Marginal ulcer on the jejunum after proximal gastrectomy by jejunal interposition

Marginal ulcer after proximal gastrectomy has never been previously reported, despite that this procedure preserves the fundic gland area of the stomach, which secretes gastric acid. In this report, we describe a patient who developed a marginal ulcer on the oral side of the gastrojejunal anastomosis after proximal gastrectomy by jejunal interposition. This case serves as a reminder that gastric acid secretion of the remnant stomach must be carefully monitored after proximal gastrectomy in gastric cancer surgery.     

Influence of an acute hypercalcemia on the gastric secretion in duodenal ulcer, peptic ulcer of the jejunum and Zollinger-Ellison syndrome]

In 36 patients with ulcer without Zollinger-Ellison-syndrome (25 patients with recurrent duodenal ulcer, 11 with an ulcus pepticum jejuni after B II-resection of the stomach) and 2 patients suffering from ulcus pepticum jejuni with an ascertained gastrinoma the secretion of acid was compared after stimulation of pentagstrin (6 mug/kg) and calcium (4 mg Ca++/kg/h). The secretion of hydrochloric acid was statistically significantly stimulated in all patients suffering from ulcer by the hypercalcaemia (increase of the serum calcium concentration from 5.0 +/- 0.3 mval/1 to 6.2 +/- 0.8 mval/1). But in patients suffering from ulcer with gastrinoma the stimulatory effect was larger than in such patients without autonomous source of gastrin: the calcium-stimulated secretion of hydrochloric acid was on the average in cases of duodenal ulcer 40% (2 to 68%), in the ulcera peptica jejuni 47% (17 to 75%), in the 4 comparative examinations of the two patients with Zollinger-Ellison-syndrome, however, always more than 100% (106 to 177%) of the pentagastrin-stimulated peak secretion. The comparative test of the pentagastrin and calcium-stimulated secretion of hydrochloric acid could be a help for the proof of autonomous places of the formation of gastrin.     

Functional and structural changes in the jejunum of the rat following cysteamine and stress-induced duodenal ulcer.

The effects of cysteamine and stress-induced duodenal ulcer on the functional and structural properties of the rat jejunum were investigated. The absorptive capacity of the jejunum was determined using alanine as the permeant solute and the single-pass perfusion technique. A statistically significant decrease (p < 0.01) in alanine absorption was observed after 8 h and 3 days of duodenal ulcer induction by stress and cysteamine respectively. However, alanine transport measured 7 days after cysteamine or stress ulcer induction showed no significant change from control values. Cysteamine and stress-induced duodenal ulcer did not show any significant change in water absorption across the jejunum when measured after 8 h, 3 and 7 days of ulcer induction. Microscopically, the jejunum of rats with 3-day cysteamine-induced ulcer exhibited diffuse type of apical derangements with excessive swelling of the villi and progressive degenerative changes. No such changes were noticed on the 7th day nor in the jejunum of the rats with stress-induced duodenal ulcer. The results suggest that cysteamine-induced duodenal ulcer produces an inhibition in the absorptive capacity of the jejunum which is time-dependent and reversible.     

Leiomyoblastoma of the jejunum

A 35-year-old male with the symptoms of acute abdomen proved to have a jejunal leiomyoblastoma. We renew recommendations for treatment by wide excision and regional lymphadenectomy.     

Nonspecific ulcers of the colon

Summary Two cases of nonspecific cecal ulceration are presented. The lesions tend to occur in the right colon, produce pain or bleeding, and generally are best managed surgically. Etiology of the ulcers is unknown, but a vascular theory of origin is favored. Read at the meeting of the American Society of Colon and Rectal Surgeons, San Diego, California, June 11 to 15, 1978.     

Polypoid hamartoma of the jejunum

The authors report an unusual case of jejunal mesenchymal hamartoma which presented as a bleeding pedunculated polyp in a 67-year-old woman. The lesion was detected by enteroclysis and resected after localization by intraoperative endoscopy.     

Adenosquamous carcinoma of the jejunum

Primary adenosquamous carcinomas of the intestine are rare, particularly in the small intestine. One case, in the jejunum of an adult female, is described here. The patient was a 70-year-old Japanese woman presenting with upper abdominal pain. Computed tomography of the abdomen showed a mass in the small intestine, measuring 86 × 44mm, and a double-contrast barium study revealed a filling defect in the upper jejunum. The patient was diagnosed as suffering from upper small-intestinal cancer, and surgical excision was performed. Histological examination, including immunohistochemistry and electron microscopy, revealed the tumor to have both malignant glandular and squamous components. A review of the literature regarding this type of lesion is presented.     

Primary carcinoma of the jejunum

Summary 1. Seven cases of carcinoma originating in the jejunum have been presented.2. The clinical features of pain, vomiting, and anemia are late in appearance and are not diagnostic in themselves.3. Routine gastrointestinal x-ray study may frequently fail to disclose a small intestinal lesion. The clinician must more often suspect the small bowel as a source of trouble and request special radiographic study.4. Resection with attempt to cure is the therapeutic method of choice. The possibility of greater salvage with second look operation is suggested.5. The prognosis is poor. The 5-year cure rate is 20 to 25 per cent, and average survival is less than 3 years.6. A plea is registered for the steps leading to earlier diagnosis of this condition.Grateful acknowledgment for the use of clinical material is made to Richard Clay, M.D., Rudolph Drosd, M.D., Eugene Greenwald, M.D., and William J. Clifford, M.D.; and to Mercy, Jackson Memorial, Mount Sinai, and St. Francis Hospitals of Greater Miami.     

非特异性间质性肺炎

非特异性间质性肺炎,是特发性间质性肺炎中继特发性肺间质纤维化后最常见的类型,它在流行病学、发病机制、临床表现、影像学特点、病理表现及预后等方面都有其自身特点,尤其是预后远较特发性肺间质纤维化好。本文将就目前对于NSIP的认识做一综述。