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At least 541 records · Page 30Linked to original sources
PubMed1996

Jejunal brake: inhibition of intestinal transit by fat in the proximal small intestine.

Optimal absorption of fat requires adequate time of contact with the absorptive sites of the small intestine. In order to prevent steatorrhea, intestinal transit must be slowed in response to the fat that has emptied into the small intestine. Intestinal transit is known to be inhibited by fat in the ileum via the ileal brake. This response has suggested that the regulation of intestinal transit is a function of the distal small intestine. However, clinical observations suggest that the ileal brake is not the only control mechanism for intestinal transit. In short bowel patients with resection of the ileum, the proportion of fecal fat recovery remained constant even after the fat intake was increased threefold. In these patients, optimal fat absorption based on the slowing of intestinal transit must have been triggered by an inhibitory mechanism located outside of the distal small intestine. To test the hypothesis that fat in the proximal small intestine inhibited intestinal transit, we compared intestinal transit during perfusion of the proximal half of the small intestine with 0 (buffer only), 15, 30, or 60 mM oleate in dogs equipped with duodenal and mid-intestinal fistula. Intestinal transit across a 150-cm test segment (between fistulas) was measured by counting for the recovery of a radioactive marker in the output of the mid-intestinal fistula during the last 30 min of a 90-min perfusion. We found that oleate inhibited intestinal transit in a load-dependent fashion (P < 0.005). Specifically, while the mean cumulative recovery of the transit marker was 95.5% during buffer perfusion, the recovery decreased when 15 mM (64.3%), 30 mM o(54.7%), or 60 mM oleate (38.7%) was perfused into the proximal half of the small intestine. We conclude that fat in the proximal small intestine inhibits intestinal transit as the jejunal brake.

Animals↗
PubMed2000

Aorto-oesophageal fistula and intestinal infarction secondary to volvulus following ingestion of foreign bodies in a schizophrenic patient.

We present a case of death caused by voluntary ingestion of non-organic foreign bodies observed at the Institute of Legal Medicine of the University of Trieste. The victim was a young schizophrenic patient whose death, at first giving rise to suspicions of murder by another psychiatric patient, was found to be caused by an uncommon chronic permanence of foreign bodies at different locations of the digestive tract which suddenly evolved into a series of simultaneous lethal complications as yet never described. The case also raised the issue of possible responsibilities of the subject's healthcare providers.

Adult↗
PubMed1978

[Enterocutaneous fistulas of the small intestine in children: therapeutic approach. Study of 22 cases].

25 cases of post-operative small intestinal fistulae in children are described. 24 benefited by intensive feeding either exclusively parenterally (20 cases) or orally by constant infusion of an elemental diet (4 cases). In 13 cases the fistulae closed spontaneously but the other 11 needed further operations after an average of 41 days feeding. 2 children died; 1 was operated on early and the other had chronic granulomatous disease. Thus it is important to avoid early surgical intervention and to ensure adequate drainage of fistulae. Intensive feeding either parenterally or orally has an important role in this condition.

Adolescent↗
PubMed1983

Surgical management of small-bowel radiation enteritis.

We treated 17 patients with severe small-bowel radiation enteritis surgically. Fourteen patients were female. Gynecologic malignant lesions (cervical, ovarian, and endometrial) were the most frequent sites of the primary tumors for which radiation was given. Thirteen patients had bowel obstruction, and the remainder had enterovaginal fistulae. Intestinal bypass, rather than resection, was the preferred approach in the treatment of these patients, and was used in 11 cases. Successful palliation was provided in nine patients, with minimal morbidity and no operative deaths. Follow-up at eight to 60 months has shown no further sequelae of radiation injury or of blind loop syndrome. This supports the relative safety of intestinal bypass for the surgical management of small-bowel radiation enteritis.

Adult↗
PubMed1979

Small intestine cutaneous fistulas.

A retrospective study of 174 patients with small intestine cutaneous fistulas was carried out. Cause, location of fistula, amount of output, presence of inflammation, intestinal obstruction, presence of malnutrition and anemia are associated wih an increased mortality. The results of various modes of treatment indicate that intestinal resection with primary anastomosis, carried out six weeks or later after the onset of the fistula, was associated with the lowest mortality and the highest success rate.

Fistula↗