusception from small intestinal lymphoma is quite rare.We present an82-year-old man with a two-month history of intermittent abdominal pain,nausea and fatigue.Clinical symptoms included moderate abdominal tenderness in the right lower abdomen.Computed tomography scan of the abdomen revealed a mass in the terminal ileum with the sign of"bowel within bowel"which was suspicious of ileo-ileum intussusception.The patient underwent laparoscopic segmental ileal resection.Pathologic evaluation revealed a diffuse large B cell non-Hodgkin’s lymphoma of the ileum.The postoperative course was uneventful.
文摘Intussusception is a rare condition in the adult population.However,in contrast to its presentation in children,an identifiable etiology is found in the majority of cases.Clinical manifestations of adult intussusception are non-specific and patients may present with acute,intermittent or chronic symptoms,predominantly those of intestinal obstruction.A 27-year-old male patient with recurrent abdominal pain secondary to intussusception is herein reported.The clinical presentation and ultrasonographic findings led to the diagnosis.At laparotomy,an ileal hamartoma was found as the lead point of the intussusception.Surgical management and histopathologic studies are described.A recurrent intestinal obstruction and classic ultrasound findings may lead to the diagnosis of intussusception but surgical exploration remains essential.The principle of resection without reduction is well established.
