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Fundoplication
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Douglas C. Barnhart, Robert A. Cina
The majority of children with pathologic gastroesophageal reflux have normal foregut anatomy. Hiatal hernias are more common in children with a history of esophageal atresia and congenital diaphragmatic hernia. Hiatal hernias can occur in otherwise normal children with GERD but are uncommon. Two types of hiatus hernia are recognized: Sliding hiatus hernia is characterized by ascent of the cardia into the mediastinum (Figure 28.1).In paraesophageal or rolling hernia, the gastroesophageal junction remains in the abdomen while part of the gastric fundus prolapses through the esophageal hiatus into the mediastinum (Figure 28.2).
Aedes Mosquitoes: The Universal Vector
Published in Jagriti Narang, Manika Khanuja, Small Bite, Big Threat, 2020
Annette Angel, Bennet Angel, Neelam Yadav, Jagriti Narang, Surender Singh Yadav, Vinod Joshi
Inside the hypopharynx, there is a salivary canal through which saliva flows. The saliva consists of many important proteins that include anticoagulant, vasodilating properties (Snodgrass, 1959). The digestive or alimentary canal consists of pharynx, esophagus, stomach divided into foregut, midgut, and hindgut, followed by intestine, rectum, and anus (Fig. 1.15). The nervous system consists of central, peripheral, and sympathetic systems with brain and ganglions connecting to all parts of the body (Fig. 1.16). On each side of the head is a compound eye consisting of hundreds of small units called ommatidia (Jirakanjanakit et al., 2008). The respiratory system includes spiracles on either side of the body, which open into tracheal trunks toward the inside of the body cavity (Mill, 1985, 1998; Sláma, 1999).
The digestive system and the respiratory system
Published in Frank J. Dye, Human Life Before Birth, 2019
The foregut gives rise to many important structures: the pharynx, esophagus, stomach, liver, biliary apparatus, pancreas, and a portion of the small intestine (the cephalic portion of the duodenum) (Figure 16.3). Initially, the foregut is a blind tube at its cephalic (head) end, but during the fourth week, with the rupture of the oropharyngeal membrane, the mouth opens to the amniotic cavity.
Assessments of CYP‑inhibition‑based drug–drug interaction between vonoprazan and poziotinib in vitro and in vivo
Published in Pharmaceutical Biology, 2023
Shan Zhou, Fang-Ling Zhao, Shuang-Hu Wang, Yi-Ran Wang, Yun Hong, Quan Zhou, Pei-Wu Geng, Qing-Feng Luo, Jian-Ping Cai, Da-Peng Dai
Acid-related diseases (ARDs) are common diseases worldwide, which mainly include the peptic ulcer disease (PUD) and the gastroesophageal reflux disease (GERD). For a long period, PUD has been one of the major scourges to humanity, and is associated with a high incidence of morbidity and mortality. However, in the past two decades GERD has replaced PUD as the major reason for physician consultation, due to foregut-related symptoms (Sachs et al. 2014). It was considered that PUD only occurred in the presence of gastric acid, leading to the pronouncement ‘no acid, no ulcer’ (Prout 1974). Obtaining a continuous and stable anti-acid effect within 24 h is the key point for the treatment of acid-related diseases (Mori and Suzuki 2019). At present, proton pump inhibitors (PPIs) and potassium competitive acid blockers (P-CABs) are the main drugs for the treatment of gastric acid-related diseases (Oshima and Miwa 2018). Among them, PPIs are prodrugs and need to be rearranged into their active form with the aid of gastric acid to irreversibly inhibit proton pumps and gastric acid secretion (Marabotto et al. 2020). Therefore, the effect of PPIs is relatively time-delayed and has a short half-life (Martinucci et al. 2017). Compared with PPIs, P-CABs have a higher acid inhibition intensity and longer acid inhibition duration, which makes them have wider clinical application prospects.
Abstracts from the Seventh Annual Baylor University Medical Center Medical Education Research Forum 2021
Published in Baylor University Medical Center Proceedings, 2021
Kashif Waqiee Ahmed, Thomas Cox, Jennifer Olvera, Natalie Gittus, Kirsten Ryan, Cristie Columbus
Enhanced recovery after surgery (ERAS) programs provide a framework for optimal perioperative care to improve postoperative outcomes. This study developed an ERAS protocol for foregut surgery patients and analyzed whether it improved outcomes. A prospectively maintained database was retrospectively reviewed for all patients undergoing bariatric surgery from October 2018 to January 2020. Propensity matching was used to match patients before and after ERAS implementation. A total of 266 patients (71 ERAS, 195 pre-ERAS) underwent foregut operations from October 2018 to January 2020. ERAS was implemented in October 2019; 44 patients were kept on the protocol and 16 deviated from it. Pre-ERAS patients had significantly more complications and a longer length of stay than ERAS patients (P < 0.05). The foregut ERAS protocol reduced complications by 81% and decreased length of stay by 16%. Patients who deviated from the ERAS protocol had a higher length of stay and higher risk of complications compared to the pre-ERAS patients. The ERAS protocol decreases complications and reduces length of stay in foregut patients.
Does transverse colon cancer spread to the extramesocolic lymph node stations?
Published in Acta Chirurgica Belgica, 2021
Bulent C. Yuksel, Sadettin ER, Erdinç Çetinkaya, Ahmet Keşşaf Aşlar
In relation to how extramesacolic lymph node metastasis occurs, in a cadaver study, Stelzner et al. [12] stated that the transverse colon originating from the midgut and hindgut, and the gastrocolic ligament, omentum and pancreas originating from the foregut were topographically intertwined. Although the greater omentum was fully separable from the transverse colon and mesocolon, the authors showed that in hepatic and splenic flexures, the small vessels in-between formed a connection between the foregut and the midgut and hindgut. These connections provide blood flow and lymphatic flow to the lymph nodes, thus allowing the tumor cells to pass between the planes. Perrakis et al. clinically demonstrated this condition. In their study of 45 patients, the authors found extramesacolic metastatic lymph nodes in the gastroepiploic and infrapyloric areas in four patients, indicating that this transition was due to a direct connection between the right gastroepiploic artery and the omentum [13]. The anatomical background of these direct lymphatic drainage pathways is that they can cause lymph node metastasis in both gastroepiploic and infrapancreatic areas in transverse colon cancers. In addition, Perrakis and Hohenberger emphasized that this metastasis could spread through the connection between the arteria pancreatica magna and arteria pancreatica transversa in the infrapanreatic area [2,13].