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Pediatric and Fetal Autopsies
Published in Cristoforo Pomara, Vittorio Fineschi, Forensic and Clinical Forensic Autopsy, 2020
Stefano D’Errico, Angelo Montana, Giulio Di Mizio, Monica Salerno
Bowels are opened, and their contents and status of the mucosa are noted. The mesenteric lymph nodes are inspected and sectioned. The liver is examined next. The portal structures are examined by exposing the portal vein and the hepatic artery posteriorly. Record the small and large intestine length, and the presence or absence of meconium in its portions.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 28 year old male patient, under the care of the gastroenterology team, has been admitted with an exacerbation of ulcerative colitis. After 48 hours in hospital he is stable but has some increased abdominal discomfort. You are asked to review his contrast-enhanced CT abdomen and pelvis. This demonstrates mural thickening and pericolic fat stranding affecting the entire colon and rectum. There is a rim of lower attenuation in the wall of the colon with a Hounsfield unit of −95 and minimal faecal residue in the colon. There is a tiny amount of peritoneal free fluid but no free gas. The colon measures up to 50 mm in diameter. Mesenteric lymph nodes measure up to 11 mm in short axis.
Gastrointestinal cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
The tumour spreads longitudinally and circumferentially along the mucosa, in some cases leading to obstruction of the bowel lumen, and invades deep to the mucosa to infiltrate the muscular wall of the bowel and serosa. Penetration of the serosa leads to direct infiltration of the surrounding abdominal and pelvic viscera, while submucosal spread in the lamina propria can lead to skip lesions well away from the primary tumour. Tumour cells have a propensity to seed in abdominal scars, perineal skin, stomas and even anal fissures. Transcoelomic spread may lead to diffuse peritoneal involvement resulting in ascites and spread to the ovaries. The regional mesenteric lymph nodes can be involved, wherein there is a likelihood of lymph node metastases increasing with the depth of bowel wall invasion. The tumour spreads to the liver (Figure 9.8) via the portal circulation, and from there to the lungs, bone, brain and skin. Rectal cancer has a particular propensity for local recurrence and often this leads to a presacral mass (Figure 9.9).
Ultrasound-guided hydrostatic reduction of ileo-colic intussusception in childhood: first-line management for both primary and recurrent cases
Published in Acta Chirurgica Belgica, 2022
Berat Dilek Demirel, Sertac Hancıoğlu, Basak Dağdemir, Meltem Ceyhan Bilgici, Beytullah Yagiz, Ünal Bıçakcı, Ferit Bernay, Ender Arıtürk
No recurrent intussusception was seen in patients who had undergone surgery, but one episode of relapse is seen in 10 patients and two episodes in two patients who were previously managed with hydrostatic reduction. The recurrence rate was 16% for the 77 patients who did not undergo surgery. Seven (58%) of these patients were male and 5 (42%) were female. The mean age was 1.16 ± 1.64 years (median: 0.58 year, 5 months–6.33 years) (Table 1). Eight patients (66%) were younger than 1 year of age. Mesenteric lymph nodes were detected in 7 patients with recurrence (58%). The median length of the intussuscepted segment was 61 mm (35–90 mm) in the recurrent episode. The earliest recurrent intussusception was seen 18 days after the first hydrostatic reduction. The median recurrence time was 67.5 days (18−110 days). None of the patients with recurrent intussusception had electrolyte abnormality as in their initial intussusception. Intestinal blood flow was normal on US and there was no significant intra-abdominal fluid. US-guided hydrostatic reduction was successful in all of the patients in the recurrence group. The follow-up protocol of the patients with recurrence after the procedure is the same as the initial approach.
Atypical and novel presentations of Coronavirus Disease 2019: a case series of three children
Published in British Journal of Biomedical Science, 2021
MS Ekbatani, SA Hassani, L Tahernia, B Yaghmaei, S Mahmoudi, A Navaeian, M Rostamyan, F Zamani, S Mamishi
A 4-year-old girl was admitted to the emergency department with a 3-day history of fever (39.7 °C), abdominal pain, vomiting, malaise, headache and moderate dehydration. On examination, there was tachopnoea (normal range 20–25 breaths/min) and hypoxaemia (pulse oximetry 85% of oxygen saturation). Due to severe abdominal pain and recurrent vomiting, an ultrasound analysis was performed and acute appendicitis and multiple reactive mesenteric lymph nodes were reported. A chest X-ray showed bilateral parahilar reticular opacity, retrocardiac alveolar opacity, paracardiac alveolar opacityreticular and retrocardiac alveolar opacity (Figure 3). Moreover, in lung view of chest CT scan, ground glass opacity and alveolar consolidation with adjacent left pleural reaction were observed (Figure 4).
Lactobacillus fermentum species ameliorate dextran sulfate sodium-induced colitis by regulating the immune response and altering gut microbiota
Published in Gut Microbes, 2019
You Jin Jang, Woon-Ki Kim, Dae Hee Han, Kiuk Lee, Gwangpyo Ko
Mesenteric lymph nodes (MLNs) were collected from the mice. The tissues were carefully crushed and filtered through a cell strainer (100 μm pore diameter). The cells were isolated, counted and subjected to FcγR blocking. The surfaces of the cells were stained for 30 min at 4°C using Fixable Viability Stain 510 (FVS510; BD Bioscience) for live cells and CD3+ fluorescein isothiocyanate (145-2C11; BD Bioscience), CD4+ Percep-Cyanine5.5 (RM4-5; BD Bioscience) and CD25+ phycoerythrin (PC61; BD Bioscience) for cell surface staining. The cells were permeabilized in fixation/permeabilization buffer (eBioscience, San Diego, CA, USA) and subjected to intracellular Foxp3 staining using the Alexa Fluor 647 anti-Foxp3 antibody (MF23; BD Bioscience). IgG isotypes were used as a control for all fluorescence-activated cell sorting experiments. The CD4+CD25+Foxp3+Treg population was analyzed using the BD FACSVerse™ Flow Cytometer (BD Bioscience).