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[Embryonic development of the human duodenum].

Epithelial duodenal anlage takes place at the end of the first month of the human embryogenesis in connection with appearance of the pancreatic epithelial germs. It has a form of a short arch with a spindle-like enlargement of the middle ductal part. Formation of the hepato-duodenal ligament and of the duodenal mesentery results in appearance of the given organ anlage with a three-layered wall in 5.5-6-week-old embryos. The anlage makes an arch, protruding to the right and forward with a spindle-like enlargement of the middle ductal part. It is tightly connected with the forming anlage of the pancreatic head, when the pancreatic epithelial anlages are fusing. An intensive growth of the pancreatic head is accompanied with emergence and enlargement of the superior, descending and inferior parts of the duodenum, that acquires a semicircular form in 8-8.5-week-old embryos. Its transitional stage is a curved semicircle having a form of a distended spiral coil; that reflects an uneven growth of the organ in the human embryogenesis.

Duodenum↗

[Endoscopic excision of a pin implanted in the 3d portion of the duodenum].

The Authors, while presenting a case of endoscopic extraction of a foreign body fixed in the duodenum, underline the value of operative endoscopy, which, going beyond the limits of a exclusively diagnostic technique, is intended as a first choice therapeutic procedure to be always carried out, leaving to surgery the treatment of the most complicated cases and those where the endoscopic attempt fails.

Adult↗

Alkaline secretion. A protective mechanism against acid injury in rabbit duodenum.

The role of alkaline secretion in the protection against acid-induced (50 mM HCl) damage was investigated in the perfused rabbit duodenum. Basal alkaline secretion was 3.86 +/- 0.23 mu Eq/cm2 . 10 min (pH-stat method). Perfusion with HCl increased alkaline secretion to 4.39 +/- 0.17 mu Eq/cm2 . 10 min and led to superficial damage of 51.8% of the villi. Intravenous treatment with NaHCO3 and glucagon increased alkaline secretion (+25% and +37%, respectively) and decreased damage (-27.7% and -25.3%, respectively), whereas mucosal blood flow as assessed by radioactive microspheres was stimulated only by glucagon. Intravenous treatment with NH4Cl, vasopressin, and furosemide decreased alkaline secretion (-31%, -52%, and -50%, respectively) and led to increased damage (+18.5%, +19.3%, and +19.6% superficial and 30%-50% deep lesions), and mucosal blood flow was decreased (vasopressin) or unchanged. There was a direct linear relationship (r = 0.88, y = 103-15.8x) between the degree of damage and alkaline secretion. These results support the hypothesis that duodenal alkaline secretion is indeed a protective factor against acid damage.

Animals↗

[Experimental diabetes mellitus induced by total pancreatectomy with preservation of the duodenum in dogs].

The total pancreatectomy without duodenectomy was carried out in 16 dogs. The postoperative diabetes mellitus leads to death on average until the 11th postoperative day. A prolongation of the survival time was possible only by an insulin injection or by pancreas transplantation. Bleedings and circulatory disturbances of the duodenum occurred in 3 of 16 dogs as a complication of the operation. The diabetes mellitus was confirmed by the estimation of the fasting blood glucose and the glucose stimulated plasma insulin concentration. The irreversible hyperglycemia syndrome after pancreatectomy proved as a pattern for the pancreas segmental transplantation.

Animals↗

Intraoperative consultation for the liver, biliary system, pancreas, duodenum, and spleen.

The urologist, when operating transabdominally, may unexpectedly encounter a cystic or solid mass in the liver, a dilated gallbladder or a gallbladder containing stones, or a mass in the pancreas, or may inadvertently injure the duodenum or spleen when mobilizing these organs for a nephrectomy or adrenalectomy. Discussed are some of these common liver, biliary, and pancreatic problems and their management, and the methods of management of duodenal and splenic injuries.

Biliary Tract↗

[Changes in the mucosa of the duodenum and stomach as a result of experimental duodenal ulcers and vagotomy].

By means of the transmissive and scanning electron microscopy methods and radioautography, structure of mucous membrane of the stomach and duodenum has been studied under experimentally induced duodenal ulcers before and after vagotomy during various time. The vagotomy results in accelerated healing of the ulcer defect. This is connected with an increased proliferative activity in the crypta cells, however, this is accompanied with deceleration of their differentiation. Under the duodenal ulcers the amount of chief and parietal cells increases in the gastric mucous membrane, this depends on gastrostasis produced by stenosis of the pylorus. At vagotomy the amount of the chief and parietal cells in the fundal glands of the mucous membrane decreases; this is accompanied with a lowered secretory activity.

Animals↗

A case of an anomalous duodenum, pancreas and biliary tract, with gallstone perforation.

A case of an elongated, anomalous duodenum with intestinal rotation, annular pancreas and disease of the biliary tract with acute jaundice caused by gallstone perforation is presented. The ERCP (endoscopic retrograde cholangiopancreatography) was of great value in the preoperative investigations. Surgical relief of the obstruction of the biliary duct made the patient free of symptoms.

Abnormalities, Multiple↗

Duodenum inversum.

Duodenum inversum is usually associated with chronic abdominal pain which is of unknown etiology. Incomplete rotation of the bowel may be associated with this anomaly. An unusually high incidence of pancreatitis, elevated bilirubin, and hypoalbuminemia was noted in this series of nine patients.

Abdomen↗

Tuberculosis of the duodenum.

At present, tuberculosis of the intestinal tract is rare in the United States. When gastrointestinal disease is seen, 85--90% of cases involve the ileocecal area. A case of tuberculosis of the duodenum unassociated with pulmonary disease is described. Although fiberoptic enndoscopy, abdominal ultrasonography and computerized axial tomography were used, the diagnosis required laprotomy with biopsy. The clinical manifestations, diagnostic investigations and treatment of the 49 previously reported cases of duodenal tuberculosis are also reviewed.

Adult↗

Mast cell increase in the duodenum and kidney of magnesium-deficient rats.

Rats were maintained on a magnesium-deficient diet for 1 to 5 weeks to study the mast cell (MC) populations in their duodenum and kidney. A marked increase of intestinal subepithelial mast cells was observed in these animals as compared with normal controls. The cells in both groups showed an identical reaction for mucopolysaccharides but the 5-hydroxytryptamine content tended to be higher in the cells of magnesium-deficient animals. Proliferation of MC was also observed in the renal cortex of the magnesium-deficient rats. This finding is significant because MC are known to be virtually absent from normal kidneys. Magnesium deprivation resulted in numerous MC not only in the intertubular spaces but also within the glomeruli. Possible correlations between these and other pertinent observations are discussed with regard to certain renal diseases. The discussion is extended to the possible mechanism through which magnesium could influence secretory processes in MC.

Alcian Blue↗

[Drug metabolizing activity in birds: compared activity of liver and duodenum in four species (author's transl)].

Drug-metabolizing activity of liver and small intestine (duodenum) was examined in birds (A. rufa, P. perdix, Ph. colchicus, G. gallus) with 4 substrates (aniline, aldrin, p-nitroanisole, aminopyrine). In order of decreasing hepatic activity: P. perdix greater than Ph. colchicus greater than A. rufa greater than G. gallus. For all species, intestinal activity is higher than in rodents, especially with aldrin as substrate.

Aldrin↗

[Vascular compression of the duodenum. Apropos of a case of acute obstruction].

A case of acute obstruction of the duodenum in an aged patient due to aorto-mesenteric squeezing is described. An account of the anatomopathological features, symptomatology, radiological diagnosis, and treatment of this condition is presented. Duodedenojejunostomy is the operation of choice, but it must be adjusted to the local and general anatomopathological situation.

Aged↗

[Incomplete membrane stenoses of the duodenum (author's transl)].

A report in 2 children with incomplete membrane stenoses of the duodenum and further abnormalities in the gastrointestinal tract, the urogenital region and on the skeleton. In the first case ileus symptoms existed in early infancy following operated anal atresia. A duodenal diverticulum near the papilla was found with reflux of contrast medium in the biliary and pancreatic tracts. In the second case the clinical symptoms were limited; however, the x-ray findings of an intraduodenal pseudodiverticulum were impressive. Both patients were operated successfully by removal of the incomplete duodenal membrane. Both cases clearly showed the great variability in clinical symptoms with etiologically similar disease patterns and typical x-ray signs.

Abnormalities, Multiple↗

Endoscopic removal of a foreign body perforating the duodenum.

Perforation of the intestine by an ingested foreign body usually results in peritonitis or abscess formation and the treatment is surgical. In one case the duodenum was perforated by a toothpick, and hemorrhage from the upper gastrointestinal tract occurred 3 months later. Diagnosis and management were accomplished by operative endoscopy.

Aged↗

Effect of D-Val1, D-Trp8-somatostatin on the motility of the stomach, duodenum and jejunum.

D-Val1, D-Trp8-somatostatin was given to seven volunteers to relax the gastrointestinal tract. Doses of drug ranging from 1-250 mcg. were given intravenously, single blind, as one bolus. The seven subjects had a total of 23 studies. The stomach never became hypotonic in any subject. The onset of drug effect on the duodenum and jejunum of moderate hypotonicity after 10-100 mcg. was 4.8 minutes and at 150-250 mcg., was 10.1 minutes. Onset of atonicity after 10-100 mcg. wa 5.7 minutes and at 150-2509 mcg., was 13.0 minutes. Duration of moderate hypotonicity after 10-100 mcg. was 20.9 minutes and at 150-250 mcg., was 22.4 minutes. Duration of atonicity at 10-100 mcg. was 11.5 minutes and at 50-250 mcg., was 14.1 minutes. Preliminary results suggest that the onset and duration of effect, relative to dose, were so variable that the drug appeared to be an unsatisfactory hypotonic agent for upper gastrointestinal radiography.

Adult↗

Normal and disturbed motility pattern in the duodenum of man. The effect of l-hyoscyamine, trimipramine and ranitidine on the maximal pressure waves.

Eight healthy subjects were examined in random order with an electronic capsule transducer, two capsules being mounted 8 cm from each other in the duodenum. At least two grade III maximal pressure waves were recorded following 0.6 mg l-hyoscyamine (Hässle), 50 mg trimipramine (Surmontil, Rhone Poulenc) or 150 mg ranitidine (Glaxo-Nyegaard & Co.) perorally. A significant prolonged cyclic length (Fig. 1) was observed on the day when l-hyoscyamine was given when compared to results on the day when placebo was given (Table I). No significant differences were observed between placebo and the other drugs given.

Adult↗