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PubMed1989

CT of the stomach and duodenum.

CT has become an important tool in the diagnosis and management of diseases that affect the stomach and duodenum. By depicting the bowel lumen, wall, and extramural structures, CT can provide unique information that complements standard air contrast radiography and endoscopy. Proper scanning methods and knowledge of normal anatomy are necessary for optimal results. We utilize the gas contrast technique for organ-specific examination in patients with known or suspected gastroduodenal disease. Gastric adenocarcinoma is an important indication for CT evaluation. Unfortunately, early hopes that CT could accurately stage gastric cancer have not been realized. CT is not as accurate as laparotomy in staging early gastric cancer, primarily owing to its inability to detect small peritoneal implants, diagnose metastases in normal-sized lymph perigastric nodes, and predict pancreatic invasion. Nevertheless, CT retains an important role in depicting gross metastatic disease and guiding percutaneous biopsy, particularly in patients who are deemed poor surgical candidates or have undergone prior gastric resection. A variety of conditions other than primary gastric adenocarcinoma produce recognizable abnormalities on CT. Gastric lipoma, leiomyosarcoma, and varices have a distinctive appearance. Others, including gastritis and uncomplicated peptic ulcer, produce nonspecific gastric wall thickening. Endoscopic correlation and biopsy are required for specific diagnosis in these cases. The duodenum, by virtue of its location in the anterior pararenal compartment of the retroperitoneum, may be involved by numerous benign and malignant conditions. In blunt trauma, complicated pancreatitis, and peptic ulcer disease, as well as primary and metastatic malignancy, CT can provide data that may alter patient management.

Duodenal Diseases↗
PubMed1989

[The effect of almagel, gastrotsepin and food on the acidity and protease activity of the stomach and duodenum in peptic ulcer].

Patients with duodenal ulcers were examined for the degree and duration of the effect of almagel, gastrocepin and food on pH and protein digestion by various enzymes of the contents of the stomach and initial part of the duodenum. Acidity and protein digestion were determined in vitro with 3 values of the substrate pH. It was established that almagel and food efficiently reduced the acidity and protein digestion in the stomach and duodenum. Gastrocepin decreased those indicators to a lesser degree but throughout a longer period of time. The data obtained can be used for optimizing the treatment of patients suffering from duodenal ulcers.

Aluminum Hydroxide↗
PubMed1989

The duodenum. Surgical anatomy.

The second part of this monograph on the duodenum describes the muscular and mucosal changes observed at the gastroduodenal junction. The structure of the duodenal wall and details of the intramural portion of the common bile and pancreatic ducts are described, together with the surgical anatomy of the four parts of the duodenum. The arterial supply, the venous and lymphatic drainage, and the innervations are described from the surgeon's point of view.

Ampulla of Vater↗
PubMed1989

The duodenum. Part 4: Surgery.

This is the last part of our efforts to present, if possible, the duodenum in toto as an anatomical and surgical entity. For all practical purposes, Part 4 is a short presentation of the anatomy involved in mobilization and exposure of the duodenum from a surgical standpoint with specific applications. A table with most of the anatomical complications of duodenal surgery is also included.

Duodenum↗
PubMedDate not supplied

[Anatomy of the upper part of the duodenum in men].

The internal anatomy of the first part of the duodenum was studied in 39 anatomical specimens obtained from necropsies. Three mucosal folds were observed in the aboral part of this segment: two folds had a radial disposition and the third a circular one. The localization of these folds corresponded to the narrow zone observed externally in the first part of the duodenum. The functional significance of these results is discussed.

Adult↗
PubMed1987

Bradykinin action in the rat duodenum: receptor binding and influence on the cyclic AMP system.

Bradykinin binds to a single class of binding sites at rat duodenum plasma membranes. In the presence of endogenous calcium and at low bradykinin concentrations the receptor activation is followed by a stimulation of adenylate cyclase activity and the elevation of the cAMP level. In the absence of calcium and at high peptide concentrations the cAMP level is lowered via both inhibition of adenylate cyclase and stimulation of cAMP-phosphodiesterase. These different changes in the cAMP level might be correlated with the biphasic pharmacological action of bradykinin in the rat duodenum. The results suggest that one type of bradykinin (B2) receptor is able to initiate several effectuation mechanisms.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1979

A preliminary study of scanning electron microscopic changes of the duodenum during healing of duodenal ulcers.

Using the scanning electron microscope, changes in the rat duodenum have been studied during the healing of gastric secretagogue-induced duodenal ulcers on the 1st, 3rd, 7th and 10th days post-infustion. A montage technique with fine resolution has allowed both the entire area of the duodenum and the cellular organization in individual villi in proximity to the ulcers to be investigated. There was a considerable range of appearances noted at any one time point due to the variations in the size and depth of the original area of ulceration. On day 1, there was acute destruction of the mucosal surface with distortion of the villi at the ulcer margin. By the 3rd day, some specimens already showed full epithelialization over the defects whereas others up to day 10 revealed persistent areas of ulceration. Occasional specimens showed areas suggestive of gastric surface metaplasia on the villous surface adjacent to these ulcers.

Animals↗
PubMed1987

Single-contrast examination of the duodenum following enteroclysis.

Important abnormalities of the distal duodenum can be missed on the usual enteroclysis examination because of placement of the intubation tube beyond the ligament of Treitz. This can be avoided by extending the examination to include visualization of the duodenum during withdrawal of the nasojejunal tube. On the basis of the case reported here this procedure is suggested for patients with unexplained upper gastrointestinal bleeding in whom the remainder of the small bowel is normal.

Adult↗
PubMed1988

[Radiological study of the duodenum in celiac disease in adults].

Celiac disease (CD) is the most common form of malabsorption in childhood when it presents with diarrhea and growth failure, a jejunal biopsy is considered the first diagnostic investigation by some authors. In adulthood, clinical symptoms of CD may mimic several different disease, such as peptic ulcer and IBS, and the first diagnostic investigation is an upper GI series. Radiological features of duodenum and small bowel were evaluated in twenty patients with adult onset celiac disease. Sign of duodenitis such as thickened folds, mucosal nodules, dilatation of duodenum and erosions were observed in 19 out of our 20 patients (95%); particularly, thickened folds in 17 (85%), nodularity in 16 (80%), duodenal dilatation in 12 (60%) and erosions in 4 (20%). In celiac disease the lesions are more severe in the upper part of small bowel, and duodenitis may be the unique sign of CD. Duodenitis may be part of a disease involving the entire small bowel; so, a duodenitis observed in the upper gastrointestinal tract requires the study of the entire small bowel--which seems to be very important in the case of celiac disease.

Adolescent↗
PubMed1987

[A study of gastric cancer invasion of the duodenum].

Gastric cancers that have invaded in the duodenum were clinicopathologically studied in 83 patients in an attempt to clarify surgical therapeutic problems. The classification and results are itemized below. 1) The extensive forms of these cancers were found to include the types of continual superficial extension (12 patients), expansion (11), deep-layer (39), whole-layer (9), non-continual extensive intralymphatic duct type (8) and specific type (4). 2) More patients manifesting a deep-layer or intralymphatic duct cancers were Borr. 3 and 4 types with a longer distance of infiltration. All of the 14 patients with an aw (+) showed these patterns of extension. 3) The n3 (+) was more common with Nos. 12, 13 and 14 lymph nodes, and similar results were seen by RI lymphography. Thus, special care may have to be exercised in treating the duodenal stump in the gastric cancers that have invaded the pyloric ring. Pancreato-duodenectomy may be required for the removal of lymph nodes in patients with gastric cancers that show a severe infiltration into the duodenum.

Duodenal Neoplasms↗
PubMed1987

Heterotopic gastric mucosa accompanied by aberrant pancreas in the duodenum.

An operated case of a heterotopic gastric mucosa, accompanied by an aberrant pancreas tissue, in the bulb of the duodenum was reported. A 40-yr-old man complained of epigastralgia and was diagnosed to have a protruding lesion in the duodenum by roentgenological and endoscopic examinations. Partial excision of the duodenal wall including the mass was performed. Cut surface of the specimen showed a yellowish-whitish mass in the submucosal through the subserosal layers, which was covered by a papillary elevated mucous membrane. Histologically the mass was an aberrant pancreas of the Heinrich I-type and the mucous membrane covering the mass was a heterotopic gastric mucosa, consisting of completely developed fundic glands.

Adult↗
PubMed1987

Bacterial overgrowth in the duodenum of dogs with exocrine pancreatic insufficiency.

Bacterial overgrowth (greater than 10(5) colony-forming units/ml duodenal juice) in the duodenum was demonstrated in 8 of 11 dogs with exocrine pancreatic insufficiency (EPI). In 4 of these 8 dogs, the overgrowth included large numbers (greater than 10(4) colony-forming units/ml) of obligate anaerobic bacteria and was associated with decreased activities of several brush border marker enzymes and, in 2 dogs, with partial villous atrophy in the jejunum. Changes in the jejunal mucosa of the remaining dogs (with either no overgrowth or overgrowth of aerobic bacteria alone) were characterized by increased activities of some brush border disaccharides and of lysosomal hydrolases. One dog was euthanatized without treatment, at the owner's request. The response of 4 of the remaining 10 dogs treated with enzyme replacement alone was poor or suboptimal, and all of these 4 dogs had bacterial overgrowth. One of these dogs had an excellent clinical response when also given oxytetracycline orally for 14 days, but the other 3 dogs did not improve further in response to the same treatment. It was concluded that bacterial overgrowth in the duodenum is common in dogs with EPI and that, when such overgrowth includes large numbers of obligate anaerobes, there may be associated biochemical and morphologic abnormalities in jejunal mucosa. Functional disturbances related to abnormal intestinal microflora may be responsible for the failure of some dogs with EPI to respond fully to oral pancreatic enzyme supplementation without antibiotic therapy.

Animals↗
PubMed1986

Histopathological changes in the epithelial cells of rat duodenum following chronic dietary exposure to cadmium, with particular reference to Paneth cells.

Male and female rats 8 weeks old were exposed for 360 days to a sole source of drinking water containing 0.2 g/l cadmium as the chloride salt. Control rats were exposed for the same period to deionized water. At 90, 180, 270 and 360 day intervals a proportion of the rats from both test and control groups were killed and the duodenums removed. The histopathology was assessed by both light and electron microscopy. In cadmium treated rats the duodenums were enlarged and there was a significant reduction in the percentage of crypts containing Paneth cells. Remaining Paneth cells appeared vacuolated. By both light and electron microscopy changes were noted in the epithelial cells covering the villus tips. These were swollen and protruded towards the duodenal lumen to give a 'cobblestone' appearance by scanning electron microscopy. It is suggested that these histopathological appearances will be seen in chronic dietary exposure to cadmium.

Animals↗
PubMed1985

[Secretin and bicarbonate secretion in probands and ulcer patients following bolus administration of hydrochloric acid into the duodenum].

Various amounts of hydrochloric acid (50, 100 and 200 ml) of two different concentrations (70- and 140 mmol/l) were rapidly instilled into the duodenum of eight healthy subjects and five duodenal ulcer patients. Secretin, gastrin and bicarbonate output were measured. Secretin release and bicarbonate secretion are dependent on acid load and not on acid concentration. There is a linear correlation between the amount of acid instilled into the duodenum and pancreatic bicarbonate output. After duodenal acidification duodenal ulcer patients released equal amounts of secretin and secreted as much bicarbonate as healthy subjects.

Adult↗
PubMed1973

[Changes in the bioelectrical activity of the stomach and duodenum in dogs with acute phosphoorganic compound poisoning before and after treatment with preparation H-5/T].

The results of investigations on bioelectric activity changes in the stomach and proximal duodenum, performed on 12 dogs under acute experiment conditions following poisoning with IMFF, PMFF and MEDETFK poisonous substance and subsequent treatment with the antidote N-5 (T) are reported. Under the effect of the poisonous substances (FOV) investigated, an overall intensification of the motoricity of the stomach and duodenum is established, manifested by the appearance of spice potentials, changes in the rhythm of the slow wave, presence of antiperistalsis and strongly pronounced spasm of the smooth musculature. The listed phenomena are successfully eliminated by the effect of the antidote N-5 (T) within 3-5 min after its injection.

Acute Disease↗
PubMed1977

Ultrastructural localization of adrenergic nerve terminals in the circular muscle layer and muscularis mucosae of the rat duodenum after acute treatment with 6-hydroxydopamine.

The ultrastructure of the intrinsic adrenergic innervation of the circular muscle coat and muscularis mucosae of rat duodenum has been studied following acute treatment with 6-hydroxydopamine. Adrenergic terminals were found among intramuscular nerve bundles. They were most numerous in the outer layer of the circular coat, where close neuromuscular contacts were commonly encountered. Adrenergic terminals also innervated the inner layer of the circular coat and the muscularis mucosae, where only wide neuromuscular contacts have been found. The evidence suggests that smooth muscle cells in the rat duodenum may be directly influenced by adrenergic nerves.

Adrenergic Fibers↗
PubMed1984

Bile diversion from the duodenum: its effect on gastric and pancreatic function.

The effect of diverting bile from the duodenum in four dogs by cholecysto-jejunostomy was studied using a double-marker perfusion technique. During digestion of a liquid meal, acid secretion increased from 0.8 mmol H+/min to 1.48 mmol H+/min (p less than 0.05, paired t test); there was an associated rise in serum levels of gastrin 120 minutes after feeding (p less than 0.001, paired t test). Pancreatic secretion of trypsin decreased from 3.91 IU/min to 2.66 IU/min after bile diversion (p less than 0.01, paired t test) and the level of CCK was significantly lower 60 mins after feeding (p less than 0.05, paired t test). There was no significant change in the rate at which the liquid meal emptied from the stomach after bile diversion but the pH of duodenal contents was lower during the later stages of digestion. These changes may explain the reported increase of peptic ulcer after diverting bile from the duodenum and the procedure should not be considered unless the consequences of acid hypersecretion and pancreatic inhibition have been anticipated.

Animals↗