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Early recognition of toxic megacolon. J. Clin. Gastroenterol. 1987;9:160-164
No full textIncreased amounts of small bowel gas are a frequent finding on plain abdominal
films in toxic megacolon (TMC), but they may also be found in patients with
severe colitis. We studied 69 consecutive patients with severe ulcerative colitis
to evaluate whether an increased gas content of the small intestine may identify
patients prone to TMC. The intestinal gas was measured on plain abdominal films
by means of a planimeter. On the basis of gas values, 38 patients showed a normal
and 31 an increased amount of small intestinal gas. The outcome of the disease
(complications, need for surgery, and mortality rate) and 18 clinical and
hematochemical findings were compared in the two groups. Of the 31 patients with
increased gas, seven developed TMC, whereas this complication was not observed in
the 38 patients with normal gas. The only other different features between the
two groups were blood pH and base excess, which were significantly higher in the
patients with increased small bowel gas content. We therefore suggest that
persistent abnormal gaseous distension of the small bowel, together with severe
metabolic alkalosis, characterizes a subgroup of patients with severe colitis at
high risk for the development of TMC. The strict surveillance of these patients
led to early recognition of seven cases of TMC and prompt institution of
aggressive medical treatment. Since all these patients survived, the early
detection of TMC may improve prognosis
Gallbladder volume variations after meal ingestion
No full textObjective: To assess gallbladder (GB) volume variations in response to a standard meal.
Methods: We assessed these variations with ultrasonography at brief intervals over the postprandial period, which included the emptying and refilling phases of the GB.
Results: During both emptying and refilling of the GB, the volume fluctuated continuously, with brief alternating volume decrements and increments. The phases of emptying and refilling appear to be the net result of the algebraic sum of these volume fluctuations. In the emptying phase, the volume decrements showed a greater volume (35.7 +/- 10.7 ml vs. 14.8 +/- 8.4 ml) and lasted longer (158 +/- 37 min vs. 85 +/- 44 min) than the volume increments, whereas the opposite took place in the refilling phase (4.3 +/- 3.4 ml vs. 16.4 +/- 12.2 ml; 39 +/- 20 min vs. 84 +/- 37 min).
Conclusion: It is probable that the continuous GB volume fluctuations are the expression of hepatic bile recycling in the GB during the entire postprandial period, and the amount of bile recycled by the GB is greater during the emptying than the refilling phase
L'esame radiografico diretto dell'addome nel follow-up dei pazienti con colite ulcerosa grave. Atti del I Congresso Biennale della Federazione Italiana di Colonproctologia e del First Biennal Congress of European Council of Colonproctology. Bologna, 29 Ottobre – 1 Novembre 1986. Advances in Coloproctology, B. Cola and I. Moranti Eds, Bologna, Monduzzi Editore, 1987:p 59-62
No full textCOMPUTED-TOMOGRAPHY CAN IDENTIFY DIFFERENT PATTERNS OF BOWEL WALL THICKENING RELATED TO CROHNS-DISEASE ACTIVITY
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Functional evaluation of colon transplants used in esophageal reconstruction
No full textStudies were performed on the mechanical activity of iso- and antiperistaltic colon segments used to replace the esophagus. Transplants were challenged with a semiliquid bolus and/or a 0.1 N HCl solution, considered as common stimuli for an in situ esophagus, and the mechanical activity was investigated by means of synchronized manometric and cinefluorographic recordings. Basal activity of the interposed colon was limited to occasional monophasic waves of the segmenting type; the acid solution and the semiliquid bolus constantly elicited a peristaltic motor response transporting the contents to the gastric fundus or, in antiperistaltic colon, from the distal to the proximal part
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