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Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The large intestine is approximately 1.5 m long from caecum to anus, with a variable calibre from between 9 and 3 cm. It lies peripheral to the small intestine, with the more lateral structures being relatively fixed in position. From the right iliac fossa where the terminal ileum communicates via the ileo-caecal valve, the ceacum extends superiorly as the ascending colon before it turns abruptly to the left, beneath the liver, at the hepatic flexure. Crossing the abdomen, the transverse colon turns inferiorly at the splenic flexure, where it continues as the descending colon. The bowel loops to a variable degree at the sigmoid colon, passing along the posterior wall of the pelvis where it merges with the rectum at the recto-sigmoid junction. The rectum is 13 cm long and is a dilated part of the large intestine, continuous with the anal canal and anus. The large intestine displays large sacculations known as haustra that are thought to slow the passage of digested matter. The relations of the large intestine are complex and variable as the bowel traverses the different regions of the abdomen (Figs 5.52a–c).
The digestive system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
The longitudinal layer of smooth muscle in the small intestine is continuous. In the large intestine, this layer of muscle is concentrated into three flat bands referred to as taniae coli. Furthermore, the large intestine appears to be subdivided into a chain of pouches or sacs referred to as haustra. The haustra are formed because the bands of taniae coli are shorter than the underlying circular layer of smooth muscle and causes the colon to bunch up.
Epidemiology, Pathophysiology, Diagnosis and Treatment
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Susannah Clark, Patricia L. Roberts, Rocco Ricciardi
During the physiologic process of segmentation, the simultaneous contraction of two neighbouring haustra creates a segment between them that is temporarily a closed loop, leading to high intraluminal pressures and contributing to the formation of diverticula.6 One popular theory is that the high pressures of segmentation cause focal muscle atrophy or attenuation, which in turn causes herniation through the mucosa.28 Another idea is that low-volume stools found in the low-fibre diets common in Western societies incur higher intraluminal pressures during colonic muscle contraction.3 Certainly a combination of some or all these theories is possible.
In-vitro and in-vivo evaluation and anti-colitis activity of esculetin-loaded nanostructured lipid carrier decorated with DSPE-MPEG2000
Published in Journal of Microencapsulation, 2023
Feng Shi, Wenxiong Yin, Michael Adu-Frimpong, Xiaoxiao Li, Xiaoli Xia, Weigang Sun, Hao Ji, Elmurat Toreniyazov, Wang Qilong, Xia Cao, Jiangnan Yu, Ximing Xu
As can be seen in Figures 5 and 6, the pathological characteristics of the colon in each group were observed after prophylactic treatment. The colon tissue of mice in DSS and B-NLC groups showed the histopathological examination, viz., formation of crypt abscesses, the disappearance of haustra (colon swelling), infiltration of inflammatory cells, colonic mucosal congestion, colonic muscle cell proliferation, failure of mucosal mast cell, edoema and other characteristics (Huang et al.2018). In contrast, the colon tissue in the control group displayed normal mucosal structure, neatly arranged cells, no muscle cell proliferation and intact epithelium. After 8 days of treatment, the pathological characteristics of the colon in esculetin and Esc-NLC groups were close to the control group, while the Esc-NLC groups were better than that the esculetin groups because we observed fewer inflammatory cells, more intact mucosal structure and muscularis tissue. In the positive group, failure of colonic mucosal cells was found but the mucosal structure was instant. These results indicate both the esculetin and the Esc-NLC could effectively reduce the inflammation caused by ulcerative colitis, while the Esc-NLC had the best inflammatory-reducing effect. Subsequently, histological grading of colitis also corroborated these results, hence the grading results were significantly reduced after the prophylactic treatment of Esc-NLC.
Malignant hydrocele: a rare manifestation of peritoneal carcinomatosis of colorectal origin as a transcoelomic spread into the scrotum – case report and literature overview
Published in Scandinavian Journal of Urology, 2018
Janusz Frey, Luiza Dorofte, Pernilla Sundqvist
The patient was a 66-year-old Caucasian male with no significant medical comorbidities or complicated medical or surgical history, besides appendectomy and open left inguinal hernia repair. In 2014, he experienced weight loss and diarrhoea, and also presented with microcytic anaemia and positive faecal occult blood test. A colonoscopy was performed, with diverticulosis as the only finding. The examination was regarded as complete, with identification of the ileocaecal valve. Since then, persistent occult gastrointestinal bleeding, slightly elevated serum C-reactive protein levels, subfebrility and further weight loss occurred, which resulted in a computed tomography (CT) scan of the abdomen on June 2015, revealing a large caecal tumour with suspected infiltration of the adjacent ileum and abdominal wall, and local lymphadenopathy. The tumour was verified by colonoscopy in June 2015 (which also showed a classical pitfall with colon haustrum mimicking the ileocaecal valve, resulting in misjudgement during the first colonoscopy). Histological examination confirmed colon adenocarcinoma, which was clinically staged as a cT4N2M0 tumour.
Inflammatory bowel disease in Nigerian children: case series and management challenges
Published in Paediatrics and International Child Health, 2020
Idowu Senbanjo, Ayodeji Akinola, Tolulope Kumolu-Johnson, Olayinka Igbekoyi, Kazeem Oshikoya
Prior to presentation, the patient had been treated for common gastrointestinal symptoms at various health facilities. Barium enema showed dilation of the sigmoid and descending colon in association with persistent narrowing of the rectum and thickening of the normal haustra of colon at regular intervals, appearing like thumbprints projecting into the lumen, suggestive of ulcerative colitis. Colonoscopy, biopsy and histology confirmed ulcerative colitis. She was commenced on oral sulfasalazine 50 mg/kg/day in two divided doses and later with the addition of oral prednisolone 1 mg/kg/day in two divided doses. She responded well to treatment and is currently in remission. She was followed up for a while at the outpatient clinic but then defaulted.