This paper is the report of a 2 kg baby girl born with a large gastroschisis at the Angau Memorial Hospital. She is the first long-term survivor in Papua New Guinea with this major ventral abdominal wall defect as far as we are aware. In the report important steps in the management of this major congenital defect are highlighted from both the surgical and anaesthetic perspectives. It is imperative that a large gastroschisis be managed by a reduction carried out over two or more stages to prevent catastrophic abdominal compartment syndrome. Postoperative ventilation via an endotracheal tube was required due to respiratory compromise from the raised intra-abdominal pressure. Deflation of the dilated small bowel was shown to be an important step to allow full return of the small bowel into the abdominal cavity. A percutaneous jejunostomy feeding tube was inserted for feeding postoperatively as total parenteral nutrition was not available, and this was crucial for the nutritional management and ultimate survival of the baby. Gastroschisis is a very significant congenital defect with major challenges in its management in a developing country, but if important principles of management are followed, the prognosis can be remarkably improved.
Gastroschisis ; Hospitals ; experience ; Feeding ; Intestines, Small

Segmental dilatation of small intestine or colon can induce signs of intestinal obstruction, such as abdominal distension, vomiting and constipation. There are no anatomical gross obstructive lesions, and moreover, ganglion cells are observed in both dilated and undilated distal segments of the intestine. It often accompanied by other congenital anomalies. We reported two cases of segmental dilatation of the intestine in the newborn infants, one in small intestine and the other in colon, with brief review of the related literatures.
Colon ; Constipation ; Dilatation* ; Ganglion Cysts ; Humans ; Infant, Newborn* ; Intestinal Obstruction ; Intestine, Small ; Intestines* ; Vomiting

A case of total aganglionic intestine in a new born infant is presented with a review of literature. Persistent vomiting, abdominal distension, failure to pass meconeum since brith were manifested. All X-rays showed multiple fluid level suggesting intestinal obstruction. In spite of colostomy with meticulous medical care, the patient expired due to cachexia. Postmortem autopsy findings were complete abscence of Auerbach's plexuses in entire intestine including esophagus, stomach, small intestine and colon.
Autopsy ; Cachexia ; Colon ; Colostomy ; Esophagus ; Humans ; Infant ; Intestinal Obstruction ; Intestine, Small ; Intestines* ; Myenteric Plexus ; Stomach ; Vomiting

BACKGROUND/AIMS: Small intestine motility is governed by an electrical slow wave activity, and abnormal slow wave events have been associated with intestinal dysmotility. High-resolution (HR) techniques are necessary to analyze slow wave propagation, but progress has been limited by few available electrode options and laborious manual analysis. This study presents novel methods for in vivo HR mapping of small intestine slow wave activity. METHODS: Recordings were obtained from along the porcine small intestine using flexible printed circuit board arrays (256 electrodes; 4 mm spacing). Filtering options were compared, and analysis was automated through adaptations of the falling-edge variable-threshold (FEVT) algorithm and graphical visualization tools. RESULTS: A Savitzky-Golay filter was chosen with polynomial-order 9 and window size 1.7 seconds, which maintained 94% of slow wave amplitude, 57% of gradient and achieved a noise correction ratio of 0.083. Optimized FEVT parameters achieved 87% sensitivity and 90% positive-predictive value. Automated activation mapping and animation successfully revealed slow wave propagation patterns, and frequency, velocity, and amplitude were calculated and compared at 5 locations along the intestine (16.4 +/- 0.3 cpm, 13.4 +/- 1.7 mm/sec, and 43 +/- 6 microV, respectively, in the proximal jejunum). CONCLUSIONS: The methods developed and validated here will greatly assist small intestine HR mapping, and will enable experimental and translational work to evaluate small intestine motility in health and disease.
Electrodes ; Electrophysiology ; Forced Expiratory Volume ; Gastrointestinal Motility ; Interstitial Cells of Cajal ; Intestine, Small ; Intestines ; Noise

Acute mesenteric infarction is a catastrophic illness representing a diverse spectrum of pathologic conditions which ultimately lead to necrosis of the intestine and which is uniformly fatal if left untreated. Despite better understanding of the disease process, acute mesenteric infarction continues to be a lethal disorder with high mortality rate. We experienced two cases of acute mesenteric infarction due to superior mesenteric arterial and venous branch occlusion, respectively, in recent years: One case was focal segmental ischemia with normal radiologic finding including angiography, successfully treated with segmental resection of the necrotized ileum, another case was mesenteric venous thrombosis, also treated with resection of necrotized small intestine followed by second look operation.
Angiography ; Catastrophic Illness ; Ileum ; Infarction* ; Intestine, Small ; Intestines ; Ischemia ; Mortality ; Necrosis ; Venous Thrombosis

Meckel diverticulum is the most common congenital abnormality of the small intestine. The condition occasionally involves invagination of the bowel lumen, leading to intussusception. We report a case in which intussusception secondary to an inverted Meckel diverticulum, together with an ectopic pancreas, occurred in an adult, and describe the associated radiologic, clinical and pathologic findings.
Abdomen ; Adult ; Congenital Abnormalities ; Diverticulum ; Humans ; Intestine, Small ; Intestines ; Intussusception* ; Meckel Diverticulum* ; Pancreas*

Malignant tumors of the small bowel are uncommon by comparison with those in other parts of the gastrointestinal tract. Adenocarcinomas account for about half of the malignant tumors of the small intestine, which account for 1% to 2% of the gastrointestinal neoplasma. Small-bowel tumors are often asymptomatic and without clinical significance, and later became symptomatic and are eventually fatal. Patient's with regional enteritis, especially those who have had segments of the intestine surgically by passed, have an increased incidence of small-bowel cancer. The author experienced a case of an adenocarcinoma at the jejunostomy site (Braun anastomosis) which was treated by using a B II type subtotal gastrectomy for stomach cancer. That case of a jejunostomy site adenocarcinoma is reported and the literature on small-bowel malignancy is reviewed.
Adenocarcinoma* ; Crohn Disease ; Gastrectomy ; Gastrointestinal Tract ; Incidence ; Intestine, Small ; Intestines ; Jejunostomy ; Stomach Neoplasms

Intussusception is a prolapse of a segment of the intestine into the lumen of the adjacent intestine. The majority of intussusceptions occur in infancy and early childhood. Intussusception arising in adulthood represents only about 5% of all intussusceptions and is usually caused by a malignant small bowel lesion acting as an apex for intussusception. Lipoma is not a common tumor in the gastrointestinal tract, and gastrointestinal lipomas may be submucosal or subserosal. Most of them are asymptomatic, although they may cause abdominal pain, bowel obstruction, and gastrointestinal bleeding. Intestinal intussusception caused by lipoma is uncommon and is particularly rare when the lipoma is located in the small intestine. We report an unusual case of intussusception in an adult male patient, which was caused by a lipomatous lesion located in the proximal jejunum acting as a lead point.
Abdominal Pain ; Adult ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestine, Small ; Intestines ; Intussusception ; Jejunum ; Lipoma ; Male ; Prolapse

BACKGROUND/AIMS: The role of the enteric (ENS) and central (CNS) nervous systems in the control of the retrograde giant contraction (RGC) associated with vomiting is unknown. METHODS: The effects of myotomy or mesenteric nerve transection (MNT) on apomorphine-induced emesis were investigated in 18 chronically instrumented dogs RESULTS: Neither surgery affected the RGC orad of the surgical site or the velocity of the RGC over the entire small intestine. Myotomy blocked the RGC for 17 ± 5 cm aborad of the myotomy, and the velocity of the RGC from 100 to 70 cm from the pylorus slowed (18.1 ± 3.0 to 9.0 ± 0.8 cm/sec) such that the RGC orad and aborad of the myotomy occurred simultaneously. After MNT, the RGC was unchanged up to 66 ± 6 cm from the pylorus, and the sequence of the RGC across the denervated intestine was unaltered. The velocity of the RGC from 100 to 70 cm from the pylorus increased from 12.8 ± 1.6 to 196 ± 116 cm/sec. After myotomy or MNT, the percent occurrence and magnitude of the RGC across the intestine 100 to 70 cm from the pylorus decreased. CONCLUSIONS: The CNS activates the RGC 10 to 20 cm aborad of its innervation of the intestine and controls the RGC sequence. On the other hand, the ENS plays a role in initiation and generation of the RGC.
Animals ; Central Nervous System ; Dogs ; Enteric Nervous System* ; Hand ; Intestine, Small ; Intestines ; Nervous System ; Pylorus ; Vomiting

PURPOSE: We aimed to investigate the extent of heterogeneity in medical terminology between South and North Korea by comparing medical terms related to the colorectal system. METHODS: North Korean medical terms were collected from the sections on diseases of the small intestine and colon in a surgery textbook from North Korea, and those terms were compared with their corresponding terms in a South Korean medical terminology textbook. The terms were categorized as either identical, similar, showing disparity, or not used in South Korea. In a subsection analysis, the terms were allocated to pathophysiology, diagnosis, symptoms and examination, drugs, testing, treatment, or others according to the categorization used in the textbook. RESULTS: We found 705 terms in the North Korean textbook, most of which were pathophysiological terms (206, 29.2%), followed by diagnostic terms (165, 23.4%) and symptom and examination terms (122, 17.3%). Treatment-, drug-, and testing-related terms constituted 15.5%, 5.8%, and 4.1% of the 705 terms, respectively. There were 331 identical terms (47.0%) and 146 similar terms (20.7%); 126 terms (17.9%) showed disparity. Another 102 terms (14.5%) were not used in South Korea. The pathophysiological terms were the least heterogeneous, with 61.2% being identical terms used in both countries. However, 26.8% of the terms in the drug category were not used in South Korea. CONCLUSION: The present study showed that less than 50% of the terms for the colorectal system used in South and North Korea were identical. As the division between South and North Korea persists, the heterogeneity of medical terminology is expected to increase.
Colon ; Colorectal Surgery* ; Democratic People's Republic of Korea* ; Diagnosis ; Intestine, Small ; Intestines ; Korea ; Population Characteristics