No abstract available.
Gastric Juice* ; Humans ; Infant, Newborn*

Malignant cologastric fistulas are relatively rare. The fistulas probably result from the contiguous growth of a tumor or tumors as they permeate and penetrate all layers of the adjacent viscus and because of the behavior characteristics of mucinoid tumor types under going avascular necrosis aided by digestion of gastric juices. An almost constant finding in cases of cologastric fistulas originating from the colon cancer is that the tumors are bulky, infiltrating, and associated with a marked inflammatory reaction. Formation of the fistulous communications depend on the anatomic locations of the primary tumor. We experienced three cases of malignant cologastric fistulas recently, and we report these three cases.
Colonic Neoplasms ; Digestion ; Fistula* ; Gastric Juice ; Necrosis

A silicone-covered modified Gianturco stent in patients with malignant esophageal stricture is an easy, safe, and effective palliative procedure, but reports of complications arising from stent placement in patients with this condition are numerous. There have been no reports of fracture of the modified Gianturco esophageal stent. We report a case of stent fracture in association with gastric migration of modified Gianturco esophageal stent in a patient with malignant esophageal stricture. It appears that the fracture was probably due to oxidation of the stent by gastric juice.
Esophageal Stenosis* ; Gastric Juice ; Humans ; Stents*

Heidenhain pouch secretion in response to small dose of serotonin was studied in conscious dogs. A single subcutaneous injection of 0.5 to 2.0 mg of serotonin produced no changes in spontaneous fasting secretion; however, the milk-induced secretion was greatly inhibited by the same dose. This inhibition was abolished by treatment of dibenzyline or LSD(d-lysergic acid die- thylamide). LSD alone enhanced the response of gastric secretion to milk. Constant intravenous infusion of serotonin, at levels of 3 to 10 microgram/kg/min was associated with a significant increase in the volume of gastric juice aspirated from three anesthetized dogs, but the acidity of juice varied very slightly. However, when histamine is given as much as 0.8 to 3 microgram/kg/min, a marked increase in both the volume and acidity was observed. A significant elevation of mucin content in the juice obtained from the Heidenhain pouch was seen in dogs receiving a single subcutaneous injection of 1.0 mg of serotonin. In case of histamine, the mucin content of pouch juice was not relatively increased and merely an increase in the total amount of mucin secondary to the volume increase was seen. The observed increase in mucin by serotonin was inhibited by LSD, BOL (2-bromo-d-lysergic acid diethylamide) or dibenzyline, and mildly by morphine. Atropine or hexamethonium did not block the response of mucin production to serotonin. The gastrointestinal motility elicited by serotonin was not affected by these agents. It is felt that the receptor(s) responsible for the mucin production in the dog belongs to the D-receptor types postulated by Gaddum and Picarelli.
Animals ; Dogs ; Gastric Juice/*drug effects ; Secretory Rate ; Serotonin/*pharmacology

BACKGROUND: Aspiration pneumonitis is one of the most severe anesthetic complications. The severity of this complication is associated with the acidic nature of aspirated gastric juice. H2 receptor antagonists inhibit gastric acid secretion and elevate the gastric juice pH. The purpose of this study was to compare the effects of preoperative night cimetidine, ranitidine and famotidine medications on gastric volume and pH. METHODS: We studied 84 healthy patients, ASA physical status I or II, who were each randomly allocated to one of 4 groups. Group I ingested only 200 ml of milk up to 8 10 hours prior to anesthesia. Groups II, III and IV ingested 200 ml of milk and 400 mg of cimetidine, 150 mg of ranitidine and 20 mg of famotidine, respectively, on the evening before elective surgery. After the induction of anesthesia, gastric juice was collected with 18 French Salem sump tube, and gastric volume and pH were measured. RESULTS: There were no significant differences in gastric juice volume among the numbers of the 4 groups. However, Group IV (famotidine) showed a significant high pH, compared with the other groups. CONCLUSIONS: Famotidine 20 mg, which is premedicated on the evening before elective surgery, is more effective in preventing aspiration pneumonitis than cimetidine 400 mg and ranitidine 150 mg.
Anesthesia ; Cimetidine* ; Famotidine* ; Gastric Acid ; Gastric Juice ; Humans ; Hydrogen-Ion Concentration* ; Milk ; Pneumonia ; Premedication* ; Ranitidine*

BACKGROUND: Aspiration pneumonitis is one of the most severe anesthetic complications. The severity of this complication is associated with the acidic nature of aspirated gastric juice. H2 receptor antagonists inhibit gastric acid secretion and elevate the gastric juice pH. The purpose of this study was to compare the effects of preoperative night cimetidine, ranitidine and famotidine medications on gastric volume and pH. METHODS: We studied 84 healthy patients, ASA physical status I or II, who were each randomly allocated to one of 4 groups. Group I ingested only 200 ml of milk up to 8 10 hours prior to anesthesia. Groups II, III and IV ingested 200 ml of milk and 400 mg of cimetidine, 150 mg of ranitidine and 20 mg of famotidine, respectively, on the evening before elective surgery. After the induction of anesthesia, gastric juice was collected with 18 French Salem sump tube, and gastric volume and pH were measured. RESULTS: There were no significant differences in gastric juice volume among the numbers of the 4 groups. However, Group IV (famotidine) showed a significant high pH, compared with the other groups. CONCLUSIONS: Famotidine 20 mg, which is premedicated on the evening before elective surgery, is more effective in preventing aspiration pneumonitis than cimetidine 400 mg and ranitidine 150 mg.
Anesthesia ; Cimetidine* ; Famotidine* ; Gastric Acid ; Gastric Juice ; Humans ; Hydrogen-Ion Concentration* ; Milk ; Pneumonia ; Premedication* ; Ranitidine*

The aim of this study was to evaluate the effect of preoperative anxiety on the gastric pH and volume. We studied 96 female patients aged 16-60 yr who underwent elective gynecological surgery. We classified the subjects into 2 groups, those presenting preoperative anxiety scores using visual analogue scale (VAS, 0-10) less than 5 (L-group, n=59), and those with 5 and more (H-group, n=37). Immediately after tracheal intubation, gastric contents were aspirated using a 14-F multiorifice nasogastric tube. The gastric acidity and volume of the two groups were not statistically different. Mean pH were 3.0+/-1.8 and 3.0+/-2.0 in each group (L-group and H-group) and mean gastric volume (mL) were 15.3 +/-11.7 and 11.8 +/-11.8, respectively. Nine (15.3%) patients in the L-group were considered to be 'at risk i.e. gastric pH <2.5 and volume >25 mL' and one patient (2.7%) in the H-group (p<0.05). The mean serum gastrin concentrations in both groups were similar (21.6+/-9.8 vs. 20.2+/-11.0 pg/mL). The pH and volume of preoperative gastric contents were not correlated with the preoperative anxiety. The results suggest that a low level of preoperative anxiety can be considered a risk factor for aspiration pneumonitis.
Adolescent ; Adult ; Anxiety/*metabolism ; Female ; *Gastric Acidity Determination ; Gastric Juice/metabolism ; Humans ; Middle Aged

Pancreaticogastrostomy (PG) has been used as an alternative procedure for pancreaticojejunostomy (PJ) for reconstruction after a pancreaticoduodenectomy (PD). Leakage at the pancreatoenteric anastomosis is still a major cause of morbidity and mortality after a PD. Therefore the major goal of technical modifications should be elimination or at least a reduction of pancreatic leakage. A number of published studies have shown that PG is associated with a low rate of anastomotic leakage. PG is easier to perform due to the thick posterior wall of the stomach and its excellent blood supply being proximal to the remaining pancreas. Furthermore, the pancreatic juice appears to be neutralized by the gastric juice, resulting in a reduction in the morbidity and mortality associated with anastomotic leakage. PG also results in a straight alignment of the digestive tract without an A-loop. PG and PJ showed an impaired exocrine and endocrine pancreatic function with a similar extent. The activity of the pancreatic enzymes is inhibited in the stomach after a PG. The enzymes become activated when gastric pH exceeds 3.1, which normally occurs after the ingestion of a meal. In conclusion, we recommend duct-to-mucosa PG as a beneficial alternative to a PJ, even in the hands of an inexperienced surgeon.
Anastomotic Leak ; Eating ; Gastric Juice ; Gastrointestinal Tract ; Hand ; Hydrogen-Ion Concentration ; Meals ; Mortality ; Pancreas ; Pancreatic Juice ; Pancreaticoduodenectomy ; Pancreaticojejunostomy* ; Stomach

Ulcerative gastric lesions in rats were produced by the procedure of Shay et al. The lesion develops uniformly in the rumen, less often in the antrum, and least frequently in the body of the stomach. Administration of serotonin (8 mg/kg) was effective in preventing the occurrence of gastric lesions and the effect is distinct particularly in the group which had 48 hrs of starvation and 10 hrs of pyloric ligation. Bilateral vagotomy was completely effective and pretreatment of atropine or morphine was moderately effective in preventing the gastric lesions. The acidity of gastric juice was considerably lower, however, the mucin content was higher in the animals treated with serotonin than nontreated control animals. Histobgically, mucus secretion was greater in the animals that were given serotonin. In summary, it is concluded that serotonin is effective in preventing ulceration in the stomach by its action of increasing mucin secretion and inhibitory gastric acid secretion.
Animals ; Female ; Gastric Juice/drug effects ; Male ; Rats ; Serotonin/*pharmacology ; Stomach Ulcer/*prevention & control

OBJECTIVE: To test the efficacy and possibility of bovine pericardial patch (BPP) for the repair of full-thickness defects in alimentary tract wall with Indermil(R) glue. BACKGROUND: There is a recent report of the successful replacement of duodenal wall with patches of ePTFE. This finding requires confirmation, Repair of other segments of the abdominal intestinal tract also merit further study. The repair of perforations of the gastrointestinal tract remain challenging. METHODS: In this study, BPP with Indermil(R) glue was used to evaluate the effectiveness, strength, adhesion formation, morphological changes, early complications and change of BPP character. We attached a BPP on the peritoneal surface of three pigs with Indermil(R) glue. After 3 weeks these animals were sacrificed and we analyzed the patch attachment. RESULTS: We made a tubelike form with BPP and Indermil(R); put it in saline (NaCl 0.9%), gastric juices and bile for 2 weeks to test the changes in the material and the strength of the attachment. Nothing changed, The attachment remained secure. We tested the BPP with glue attached to the alimentery tract and liver surface. There were no patch failures. For the next study we attached a BPP on the peritoneal surface. After 3 weeks these animal were sacrificed and the patch attachment was evaluated. One significant adhesion with fibrosis in surround tissue was noted. In this animal more Indermil(R) glue was used. Serosal surface healings was complete in all animals at 3 weeks. CONCLUSION: These observations suggest that BPP with Indermil(R) glue may well be an acceptable membrane for at least temporary replacement of the peritoneral surface. Further study is required.
Adhesives* ; Animals ; Bile ; Fibrosis ; Gastric Juice ; Gastrointestinal Tract ; Liver ; Membranes ; Pericardium* ; Pilot Projects* ; Swine