MyMedR

Toxocara malaysiensis n. sp. (Nematoda: Ascaridoidea) from the domestic cat (Felis catus Linnaeus, 1758)

Gibbons LM, Jacobs DE, Sani RA

J Parasitol, 2001 Jun;87(3):660-5.

Toxocara malaysiensis n. sp. from the small intestine of the domestic cat (Felis catus L.) in Malaysia is described and illustrated. This ascaridoid nematode was previously assumed to be Toxocara canis, which it superficially resembles, or designated Toxocara sp. cf. canis. The new species differs from T. canis in the shape of the cervical alae in cross section, spicule length, and the lip structure. It is also distinct from other species assigned to Toxocara.

Matched MeSH terms: Intestine, Small/parasitology

Total jejuno-ileal volvulus with jejunal diverticulosis

Vine LE

Journal of the Malaya Branch of the British Medical Association, 1941;5:58-9.

Matched MeSH terms: Intestine, Small

The transit of dosage forms through the small intestine

Yuen KH

Int J Pharm, 2010 Aug 16;395(1-2):9-16.

PMID: 20478371 DOI: 10.1016/j.ijpharm.2010.04.045

The human small intestine, with its enormous absorptive surface area, is invariably the principal site of drug absorption. Hence, the residence time of a dosage form in this part of the gut can have a great influence on the absorption of the contained drug. Various methods have been employed to monitor the gastrointestinal transit of pharmaceutical dosage forms, but the use of gamma-scintigraphy has superceded all the other methods. However, careful consideration of the time interval for image acquisition and proper analysis of the scintigraphic data are important for obtaining reliable results. Most studies reported the mean small intestinal transit time of various dosage forms to be about 3-4h, being closely similar to that of food and water. The value does not appear to be influenced by their physical state nor the presence of food, but the timing of food intake following administration of the dosage forms can influence the small intestinal transit time. While the mean small intestinal transit time is quite consistent among dosage forms and studies, individual values can vary widely. There are differing opinions regarding the effect of density and size of dosage forms on their small intestinal transit properties. Some common excipients employed in pharmaceutical formulations can affect the small intestinal transit and drug absorption. There is currently a lack of studies regarding the effects of excipients, as well as the timing of food intake on the small intestinal transit of dosage forms and drug absorption.

Matched MeSH terms: Intestine, Small/drug effects; Intestine, Small/physiology*; Intestine, Small/radionuclide imaging

The potential of resistant starch as a prebiotic

Zaman SA, Sarbini SR

Crit Rev Biotechnol, 2016 Jun;36(3):578-84.

PMID: 25582732 DOI: 10.3109/07388551.2014.993590

Resistant starch is defined as the total amount of starch and the products of starch degradation that resists digestion in the small intestine. Starches that were able to resist the digestion will arrive at the colon where they will be fermented by the gut microbiota, producing a variety of products which include short chain fatty acids that can provide a range of physiological benefits. There are several factors that could affect the resistant starch content of a carbohydrate which includes the starch granule morphology, the amylose-amylopectin ratio and its association with other food component. One of the current interests on resistant starch is their potential to be used as a prebiotic, which is a non-digestible food ingredient that benefits the host by stimulating the growth or activity of one or a limited number of beneficial bacteria in the colon. A resistant starch must fulfill three criterions to be classified as a prebiotic; resistance to the upper gastrointestinal environment, fermentation by the intestinal microbiota and selective stimulation of the growth and/or activity of the beneficial bacteria. The market of prebiotic is expected to reach USD 198 million in 2014 led by the export of oligosaccharides. Realizing this, novel carbohydrates such as resistant starch from various starch sources can contribute to the advancement of the prebiotic industry.

Matched MeSH terms: Intestine, Small

The pigbel story of Papua New Guinea

Murrell TG, Walker PD

Trans R Soc Trop Med Hyg, 1991 1 1;85(1):119-22.

PMID: 2068739

Enteritis necroticans (EN), known as pigbel in Papua New Guinea (PNG), may be the important predisposing lesion to mid-gut volvulus, jejunal and ileal ileus and other forms of small bowel strangulation in communities where protein deprivation, poor food hygiene, epochal meat feasting and staple diets containing trypsin inhibitors co-exist. Such human habitats occur in Africa, Central and South America, western Pacific, Asian and south-east Asian cultures. Isolated outbreaks of necrotizing enteritis have been reported from Uganda, Malaysia and Indonesia but as yet no systematic epidemiological study of the prevalence of small bowel strangulations has been described in the surgical literature of 'third world' countries. Now that enteritis necroticans is preventable by vaccination, such studies should be undertaken. This paper outlines the story of pigbel and its control in PNG.

Matched MeSH terms: Intestine, Small/pathology

The establishment and development of Trichostrongylus colubriformis in goats

Rahman WA, Collins GH

Vet Parasitol, 1990 Mar;35(3):195-200.

PMID: 2343537

Twelve goats were inoculated with 20,000 infective larvae of Trichostrongylus colubriformis and two were killed on each of Days 4, 7, 11, 14, 18 and 21 after inoculation (DAI). The number of worms that established, and the site of development were recorded. Most of the worms established within the first 3 m of the small intestine. There was little relocation or loss of nematodes after establishment. The worms started to migrate from the mucosa to the lumen 11 days after infection. At 4 DAI, 63% of the worms were still at the late L3 stage; the remainder of the worm population had completed the third moult to the L4 stage. The population at 11 DAI comprised largely young adults. When 21 DAI was reached, about 57% of the female worms had eggs in their uteri.

Matched MeSH terms: Intestine, Small/parasitology*

Fulltext The abdominal cocoon: a case report

Kyaw K

Singapore Med J, 1994 Dec;35(6):653-4.

PMID: 7761900

A 15-year-old Chinese girl, with abdominal cocoon, is reported. The literature (in English) concerning the condition was reviewed. Also, a possible cause is suggested and the various terms used for this condition are discussed.

Matched MeSH terms: Intestine, Small/pathology*

The abdominal cocoon

Yip FW, Lee SH

Aust N Z J Surg, 1992 Aug;62(8):638-42.

PMID: 1642584

Since it was first described in 1978 the abdominal cocoon continues to be a rare cause of intestinal obstruction. So far this rare condition where the small intestine is encased in a fibrous membrane has been reported only in females. Diagnosis is usually made at laparotomy and the treatment of choice is lysis of adhesions. Proper recognition of this benign condition will result in the correct management of it and prevent unnecessary bowel resections. Five new cases including one male patient, together with a review of previous reports in the English literature, are presented.

Matched MeSH terms: Intestine, Small/abnormalities*; Intestine, Small/pathology; Intestine, Small/surgery

Fulltext Successful management of intussusception with total polyp clearance in Peutz-Jeghers syndrome using a combined endoscopic and surgical approach

Kong SS, Taib NA, Mahadeva S

BMJ Case Rep, 2009;2009.

PMID: 21686715 DOI: 10.1136/bcr.08.2008.0628

Intussusception due to small intestinal polyps in Peutz-Jeghers syndrome represents a significant clinical challenge. Neither pure surgical nor endoscopic approaches alone are effective in the long-term management of this problem. We describe a combined approach using both surgery and small bowel endoscopy in the management of this condition, which resulted in both immediate and long-term success. Although not new, we believe this approach remains relevant despite recent technological advancements in this area.

Matched MeSH terms: Intestine, Small

Fulltext Small bowel obstruction secondary to obturator hernia: A pre-operative diagnosis at computed tomography

Marlina Tanty Ramli Hamid, Mohd Shukry Mohd Khalid, Kartini Rahmat

Journal of Clinical and Health Sciences, 2021;6(1):46-49.

MyJurnal

Obturator hernia is rare, but it must be considered in elderly patients who present with small
bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as
the presenting symptoms and signs are usually non-specific. Presence of positive HowshipRomberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention
will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We
report a case of a 93-year-old female patient who was admitted to our surgical department with
symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative.
Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal
small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy
post-CT where the incarcerated bowel loop was released and the obstructed bowel was
decompressed without any complication. The hernial defect was close with a mesh and the
patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of
obturator hernia must always be considered in elderly patients who present with intestinal
obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids in appropriate
surgical intervention planning which is crucial in optimising the outcome.

Matched MeSH terms: Intestine, Small

Route delivery of nutrition in patients with enterocutaneous fistula

Rizka H, Diyah EA

Med J Malaysia, 2023 Jul;78(4):541-546.

PMID: 37518930

Malnutrition is one of the most frequent effects of an enterocutaneous fistula (ECF). There are some factors that contribute to it including inadequate intake, fluid loss via fistula and underlying disease. The role of nutrition is very important as a part of ECF therapy to give adequate nutrition, maintain fluid and electrolyte state and increase the likelihood of fistula closure spontaneously. Therefore, it is anticipated that adequate nutrition management will lower morbidity and mortality while enhancing clinical results. Nutritional requirements and nutritional route, whether oral, enteral and parenteral nutrition in ECF management, are influenced by the anatomical, physiological and aetiology of the fistula. The purpose of this review was to highlight the evidence based on nutritional therapy in ECF patients by calling attention to nutritional route selection based on the anatomy and physiology fistula to prevent malnutrition.

Matched MeSH terms: Intestine, Small

Fulltext Revisiting the global problem of cryptosporidiosis and recommendations

Shrivastava AK, Kumar S, Smith WA, Sahu PS

Trop Parasitol, 2017 Jan-Jun;7(1):8-17.

PMID: 28459010 DOI: 10.4103/2229-5070.202290

Cryptosporidiosis is a gastrointestinal illness caused by the protozoan parasite Cryptosporidium species, which is a leading cause of diarrhea in a variety of vertebrate hosts. The primary mode of transmission is through oral routes; infections spread with the ingestion of oocysts by susceptible animals or humans. In humans, Cryptosporidium infections are commonly found in children and immunocompromised individuals. The small intestine is the most common primary site of infection in humans while extraintestinal cryptosporidiosis occurs in immunocompromised individuals affecting the biliary tract, lungs, or pancreas. Both innate and adaptive immune responses play a critical role in parasite clearance as evident from studies with experimental infection in mice. However, the cellular immune responses induced during human infections are poorly understood. In this article, we review the currently available information with regard to epidemiology, diagnosis, therapeutic interventions, and strategies being used to control cryptosporidiosis infection. Since cryptosporidiosis may spread through zoonotic mode, we emphasis on more epidemiological surveillance-based studies in developing countries with poor sanitation and hygiene. These epidemiological surveys must incorporate fecal source tracking measures to identify animal and human populations contributing significantly to the fecal burden in the community, as mitigation measures differ by host type.

Matched MeSH terms: Intestine, Small

Rare complication of appendix: small bowel gangrene caused by the appendicular knot

Mohana RT, Zainal AA

Med J Malaysia, 2017 12;72(6):370-371.

PMID: 29308777 MyJurnal

Intestinal knot formation was first described by Riverius in 16th century and later by Rokitansky in 1836. We report a very rare cause of small bowel gangrene caused by appendiceal knotting on to the ileum in a previously healthy mid aged lady. Patient underwent laparatomy and right hemicolectomy and primary anastomosis. The intra operative findings were the appendix was twisting (knotting) the small bowel about 40cm from the terminal ileum and causing gangrene to the segment of small bowel. Appendicitis is a common condition and management is usually straightforward. However we must be aware of rare complications which may arise that require a change from the standard treatment of acute appendicitis.

Matched MeSH terms: Intestine, Small/physiopathology*; Intestine, Small/surgery*

Pig-bel but no pig: enteritis necroticans acquired in Australia

Watson DA, Andrew JH, Banting S, Mackay JR, Stillwell RG, Merrett M

Med J Aust, 1991 Jul 01;155(1):47-50.

PMID: 2067439

OBJECTIVE: To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.

CLINICAL FEATURES: A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans.

INTERVENTION AND OUTCOME: He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered.

CONCLUSIONS: Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

Matched MeSH terms: Intestine, Small/pathology; Intestine, Small/surgery

Fulltext Phytobezoar: an unusual cause of intestinal obstruction

Teng H, Nawawi O, Ng K, Yik Y

Biomed Imaging Interv J, 2005 Jul;1(1):e4.

PMID: 21625276 MyJurnal DOI: 10.2349/biij.1.1.e4

Small bowel phytobezoars are rare and almost always obstructive. There have been previously reported cases of phytobezoars in the literature, however there are few reports on radiological findings for small bowel bezoars. Barium studies characteristically show an intraluminal filling defect of variable size that is not fixed to the bowel wall with barium filling the interstices giving a mottled appearance. On CT scan, the presence of a round or ovoid intraluminal mass with a 'mottled gas' pattern is believed to be pathognomonic. Since features on CT scans are characteristics and physical findings are of little assistance in the diagnosis of bezoar, the diagnostic value of CT needs to be emphasised.

Matched MeSH terms: Intestine, Small

Parapleurogonius brevicecum gen. et sp. n. (Trematoda: Pronocephalidae) from a freshwater turtle in peninsular Malaysia

Sullivan JJ

Southeast Asian J. Trop. Med. Public Health, 1976 Dec;7(4):540-2.

PMID: 1025749

Parapleurogonius brevicecum gen. et sp. n. is described from the freshwater turtle, Kachuga trivittata, in Selangor, Malaysia. Parapleurogonius is most closely related to Pleurogonius Looss, 1901, but from which it can be distinguished by the termination of the ceca at or just overlapping the anterior border of the testes and the pretesticular position of the excretory pore. Additionally, Parapleurogonius is described from a freshwater turtle, whereas Pleurogonius is only known from marine hosts.

Matched MeSH terms: Intestine, Small/parasitology

PRIMARY VOLVULUS OF THE SMALL INTESTINE

BALASEGARAM M

Med J Malaysia, 1963 Dec;18:122-4.

PMID: 14117280

Matched MeSH terms: Intestine, Small*

On the life history of Hepatojarakus malayae (Nematoda : Trichostrongylidae), a parasite of the feral rat in Malaysia

Ow-Yang CK

J Helminthol, 1974 Dec;48(4):293-310.

PMID: 4448893

Matched MeSH terms: Intestine, Small/parasitology

Obstructed jejunal duplication cyst in an infant

Ho CK

Med J Malaysia, 2020 03;75(2):167-168.

PMID: 32281600

Intestinal obstruction in infancy due to duplication cyst is rare. This is a case of a three-month old boy presented to the hospital with symptoms and signs of intermittent intestinal obstruction for three-week duration. Investigation with ultrasound revealed a small bowel duplication cyst. Patient underwent successful segmental jejunal resection and made an uneventful recovery. He made significant weight gain at one-year follow-up. The diagnostic approach to infant with intestinal obstruction is described with special emphasis on ultrasonographic features of jejunal duplication cyst.

Matched MeSH terms: Intestine, Small

Necrotizing angiitis of the small intestine related to AA-amyloidosis: a novel association

Oweity T, West AB, Stokes MB

Int. J. Surg. Pathol., 2001 Apr;9(2):149-54.

PMID: 11484503

A 71-year-old man with intestinal pseudo-obstruction was found to have a diffusely thickened adynamic small bowel with AA-amyloid in submucosal vessels and muscularis propria, foreign body giant cell reaction to amyloid, and necrotizing angiitis. The mucosa was unremarkable. Immunostains demonstrated numerous CD68+ monocyte/macrophages and CD8+ T cells associated with the amyloid deposits. The patient had no evidence of systemic vasculitis and no underlying cause for AA-amyloidosis was identified. Necrotizing angiitis coexistent with amyloid angiopathy has been reported in brain and temporal arteries, but not in the gastrointestinal tract and not with AA-amyloid. The inflammatory cell infiltrates in this case are consistent with a foreign-body and/or cell-mediated immunologic reaction to AA-amyloid, although a role for these cells in amyloid formation cannot be excluded.

Matched MeSH terms: Intestine, Small/pathology*

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