Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent e...Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum. According to our knowledge, this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.展开更多
Behcet's disease(BD) is a rare and life-long disorder characterized by inflammation of blood vessels throughout the body. BD was originally described in 1937 as a syndrome involving oral and genital ulceration in ...Behcet's disease(BD) is a rare and life-long disorder characterized by inflammation of blood vessels throughout the body. BD was originally described in 1937 as a syndrome involving oral and genital ulceration in addition to ocular inflammation. Intestinal BD refers to colonic ulcerative lesions documented by objective measures in patients with BD. Many studies have shown that over 40% of BD patients have gastrointestinal complaints. Symptoms include abdominal pain, diarrhea, nausea, anorexia and abdominal distension. Although gastrointestinal symptoms are common, the demonstration of gastrointestinal ulcers is rare. This so-called intestinal BD accounts for approximately 1% of cases. There is no specific test for BD, and the diagnosis is based on clinical criteria. The manifestations of intestinal BD are similar to those of other colitis conditions such as Crohn's disease or intestinal tuberculosis, thus, it is challenging for gastroenterologists to accurately diagnose intestinal BD in patients with ileocolonic ulcers. However, giant ulcers distributed in the esophagus and ileocecal junction with gastrointestinal hemorrhage are rare in intestinal BD. Here, we present a case of untypical intestinal BD. The patient had recurrent aphthous ulceration of the oral mucosa, and esophageal and ileo-colonic ulceration, but no typical extra-intestinal symptoms. During examination, the patient had massive acute lower gastrointestinal bleeding. The patient underwent ileostomy after an emergency right hemicolectomy and partial ileectomy, and was subsequently diagnosed with incomplete-type intestinal BD by pathology. The literature on the evaluation and management of this condition is reviewed.展开更多
Objective. To improve the localized diagnosis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases,which were admitted from 1988 to 1998 to our hos...Objective. To improve the localized diagnosis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases,which were admitted from 1988 to 1998 to our hospital. Result. Ultrasonography, CT, small bowel pneumobariumgraphy, diluted barium enema,isotopic examination, DSA and intraoperative small-bowel endoscopy were used for diagnosis of hemorrhagic site, and 37 cases got a definite location before operation,while 10 cases were confirmed the diagnosis during the operation.Forty-seven cases were treated surgically, while the other 17 cases had non-surgical treatment.Of the 47 cases,39 cases underwent partial enterectomy, 5 cases had suture and ligature of vascular deformity, 2 cases had Whipple’s operation, and one patient had ectomy of the end of ileum and right colon. Conclusion. DSA, Isotopic examination and intraoperative enteroscopy are of considerable importance for the location judgement of recurrent small intestinal hemorrhage.展开更多
Henoch-Schonlein purpura (HSP) with intestinal perforation and cerebral hemorrhage is a very rare clinical condition. There has been no report of HSP complicated with both intestinal perforation and cerebral hemorrhag...Henoch-Schonlein purpura (HSP) with intestinal perforation and cerebral hemorrhage is a very rare clinical condition. There has been no report of HSP complicated with both intestinal perforation and cerebral hemorrhage until October 2012. Here we describe a case of HSP with intestinal perforation and cerebral hemorrhage in a 5-year-old girl. Plain abdominal radiograph in the erect position showed heavy gas in the right subphrenic space with an elevated diaphragm. Partial resection of the small intestine was performed, and pathological analysis suggested chronic suppurative inflammation in all layers of the ileal wall and mesentery. Seventeen days after surgery, cerebral hemorrhage developed and the patient died.展开更多
The main reason for the death of the patient with acute hemorrhage necrosis pancreatitis (AHNP) is pancreatic infection and multi-organ failure caused by endotoxemia and intestinal bacterial translocation[1-7]. Howeve...The main reason for the death of the patient with acute hemorrhage necrosis pancreatitis (AHNP) is pancreatic infection and multi-organ failure caused by endotoxemia and intestinal bacterial translocation[1-7]. However, the pathogenesis of endotoxemia and intestinal bacterial translocation remains a question[8-10]; moreover, no effective method of prevention and cure for it has been found till now[11 -15] In the present study, we infused low dose dopamine and low molecular weight dextran through the catheters to abdominal aorta and portal vein, and observed its influence on the endotoxin concentration in plasma and the rate of translocation of intestinal bacteria in AHNP rats.展开更多
We are reporting a rare case of a patient with primary(AL) amyloidosis presenting with an acute non-varicealupper gastrointestinal hemorrhage in the absence ofother systemic involvement. The case report involves a58-y...We are reporting a rare case of a patient with primary(AL) amyloidosis presenting with an acute non-varicealupper gastrointestinal hemorrhage in the absence ofother systemic involvement. The case report involves a58-year-old woman with significant cardiac history andhereditary blood disorder who came in complaining ofabdominal pain and coffee-ground emesis for two days.Computed tomography(CT) scan of the abdomen andpelvis with contrast revealed segmental wall thickeningof the proximal jejunum with hyperdense, heterog-enous luminal content. Similar findings were evident inthe left lower small bowel region, suspicious for smallbowel hematoma and the possibility of intraluminalclots. Esophagogastroduodenoscopy performed postresuscitation showed punctate, erythematous lesionsthroughout the stomach as well as regions of smallbowel mucosa that appeared scalloped, ulcerated, andhemorrhaged on contact. Despite initial treatment for immunostain-positive focal cytomegalovirus gastritis, follow-up esophagogastroduodenoscopy after two months continued to demonstrate friable and irregular duodenal mucosa hinting at a different underlying etiol-ogy. Pathology reports from analyses of biopsy samples highlighted infiltration and expansion of the lamina pro-pria and submucosa. Subsequent staining with congo red/crystal violet and appropriate subtyping established the diagnosis of AL(kappa)-type amyloidosis. The sig-nificance of this case lies in the fact that our patient did not have the typically seen diagnostic systemic involvements-namely of heart and kidneys-usually seen in primary(AL) amyloidosis patients. It was the persis-tent endoscopic findings and biopsy results which gave clues to the physicians regarding the possibility of an abnormal protein-deposition entity.展开更多
OBJECTIVE Xingnaojing injection(XNJ) is an extracts of Angong Niuhuang Pill that is a well-known traditional Chinese medicine used for the treatment of septicemia and stroke.This study aims to investigate the effect o...OBJECTIVE Xingnaojing injection(XNJ) is an extracts of Angong Niuhuang Pill that is a well-known traditional Chinese medicine used for the treatment of septicemia and stroke.This study aims to investigate the effect of XNJ on intestinal mucosal barrier in septicemia and intracerebral hem.orrhage(ICH) mice models.METHODS The septicemia mice models were induced by intravenous in.jection with lipopolysaccharide(20 mg·kg^(-1)).And the ICH mice models were made by intrastriatal injec.tion of bacterial collagenase.The septicemia animals were treated intravenously with XNJ at dose of2.5,5,10,or 15 mL·kg^(-1).The ICH animals were treated intravenously with XNJ at dose of 10 mL·kg^(-1).Thereafter,the permeability of intestinal mucosa was assayed by FITC-D method.RESULTS Com.pared with the control group(44.72±4.30),the permeability of intestinal mucosa in the mice in septice.mia group(233.68±28.18) was significantly increased(P<0.01).Treatment with XNJ at dose of 5,10,and 15 mL·kg^(-1) reduced the permeability of intestinal mucosa(150.45±17.52,139.21±17.05,132.55±18.88,respectively,P<0.01) except 2.5 mL·kg^(-1)(240.71±21.42,P>0.01);Compared with sham group(57.88±7.31),the permeability of intestinal mucosa in the mice of ICH(282.25±23.78) was significantly in.creased(P<0.01).Treatment with XNJ(10 mL·kg^(-1)) in the mice of ICH group ameliorated the change of permeability in intestinal mucosa(148.83±15.86,P<0.01).CONCLUSION XNJ exhibits the protec.tive effect on the intestinal mucosal barrier in septicemia and ICH,which will prevent the endotoxin to penetrate the intestinal mucosa and then to enter the circulation in infections and stress.展开更多
BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intes...BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intestine,is an extremely rare condition with highly atypical clinical presentations,making diagnosis even more challenging.CASE SUMMARY We report three cases of small intestinal tuberculosis,two of the patients pre-sented primarily with abdominal pain,and one presented with gastrointestinal bleeding.All patients underwent blood tests and imaging examinations.Small bowel endoscopy(SBE)revealed that the main lesions in these patients were in-testinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers.One patient ultimately underwent surgical treatment.Following a complex diagnostic process and comprehensive analysis,all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment,leading to an improvement in their condition.CONCLUSION Patients with SBTs present with nonspecific symptoms such as abdominal pain,weight loss,and occasional gastrointestinal bleeding.Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagno-sis and complications.展开更多
OBJECTIVE To investigate the effect and mechanism of AngongNiuhuang Pill(AGNH)on neurological function and intestinal mucosal barrier in intracerebral hemorrhage(ICH).METHODS Male CD-1 mice were randomly divided into ...OBJECTIVE To investigate the effect and mechanism of AngongNiuhuang Pill(AGNH)on neurological function and intestinal mucosal barrier in intracerebral hemorrhage(ICH).METHODS Male CD-1 mice were randomly divided into sham,ICH,AGNH 0.1 g · kg^(-1),AGNH 0.2 g · kg^(-1),and AGNH 0.4 g·kg^(-1) groups.The ICH mice models were prepared by intrastriatal injection with collage.nase using a stereotaxic frame.Garcia test was used to evaluate the neurological function of mice.The brain water content was measured with dry/wet weight method.The permeability of intestinal mucosa was detected by FITC-D method.H&E staining was used to observe the pathological changes of intestine.The content of endotoxin in blood and the expressions of ZO-1,occludin in intestinewere also investigated.RESULTS After AGNH administration,the neurological score of mice was increased,and the brain water content was decreased(P<0.01).AGNH attenuated the ICH-induced increase of perme.ability of intestinal mucosa(P<0.01).Treatment with AGNHnot only alleviated the pathological changes of the intestine but alsoreduced the endotoxin content in blood(P<0.01).The expressions of ZO-1,occludinin AGNH groups were significantly increased compared with that of ICH group(P<0.05).CONCLUSION AGNH improves the neurological dysfunction in ICH mice and the mechanism of action is implicated in protecting the intestinal mucosa.展开更多
Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic ...Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.展开更多
AIM: To investigate the causes of small intestinal bleed- ing as well as its diagnosis and therapeutic approaches. METHODS: A retrospective analysis was conducted ac- cording to the clinical records of 76 patients wit...AIM: To investigate the causes of small intestinal bleed- ing as well as its diagnosis and therapeutic approaches. METHODS: A retrospective analysis was conducted ac- cording to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years. RESULTS: In these patients, tumor was the most fre- quent cause of small intestinal bleeding (37/76), fol- lowed by Meckel’s diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by ex- ploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and entero- anastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications. CONCLUSION: Tumor is the major cause of small in- testinal bleeding followed by Meckel’s diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction an- giography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examina- tion of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleed- ing.展开更多
Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mucosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was estab...Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mucosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 21 Sprague-Dawley (SD) rats. The rats were randomly divided into the sham group, normal saline resuscitation (NS) group, and hypertonic saline resuscitation (HTS) group, with 7 in each group. We detected and compared the apoptosis in small intestinal mucosa of rats after hemorrhagic shock and resuscitation by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), FITC (fluo- rescein-iso-thiocyanate)-Annexin V/PI (propidium iodide) double staining method, and flow cytometry. Results: In the early stage of hemorrhagic shock and resuscitation, marked apoptosis of small intestinal mucosa in the rats of both NS and HTS groups was observed. The numbers of apoptotic cells in these two groups were significantly greater than that in the sham group (P<0.01). In the HTS group, the apoptic cells significantly decreased, compared with the NS group (P<0.01). Conclusion: In this rat model of severe hemorrhagic shock, the HTS resuscitation of small volume is more effective than the NS resuscitation in reducing apoptosis of intestinal mucosa in rats, which may improve the prognosis of trauma.展开更多
AIM： To study the protective effect of Astragalus rnernbranaceus on intestinal mucosa reperfusion injury and its mechanism after hemorrhagic shock in rats. METHODS： A total of 32 SD rats were randomly divided into f...AIM： To study the protective effect of Astragalus rnernbranaceus on intestinal mucosa reperfusion injury and its mechanism after hemorrhagic shock in rats. METHODS： A total of 32 SD rats were randomly divided into four groups （n = 8, each group）： normal group, model group, low dosage group （treated with 10 g/kg Astragalus membranaceus） and high dosage group （treated with 20 g/kg Astragalus membranaceus）. The model of hemorrhagic shock for 60 min and reperfusion for 90 min was established. Therapeutic solution （3 mL） was administrated before reperfusion. At the end of the study, the observed intestinal pathology was analyzed. The blood concentrations of lactic acid （LD）, nitric oxide （NO）, endothelin-1 （ET-1）, malondialdehyde （MDA） and the activity of superoxide dismutase （SOD）, glutathione peroxidase （GSH-PX） in intestinal mucosa were determined. RESULTS： The intestinal mucosa pathology showed severe damage in model group and low dosage group, slight damage in high dosage group and no obvious damage in normal group. The Chiu＇s score in low dose group and high dose group was significantly lower than that in model group. The content of MDA in model group was higher than that in low and high dose groups, while that in high dose group was almost the same as in normal group. The activity of SOD and GSH-PX was the lowest in model group and significantly higher in high dose group than in normal and low dose groups. The concentrations of LD and ET-1 in model group were the highest. The concentrations of NO in model group and low dose group were significantly lower than those in high dose group and normal group. CONCLUSION： High dose Astraga/us membranaeus has much better protective effect on hemorrhagic shockreperfusion injury of intestinal mucosa than low dose Astragalus membranaceus. The mechanism may be that Astragalus membranaceus can improve antioxidative effect and regulate NO/ET level during hemorrhagic reperfusion.展开更多
BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of...BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of colorectal bleeding caused by syphilis,small intestinal bleeding caused by syphilis is still rare.CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years.Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions.During the same admission,multiple intestinal ulcers were found by capsule endoscopy,and syphilis was also diagnosed.With a history of atrial fibrillation and chronic pancreatitis,he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease.After anti-syphilis treatment,the melena and abdominal pain disappeared and his hemoglobin gradually increased.It is considered that gastrointestinal bleeding,chronic pancreatitis,atrial fibrillation,and heart valvular disease may have been caused by syphilis.CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding.In addition,treatment of the disease requires both sexual partners to be treated.Finally,although syphilis is easy to treat,it is more important to consider that bleeding could be caused by syphilis.展开更多
The increased risk of mucosa-associated lymphoid tissue(MALT)lymphoma is closely associated with chronic antigenic stimulation,with infection being the most common cause of recurrence.Lesions are usually associated wi...The increased risk of mucosa-associated lymphoid tissue(MALT)lymphoma is closely associated with chronic antigenic stimulation,with infection being the most common cause of recurrence.Lesions are usually associated with the gastrointestinal tract,and the involvement of small intestinal is rare.Recent studies have established a close relationship between novel coronavirus 2019(COVID-19)and the occurrence and progression of various diseases.This article presents a rare case of a small intestinal MALT lymphoma.The patient was initially admitted with COVID-19 pneumonia and subsequently developed gastrointestinal bleeding during hospitalization.Medical and endoscopic treatments were ineffective,and an emergency exploratory laparotomy was performed.The affected segment of the small intestine was excised,and a pathological biopsy confirmed the diagnosis of MALT lymphoma.This case underscores the significance of raising clinical awareness of this condition among health care professionals.展开更多
Depression is a recurrent,common,and potentially life-threatening psychiatric disease.Intestinal flora is a large number of microbial communities that are parasitic in the human digestive tract.Current evidence sugges...Depression is a recurrent,common,and potentially life-threatening psychiatric disease.Intestinal flora is a large number of microbial communities that are parasitic in the human digestive tract.Current evidence suggests that the occurrence of depression may be related to intestinal flora.Long time ago,Bai He Di Huang decoction was used to treat the depression.Recently,researchers found that Bai He Di Huang decoction could affect the the intestinal flora of patients with depression.This review focuses on the clinical progress of Bai He Di Huang decoction in the treatment of depression,and explores the effect and mechanism of Bai He Di Huang decoction on the intestinal flora of depressive mouse.展开更多
Objective To observe the intestinal mucosal injury and the change of TNF-αcontent in rabbits with hemorrhagic shock/reperfusion(HS-R)and the effects of ganoderma Lcidum polysaccharide(GLP)on them.Methods 30rabbits we...Objective To observe the intestinal mucosal injury and the change of TNF-αcontent in rabbits with hemorrhagic shock/reperfusion(HS-R)and the effects of ganoderma Lcidum polysaccharide(GLP)on them.Methods 30rabbits were made into hemorrhagic shock,then reperfused with different liquids.These rabbits were divided by random number table into three groups:sham operation group(Sham group),reperfusion with normal saline group(NS group),reperfusion with 1%GLP group(LS group).Bacterial translocation of blood and TNF-αcontent in serum were respectively observed at the time before shock,40 min after shock,40 min and 90 min after.TNF-αcontent in intestinal mucosa and the degree of intestinal mucosal injury were examined at 90 min post-resuscitation.Results 1 With the extension of reperfusion time,the positive rate of blood bacteria increased gradually in NS group,which was significantly higher than that of Sham group and LS group(P<0.05),meanwhile the degree of intestinal mucosal injury in NS group was more severe than that of Sham group and LS group too(P<0.05).2TNF-αcontent in serum of NS group and LS group were increased obviously compared with that before shock and in Sham group(P<0.05).TNF-αcontent in serum was further increased after reperfusion with NS,which was distinctly higher than that in LS group.TNF-αcontent in intestinal mucosa of NS group was significantly higher than that in LS group and Sham group too(P<0.05).Conclusion GLP can protect intestinal mucosa against HS-R injury,and its effects may relate with the change of TNF-αin hemorrhagic shock rabbits.展开更多
AIM To investigate the mechanism of the rhubarb on gut barrier protection. METHODS The models of gut barrier damage caused by hemorrhagic shock and intraperitoneal endotoxin were used to study the protective effect...AIM To investigate the mechanism of the rhubarb on gut barrier protection. METHODS The models of gut barrier damage caused by hemorrhagic shock and intraperitoneal endotoxin were used to study the protective effect of rhubarb on the barrier of intestinal mucosa. They were randomly divided into four groups: treatment (rhubarb) group; positive control group; negative control group; placebo treatment group. The concentration of plasma endotoxin, tissue superoxide dismutase and lipoperoxide were measured. The histological analysis was also used. The effect of rhubarb on gut protection was observed. RESULTS The rhubarb could decrease intestinal permeability, attenuate endotoxin absorption within the gut, (the content of endotoxin in serum: shock group 0 557EU/ml±0 069EU/ml vs rhubarb group 0 345EU/ml±0 055EU/ml), obviously decrease the consumption of tissue SOD and the formation of tissue LPO (the content of SOD in serum, intestine and liver: endotoxin group 122 92NU/ml±43 19NU/ml, 292 24NU/ml±88 76NU/ml, 272 70NU/ml±85 79NU/ml vs rhubarb group 312 23NU/ml±54 93NU/ml, 391 09NU/mg±98 16NU/mg, 542 86NU/mg±119 93NU/mg; The content of LPO in intestine and liver: endotoxin group 8 57μmol/L±2 58μmol/L, 86 97μmol/L±46 54μmol/L vs rhubarb group 3 05μmol/L±1 13μmol/L, 13 18μmol/L±19 64μmol/L). Gut histopathology revealed that rhubarb could promote proliferation of gut goblet cells, increase secretion of mucus and protect intestinal mucosa in hemorrhagic shock model. CONCLUSION The mechanism of the rhubarb on gut barrier protection might involve in decreasing intestinal permeability, scavenging oxygen free radicals, promoting proliferation of goblet cells within intestinal mucosa.展开更多
BACKGROUND The occurrence of gastrointestinal stromal tumors(GISTs)in the small intestine is rare,and a case of wandering small intestinal stromal tumor has been rarely reported to date.Dissemination of this case can ...BACKGROUND The occurrence of gastrointestinal stromal tumors(GISTs)in the small intestine is rare,and a case of wandering small intestinal stromal tumor has been rarely reported to date.Dissemination of this case can help inform future diagnosis and effective treatment.CASE SUMMARY A 68-year-old patient presented to us with tarry stools.Computed tomography showed a mobile tumor moving widely within the abdominal cavity.As the laboratory data showed a low range of red blood cells and an immediate surgery was not indicated,we performed digital subtraction angiography and embolization to achieve hemostasis.Surgical resection was performed after the patient’s condition improved.The tumor was successfully removed laparoscopically.Histological examination revealed submucosal GIST with infarction,which was of intermediate-risk,with mitotic count<1 per 10 high-power field.Immunohistochemical studies revealed the following:CD117+,Dog1+,CD34+,SMA+,S100-,CK-,Des-,SOX-11-,STAT6-,Ki67 Hotspots 10%+.The patient was ultimately diagnosed with wandering small intestinal stromal tumor.CONCLUSION When a highly vascularized tumor is clinically encountered in the small intestine,the possibility of stromal tumors should be considered.However,when the tumor cannot be visualized at its original location,the possibility of tumor migration is considered.展开更多
文摘Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum. According to our knowledge, this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.
文摘Behcet's disease(BD) is a rare and life-long disorder characterized by inflammation of blood vessels throughout the body. BD was originally described in 1937 as a syndrome involving oral and genital ulceration in addition to ocular inflammation. Intestinal BD refers to colonic ulcerative lesions documented by objective measures in patients with BD. Many studies have shown that over 40% of BD patients have gastrointestinal complaints. Symptoms include abdominal pain, diarrhea, nausea, anorexia and abdominal distension. Although gastrointestinal symptoms are common, the demonstration of gastrointestinal ulcers is rare. This so-called intestinal BD accounts for approximately 1% of cases. There is no specific test for BD, and the diagnosis is based on clinical criteria. The manifestations of intestinal BD are similar to those of other colitis conditions such as Crohn's disease or intestinal tuberculosis, thus, it is challenging for gastroenterologists to accurately diagnose intestinal BD in patients with ileocolonic ulcers. However, giant ulcers distributed in the esophagus and ileocecal junction with gastrointestinal hemorrhage are rare in intestinal BD. Here, we present a case of untypical intestinal BD. The patient had recurrent aphthous ulceration of the oral mucosa, and esophageal and ileo-colonic ulceration, but no typical extra-intestinal symptoms. During examination, the patient had massive acute lower gastrointestinal bleeding. The patient underwent ileostomy after an emergency right hemicolectomy and partial ileectomy, and was subsequently diagnosed with incomplete-type intestinal BD by pathology. The literature on the evaluation and management of this condition is reviewed.
文摘Objective. To improve the localized diagnosis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases,which were admitted from 1988 to 1998 to our hospital. Result. Ultrasonography, CT, small bowel pneumobariumgraphy, diluted barium enema,isotopic examination, DSA and intraoperative small-bowel endoscopy were used for diagnosis of hemorrhagic site, and 37 cases got a definite location before operation,while 10 cases were confirmed the diagnosis during the operation.Forty-seven cases were treated surgically, while the other 17 cases had non-surgical treatment.Of the 47 cases,39 cases underwent partial enterectomy, 5 cases had suture and ligature of vascular deformity, 2 cases had Whipple’s operation, and one patient had ectomy of the end of ileum and right colon. Conclusion. DSA, Isotopic examination and intraoperative enteroscopy are of considerable importance for the location judgement of recurrent small intestinal hemorrhage.
文摘Henoch-Schonlein purpura (HSP) with intestinal perforation and cerebral hemorrhage is a very rare clinical condition. There has been no report of HSP complicated with both intestinal perforation and cerebral hemorrhage until October 2012. Here we describe a case of HSP with intestinal perforation and cerebral hemorrhage in a 5-year-old girl. Plain abdominal radiograph in the erect position showed heavy gas in the right subphrenic space with an elevated diaphragm. Partial resection of the small intestine was performed, and pathological analysis suggested chronic suppurative inflammation in all layers of the ileal wall and mesentery. Seventeen days after surgery, cerebral hemorrhage developed and the patient died.
基金the China Postdoctoral Sciences Foundation No C.P.S.F 1996.2~#
文摘The main reason for the death of the patient with acute hemorrhage necrosis pancreatitis (AHNP) is pancreatic infection and multi-organ failure caused by endotoxemia and intestinal bacterial translocation[1-7]. However, the pathogenesis of endotoxemia and intestinal bacterial translocation remains a question[8-10]; moreover, no effective method of prevention and cure for it has been found till now[11 -15] In the present study, we infused low dose dopamine and low molecular weight dextran through the catheters to abdominal aorta and portal vein, and observed its influence on the endotoxin concentration in plasma and the rate of translocation of intestinal bacteria in AHNP rats.
文摘We are reporting a rare case of a patient with primary(AL) amyloidosis presenting with an acute non-varicealupper gastrointestinal hemorrhage in the absence ofother systemic involvement. The case report involves a58-year-old woman with significant cardiac history andhereditary blood disorder who came in complaining ofabdominal pain and coffee-ground emesis for two days.Computed tomography(CT) scan of the abdomen andpelvis with contrast revealed segmental wall thickeningof the proximal jejunum with hyperdense, heterog-enous luminal content. Similar findings were evident inthe left lower small bowel region, suspicious for smallbowel hematoma and the possibility of intraluminalclots. Esophagogastroduodenoscopy performed postresuscitation showed punctate, erythematous lesionsthroughout the stomach as well as regions of smallbowel mucosa that appeared scalloped, ulcerated, andhemorrhaged on contact. Despite initial treatment for immunostain-positive focal cytomegalovirus gastritis, follow-up esophagogastroduodenoscopy after two months continued to demonstrate friable and irregular duodenal mucosa hinting at a different underlying etiol-ogy. Pathology reports from analyses of biopsy samples highlighted infiltration and expansion of the lamina pro-pria and submucosa. Subsequent staining with congo red/crystal violet and appropriate subtyping established the diagnosis of AL(kappa)-type amyloidosis. The sig-nificance of this case lies in the fact that our patient did not have the typically seen diagnostic systemic involvements-namely of heart and kidneys-usually seen in primary(AL) amyloidosis patients. It was the persis-tent endoscopic findings and biopsy results which gave clues to the physicians regarding the possibility of an abnormal protein-deposition entity.
文摘OBJECTIVE Xingnaojing injection(XNJ) is an extracts of Angong Niuhuang Pill that is a well-known traditional Chinese medicine used for the treatment of septicemia and stroke.This study aims to investigate the effect of XNJ on intestinal mucosal barrier in septicemia and intracerebral hem.orrhage(ICH) mice models.METHODS The septicemia mice models were induced by intravenous in.jection with lipopolysaccharide(20 mg·kg^(-1)).And the ICH mice models were made by intrastriatal injec.tion of bacterial collagenase.The septicemia animals were treated intravenously with XNJ at dose of2.5,5,10,or 15 mL·kg^(-1).The ICH animals were treated intravenously with XNJ at dose of 10 mL·kg^(-1).Thereafter,the permeability of intestinal mucosa was assayed by FITC-D method.RESULTS Com.pared with the control group(44.72±4.30),the permeability of intestinal mucosa in the mice in septice.mia group(233.68±28.18) was significantly increased(P<0.01).Treatment with XNJ at dose of 5,10,and 15 mL·kg^(-1) reduced the permeability of intestinal mucosa(150.45±17.52,139.21±17.05,132.55±18.88,respectively,P<0.01) except 2.5 mL·kg^(-1)(240.71±21.42,P>0.01);Compared with sham group(57.88±7.31),the permeability of intestinal mucosa in the mice of ICH(282.25±23.78) was significantly in.creased(P<0.01).Treatment with XNJ(10 mL·kg^(-1)) in the mice of ICH group ameliorated the change of permeability in intestinal mucosa(148.83±15.86,P<0.01).CONCLUSION XNJ exhibits the protec.tive effect on the intestinal mucosal barrier in septicemia and ICH,which will prevent the endotoxin to penetrate the intestinal mucosa and then to enter the circulation in infections and stress.
文摘BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intestine,is an extremely rare condition with highly atypical clinical presentations,making diagnosis even more challenging.CASE SUMMARY We report three cases of small intestinal tuberculosis,two of the patients pre-sented primarily with abdominal pain,and one presented with gastrointestinal bleeding.All patients underwent blood tests and imaging examinations.Small bowel endoscopy(SBE)revealed that the main lesions in these patients were in-testinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers.One patient ultimately underwent surgical treatment.Following a complex diagnostic process and comprehensive analysis,all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment,leading to an improvement in their condition.CONCLUSION Patients with SBTs present with nonspecific symptoms such as abdominal pain,weight loss,and occasional gastrointestinal bleeding.Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagno-sis and complications.
文摘OBJECTIVE To investigate the effect and mechanism of AngongNiuhuang Pill(AGNH)on neurological function and intestinal mucosal barrier in intracerebral hemorrhage(ICH).METHODS Male CD-1 mice were randomly divided into sham,ICH,AGNH 0.1 g · kg^(-1),AGNH 0.2 g · kg^(-1),and AGNH 0.4 g·kg^(-1) groups.The ICH mice models were prepared by intrastriatal injection with collage.nase using a stereotaxic frame.Garcia test was used to evaluate the neurological function of mice.The brain water content was measured with dry/wet weight method.The permeability of intestinal mucosa was detected by FITC-D method.H&E staining was used to observe the pathological changes of intestine.The content of endotoxin in blood and the expressions of ZO-1,occludin in intestinewere also investigated.RESULTS After AGNH administration,the neurological score of mice was increased,and the brain water content was decreased(P<0.01).AGNH attenuated the ICH-induced increase of perme.ability of intestinal mucosa(P<0.01).Treatment with AGNHnot only alleviated the pathological changes of the intestine but alsoreduced the endotoxin content in blood(P<0.01).The expressions of ZO-1,occludinin AGNH groups were significantly increased compared with that of ICH group(P<0.05).CONCLUSION AGNH improves the neurological dysfunction in ICH mice and the mechanism of action is implicated in protecting the intestinal mucosa.
文摘Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.
文摘AIM: To investigate the causes of small intestinal bleed- ing as well as its diagnosis and therapeutic approaches. METHODS: A retrospective analysis was conducted ac- cording to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years. RESULTS: In these patients, tumor was the most fre- quent cause of small intestinal bleeding (37/76), fol- lowed by Meckel’s diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by ex- ploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and entero- anastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications. CONCLUSION: Tumor is the major cause of small in- testinal bleeding followed by Meckel’s diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction an- giography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examina- tion of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleed- ing.
基金Project (No. 20061420) supported by the Education and Research Foundation of Zhejiang Province, China
文摘Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mucosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 21 Sprague-Dawley (SD) rats. The rats were randomly divided into the sham group, normal saline resuscitation (NS) group, and hypertonic saline resuscitation (HTS) group, with 7 in each group. We detected and compared the apoptosis in small intestinal mucosa of rats after hemorrhagic shock and resuscitation by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), FITC (fluo- rescein-iso-thiocyanate)-Annexin V/PI (propidium iodide) double staining method, and flow cytometry. Results: In the early stage of hemorrhagic shock and resuscitation, marked apoptosis of small intestinal mucosa in the rats of both NS and HTS groups was observed. The numbers of apoptotic cells in these two groups were significantly greater than that in the sham group (P<0.01). In the HTS group, the apoptic cells significantly decreased, compared with the NS group (P<0.01). Conclusion: In this rat model of severe hemorrhagic shock, the HTS resuscitation of small volume is more effective than the NS resuscitation in reducing apoptosis of intestinal mucosa in rats, which may improve the prognosis of trauma.
基金Supported by the Chinese Traditional Medicine Foundation of Guangdong Province, China, No. 102061
文摘AIM： To study the protective effect of Astragalus rnernbranaceus on intestinal mucosa reperfusion injury and its mechanism after hemorrhagic shock in rats. METHODS： A total of 32 SD rats were randomly divided into four groups （n = 8, each group）： normal group, model group, low dosage group （treated with 10 g/kg Astragalus membranaceus） and high dosage group （treated with 20 g/kg Astragalus membranaceus）. The model of hemorrhagic shock for 60 min and reperfusion for 90 min was established. Therapeutic solution （3 mL） was administrated before reperfusion. At the end of the study, the observed intestinal pathology was analyzed. The blood concentrations of lactic acid （LD）, nitric oxide （NO）, endothelin-1 （ET-1）, malondialdehyde （MDA） and the activity of superoxide dismutase （SOD）, glutathione peroxidase （GSH-PX） in intestinal mucosa were determined. RESULTS： The intestinal mucosa pathology showed severe damage in model group and low dosage group, slight damage in high dosage group and no obvious damage in normal group. The Chiu＇s score in low dose group and high dose group was significantly lower than that in model group. The content of MDA in model group was higher than that in low and high dose groups, while that in high dose group was almost the same as in normal group. The activity of SOD and GSH-PX was the lowest in model group and significantly higher in high dose group than in normal and low dose groups. The concentrations of LD and ET-1 in model group were the highest. The concentrations of NO in model group and low dose group were significantly lower than those in high dose group and normal group. CONCLUSION： High dose Astraga/us membranaeus has much better protective effect on hemorrhagic shockreperfusion injury of intestinal mucosa than low dose Astragalus membranaceus. The mechanism may be that Astragalus membranaceus can improve antioxidative effect and regulate NO/ET level during hemorrhagic reperfusion.
基金Supported by Science and Technology Innovation Joint Fund Project of Fujian Province,No.2018Y9116.
文摘BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of colorectal bleeding caused by syphilis,small intestinal bleeding caused by syphilis is still rare.CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years.Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions.During the same admission,multiple intestinal ulcers were found by capsule endoscopy,and syphilis was also diagnosed.With a history of atrial fibrillation and chronic pancreatitis,he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease.After anti-syphilis treatment,the melena and abdominal pain disappeared and his hemoglobin gradually increased.It is considered that gastrointestinal bleeding,chronic pancreatitis,atrial fibrillation,and heart valvular disease may have been caused by syphilis.CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding.In addition,treatment of the disease requires both sexual partners to be treated.Finally,although syphilis is easy to treat,it is more important to consider that bleeding could be caused by syphilis.
基金the Wuhan Young and Middle-aged Medical Backbone Personnel Training Project(No.2016(59)).
文摘The increased risk of mucosa-associated lymphoid tissue(MALT)lymphoma is closely associated with chronic antigenic stimulation,with infection being the most common cause of recurrence.Lesions are usually associated with the gastrointestinal tract,and the involvement of small intestinal is rare.Recent studies have established a close relationship between novel coronavirus 2019(COVID-19)and the occurrence and progression of various diseases.This article presents a rare case of a small intestinal MALT lymphoma.The patient was initially admitted with COVID-19 pneumonia and subsequently developed gastrointestinal bleeding during hospitalization.Medical and endoscopic treatments were ineffective,and an emergency exploratory laparotomy was performed.The affected segment of the small intestine was excised,and a pathological biopsy confirmed the diagnosis of MALT lymphoma.This case underscores the significance of raising clinical awareness of this condition among health care professionals.
文摘Depression is a recurrent,common,and potentially life-threatening psychiatric disease.Intestinal flora is a large number of microbial communities that are parasitic in the human digestive tract.Current evidence suggests that the occurrence of depression may be related to intestinal flora.Long time ago,Bai He Di Huang decoction was used to treat the depression.Recently,researchers found that Bai He Di Huang decoction could affect the the intestinal flora of patients with depression.This review focuses on the clinical progress of Bai He Di Huang decoction in the treatment of depression,and explores the effect and mechanism of Bai He Di Huang decoction on the intestinal flora of depressive mouse.
基金Natural Science Research Project of Henan Province Education Department(NO.2006310021)
文摘Objective To observe the intestinal mucosal injury and the change of TNF-αcontent in rabbits with hemorrhagic shock/reperfusion(HS-R)and the effects of ganoderma Lcidum polysaccharide(GLP)on them.Methods 30rabbits were made into hemorrhagic shock,then reperfused with different liquids.These rabbits were divided by random number table into three groups:sham operation group(Sham group),reperfusion with normal saline group(NS group),reperfusion with 1%GLP group(LS group).Bacterial translocation of blood and TNF-αcontent in serum were respectively observed at the time before shock,40 min after shock,40 min and 90 min after.TNF-αcontent in intestinal mucosa and the degree of intestinal mucosal injury were examined at 90 min post-resuscitation.Results 1 With the extension of reperfusion time,the positive rate of blood bacteria increased gradually in NS group,which was significantly higher than that of Sham group and LS group(P<0.05),meanwhile the degree of intestinal mucosal injury in NS group was more severe than that of Sham group and LS group too(P<0.05).2TNF-αcontent in serum of NS group and LS group were increased obviously compared with that before shock and in Sham group(P<0.05).TNF-αcontent in serum was further increased after reperfusion with NS,which was distinctly higher than that in LS group.TNF-αcontent in intestinal mucosa of NS group was significantly higher than that in LS group and Sham group too(P<0.05).Conclusion GLP can protect intestinal mucosa against HS-R injury,and its effects may relate with the change of TNF-αin hemorrhagic shock rabbits.
文摘AIM To investigate the mechanism of the rhubarb on gut barrier protection. METHODS The models of gut barrier damage caused by hemorrhagic shock and intraperitoneal endotoxin were used to study the protective effect of rhubarb on the barrier of intestinal mucosa. They were randomly divided into four groups: treatment (rhubarb) group; positive control group; negative control group; placebo treatment group. The concentration of plasma endotoxin, tissue superoxide dismutase and lipoperoxide were measured. The histological analysis was also used. The effect of rhubarb on gut protection was observed. RESULTS The rhubarb could decrease intestinal permeability, attenuate endotoxin absorption within the gut, (the content of endotoxin in serum: shock group 0 557EU/ml±0 069EU/ml vs rhubarb group 0 345EU/ml±0 055EU/ml), obviously decrease the consumption of tissue SOD and the formation of tissue LPO (the content of SOD in serum, intestine and liver: endotoxin group 122 92NU/ml±43 19NU/ml, 292 24NU/ml±88 76NU/ml, 272 70NU/ml±85 79NU/ml vs rhubarb group 312 23NU/ml±54 93NU/ml, 391 09NU/mg±98 16NU/mg, 542 86NU/mg±119 93NU/mg; The content of LPO in intestine and liver: endotoxin group 8 57μmol/L±2 58μmol/L, 86 97μmol/L±46 54μmol/L vs rhubarb group 3 05μmol/L±1 13μmol/L, 13 18μmol/L±19 64μmol/L). Gut histopathology revealed that rhubarb could promote proliferation of gut goblet cells, increase secretion of mucus and protect intestinal mucosa in hemorrhagic shock model. CONCLUSION The mechanism of the rhubarb on gut barrier protection might involve in decreasing intestinal permeability, scavenging oxygen free radicals, promoting proliferation of goblet cells within intestinal mucosa.
文摘BACKGROUND The occurrence of gastrointestinal stromal tumors(GISTs)in the small intestine is rare,and a case of wandering small intestinal stromal tumor has been rarely reported to date.Dissemination of this case can help inform future diagnosis and effective treatment.CASE SUMMARY A 68-year-old patient presented to us with tarry stools.Computed tomography showed a mobile tumor moving widely within the abdominal cavity.As the laboratory data showed a low range of red blood cells and an immediate surgery was not indicated,we performed digital subtraction angiography and embolization to achieve hemostasis.Surgical resection was performed after the patient’s condition improved.The tumor was successfully removed laparoscopically.Histological examination revealed submucosal GIST with infarction,which was of intermediate-risk,with mitotic count<1 per 10 high-power field.Immunohistochemical studies revealed the following:CD117+,Dog1+,CD34+,SMA+,S100-,CK-,Des-,SOX-11-,STAT6-,Ki67 Hotspots 10%+.The patient was ultimately diagnosed with wandering small intestinal stromal tumor.CONCLUSION When a highly vascularized tumor is clinically encountered in the small intestine,the possibility of stromal tumors should be considered.However,when the tumor cannot be visualized at its original location,the possibility of tumor migration is considered.
