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Bilharzial granuloma of the gastro-intestinal tract.

Thirty-four patients with bilharzial granuloma of the gastro-intestinal tract were analysed. The commonest site was the rectosigmoid, Bilharzial "appendicitis" was also common but the exact relation between bilharzial granuloma and acute inflammation remains unclear. Preoperative diagnosis is bilharzial granuloma is occasionally difficult and histological proof is necessary. Surgical treatment with polypectomy in the case of a solitary polyp and excision of the affected segment of bowel when there are multiple polps are recommended. There is no evidence that the condition is premalignant.

Adult↗

Small bowel volvulus complicating intestinal ascariasis in children.

Twenty-nine patients in whom small bowel volvulus complicated intestinal ascariasis are reported. Attention is drawn to the varied clinical and radiological presentation and the relationship of volvulus to the use of vermifuge. The mortality of 17 per cent was contributed to by delay in diagnosis and failure of pre-operative resuscitation. Early diagnosis is dependent upon clinical vigilance and repeated radiological assessment of those patients with simple ascaris obstruction who fail to improve rapidly with conservative treatment. The instillation of intraluminal vermifuge intra-operatively has minimized postoperative worm migration through suture lines and anastomoses.

Ascariasis↗

Ascaris lumbricoides: an unusual cause of shunt infection.

Two cases of delayed shunt infection attributable to the abdominal complications of Ascaris lumbricoides infestation are reported. The first child presented with a peritoneal shunt catheter protruding through the anus and the second patient was found to have two live worms around the cephalic shunt tubing. Both had enteric shunt infections which responded well to therapy. The epidemiology and treatment of ascariasis are briefly discussed.

Animals↗

The distribution of inhibited early third stage Cyathostominae larvae in the large intestine of the horse.

The distribution of inhibited early third stage Cyathostominae larvae in different parts of the large intestine of the horse was studied in 20 Shetland ponies necropsied in autumn 1982, 1983 and 1984. The location of the larvae in the large intestinal wall was studied by histological examination of the intestines of the eight ponies from 1984. Inhibited larvae were located predominantly and more or less equally in the caecum and the ventral colon. Generally fewer early L3 were in the dorsal colon. In 1984 a considerable proportion (mean 17%, range 9.7-36.9%) of the inhibited larvae was found in the contents instead of in the mucosa of the large intestine, despite a housing period under helminth free conditions of 5 weeks. These larvae probably had been overlooked in 1982 and 1983. In sections cut from the intestinal wall most early L3 were found in the lamina propria. They were surrounded by a small fibrous capsule. Some were found in the lumen or epithelium of the Lieberkühn's crypts and a small proportion in the submucosa.

Animals↗

Histopathological criteria for the diagnosis of abdominal angiostrongyliasis.

An increasing number of cases of abdominal angiostrongyliasis have recently been diagnosed in southern Brazil. A comparative study of 19 confirmed cases and 15 suspected cases was undertaken to review the anatomo-pathology of the disease and to establish histopathological criteria for its diagnosis. The results were similar in both groups, except for the identification of the worm in the confirmed cases. Macroscopic features comprised two types: a predominant thickening of the intestinal wall (pseudo-neoplastic pattern) and a congestive necrotic lesion (ischemic-congestive pattern). Microscopically, three fundamental histopathological findings were detected: (1) a massive infiltration of eosinophils in all layers of the intestinal wall, (2) a granulomatous reaction and (3) eosinophilic vasculitis affecting arteries, veins, lymphatics and capillaries. We conclude that observation of this histopathological triplet excludes other causes of "eosinophilic gastroenteritis" and establishes the diagnosis of probable abdominal angiostrongyliasis.

Angiostrongylus↗

Prevention of clinical trichostrongylidosis in calves by strategic feeding with the predacious fungus Duddingtonia flagrans.

The present investigation showed that strategic feeding of first-season calves with the microfungus Duddingtonia flagrans through the initial 3 months of the grazing season could prevent severe clinical trichostrongylidosis in the late summer. The successful prevention of disease was particularly noteworthy in view of the high stocking rate practiced on this permanent pasture, which was widely contaminated with a range of gastrointestinal nematodes. The results showed that larval populations of Ostertagia and Cooperia were significantly reduced on the pasture grazed by the fungus-treated calves. Numbers of Nematodirus seemed less affected. The present paper discusses the complexity of fungus-nematode interactions in dung pats under natural conditions.

Animals↗

IgE levels in intestinal juice.

This investigation was performed to determine the possible significance of the IgE levels in intestinal secretions for the recognition of type I food allergy (immediate hypersensitivity). Four groups of individuals were studied and compared with each other: (1) healthy controls and patients with gastrointestinal disorders not affecting the small intestine; (2) patients with small intestinal disease; (3) patients with various manifestations of allergy but without food intolerance; and (4) patients with atopic sensitivity to foods. Despite the presence of proteolysis in the intestinal fluid, a statistically highly significant increase of the intestinal IgE level was observed in patients of group 4 with type I food allergy and in patients of group 3 as compared with normals. This was associated with an increase in the serum IgE level. An increased synthesis of the IgE in the lamina propria of the small intestine is most probable, but not yet adequately established.

Ancylostomiasis↗

Harvesting of leukocytes from intestinal lumen in murine giardiasis and preliminary characterization of these cells.

The aims of this study were to develop a method for harvesting leukocytes from the mouse small intestinal lumen and to identify leukocytes which enter the intestinal lumen of mice infected with Giardia muris. Giardia-infected and uninfected BALB/c mice were anesthetized, and the small intestine was removed. The intestinal lumen was then flushed with nutrient medium, and the luminal washings were found to contain substantial numbers of mononuclear leukocytes. The number of these cells harvested from the intestinal lumen of 24 mice infected with Giardia muris was 22 +/- 3 X 10(4) (mean value +/- standard error). Most of the cells were lymphocytes, although small numbers of macrophages were also obtained. By staining with monoclonal antibodies, approximately 50% of the intraluminal leukocytes were shown to be T lymphocytes. Similar numbers of mononuclear leukocytes were obtained from the intestinal lumen of Giardia-infected and uninfected mice. However, T lymphocytes and other mononuclear cells from infected animals were frequently observed in contact with Giardia trophozoites. This observation is consistent with the hypothesis that intraluminal leukocytes play a part in gastrointestinal immune defense.

Animals↗

Intestinal secretion as a cause of hypokalemia and cardiac arrest in a patient with strongyloidiasis.

A 32-year-old white American male contracted strongyloidiasis in Nigeria. Prolonged and severe watery diarrhea was complicated by hypokalemia and cardiac arrest. Steady-state perfusion studies with a plasma-like electrolyte solution revealed net secretion of water, sodium, potassium, and chloride in a segment of jejunum. Mucosal permeability measured by the ratio of [14C]urea and tritiated water diffusion was unchanged. Chloride secretion occurred against both an electrical and chemical gradient, which suggests that chloride secretion was active. Intestinal water and electrolyte secretion may be the mechanism of watery diarrhea in patients with strongyloidiasis.

Adult↗