BACKGROUND:Disturbance of gastrointestinal function is a common complication in the early phase of acute pancreatitis(AP).Intestinal gas may reflect the function of the gut.Using plain abdominal radiographs,we investi...BACKGROUND:Disturbance of gastrointestinal function is a common complication in the early phase of acute pancreatitis(AP).Intestinal gas may reflect the function of the gut.Using plain abdominal radiographs,we investigated whether intestinal gas volume is related to AP.METHODS:Plain abdominal radiographs of 68 patients with AP within 24 hours after admission and 21 normal controls were digitized and transmitted to a computer.The region of intestinal gas was identified by an image manipulation software and the gas volume score(GVS)was calculated.The relationships between the GVS values and various clinical factors of AP were analyzed.RESULTS:The GVS in the AP group was 0.084±0.016,in the mild AP(MAP)group 0.070±0.005,and in the severe AP(SAP)group 0.094±0.013;all values were higher than that in the control group(P<0.01).The GVS in the SAP group was higher than that in the MAP group.The GVSs were correlated to the Ranson’s scores(r=0.762,P<0.01)and the acute physiology and chronic health evaluation II(APACHE II)scores(r=0.801,P<0.01).In addition,the GVS in patients with secondary pancreatic and/or peripancreatic infection was 0.107±0.014,higher than that in patients without secondary infection(P<0.01).GVS was not related to gender,age,etiology or clinical outcome of AP.CONCLUSIONS:Intestinal gas volume is significantly elevated in patients with AP.It is closely related to Ranson’s and APACHE II score and secondary pancreatic and/or peripancreatic infection.GVS may be a new prognostic tool for assessing the severity of AP in the early course of the disease.展开更多
Objective: to summarize and analyze the CT features of intestinal gas cyst of colon under the multi-plane reconstruction technique of MSCT, in order to improve the correct diagnosis rate of intestinal gas cyst of colo...Objective: to summarize and analyze the CT features of intestinal gas cyst of colon under the multi-plane reconstruction technique of MSCT, in order to improve the correct diagnosis rate of intestinal gas cyst of colon. Methods: the clinical and MSCT data of 8 patients with clinically diagnosed intestinal gas cyst of colon were retrospectively analyzed. Results: CT multiplanar reconstruction showed that 8 cases were of mixed type of colonic air cyst, of which 5 cases were subserous type and 3 cases were submucosal type. In the mixed type of intestinal gas cyst with subserosal type, 5 cases showed extraintestinal free gas and 1 case showed small amount of subdiaphragmatic free gas. All 8 cases showed no signs of peritonitis. Conclusion: the possibility of intestinal gas cyst should be considered when other diseases are excluded for abdominal pain with unknown causes. CT multiplanar reconstruction of colonic gas cyst showed that there were multiple cystic gas accumulation areas under the mucosa or serosa of the intestinal wall. The intestinal wall was clearly visible and accompanied by free pneumoperitoneum when the serosa was involved.展开更多
The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought t...The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidence supporting altered secretion in the small intestine of IBS patients. Visceral hypersensitivity is currently considered to be perhaps the most important pathophysiological factor in IBS. Importantly, several external and internal factors can modulate visceral sensitivity, as well as GI motility, and enhanced responsiveness within the GI tract to for instance stress and nutrients has been demonstrated in IBS patients. Today IBS is viewed upon as a disorder of dysregulation of the so-called brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems, with peripheral alterations probably dominating in some patients and disturbed central processing of signals from the periphery in others.展开更多
基金supported by a grant from the National Natural Science Foundation of China(81070297)
文摘BACKGROUND:Disturbance of gastrointestinal function is a common complication in the early phase of acute pancreatitis(AP).Intestinal gas may reflect the function of the gut.Using plain abdominal radiographs,we investigated whether intestinal gas volume is related to AP.METHODS:Plain abdominal radiographs of 68 patients with AP within 24 hours after admission and 21 normal controls were digitized and transmitted to a computer.The region of intestinal gas was identified by an image manipulation software and the gas volume score(GVS)was calculated.The relationships between the GVS values and various clinical factors of AP were analyzed.RESULTS:The GVS in the AP group was 0.084±0.016,in the mild AP(MAP)group 0.070±0.005,and in the severe AP(SAP)group 0.094±0.013;all values were higher than that in the control group(P<0.01).The GVS in the SAP group was higher than that in the MAP group.The GVSs were correlated to the Ranson’s scores(r=0.762,P<0.01)and the acute physiology and chronic health evaluation II(APACHE II)scores(r=0.801,P<0.01).In addition,the GVS in patients with secondary pancreatic and/or peripancreatic infection was 0.107±0.014,higher than that in patients without secondary infection(P<0.01).GVS was not related to gender,age,etiology or clinical outcome of AP.CONCLUSIONS:Intestinal gas volume is significantly elevated in patients with AP.It is closely related to Ranson’s and APACHE II score and secondary pancreatic and/or peripancreatic infection.GVS may be a new prognostic tool for assessing the severity of AP in the early course of the disease.
文摘Objective: to summarize and analyze the CT features of intestinal gas cyst of colon under the multi-plane reconstruction technique of MSCT, in order to improve the correct diagnosis rate of intestinal gas cyst of colon. Methods: the clinical and MSCT data of 8 patients with clinically diagnosed intestinal gas cyst of colon were retrospectively analyzed. Results: CT multiplanar reconstruction showed that 8 cases were of mixed type of colonic air cyst, of which 5 cases were subserous type and 3 cases were submucosal type. In the mixed type of intestinal gas cyst with subserosal type, 5 cases showed extraintestinal free gas and 1 case showed small amount of subdiaphragmatic free gas. All 8 cases showed no signs of peritonitis. Conclusion: the possibility of intestinal gas cyst should be considered when other diseases are excluded for abdominal pain with unknown causes. CT multiplanar reconstruction of colonic gas cyst showed that there were multiple cystic gas accumulation areas under the mucosa or serosa of the intestinal wall. The intestinal wall was clearly visible and accompanied by free pneumoperitoneum when the serosa was involved.
文摘The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidence supporting altered secretion in the small intestine of IBS patients. Visceral hypersensitivity is currently considered to be perhaps the most important pathophysiological factor in IBS. Importantly, several external and internal factors can modulate visceral sensitivity, as well as GI motility, and enhanced responsiveness within the GI tract to for instance stress and nutrients has been demonstrated in IBS patients. Today IBS is viewed upon as a disorder of dysregulation of the so-called brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems, with peripheral alterations probably dominating in some patients and disturbed central processing of signals from the periphery in others.
