• Journal of Digestive Cancer Research
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• v.9 no.2
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• pp.60-67
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• 2021

Tumors of the small intestine are rare and generally asymptomatic or with nonspecific symptoms. The small intestine is difficult to approach using conventional endoscopy, and early diagnosis of the small intestinal tumors is difficult. Therefore, many of the small intestinal tumors are diagnosed at an advanced stage, which makes the prognosis poor. Premalignant lesions of the small intestine or known risk factors of small bowel cancer are sporadic adenoma, adenoma associated with familial adenomatous polyposis, hamartomatous polyp associated with Peutz-Jeghers syndrome, Crohn's disease, and celiac disease. Therefore, it is necessary to recognize that the small bowel cancer can occur in these patients with premalignant lesions or risk factors of small bowel cancer. To reduce the possibility of small bowel cancer or to detect at an earlier stage, attention should be paid to screening and surveillance of these patients with premalignant lesions or risk factors of the small bowel cancer.

• Journal of information and communication convergence engineering
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• v.20 no.3
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• pp.153-159
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• 2022

Plain radiographic analysis is the initial imaging modality for suspected small bowel obstruction. Among the many features that affect the diagnosis of small bowel obstruction (SBO), the presence of gas-filled or fluid-filled small bowel loops is the most salient feature that can be automatized by computer vision algorithms. In this study, we compare three frequently applied pixel-clustering algorithms for extracting gas-filled areas without human intervention. In a comparison involving 40 suspected SBO cases, the Possibilistic C-Means and Fuzzy C-Means algorithms exhibited initialization-sensitivity problems and difficulties coping with low intensity contrast, achieving low 72.5% and 85% success rates in extraction. The Adaptive Resonance Theory 2 algorithm is the most suitable algorithm for gas-filled region detection, achieving a 100% success rate on 40 tested images, largely owing to its dynamic control of the number of clusters.

• Investigative Magnetic Resonance Imaging
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• v.24 no.2
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• pp.85-89
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• 2020

Amyloidosis is an all-inclusive disease of deposition of amyloid proteins in the extracellular spaces, which in localized or systemic form cause tissue damage and dysfunction. Herein, we report a case of small bowel involvement of systemic amyloidosis presenting with multiple polypoid wall thickening mimicking small bowel polyposis syndrome in an age 75 male. Interestingly, polypoid wall thickening and amyloidoma showed hypointensity on T2-weighted images. To our knowledge, there has been no literature describing MRI findings of poylpoid wall thickening and amyloidoma. Although the underlying mechanisms are unclear and need validation, hypointensity on T2-weighted images could be valuable in diagnosing small bowel involvement of amyloidosis in patients presenting with poylpoid wall thickening and amyloidoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.70-74
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• 2006

Isolated small bowel intussusception accounts for 10% of all pediatric intussusception. It is more common in children older than 2 years of age. Presentation usually is with vomiting and abdominal pain. Currant jelly stool and palpable mass are less frequent than typical intussusception. There are few reported cases of children with transient small bowel intussusception. We describe 3-year-old boy presented with intermittent cyclic crampy abdominal pain for 6 months was diagnosed as having recurrent transient small bowel intussusception by abdominal ultrasonography and small bowel series.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.98-104
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• 2019

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.263-268
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• 1997

Purpose : Authors designed a customized Small Bowel Displacement System (SBDS) to displace the small bowel from the Pelvic radiation fields and minimize treatment-related bowel morbidities. Materials and Methods : From August 1995 to Mar 1996. 55 consecutive patients who received pelvic radiation therapy with the SBDS were included in this study. The SBDS consists of a customized styrofoam compression device which can displace the small bowel from the radiation fields and an individualized immobilization abdominal board for easy daily setup in prone position After opacifying the small bowel with Barium3, the patients were laid Prone and posterior-anterior (PA) and lateral (LAT) simulation films were taken with and without the SBDS. The areas of the small bowel included in the radiation fields with and without the SBDS were compared. Results : Using the SBDS, the mean small bowel area was reduced by $59\%;on\;PA\;and\;51\%$ on LAT films (P=0.0001). In six Patients (6/55. $11\%$), it was Possible that no small bowel was included within the treatment fields. The mean upward displacement of the most caudal small bowel was 4.8 cm using the SBDS. Only $15\%$ (8/55) of patients treated with the SBDS manifested diarrhea requiring medication. Conclusion : The SBDS is a novel method that can be used to displace the small bowel away from the treatment portal effectively and reduce the radiation therapy morbidities. Compliance with setup is excellent when the SBDS is used.

• Journal of radiological science and technology
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• v.36 no.1
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• pp.39-47
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• 2013

For radiotherapy in rectal cancer patients treated with small bowel displacement device (SBDD) and belly board, We will suggest new indication of using SBDD depending on obesity index by analyzing correlation between obesity and irradiated small bowel volume. In this study, We reviewed 29 rectal cancer patients who received pelvic radiation therapy with belly board and SBDD from January to April in 2012. We only analyzed those patients treated with three-field technique (PA and both LAT) on 45 Gy (1.8 Gy/fx). We measured patients' height, weight, body mass index (BMI), waist-hip ratio (WHR) and divided BMI into two groups.(${\geq}23$:BMI=group1, <23:BMI=group2) We performed a statistical analysis to evaluate correlation between total volume of bladder($TV_{bladder}$), obesity index and high dose volume of small bowel (small bowel volume irradiated at 90% of prescribed dose, $HDV_{sb}$), low dose volume of small bowel (small bowel volume irradiated at 33% of prescribed dose, $LDV_{sb}$). The result shows, gender, WHR and status of pre operative or post operative do not greatly affect $HDV_{sb}$ and $LDV_{sb}$. Statistical result shows, there are significant correlation between $HDV_{sb}$ and BMI (p<0.04), $HDV_{sb}$ and $TV_{bladder}$ (p<0.01), $LDV_{sb}$ and $TV_{bladder}$ (p<0.01). BMI seems to correlate with $HDV_{sb}$ but does not with $LDV_{sb}$ (p>0.05). There are negative correlation between $HDV_{sb}$ and BMI, $TV_{bladder}$ and $HDV_{sb}$, $TV_{bladder}$ and $LDV_{sb}$. Especially, BMI group1 has more effective and negative correlation with $HDV_{sb}$ (p=0.027) than in BMI group2. In the case of BMI group 1, $TV_{bladder}$ has significant negative correlation with $HDV_{sb}$ and $LDV_{sb}$ (p<0.04). In conclusions, we confirmed that Using SBDD with belly board in BMI group1 could more effectively reduce irradiated small bowel volume in radiation therapy for rectal cancer. Therefore, We suggest using belly board with SBDD in order to reduce the small bowel toxicity in rectal radiotherapy, if patients' BMI is above 23.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8613-8618
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• 2016

Background: The symptoms of small bowel malignancies are mild and frequently nonspecific, thus patients are often not diagnosed until the disease is at an advanced stage. Moreover, the lack of sufficient studies and available data on small bowel cancer makes diagnosis difficult, further delaying proper treatment for these patients. In fact, only a small number of published studies exist, and there are no studies specific to Thailand. Radiologic and endoscopic studies and findings may allow physicians to better understand the disease, leading to earlier diagnosis and improved patient outcomes. Objective: To retrospectively analyze the clinical, radiologic, and endoscopic characteristics of small bowel cancer patients in Thailand's Siriraj Hospital. Materials and Methods: This retrospective analysis included 185 adult patients (97 men, 88 women; mean age = $57.6{\pm}14.9$) with pathologically confirmed small bowel cancer diagnosed between January 2006 and December 2013. Clinical, radiologic, and endoscopic findings were collected and compared between each subtype of small bowel cancer. Results: Of the 185 patients analyzed, gastrointestinal stromal tumor (GIST) was the most common diagnosis (39.5%, n=73). Adenocarcinoma was the second most common (25.9%, n = 48), while lymphoma and all other types were identified in 24.3% (n = 45) and 10.3% (n = 19) of cases, respectively. The most common symptoms were weight loss (43.2%), abdominal pain (38.4%), and upper gastrointestinal bleeding (23.8%). Conclusions: Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST. Obstruction and ulcerating/circumferential masses were findicative of adenocarcinoma, as revealed by radiology and endoscopy, respectively. Finally, no specific symptoms were related to lymphoma.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.219-221
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• 2008

Intestinal obstruction is not uncommon in infants. The common causes of intestinal obstruction in the neonatal period are Hirschsprung disease, intestinal atresia, meconium ileus, and intussusception. However, small bowel obstruction caused by a congenital band is very rare. We report a 27-day-old baby who was admitted with abdominal distension and fever. The abdominal X-ray revealed massive bowel dilatation and the contrast gastrografin enema suggested a distal small bowel obstruction. The explolaparotomy showed small bowel entrapment due to an unusual anomalous congenital band.

• Journal of Physiology & Pathology in Korean Medicine
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• v.37 no.1
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• pp.19-24
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• 2023

Postoperative adhesive small bowel obstruction (ASBO) is an intractable disorder which sometimes leads to adhesiolysis or small bowel resection. These therapeutic reoperations, however, also have many limitations including complications. An 80-year-old female, who had undergone 4-abdominal surgeries, visited the hospital with continuous vomiting. Based on her clinical symptoms and history, multiple air-fluid levels and distention of the small bowel in an abdominal X-ray, we diagnosed her with postoperative incomplete ASBO. We conducted acupuncture and an herbal medicine enema to stimulate bowel movement and relieve pain. The patient came in complaining of abdominal pain and vomited more than 10 times on hospital day 0 stopping on hospital day 4. Comparing hospital day 0 with hospital day 4, the abdominal pain decreased from a numerical rating scale (NRS) 10 to 4. There were no side effects such as redness or burns during the treatment process. This study presented an acupuncture-based treatment will be helpful for clinicians managing cases of ASBO with poor performance in elderly individuals.