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Imaging Considerations in NEC Diagnosis
Published in David J. Hackam, Necrotizing Enterocolitis, 2021
Abnormalities of intestinal wall thickness may result from causes other than NEC, for instance, volume overload, hypovolemia, and other etiologies of inflammation or ischemia. Additionally, it may be difficult to distinguish thin, diseased bowel from stretched, apparently thin walls of distended bowel. One might expect that healthy bowel, even if distended, would demonstrate normal perfusion and motion (6).
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Nausea and vomiting generally occur together and can reflect the presence of acute abdominal emergencies, chronic indigestion, and acute systemic infections, as well as many diseases involving other body systems. They are often associated with abdominal pain. The medical term for vomiting is emesis.Colic can refer to spasmodic pains in the abdomen, to the paroxysms of pain seen in young infants, or to a variety of pain or cramping episodes due to a number of causes. Anorexia (loss of desire to eat) is a primary symptom in a number of disorders of the gastrointestinal tract and liver. Diverticula or pouches can occur along the intestinal wall. Meckel's diverticulum refers to such an area on the ileum that can produce ulceration and bleeding. Dlverticislosls denotes the presence of multiple sites; diverticulitis specifically describes inflammation.
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Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Acute mesenteric ischaemia is commonly due to arterial thrombosis, arterial embolism, venous thrombosis or non-occlusive ischaemia (often due to poor cardiac output). The pathogenesis involves reduced blood flow to the intestines, bacterial translocation across the dying intestinal wall and systemic inflammatory response syndrome. The classic presentation is of acute severe abdominal pain with minimal or no abdominal signs. The degree of pain is out of keeping with the clinical findings. Blood tests may often reveal a metabolic acidosis with a raised white cell count. AXRs are often non-specific in the early phase, CT scanning is often used to assist in the diagnosis, but angiography remains the gold standard. Aggressive fluid resuscitation, antibiotics and heparin are important in the initial management. Early surgical revascularisation with the removal of necrotic bowel remains the treatment of choice, but thrombolydcs at the time of angiography and embolectomy may also have a role. Prognosis of acute mesenteric ischaemia is poor, especially if diagnosis is not made early.
External validation and comparison of simple ultrasound activity score and international bowel ultrasound segmental activity score for Crohn’s disease
Published in Scandinavian Journal of Gastroenterology, 2023
Lu Wang, Chenjing Xu, Yanyan Zhang, Wenyu Jiang, Jingjing Ma, Hongjie Zhang
Additionally, the diagnostic potential of the IBUS-SAS was slightly higher than that of the SUS-CD (AUC = 0.895 vs. 0.835) without a significant difference. This may be attributed to the inclusion of inflammatory fat and intestinal wall stratification in the IBUS-SAS. The proliferation of mesenteric inflammatory fat is characteristic of active CD. Previous studies have confirmed that mesenteric inflammatory fat is significantly related to disease activity [26,27]. The stratification of the intestinal wall may also reflect CD activity to some extent. In severe CD, the layers of the intestinal wall disappear, which makes distinguishing the structure of each layer impossible, although the structure of the intestinal wall may reappear with the remission phase [28]. For mild lesions, intestinal wall layers will reappear with the remission of the disease. This panel of international, multidisciplinary experts has determined mesenteric inflammatory fat and loss of bowel wall stratification as valuable markers of disease activity [29]. Therefore, the IBUS-SAS can present more specific information on CD severity compared to the SUS-CD. The inter-rater reliability by two independent expert operators evaluating i-fat and BWS demonstrated good agreement, and the weighted kappa was 0.84 and 0.86, respectively (p < 0.001). This result highlights the importance of mesenteric inflammatory fat and intestinal wall stratification in US scoring systems.
Effect of Glutamine on Short-term Surgical Outcomes in Rectal Cancer Patients Receiving Neoadjuvant Therapy: A Propensity Score Matching Study
Published in Nutrition and Cancer, 2023
Gang Tang, Feng Pi, Zhengqiang Wei, Xiangshu Li
Colorectal cancer, one of the most common malignant tumors worldwide, has an estimated incidence of more than 1.8 million cases every year. Rectal cancers comprise nearly 40% of these cases and are primarily treated by surgical interventions (1, 2). The advent of total mesorectal excision has greatly improved the oncologic prognosis of patients with rectal cancer (3). However, given that most patients receive an initial diagnosis only after the development of locally advanced disease due to lack of obvious clinical symptoms, the efficacy of surgical treatment in isolation is limited. In view of the fact that preoperative chemoradiotherapy is known to reduce tumor stage and local recurrence rate, as well as increase the radical resection rate (4, 5), neoadjuvant chemoradiotherapy in combination with total mesorectal excision has become the standard treatment for locally advanced rectal cancers (3). Certain studies, however, highlight the damage to the local intestinal wall tissue as well as an increased incidence of postoperative complications as consequences of neoadjuvant therapy (6, 7). A recent metastudy revealed the association between the increased incidence of pelvic abscess, anastomotic leakage, and wound infection and neoadjuvant radiotherapy (3). Such complications not only increase the economic burden on patients, but also negatively affect their cancer prognosis (8, 9). Therefore, the development of strategies to reduce the incidence of postoperative complications in rectal cancer patients receiving neoadjuvant therapy has become a research hotspot.
Immune activation by microbiome shapes the colon mucosa: Comparison between healthy rat mucosa under conventional and germ-free conditions
Published in Journal of Immunotoxicology, 2021
Fabián Čaja, Dmitry Stakheev, Oleksander Chernyavskiy, Jiří Křížan, Jiří Dvořák, Pavel Rossmann, Renata Štěpánková, Peter Makovický, Pavol Makovický, Hana Kozáková, Luca Vannucci
The anatomical differences in the bowel under CV and GF conditions suggest that dynamic relationships between the intestinal microbiota and both local and systemic immunity are able to influence the structures of the intestinal wall. Previous observations by various authors showed changes in the GF bowel anatomy after bacterial colonization, with conversion to CV animal characteristics. Therefore, the presence of the commensal microflora was considered an efficient factor for shaping the bowel anatomy (Freter and Abrams 1972; Pesti 1979; Koopman et al. 1984). The idea of a relationship between different bacterial strains and collagenolytic activity was also recently reported by Guyton et al. (2019). In the present study, whether in GF or CV hosts immunological conditions may have a possible role in shaping the colon mucosa structure was investigated.