• Title/Summary/Keyword: Small-bowel

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Intestinal pseudo-obstruction as the initial presentation of systemic lupus erythematosus in a 13-year-old girl (장 가성 폐쇄로 진단된 전신 홍반 루푸스 1예)

  • Cho, Ky Young;Khil, Tae Young;Ahn, Hye Mi;Lee, Sun Wha;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.655-659
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    • 2008
  • Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.

A Case of Jejunal Diverticula Which Caused Massive Small Bowel Bleeding (소장의 대량출혈을 유발한 공장게실 1예)

  • Lee, Ho-Chan;Jang, Byung-Ik;Park, Jae-Hyun;Kim, Sung-Joon;Park, Jun-Seok;Jung, Sang-Hoon
    • Journal of Yeungnam Medical Science
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    • v.26 no.2
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    • pp.120-124
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    • 2009
  • Gastrointestinal bleeding is a common cause of hospitalization. Jejunal diverticula is a rare disease and it is an unusual cause of obscure gastrointestinal bleeding. After exclusion of the more common bleeding sources, small bowel diverticula should be considered as a possible rare cause of gastrointestinal bleeding. Jejunal diverticular bleeding is difficult to diagnose and treat because the bleeding site cannot be identified by routine endoscopy and radiologic studies. An exploratory operation is sometimes needed to diagnose and treat obscure gastrointestinal bleeding. If the bleeding site is certain, then surgical resection of the bleeding part of the bowel is the procedure of choice. We report here on a case of jejunal diverticular bleeding that was diagnosed by and treated with surgical resection.

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A Case of Traumatic Ventral Hernia Repair with a Porcine Dermal Collagen Graft (Permacol) (외상성 복벽 탈장 환자에서 biologic mesh를 이용한 치료)

  • Yu, Byung Chul;Chung, Min
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.63-66
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    • 2012
  • Resection of the bowel is necessary for the repair of a ventral hernia after recovery from trauma in some cases. In such instances, polyester or polypropylene meshcannot be used due to the possibility of infection; we had to use biological mesh instead. We report a case in which a traumatic hernia was repaired with Permacol (Covidien, Norwalk, CT, USA). A 42-year-old male patient had been injured by a factory machine seven months prior to admission. At that time, he had abdominal wall injury and small bowel perforation. His abdominal wall had been a defect after operation. A CT scan of the abdomen showed that the left abdominal wall, which is lateral to left rectus abdominis muscle had only one muscle layer, an external oblique muscle, and that a previous abdominal incision had a defect along the entire incision. During the exploration, 10 cm of small bowel was removed due to firm adhesion to the previous surgical scar. Permacol mesh was applied and fixed with transfascial fixations and tacks by using the intraperitoneal onlay mesh technique. There were no complications after the surgery and the patient was discharged without any problems.

The Effect of Dietary Fiber on the Serum Lipid Level and Bowel Function in Rats (식이섬유질의 종류가 흰쥐의 혈청지질농도와 장기능에 미치는 영향)

  • 김미정;이상선
    • Journal of Nutrition and Health
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    • v.28 no.1
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    • pp.23-32
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    • 1995
  • This study was performed to investigate the influence of dietary fibers from the whole foods on the serum lipid level and bowel function in rats. The fiber sources of experimental diets were prepared by drying and milling of cereal(rice bran), vegetables(Korean cabbage, radish), fruit(apple), and sea weeds(laver, sea tangle). Each of fiber sources was mixed into the diet to make the 5% level of total dietary fiber. Male rats of Sprague-Dawley strain were blocked into 8 groups : FF, CC, CE, V1, V2, ER, S1, and S2. The animals were fed ad libitum each of experimental diets for 4 weeks. Serum triglyceride level was not significantly different among groups. The laver group showed the lowest level in the serum total cholesterol. The Korean cabbage group showed the highest level in the serum HDL cholesterol. The longest transit time was observed in the fiber free group and the shortest transit time was observed in the sea tangle group. Absorption rates of calcium were especially lower in the Korean cabbage and the sea tangle groups than the other groups. Magnesium and phosphorus absorption rates were influenced by SDF(Soluble Dietary Fiber) intake and TDF(Total Dietary Fiber) intake, respectively. Mucosa weight in the small intestine showed the tendency to increase by increasing of IDF (Insoluble Dietary Fiber) intake. especially the Korean cabbage group was the heaviest. The activity of maltase in the mucosa of small intestine was the lowest in the radish group.

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Recent insights into the role of ChREBP in intestinal fructose absorption and metabolism

  • Lee, Ho-Jae;Cha, Ji-Young
    • BMB Reports
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    • v.51 no.9
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    • pp.429-436
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    • 2018
  • Fructose in the form of sucrose and high fructose corn syrup is absorbed by the intestinal transporter and mainly metabolized in the small intestine. However, excess intake of fructose overwhelms the absorptive capacity of the small intestine, leading to fructose malabsorption. Carbohydrate response element-binding protein (ChREBP) is a basic helix-loop-helix leucine zipper transcription factor that plays a key role in glycolytic and lipogenic gene expression in response to carbohydrate consumption. While ChREBP was initially identified as a glucose-responsive factor in the liver, recent evidence suggests that ChREBP is essential for fructose-induced lipogenesis and gluconeogenesis in the small intestine as well as in the liver. We recently identified that the loss of ChREBP leads to fructose intolerance via insufficient induction of genes involved in fructose transport and metabolism in the intestine. As fructose consumption is increasing and closely associated with metabolic and gastrointestinal diseases, a comprehensive understanding of cellular fructose sensing and metabolism via ChREBP may uncover new therapeutic opportunities. In this mini review, we briefly summarize recent progress in intestinal fructose metabolism, regulation and function of ChREBP by fructose, and delineate the potential mechanisms by which excessive fructose consumption may lead to irritable bowel syndrome.

Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding (그물막과 복막파종을 동반한 회장의 상피양 평활근육종)

  • Kim, Chung-Hyoun;Kim, Sun-Young;Jung, Chang-Kil;Choi, Jung-Pil;Seo, Keum-Soo;Lee, Jun-Ho;Choi, Jae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.132-136
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    • 2017
  • Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

Ileal Fecaloma Presenting with Small Bowel Obstruction

  • Yoo, Ha Yeong;Park, Hye Won;Chang, Seong-Hwan;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.193-196
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    • 2015
  • A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.