Loops Of Small Intestine Research Articles

Beware the band adhesion: an unexpected cause of double obstruction following intraperitoneal kidney transplantation.

Small bowel obstruction (SBO) following intraperitoneal renal transplantation, either solitary or due to simultaneous pancreas-kidney transplantation, is a known complication. While SBO is most commonly due to adhesions, there have been documented cases of internal herniation following simultaneous pancreas-kidney transplantation with enteric drainage due to the formation of a mesenteric defect. We present a unique complication in which the transplant ureter has caused strangulation and necrosis of a length of small intestine. The transplant ureter was mistaken for a band adhesion and divided. Post-operative anuria signalled this difficult diagnosis. Subsequent re-look laparotomy and ureteric reimplantation with Boari flap were required. Therefore, it is important to consider the ureter as a cause of internal herniation in kidney transplant patients and recognize that a band adhesion within the pelvis may in fact be the transplant ureter, obstructing a loop of small intestine beneath its course.

Kinetics of selenium absorption in ligated small intestinal loops of chicks

Selenium (Se) is an essential trace element that has a large number of biological functions for broilers. However, the absorption kinetics of Se from sodium selenite in the small intestine of broilers remains unclear. Therefore, two experiments were conducted with 28-d-old commercial male broilers to study the kinetics of Se absorption in ligated small intestinal segments. In experiment 1, the Se absorption in duodenal, jejunal, and ileal segments at different post-perfusion time points (0, 20, 40, 60, 80, 100 and 120 min) were compared. In experiment 2, a kinetic study of Se absorption was conducted with the duodenal, jejunal, and ileal loops perfused with solutions containing 0, 0.0375, 0.075, 0.15, 0.30, or 0.60 μg mL−1 of Se as sodium selenite, and Se contents in perfusates were determined at 100 min after perfusion. The results from experiment 1 showed that the Se absorption increased in an asymptotic response (P<0.0001) to post-perfusion time within 120 min in all the small intestinal segments, but increased linearly (P<0.0001) at less than 100 min after perfusion in duodenal and ileal segments, while more than 96.0% of the maximum Se absorption occurred at 100 min after perfusion in each small intestinal segment. In experiment 2, there was no difference (P>0.05) in the Se absorption rate among different ligated small intestinal segments perfused with solutions containing 0.0375–0.15 μg mL−1 of Se, however, the Se absorption rate was higher (P<0.05) in the jejunum than that in the duodenum perfused with solutions containing 0.30–0.60 μg mL−1 of Se. The kinetic curves of Se absorption demonstrated that the Se absorption was a saturated carrier-mediated process in the duodenum, and the maximum absorption rate was 1 271 pg min−1 cm−1; whereas the Se absorptions were a non-saturated diffusion process in the jejunum and ileum, and the diffusive constants were 2 107 and 1 777 cm2 min−1, respectively. The results from the present study indicate that the jejunum is the main Se absorption site, and the Se absorption is a saturated carrier-mediated process in the duodenum, but a non-saturated diffusion process in the jejunum and ileum of broilers.

A Rare Case of Intestinal Obstruction from Internal Hernia through a Foramen Formed by Appendices Epiploicae – A Case Report and Review of Literature

BACKGROUND: Internal hernias are uncommon causes of acute abdomen and intestinal obstruction. Internal herniation due to appendices epiploicae is very rare with only six cases reported in the literature.CASE REPORT: We, herein, present the report of a 64-year-old female who presented with features of intestinal obstruction due to internal herniation of a loop of small intestine through an orifice formed by the fusion of two appendices epiploicae. The band was divided into release the entrapped loop of bowel.CONCLUSION: A high index of suspicion with prompt surgical intervention will improve outcome.

Cutaneous mastocytoma with eosinophilia and eosinophilic infiltration of the small intestine in an Arabian gelding

A 12-year-old Arabian gelding presented to the University of Adelaide for investigation of a firm subcutaneous mass, just proximal to the digital flexor tendon sheath of the right forelimb, that...

Massive Hiatal Hernia after Total Gastrectomy

Abstract Background: Hiatal hernia is a very rare late complication after gastrectomy but it is potentially lethal. Case Presentation: A 73 year-old patient with history of gastric cancer treated with perioperative chemotherapy and total gastrectomy five months prior, presented to the Emergency Department due to the rapid onset of abdominal symptoms and severe dyspnea. A CT-Scan was done with large hiatal hernia with small intestine loops in both hemithorax and vascular congestion. An urgent reoperation was performed. Conclusions: An early diagnosis is crucial to reduce the mortality of this uncommon complication. Keywords Gastric cancer; Hiatal hernia; Postgastrectomy complications; Total gastrectomy Abbreviations CT: Computed tomography

Small bowel obstruction due to congenital adhesion bands during pregnancy

Small bowel obstruction due to congenital adhesion bands is a very rare occurrence during pregnancy, but is associated with significant fetal and maternal mortality. A 24-year-old primigravida woman, without previous abdominal surgeries, was referred to the emergency department at 35 weeks of gestation with the complaint of sudden abdominal pain. Abdominal magnetic resonance imaging revealed multiple loops of dilated small intestine and adhesion bands in the distal jejunum. The decision was made to proceed with a cesarean delivery and to explore the abdomen to determine the cause of the small bowel obstruction. A 2,680-gram male baby with a 7/9 Apgar score was delivered. A fibrotic band between the jejunal mesentery and distal jejunum caused the small bowel obstruction. After release of the adhesive band, the bowel regained its color and was viable. No adverse event developed in the mother or baby during a 1-year period. Although congenital bands are very rare in pregnant women, they can cause serious maternal and fetal mortality due to the delayed diagnosis and treatment, and physicians should be aware of this clinical condition.

Clinical management of gastroduodenitis and equine gastric ulcer syndrome grade IV of unknown origin in an Arabian mare

A two-year-old Arabian filly was referred with symptons of colic. Clinical examination revealed signs associated with endotoxemia. Ultrasonographic examination of the abdomen demonstrated severe distention of the stomach and distended loops of small intestine with reduced motility. With nasogastric intubation, eight liters of hemorrhagic reflux were retrieved. Gastroscopic examination showed a severe degree of gastric ulceration scored as equine gastric ulcer syndrome (EGUS) grade IV. Based on these findings, EGUS and gastroduodenitis (GD) were diagnosed. Initially, the horse was treated using parenteral pantoprazole, which was supplemented by adding enteral ranitidine and sucralfate when the horse ceased refluxing. The horse was discharged eleven days after presentation with a 75%-healing of the gastric ulcers. A control gastroscopic examination was performed thirty days after discharge showing a 90%-healing (EGUS Grade I). To the authors’ knowledge, this is the first case report in which pantoprazole in combination with ranitidine and sucralfate has been used to treat a severe degree of gastric ulceration.

Surgical treatment of patients with duodenal fistulas and duodenal injuries

The aim — to improve the treatment results of patients with external fistulas of duodenum (EFD) and retroperitoneal duodenal lesions of the by selecting the optimal surgical procedure and determining the most effective treatment for duodenal fistulas of different etiology.Materials and methods. The results of treatment of 29 patients (19 men and 10 women) aged from 24 to 72 years; from 2002 to 2016 with external unformed high flow complete duodenal fistulas were analyzed. In 6 patients with external unformed high flow complete duodenal fistulas, emergency surgery was performed according to urgent indications (group I). In 9 patients with damage to the II‑B part of the duodenum was formed behind the transversal colon Roux‑en‑Y anastomosis with the exception of duodenum (group II). Multi‑staged surgery was performed in 8 patients with iatrogenic lesions of the retroperitoneal descended (II‑A and II‑B) parts of the duodenum and retroperitoneal phlegmon (group III). A resection of the lower horizontal part of the duodenum was performed in 2 patients with damage of the III (lower horizontal) duodenal part, with the duodenal — jejunal anastomosis formation on the small intestine loop with stoma. In 2 patients with aortal‑duodenal fistulas after the end of the vascular stage of the operation performed resection of the duodeno‑jejunal anastomosis in front of the root of the mesentery (group IV).Results and discussion. Early surgical intervention with the gastroenteroanastomosis behind the colon transverse with duodenum disabling is consider to be the optimal treatment method for high duodenal EF, which helps to reduce the fistula elimination time and to early rehabilitation of patients. External drainage of common bile duct is considered to be a mandatory stage of surgical treatment of duodenal EF, which is developed as a result of pancreatic necrosis or iatrogenic damage during endoscopic retrograde cholangiopancreatography and endoscopic papillosphincterotomy. Early enteral probe nutrition is essential condition for adequate management of patients in the postoperative period.Conclusions. Active surgical tactics with early surgery prevent the development of purulent‑septic complications and electrolyte disorders, especially in the case of lesions of the retroperitoneal part of the duodenum. An individual approach to the choice of the method of exclusion from the passage of the duodenum in a short mono‑ or long loop allows to reduce the flow of the damaged intestine and to reduce the possibility of fatal postoperative complications.

Encarcelamiento intestinal en forame epiplóico: Relato de caso en equino

The epiplastic foramen is a natural opening in the thoracic cavity that communicates with the abdominal cavity, located dorsally to the cleft of the liver, contacting the caudal vena cava, portal vein, pancreas, hepatoduodenal ligament and with the small intestine loops. Horses diagnosed with intestinal loop incarceration in the epiplastic foramen require surgical treatment, with a prognosis of being reserved to unfavorable, and the ileum is the intestinal segment most affected in this disease. In addition, because of a strangulative process, the animal shows signs of abdominal discomfort called colic and enterogastric reflux, but clinical signs are variable. Some animals in the palpation present palpable small intestine or not and abdominal discomfort varying from mild to severe. The objective of this work is to report a case of a 5-year-old female Quarter Horse, weighing 430 kg, with a history of abdominal discomfort two days ago and with intermittent pains, from the municipality of Batatais, Veterinary Hospital of Batatais, addressing the animal clinic, diagnosis and treatment. In the rectal palpation he identified slightly distended loops and palpable small intestine and puncture of the peritoneal fluid through the abdominocentesis showed a reddish coloration. The animal was under observation, but even with all the clinical interventions, the pain picture increased and with that it was submitted to exploratory laparotomy, where the incarceration was diagnosed in the epiplastic foramen. In view of the clinical case, it was concluded that the incarceration of the epiplastic foramen may lead to significant intestinal loops involvement, progressing to destabilization of the general state of the animal, being aggravating factors for the surgical procedure, becoming a case of risk of the patient. The animal in this report was submitted to euthanasia due to the great compromise of the intestinal loops. It is concluded that the diagnosis should be performed as early as possible, increasing the chance of resolution with favorable prognosis.

Traumatic right hemi-diaphragmatic injury: delayed diagnosis

BackgroundTraumatic diaphragmatic injury is known to present with the spectrum of symptoms, and most patients would have some symptoms due to abdominal organ herniation. Majority of injuries tend to present on the left hemidiaphragm but right-sided injuries also occur mostly with subtle, delayed presentation due to the buffering effect of the liver.Case presentationA 65-year-old male presented to the emergency department with a complaint of nausea and vomiting and reported no bowel movement or passing of flatus for 5 days. Upon further questioning, he recalled that he fell from a tractor while working in his farm 2 months earlier and sustained blunt trauma to his abdomen. Both chest and abdominal X-rays revealed the niveau formation of the small intestine on the right side above the liver and right hemidiaphragm. Further evaluation with CT scan confirmed the presence of a few small intestinal loops behind the liver and also in the chest through a rupture in the right hemidiaphragm. Exploratory laparotomy was performed. Some small intestine loops had gone behind the liver and through 4 cm rupture in the posterior aspect of the diaphragm into the chest. Displaced intestinal loops were relocated and no sign of ischemia or necrosis was observed. The patient was symptom-free within 2 days and he was discharged after 4 days.ConclusionTraumatic injuries of the diaphragm are rare, yet underestimated; therefore, they need a high index of suspicion for timely diagnosis and neglected diagnosis may present with a range of symptoms such as herniation months to years later.

Perfusion-related changes in intestinal diffusion detected by NMR-MOUSE® monitoring in minipigs

ObjectiveThe aim was to investigate perfusion-related changes in the intestinal diffusion assessed by NMR-MOUSE monitoring in minipigs. This was a follow-up study of previous experiments on landrace pigs demonstrating the feasibility of NMR-MOUSE monitoring in large animals. Methods5 mature female minipigs (mean body weight 50 ± 2 kg) underwent laparotomy with exposition of several small intestinal loops and their feeding vessels. The loops were examined consecutively using NMR-MOUSE monitoring for assessment of intestinal proton diffusion (fast diffusion component [FC] and slow diffusion component [SC]) and oxygen to see monitoring (O2C, LEA Medizintechnik GmbH, Giessen, Germany) for microcirculatory evaluation. Following a baseline measurement on each loop under physiological perfusion, measurements were continued as one of the following main treatments were performed per loop: method 1 – ischemia; method 2 – flow reduction; method 3 – intraluminal glucose followed by ischemia; method 4 – intraluminal glucose followed by flow reduction. Perioperative monitoring was supplemented by blood gas analyses and histopathological assessment of H.E. stained intestinal biopsies. ResultsThe NMR-MOUSE measurement showed a significant difference in the change to baseline values in the FC during flow reduction compared to the other treatments according to the unadjusted (pM2 vs. M1 < 0.0001, pM2 vs. M3 = 0.0005, pM2 vs. M4 = 0.0005) and the adjusted p-values (pM2 vs. M1 < 0.0001, pM2 vs. M3 = 0.0030, pM2 vs. M4 = 0.0030). In the SC, the difference between ischemia and flow reduction was significant according to the unadjusted p-values (pM2 vs. M1 = 0.0397). Whereas the FC showed a trend towards ongoing increase during ischemia but towards ongoing decrease during flow reduction, the SC showed contrary trends. These effects seemed to be attenuated by prior glucose application. According to the results of O2C monitoring, ischemia as well as flow reduction caused a significant decrease of microcirculatory oxygen saturation (inner probe: methods 1–4 and outer probe methods 1, 2: p < 0.0001; outer probe: pM2 = 0.0001), velocity (inner probe: pM1 < 0.0001, pM2 = 0.0155, pM3 = 0.0027; outer probe: pM1 < 0.0001, pM2 = 0.0045, pM3 = 0.0047, pM4 = 0.0037) and serosal flow (outer probe, methods 1 and 2: p < 0.0001; pM3 = 0.0009, pM4 = 0.0008). The histopathological analysis showed a significant association with time (p = 0.003) but not with the experimental method (p = 0.1386). ConclusionsIntestinal diffusion is affected significantly by perfusion changes in mature minipigs. As shown by NMR-MOUSE monitoring, ischemia and flow reduction have contrary effects on intestinal diffusion and, additionally, the fast and slow diffusion components show opposite trends during each of those pathological perfusion states. Prior intraluminal glucose application seems to attenuate the effects of malperfusion on intestinal diffusion.

Novel Junctional Adhesion Molecule‐Like (JAML) Regulates Neutrophil Transepithelial Migration During Intestinal Inflammation

Neutrophil (PMN) migration in the intestine is an essential component of host defense and wound repair. However, dysregulated PMN recruitment is a hallmark of inflammatory bowel disease (IBD). Disease flares in IBD are associated with robust PMN migrating across the intestinal mucosa resulting in crypt abscess formation and mucosal ulceration. Despite strong association of PMN infiltration into the gut with patient symptoms in IBD, the molecular basis of PMN transepithelial migration (TEpM) represents a significantly understudied area. It is now appreciated that PMN migration into intestinal mucosa requires multiple adhesive interactions between migrating PMN and intestinal epithelial cells (IECs), that represents a multi‐step process facilitated by complex interactions between PMN and IEC expressed proteins including members of the Junctional Adhesion Molecules (JAMs) family. We have reported that the novel JAM‐like protein termed JAML expressed on PMN, associates with the coxsackie and adenovirus receptor (CAR) expressed on epithelial cells. Binding of soluble JAML ectodomains to CAR has been shown to disrupt JAML‐CAR interactions and reduce PMN TEpM in‐vitro. To define the molecular mechanism of JAML regulation of PMN TEpM during intestinal inflammation in‐vivo, we generated JAML knockout mice (JAML−/−). PMN TEpM was evaluated using a small intestinal loop model, and PMN migration in response to the chemoattractant LTB4 (1nM) quantified by flow cytometry. While WT and JAML−/− mice had similar numbers of circulating leukocytes, we observed reduced PMN TEpM in‐vivo in JAML−/− mice compared to WT animals. This decrease in PMN traffic into the lumen was associated with increased retention of PMN within the intestinal epithelium in JAML−/− mice. In addition, epithelial accumulation of PMN in JAML−/− mice paralleled an increase in intestinal permeability to a 4KDa FITC‐dextran as detected by fluorescence intensity in serum. Finally, we studied the role of JAML on susceptibility to DSS induced colitis. Loss of JAML markedly increased disease activity index, inflammation and mucosal ulceration compared to WT mice. Overall, these observations suggest that JAML is an important adhesion molecule that regulates PMN TEpM in the intestinal mucosa. JAML thus represents a new therapeutic target to dampen excessive PMN migration during intestinal inflammation as seen in IBD.Support or Funding InformationCCFA CDA454814 and NIH 3R01 DK072564‐23S1This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Formation and evaluation of bilio-digestive and interintestinal anastomoses by the method of high-frequency electric welding of tissues in experiment

Objective. To develop a new method of the anastomoses formation, that would allow to form bilio-digestive and entero-entero anastomoses both on unchanged and inflamed tissues.&#x0D; Маterials and methods. In experimental on 50 laboratory rabbits the single-layer everting cholecysto-entero and entero-entero anastomoses on the Roux-defunctionalized loop of small intestine was created by the method of a high-frequency electric welding. The welding anastomoses were formed both on non-inflamed tissues and in the setting of biliary peritonitis. Patency, hermeticity, strength, macroscopic and microscopic pictures of the obtained joints were evaluated at different postoperative periods.&#x0D; Results. All anastomoses, formed by the method of a high-frequency electric welding, were not only patent and hermetic, but also sufficiently strong (40 – 100 mm Hg). The tissues were joined using thermo-adhesion; a coagulation scar was rather narrow, its complete epithelization was accomplished in 3 mo, and a scar maturation completed – in 6 mo.&#x0D; Conclusion. The method of a high-frequency electric welding permits to form both, bilio-digestive and inter-intestinal, anastomoses of equal reliability in the settings of non-inflamed and inflamed tissues.

P147 NOVEL JUNCTIONAL ADHESION MOLECULE-LIKE (JAML) REGULATES NEUTROPHIL TRANSEPITHELIAL MIGRATION DURING INTESTINAL INFLAMMATION

Neutrophil (PMN) migration in the intestine is an essential component of host defense and wound repair. However, dysregulated PMN recruitment is a hallmark of chronic active inflammatory bowel disease (IBD) characterized by persistent inflammation. Disease flares in IBD are associated with marked recruitment of PMN into the intestinal mucosa that results in crypt abscess formation and mucosal ulcerations. Despite the strong association with IBD, the process of PMN transepithelial migration (TEpM) represents a significantly understudied area. PMN migration into the intestinal mucosa requires multiple adhesive interactions between migrating PMN and intestinal epithelial cells (IECs). PMN TEpM is a multi-step process facilitated by complex interactions between PMN and IEC expressed proteins including members of the Juntional Adhesion Molecules (JAMs) family. We have reported that the novel JAM-like protein termed JAML expressed on PMN, associates with the coxsackie and adenovirus receptor (CAR) on epithelial cells. Binding of recombinant JAML ectodomains disrupts JAML-CAR interactions and reduces PMN TEpM. To define the molecular mechanism of JAML regulation of PMN TEpM during intestinal inflammation in-vivo, we generated JAML knockout mice (JAML-/-). PMN TEpM was evaluated using a small intestinal loop model, and PMN migration into the intestinal lumen in response to the chemoattractant LTB4(1nM) for 1h was quantified by flow cytometry. While WT and JAML-/- mice had similar numbers of circulating leukocytes, we observed reduced PMN migration into the intestinal lumen in response to LTB4 in JAML-/- mice compared to WT animals. In addition, there were increased PMN in the epithelial cell fractions derived from intestines of JAML-/- mice suggesting that JAML regulates PMN TEpM in vivo. We also assessed the role of JAML on susceptibility to DSS induced colitis and recovery. Markedly increased disease activity index, inflammation and mucosal ulceration were observed in JAML-/- mice compared to controls. These observations suggest that JAML represents an important adhesion molecule that regulates PMN TEpM. Furthermore, loss of JAML increases susceptibility to colitis. JAML may thus represent a new therapeutic target to dampen excessive PMN migration during intestinal inflammation as seen in IBD.

УЛУЧШЕНИЕ РЕЗУЛЬТАТОВ ДИАГНОСТИКИ И ЛЕЧЕНИЯ АБДОМИНАЛЬНОГО ТУБЕРКУЛЁЗА

Objective: To improve the results of diagnosis and surgical treatment of abdominal tuberculosis (AT) Methods: The results of the diagnosis and treatment of 56 patients with AT were studied. Clinical, laboratory and instrumental methods of investigation, including ultrasound (US) and computed tomography (CT) were used. In 49 cases video laparoscopy was made, both in terms of diagnosis and treatment Results: With US of the abdominal cavity in patients with AT, there has been a specific ultrasound semiotics with the form of having a free fluid, moderate inflating the intestinal loops and reducing peristalsis. Thickening and knotty of the parietal and, in places, the visceral peritoneum were additional signs of AT. Radiographically, in 17 (30.3%) patients, local spasm, spastic filling defect, delay of barium suspension in the iliac either caecum «reared» loops of small intestine and segmental expansion of intestinal loops. 21 observations of CT showed itself as the most effective imaging method. Tuberculosis of the liver and spleen (n=5) with CT has manifested itself in the form of tiny low-density foci distributed throughout the body. Video laparoscopy in 34 (69.4%) cases revealed hypertrophic form of AT, in 10 (20.4%) – ulcerative-hypertrophic and in 5 (10.2%) observations – ulcerative form of AT. After taking a biopsy and fluid, aeration and irradiation of the abdominal cavity was carried out with ultraviolet rays. In 2 (4.1%) cases, the conversion was completed. In the postoperative period, all patients received symptomatic therapy. No early ostoperative complications were noted Conclusion: Both US and CT were the most effective in terms of non-invasive diagnosis. Videolaparoscopy along with an important diagnostic value in some cases can be effectively used as a therapeutic method. Keywords: Abdominal tuberculosis, diagnosis, surgical treatment, computed tomography, video laparoscopy.

Abdominal cocoon: a surgical challenge

Encapsulating peritoneal sclerosis (EPS) or sclerosing peritonitis best described as abdominal cocoon is a complex syndrome characterized by formation of a thick fibrocollagenous membrane that totally encloses the small intestinal loops. The etiology is varied and multifactorial. This complex disease is usually associated with continuous peritoneal dialysis (PD), tuberculosis, post renal transplant, or with long term use of beta blockers. A few cases may even be idiopathic in origin. The pathogenesis is attributed to conversion of epithelial cells from the peritoneal lining to mesenchymal cells leading to a formation of a thick membrane. The clinical features range from abdominal pain due to altered gut motility to frank features suggestive of intestinal obstruction. Making a pre-operative diagnosis is the biggest challenge in abdominal cocoon. However computerized tomography provides enough information to arrive at a diagnosis. Surgical intervention continues to remain the final option in an unremitting intestinal obstruction despite the role of conservative therapy using drugs proposed for treatment. The focus of management is early diagnosis and treatment in order to halt the progression to a frank cocoon. The paper reviews the etiopathogenesis and management of this intricate condition.

Small bowel obstruction secondary to an adhesion between ovary and small intestine loops: Case report

Adhesion-related small bowel obstruction is a common pathology in visceral surgery. Postoperative adhesion is the most common etiology of acute intestinal occlusion. We report the case of an intestinal occlusion caused by an adhesion between the ovary and the small bowel loops. In order to share the epidemiological, clinical, prognostic and therapeutic aspects of this affection, and also the unusual localization of the adhesion, this is described in our case report. Computed tomography has improved the diagnosis of adhesive small bowel obstruction and its findings in bowel ischemia are helpful to guide the therapeutic attitude. The treatment was surgical and the postoperative course was simple.

Intestinal absorption of black chokeberry cyanidin 3-glycosides is promoted by capsaicin and capsiate in a rat ligated small intestinal loop model.

Recent studies have shown that aronia (black chokeberry) and haskap fruits (contain anthocyanins) have beneficial health effects in animals and humans. However, some reports have shown that anthocyanin is poorly absorbed in the small intestine. In this study, we compared the intestinal absorption of aronia and haskap anthocyanins by using rats with a ligated small intestinal loop and cannulated portal vein. Our results clearly showed that the intestinal absorption of aronia anthocyanins was significantly lower than that of haskap anthocyanins, suggesting that the intestinal absorption of anthocyanins is influenced by the glycoside type (galactoside or glucoside). In addition, we also examined the effects of capsaicin and capsiate on intestinal anthocyanin absorption. The amount of aronia anthocyanins in portal blood was much higher when they were co-administered with capsaicin or capsiate. Our study is the first to show that the intestinal absorption of aronia anthocyanins is promoted by capsaicin and capsiate.

ARECA NUT - AN UNUSUAL CAUSE OF SMALL INTESTINAL OBSTRUCTION

Ingested foreign bodies are commonly encountered in clinical practice, especially in children. Till now, no case has been reported in the literature where a small intestinal obstruction was produced as a result of foreign body (areca nut) ingestion. We report a case of a 30-year-old female clinically presented as an acute intestinal obstruction of 4 days duration. Her plain X-ray abdomen showed multiple small intestinal fluid levels. Abdominal ultrasound showed dilated loops of small intestine. Contrast-enhanced computed tomography abdomen showed an intraluminal non-enhancing lesion near ileocecal junction. Exploratory laparotomy revealed 3 cm

Evidence that Clostridium perfringens Enterotoxin-Induced Intestinal Damage and Enterotoxemic Death in Mice Can Occur Independently of Intestinal Caspase-3 Activation.

Clostridium perfringens enterotoxin (CPE) is responsible for the gastrointestinal symptoms of C. perfringens type A food poisoning and some cases of nonfoodborne gastrointestinal diseases, such as antibiotic-associated diarrhea. In the presence of certain predisposing medical conditions, this toxin can also be absorbed from the intestines to cause enterotoxemic death. CPE action in vivo involves intestinal damage, which begins at the villus tips. The cause of this CPE-induced intestinal damage is unknown, but CPE can induce caspase-3-mediated apoptosis in cultured enterocyte-like Caco-2 cells. Therefore, the current study evaluated whether CPE activates caspase-3 in the intestines and, if so, whether this effect is required for the development of intestinal tissue damage or enterotoxemic lethality. Using a mouse ligated small intestinal loop model, CPE was shown to cause intestinal caspase-3 activation in a dose- and time-dependent manner. Most of this caspase-3 activation occurred in epithelial cells shed from villus tips. However, CPE-induced caspase-3 activation occurred after the onset of tissue damage. Furthermore, inhibition of intestinal caspase-3 activity did not affect the onset of intestinal tissue damage. Similarly, inhibition of intestinal caspase-3 activity did not reduce CPE-induced enterotoxemic lethality in these mice. Collectively, these results demonstrate that caspase-3 activation occurs in the CPE-treated intestine but that this effect is not necessary for the development of CPE-induced intestinal tissue damage or enterotoxemic lethality.