China
Africa
Explore chapters and articles related to this topic
Bacterial Communities in the Pathogenesis of Necrotizing Enterocolitis
Published in David J. Hackam, Necrotizing Enterocolitis, 2021
Brigida Rusconi, Misty Good, Barbara Warner
Only two publications have explored the idea of using fecal microbiota transplants (FMTs) to prevent the development of NEC. Similar to other intestinal diseases, such as inflammatory bowel diseases, the FMT experiments are premised on the idea that a healthy microbial community will prevent the inflammatory response that results in the necrosis of the intestinal wall. A recent publication by Prado et al. used a single dosage of cecal content gavage from adult rats prior to experimental NEC induction and during the early stages of the model (54). With both treatments, the inflammatory cytokines were reduced and there was an improvement in the architecture of the terminal ileum as determined by histological scores. Li et al. used a daily rectal enema for their FMT in mice, circumventing the burden of a high bacterial load on the small intestine (55). These animals also had improved histological scores and additionally were shown to have reduced bacterial translocation. By reducing the oxidative stress in the intestine, the FMT prevented the development of the hyperinflammatory state that underlies NEC.
Low-Dose Naltrexone
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Crohn’s disease is an inflammatory disease typically affecting the terminal ileum; however it may encompass any part of the gastrointestinal tract. The presence of TNFα, IL-2, and IL-10 leads to the inflammation of the gastrointestinal tract seen in CD. The inflammation of the gastrointestinal tract can cause edema, fibrosis, ulceration, mucosal thickening, narrowing of the intestinal lumen, and fistulas. Anemia and nutritional deficiencies due to bleeding in CD are common because of malabsorption, increased motility, and interactions between medications and nutrients. Additional complications include hepatobiliary, joint, ocular, dermatologic, coagulation, and metabolic disorders.
Laparoscopic Ileocecal Resection
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Long-term consequences and physiological changes should be kept in view in surgeries for benign disease. As mentioned earlier, the terminal ileum is a distinct and fairly important area for nutrient absorption, and its loss may lead to deficiency of fat soluble vitamins and vitamin B12. However, physiological adaptation of the remaining bowels generally compensates the loss after a certain period of time. Possibilities of gall stones increases in patients with an absent terminal ileum due to a disturbance in the bile acid pool. Oxalate urinary stones are formed more frequently in patients with a loss of the terminal ileum because the colon gets a greater quantity of free oxalate to absorb. Loss of the ileocecal valve and the initial part of colon may lead to diarrhea, or at least increased stool frequency, in some patients. Similarly, loss of the ileocecal valve allows the colonic flora to populate the distal small bowel, which may lead to possible disturbances in digestive function.
Ileocolic anastomotic inflammation after resection for Crohn’s disease indicates disease recurrence: a histopathologic study
Published in Scandinavian Journal of Gastroenterology, 2020
Robert P. Hirten, Simran Mashiana, Benjamin L. Cohen, Bruce E. Sands, Jean Frederic Colombel, Noam Harpaz
Crohn’s disease (CD) frequently results in ileocolic resections, with postoperative disease recurrence occurring in the neo-terminal ileum of up to 70% of patients within 1 year [1]. Recurrence after ileocolic resection (ICR) is graded using the Rutgeerts score, with categories ≥ i2 portending an increased risk of clinical recurrence [1]. Although the i2 category is characterized by >5 ulcers in the neo-terminal ileum or lesions confined to the anastomosis, there is controversy whether anastomotic ulcers (AU) should be excluded from the scoring system, out of concern they result from postoperative ischemia rather than CD (Figure 1). Variability in classification of AU as CD results in heterogeneity in the grading of recurrence in postoperative trials and in practice. We recently showed that AU in subjects in endoscopic remission are associated with an increased risk of endoscopic recurrence or subsequent ICR [2]. A recent technical review by the International Organization for the Study of Inflammatory Bowel Disease highlighted the controversy regarding AU, by calling for the confirmation as to whether they represent CD or ischemia through assessment of histology [3].
Beyond the commonest: right lower quadrant abdominal pain is not always appendicitis
Published in Alexandria Journal of Medicine, 2020
Mahmoud Agha, Maha Sallam, Mohamed Eid
Crohn’s disease or regional enteritis is an idiopathic chronic inflammatory bowel disease, which may affect any segment of the gastrointestinal tract, from the mouth to the anus. Crohn’s disease usually shows multiple asynchronous skip segmental gastrointestinal involvement with varying degrees of severity. Ileocecal region is the most commonly involved site, with relative long segmental affection of the terminal ileum and the proximal right colon. The revised history of our candidates documented 6 (0.6%) radiologically diagnosed and histopathologically proven Chron’s disease. Patients’ age ranged between the ages of 15 and 25 years, with near similar clinical and laboratory presentation of questionable acute appendicitis. The complaint was acute exacerbated right iliac fossa pain on top of chronic pain. [26]
Correlation between the macroscopic severity of Crohn’s disease in resected intestine and bowel wall thickness evaluated by water-immersion ultrasonography
Published in Scandinavian Journal of Gastroenterology, 2019
Katsuki Yaguchi, Tomohiko Sasaki, Tsuyoshi Ogashiwa, Masafumi Nishio, Yu Hashimoto, Aya Ikeda, Misato Izumi, Akiho Hanzawa, Naomi Shibata, Hiromi Yonezawa, Kentaro Sakamaki, Yoko Tateishi, Kazushi Numata, Shin Maeda, Hideaki Kimura, Reiko Kunisaki
All 27 patients underwent preoperative TAUS within 1 month prior to surgical resection. The examinations were performed by four highly experienced ultrasound technicians (A. H., M. I., and N. S., H. Y.). TAUS examinations were performed without special patient preparation; i.e., no prior fast, parenteral contrast reagents, or administration of oral contrast media, to achieve adequate distension. The ultrasonography equipment used was Aplio XG and XV (Canon Medical Systems, Tochigi, Japan) and LOGIQ 7 and E9 (GE Healthcare, Ltd., Chicago, IL). A general scan was performed using a 3.5–6-MHz convex probe, and a more localized and detailed scan of the affected area was performed using a 7.5–12-MHz linear probe. BWT was measured three times in the measuring positions, and the average value was adopted (Figure 1(A)). The terminal ileum was identified using the ileocecal (Bauhin’s) valve as a marker in the right iliac fossa. We systematically scanned the small bowel beginning in the terminal ileum and following its course proximally for as far as possible.