MyMedR

Giardia duodenalis pathogenicity on immunosuppressed animal model

Wakid MH, Toulah FH, Mahjoub HA, Alsulami MN, Hikal WM

Trop Biomed, 2020 Dec 01;37(4):1008-1017.

PMID: 33612753 DOI: 10.47665/tb.37.4.1008

Giardiasis is the major water-borne diarrheal disease present worldwide caused by the common intestinal parasite, Giardia duodenalis. This work aims to investigate the effect of G. duodenalis infection pathogenicity in immunosuppressed animals through histopathological examination. A total of 45 BALB/c mice were divided into four groups; G1 (negative control), G2 (healthy animals exposed to Giardia); G3 (immunosuppressed animals exposed to Giardia), and G4 (non-exposed immunosuppressed animals). Our study revealed that G3 was the most affected group with an infection rate of 100%. The animals showed general weakness, soft stool, and high death rate with severe histopathological changes in the duodenum and mild degenerative changes in hepatic tissues. In G2, the maximal lesions in both duodenum and liver were on the 11th day. We spotted damage in the villi, edema in the central core, and submucosa, in addition to increased cellular infiltration with inflammation in lamina propria. The presence of the parasites within the villi and the lumen was clear. Most of the hepatocytes revealed hydropic and fatty changes, also dilated congested central veins and edema were observed. G3 changes were more intense than G2 with massive Giardia trophozoites between the intestinal villi, lumen, and extensive fatty liver degeneration. Immune suppression plays a significant role in the severity of injury with the Giardia parasites in duodenum and liver cells.

Matched MeSH terms: Duodenum/parasitology; Duodenum/pathology

Fulltext I jejunal patch repair of a duodenal perforation

Kalyani A, Teoh CM, Sukumar N

Med J Malaysia, 2005 Jun;60(2):237-8.

PMID: 16114169

A patient with duodenal ulcer who developed iatrogenic perforation post endoscopy is presente. We present t is case that was treated successfully treated by jejunal serosal patch.

Matched MeSH terms: Duodenum/injuries*; Duodenum/surgery*

Fulltext Transudation of immunoglobulins into duodenal juice of infants with cow's milk protein sensitive enteropathy

Yadav M, Iyngkaran N

Med J Malaysia, 1982 Sep;37(3):239-44.

PMID: 7177005

Eighteen infants clinically suspected to be intolerant of cow's milk were placed on a milk-free formula and six to eight weeks later were orally challenged with cow's milk. Following challenge three groups were recognised. Group A: Four infants tolerated oral feeds ofcow's milk and lacked mucosal abnormality or clinical symptoms. Group B: Seven infants had mucosal deterioration but lacked clinical symptoms and tolerated cow's milk. Group C: Seven infants had mucosal abnormality, developed clinical symptoms and were intolerant of cow's milk. The intestinal transudation of IgA was increased in Group A and unchanged in Group Band C : the IgM levels in the duodenal juice was increased in Group A and B but unchanged in Group C : the IgG levels in the juice were increased in all Groups following challenge. It appears that increased transmission of IgA and IgM or IgM alone in the duodenal juice is associated with lack of development of clinical symptoms. Symptoms are present in infants in whom the IgA and IgM levels in duodenal juice remained unchanged after challenge. It is suggested that patients responding to cow's millt challenge with intestinal production of IgA and IgM (or IgM alone) are able to counter balance the deleterious mechanisms leading to clinical cow's milk intolerance whereas those who, for some unknown reason, do not mount a secretory immune response become ill.

Matched MeSH terms: Duodenum/immunology*

Fulltext Prolonged conjugated hyperbilirubinaemia--evaluation using duodenal fluid inspection for bile

Halim AJ, Yakin F

Med J Malaysia, 1983 Dec;38(4):327-30.

PMID: 6599993

Eight infants between the ages of one and three months with prolonged conjugated hyperbilirubinaemia had duodenal aspirations performed to differentiate between biliary atresia and neonatal hepatitis. Four infants had bile-stained aspirates and in all of them the jaundice subsided completely by eight months of age. We have found duodenal aspiration a safe, inexpensive and simple procedure to undertake in helping us make a rapid differentiation between patients with conjugated hyperbilirubinaemia requiring urgent laparotomy and those that do not require surgery. This approach appears to be reliable although further studies need to be undertaken.

Matched MeSH terms: Duodenum*

Congenital atresia and stenosis of the duodenum--a case report

Lal M, Said MY

Med J Malaysia, 1974 Jun;28(4):283-6.

PMID: 4278623

Matched MeSH terms: Duodenum/abnormalities*

The role of hypotonic duodenography in the diagnosis of inflammatory and neoplastic lesions of the head of the pancreas

Galanti A, Wong Wai Kwan

Med J Malaya, 1971 Mar;25(3):198-204.

PMID: 4253569

Matched MeSH terms: Duodenum/radiography*

Fulltext The value of pre-operative embolisation in primary inferior vena cava paraganglioma

Zaki FM, Osman SS, Abdul Manaf Z, Mahadevan J, Yahya M

Malays J Med Sci, 2011 Apr;18(2):70-3.

PMID: 22135590

We report a case of a 13-year-old boy who complained of progressive abdominal distension and symptoms of anaemia. Radiological investigations revealed that the child had a hypervascular tumour of the inferior vena cava (IVC). Unfortunately, the child presented with acute lower gastrointestinal bleed soon after the investigation. He underwent an urgent pre-operative embolisation, aimed to reduce the tumour vascularity. A total resection of the tumour, right nephrectomy, and partial duodenal resection were done within 24 hours post-embolisation. The child was stable postoperatively. The histopathological examination revealed chromogranin-positive paraganglioma originating from the IVC. We highlight the radiological findings of rare primary IVC paraganglioma and the role of embolisation prior to surgical removal of the tumour.

Matched MeSH terms: Duodenum

Fulltext Superior Mesenteric Artery Syndrome in association with Abdominal Tuberculosis: An Eye Opener

Bhatt S, Mishra B, Tandon A, Manchanda S, Parthsarathy G

Malays J Med Sci, 2017 May;24(3):96-100.

PMID: 28814938 DOI: 10.21315/mjms2017.24.3.12

Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge. Therefore, an unknown cause (SMAS) of upper gastrointestinal obstruction in a patient of abdominal tuberculosis is being presented for the first time through this case report. An imaging diagnosis of SMAS was made on contrast enhanced CT abdomen which also confirmed the clinical suspicion of abdominal tuberculosis in the patient. The patient was managed conservatively and recovered without requiring any surgical intervention for the obstructive symptoms.

Matched MeSH terms: Duodenum

Laparoscopic loop duodenaljejunal bypass with sleeve gastrectomy in type 2 diabetic patients

Nor Hanipah Z, Hsin MC, Liu CC, Huang CK

Surg Obes Relat Dis, 2019 May;15(5):696-702.

PMID: 30935839 DOI: 10.1016/j.soard.2019.01.016

BACKGROUND: Laparoscopic loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) is a new metabolic procedure. Our initial data on type 2 diabetes (T2D) remission after LDJB-SG were promising.

OBJECTIVES: The aim of this study was to look at our intermediate outcomes after LDJB-SG.

SETTING: An academic medical center.

METHODS: A prospective analysis of T2D patients who underwent LDJB-SG between October 2011 and October 2014 was performed. Data collected included baseline demographic, body mass index, fasting blood glucose, glycosylated hemoglobin, C-peptide, resolution of co-morbidities, and postoperative complications.

RESULTS: A total of 163 patients with minimum of follow-up >1 year were enrolled in this study (57 men and 106 women). The mean age and body mass index were 47.7 (±10.7) years and a 30.2 (±5.1) kg/m2, respectively. There were 119 patients on oral hypoglycemic agents only, 29 patients were on oral hypoglycemic agents and insulin, 3 patients were on insulin only, and the other 12 patients were not on diabetic medication. Mean operation time and length of hospital stay were 144.7 (± 45.1) minutes and 2.4 (± 1.0) days, respectively. Seven patients (3.6%) needed reoperation due to bleeding (n = 1), anastomotic leak (n = 2), sleeve strictures (n = 2), and incisional hernia (n = 2). At 2 years of follow-up, there were 56 patients. None of the patients were on insulin and only 20% of patients were on oral hypoglycemic agents. Mean body mass index significantly dropped to 22.9 (±5.6) kg/m2 at 2 years. The mean preoperative fasting blood glucose, glycosylated hemoglobin, and C-peptide levels were 174.7 mg/dL (± 61.0), 8.8% (±1.8), and 2.6 (±1.7) ng/mL, respectively. The mean fasting blood glucose, glycosylated hemoglobin, and C-peptide at 2 years were 112.5 (±60.7) mg/dL, 6.4% (±2.0), and 1.5 (±0.6) ng/mL, respectively. No patient needed revisional surgery because of dumping syndrome, marginal ulcer, or gastroesophageal reflux disease at the last follow up period.

CONCLUSION: At 2 years, LDJB-SG is a relatively safe and effective metabolic surgery with significant weight loss and resolution of co-morbidities.

Matched MeSH terms: Duodenum/surgery*

Fulltext Cystogastrocolic fold and associated atrophy of the gallbladder

Pamidi N, Nayak S, Vollala VR

Singapore Med J, 2008 Sep;49(9):e250-1.

PMID: 18830532

Peritoneal anomalies are common in humans. We report the presence of a cystogastrocolic fold associated with an abnormally small gallbladder in a 50-year-old male cadaver. Presence of this fold is one of the clinically important anomalies, which can result in atrophy of the gallbladder or congenital obstruction of the duodenum.

Matched MeSH terms: Duodenum/pathology

Fulltext Successful endovascular treatment of post-traumatic inferior pancreaticoduodenal artery pseudoaneurysm

Leong BD, Chuah JA, Kumar VM, Mazri MY, Zainal AA

Singapore Med J, 2008 Nov;49(11):e300-2.

PMID: 19037533

True and pseudoaneurysms of the visceral arteries are uncommon. They represent 0.1-0.2 percent of all vascular aneurysms. Visceral artery aneurysms (VAAs) should be treated due to their propensity to rupture and associated high mortality. We describe a 58-year-old man with pseudoaneurysm of the inferior pancreaticoduodenal artery and who presented with post-motor vehicle accident abdominal pain and a pulsatile epigastic mass. Computed tomography (CT) showed a pseudoaneurysm of the visceral artery, and selective mesenteric angiography showed the aneurysm to be arising from the inferior pancreaticoduodenal artery. The aneurysm was successfully treated with endovascular coil embolisation. CT angiogram at one month post-procedure revealed persistent occlusion of the aneurysm. To the best of our knowledge, this is the first reported pseudoaneurysm of inferior pancreaticoduodenal artery secondary to blunt abdominal trauma from a motor vehicle accident and also the first reported VAA from Malaysia.

Matched MeSH terms: Duodenum/pathology*

Fulltext Early roentgen diagnosis of retroperitoneal duodenal rupture due to blunt abdominal trauma

Sathyamoorthy P

Singapore Med J, 1992 Jun;33(3):306-7.

PMID: 1631597

Retroperitoneal duodenal rupture due to blunt abdominal trauma is relatively uncommon. Diagnosis is difficult because the physical signs are subtle or they are difficult to interpret. A case of retroperitoneal duodenal rupture due to blunt abdominal trauma in whom the diagnosis was delayed is reported. Radiographic features are discussed. The role of early roentgen diagnosis is stressed in order to reduce the very high mortality which is associated with delay in diagnosis and treatment.

Matched MeSH terms: Duodenum/injuries*; Duodenum/radiography

Fulltext A 'Hairy' problem: Trichotillomania, trichophagia and trichobezoars

Yik YI, How AK

Singapore Med J, 2016 Jul;57(7):411.

PMID: 27439704 DOI: 10.11622/smedj.2016125

Matched MeSH terms: Duodenum/surgery

Single dose treatment with Tiberal of Giardia lamblia infection in children

Iyngkaran N, Lee IL, Robinson MJ

Scand. J. Infect. Dis., 1978;10(3):243-6.

PMID: 362519

A new metronidazole derivative, Tiberal (Ro-07-0207, Roche Laboratories), was evaluated in 22 children with Giardia lamblia infection. Seven patients received an oral dose of 1 g twice daily for one day; the remaining 15 patients received a single dose of 50 mg/kg. Parasitological cure was noted in all 22 patients. Significant side effects were observed only in those children who received the drug at the higher dosage regime. The present study also confirms the findings of other authors that a mucosal imprint method is more reliable than examination of stools, duodenal juice or jejunal biopsy material for the detection of G. lamblia infection.

Matched MeSH terms: Duodenum/parasitology

Fulltext Concurrence of duodenal carcinoid and diffuse gastric adenocarcinoma: a rare phenomenon

Srilatha PS

Saudi J Gastroenterol, 2007 Oct-Dec;13(4):197-9.

PMID: 19858647 DOI: 10.4103/1319-3767.36754

Synchronous tumors are well documented in the gastrointestinal tract. Various combinations have been studied. There are a few studies, which highlight the incidental finding of the yellow beauty-the "carcinoid" of the duodenum simultaneously occurring with the venomous "diffuse gastric adenocarcinoma". This is a report one such case in a 58 year-old man, who unfortunately died on the 4th postoperative day due to cardiopulmonary arrest.

Matched MeSH terms: Duodenum

Fulltext Effects of graded dose dietary supplementation of Piper betle leaf meal and Persicaria odorata leaf meal on growth performance, apparent ileal digestibility, and gut morphology in broilers

Basit MA, Arifah AK, Loh TC, Saleha AA, Salleh A, Kaka U, et al.

Saudi J Biol Sci, 2020 Jun;27(6):1503-1513.

PMID: 32489287 DOI: 10.1016/j.sjbs.2020.04.017

Due to antimicrobial resistance and the public health hazard of antibiotic growth promoters, there is a grave need to find potential alternatives for sustainable poultry production. Piper betle (PB) and Persicaria odorata (PO) are herbs, which have been reported for antimicrobial, antioxidant, and anti-inflammatory properties. The present study aimed to estimate the influence of different dose supplementation of Piper betle leaf meal (PBLM) and Persicaria odorata leaf meal (POLM) on growth performance, ileal digestibility and gut morphology of broilers chickens. A total of 210 one day-old broiler chicks were randomly grouped into 7 treatments, and each treatment group has 3 replicates (n = 10) with a total number of 30 chicks. The treatments included T1 control (basal diet (BD) with no supplementation), T2 (BD + 2 g/kg PBLM); T3 (BD + 4 g/kg PBLM), T4 (BD + 8 g/kg PBLM), T5 (BD + 2 g/kg POLM), T6 (BD + 4 g/kg POLM), T7 (BD + 8 g/kg POLM). Growth performance, gut morphology and ileal digestibility were measured. Except for T4 (8 g/kg PBLM), graded dose inclusion of PBLM and POLM increased (P duodenum as well as for jejunum. Furthermore, the birds fed on supplementations T3 and T7 showed improved (P

Matched MeSH terms: Duodenum

Gut health and serum growth hormone levels of broiler chickens fed dietary chitin and chitosan from cricket and shrimp

Ibitoye EB, Lokman IH, Hezmee MNM, Goh YM, Zuki ABZ, Jimoh AA, et al.

Poult Sci, 2019 Feb 01;98(2):745-752.

PMID: 30265345 DOI: 10.3382/ps/pey419

Growth hormones (GH) alone does not explain the growth rate in the chicken as growth in an animal is multi-factorial. Normal morphology of the intestinal villus and crypt, with adequate regulation of intestinal nutrient transporters, is essential to a healthy gut. Nutrition plays a significant role in gut health management, but information on the effect of dietary chitin and chitosan on gut morphology, gene expression of nutrient transporter, and serum levels of GH in broiler chickens is scanty. Thus, this study aimed at evaluating the comparative effect of dietary chitin and chitosan from cricket and shrimp on the small intestinal morphology, relative gene expression of intestinal nutrient transporters and serum level of GH in the broiler. A total of 150 day-old male Cobb500 broiler chicks were randomly allotted to one of the five treatment groups (n = 30). Treatment 1 was fed basal diet only, treatments 2 to 5 were fed a basal diet with 0.5 g cricket chitin, cricket chitosan, shrimp chitin, and shrimp chitosan, respectively, per kg diet. At days 21 and 42, duodenal and jejunal samples were assessed for structural morphology and jejunum for the relative gene expression of PepT1, EAAT3, SGLT1, and SGLT5 using quantitative real-time PCR. Results bared that dietary cricket chitosan and shrimp chitosan significantly (P < 0.05) improved jejunal villus height and reduced crypt depth without improving the body weight (BW). The gut morphology of birds under cricket chitin was poor and significantly (P < 0.05) different from other treated groups. Both the dietary chitin and chitosan at day 21 and only dietary chitosan at day 42 significantly (P < 0.05) down-regulated the relative mRNA expression of PepT1, EAAT3, SGLT1, and SGLT5 of broiler chickens. Treated groups differ non-significantly at both phases, while cricket chitin numerically increased the relative expression of PepT1, EAAT3, and SGLT1. Therefore, the potential of cricket chitin to improve BW and to up-regulate nutrient transporters is worthy of further exploration.

Matched MeSH terms: Duodenum

Experimental infection of chickens with two species of Eimeria isolated from the Malaysian jungle fowl

Long PL

Parasitology, 1974 Dec;69(3):337-47.

PMID: 4449661

Matched MeSH terms: Duodenum/parasitology

Possible underestimation of SIBO in IBS patients: is lack of Glucose Breath Test standardization responsible?

Erdogan A, Rao SS, Gulley D, Jacobs C, Lee YY, Badger C

Neurogastroenterol Motil, 2015 Aug;27(8):1192-3.

PMID: 26220649 DOI: 10.1111/nmo.12603

Matched MeSH terms: Duodenum/microbiology*

Fulltext Eosinophilic Gastroenteritis as the initial manifestation of Hypereosinophilic Syndrome

Narisa, S.S., Shanti, P., Jeevinesh, N.A., Sakthiswary, R.

Medicine & Health, 2013;8(2):0-0.

MyJurnal

Eosinophilic gastroenteritis, an inflammatory disease of unknown etiology, commonly involves the stomach and small intestine with eosinophilic infiltration. Here, we report an unusual case of eosinophilic gastroenteritis involving the entire digestive tract as a manifestation of hypereosinophilic syndrome (HES). A 22-year-old woman presented to us with diarrhoea, pleural effusion, ascites and marked peripheral oeosinophilia. Stool specimens were negative for parasites, ova, bacteria, and fungi. Endoscopic studies showed pangastritis and duodenitis. Biopsy specimens of the oesophagus, stomach, duodenum, ileum, and colon demonstrated oeosinophilic infiltration. A diagnosis of hypereosinophilic syndrome with eosinophilic gastroenteritis involving the entire digestive tract was made. Hence, she was treated with prednisolone. Symptoms and peripheral oeosinophilia rapidly resolved with treatment, and radiological investigations revealed resolution of effusion. This case illustrates the wide spectrum of clinical manifestation of the disease, whereby it involves the entire digestive tract and it also emphasizes the diagnostic yields of endoscopic biopsies.

Matched MeSH terms: Duodenum

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