This study was an attempt to investigate the relative distribution and morphology of serotonin cells (SC) in intestinal glands of adult rodents, rats, guinea pigs and mice. The intact isolated epithelial sheets of intestinal glands from duodenum, jejunum, ileum, cecum, and proximal and distal colon were prepared for immunohistochemistry using antiserotonin antisera. Examination of isolated epithelia reveals an actual number of SC in one intestinal gland and whole image of individual serotonin cell. In small intestine of all species in this study, the average number of SC per one intestinal gland was the highest in duodenum, and decreased in jejunum and ileum. The distributional patterns of SC in large intestine of three species, however, were different. The number of SC decreased towards distal colon in both rat and guinea pig, and vice versa in mouse. And in the rat, the number of SC in colon was even higher than in duodenum, while in the guinea pig the number of SC in colon was lower than any other part of small intestine. In all the intestinal region of three species, SC were more numerous towards the bases of glands. The open type of SC whose apical cytoplasmic process reach glandular lumen were predominant (over 97% in average) in small intestine of all species in this study. The frequency of closed type was increased in large intestine (up to 44.9% in proximal colon of guinea pig). And closed type was more frequently detected towards the upper part of gland. In small intestine of all species in this study, SC were predominantly flask-like in shape without basal processes. In large intestine, SC with basal processes were often detected, and their frequencies increased towards the upper part of gland. In mice, basal processes were usually long in length (over the long axis of cell), while all the basal precesses of SC of guinea pig were short. We found that the isolated epithelium were very useful to figure out the actual number and whole images of enteroendocrine cells in intestinal mucosal epithelium. The present results demonstrated that relative distribution and morphology of SC were very different among the species especially in large intestine.
Adult ; Animals ; Axis, Cervical Vertebra ; Cecum ; Colon ; Cytoplasm ; Duodenum ; Enteroendocrine Cells ; Epithelium ; Guinea ; Guinea Pigs ; Humans ; Ileum ; Immune Sera ; Immunohistochemistry ; Intestinal Mucosa* ; Intestine, Large ; Intestine, Small ; Jejunum ; Mice ; Rats ; Rodentia* ; Serotonin*

Inflammatory myofibroblastic tumors (IMTs) are solid neoplastic mesenchymal proliferations composed of myofibroblastic spindle cells admixed with inflammatory infiltrates. The documented sites in the gastrointestinal tract include the esophagus, small intestine, colon, appendix, rectum, pancreas, spleen, liver, and Meckel's diverticulum. Biliary IMTs are rare, and IMTs arising from the ampulla of Vater have not been reported previously. Herein we report the case of a 65-year-old woman with an extrahepatic biliary obstruction due to IMT of the ampulla of Vater, and a successful therapeutic approach using endoscopic ultrasonography and endoscopic papillectomy.
Aged ; Ampulla of Vater ; Appendix ; Colon ; Endosonography ; Esophagus ; Female ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Liver ; Meckel Diverticulum ; Myofibroblasts ; Pancreas ; Rectum ; Spleen

Diverticulum is considered as common lesion involving any gastrointestinal tract from the pharynx to therectum. We reviewed 5806 cases of upper GI series and 801 cases of Barium enema during the period from Jan. 1978to Dec. 1981 in the Departement of Radiology, school of medicine, JeonBug National University Hospital to analizediverticula of the entire GI tract. The results are follows : 1. Roetgen examination of 5806 esophagus, stomachs,duodenums and small bowels, and 801 colons during the past four years: diverticular of esophagus, 60 cases(1.0%);diverticula of stomach, 42 cases (0.7%); diverticula of duodenum, 358 cases (6.2%); diverticula of small bowel,20( 0.3%); diverticula of the colon, 26 cases (3.2%). The location of diverticula inorder of frequency wasduodenum, colon, esophagus, stomach, and small bowel. 2. the most common site of diverticula of each GI tract wasfollows : diverticula of the esophagus, middle portion (84.7%); diverticula of stomach, the cardia(59.5%);diverticula of the duodenum, second portion(81.3%); diverticula of small bowel, the jejunum(96.4%) especially thelarger percentage were observed at the upper jejunum near the ligament of Treitz; diverticula of the colon, rightsided colon(80.8%), the cecum and ascending colon(57.1%) 3. Diverticula may occur at any age. The majority ofdiverticula of the entire GI tract were observed over 40 years of age. Especialy in diverticula of duodenum andcolon, thir frequency increase with age. 4. Duodenal diverticula were observed more frequently in womanthan in manbut in diverticula of the esophagus, stomach, small bowel, and colon, male was more frequently affected. 5. Thesize of diverticula of entire GI tract was variable. The majoprity of diverticula of the esophagus, stomach,duodenum and small bowel were intermediate size (10-49 mm). Diverticula of the colon were usually smaller than 10mm. 6. Multiplicity of diverticula of entire GI tract was 16.2% of 506 cases. In diverticula of esophagus,stomach, duodenum and small bowel, single lesion was more frequently found. on the other hand, the majority ofdiverticula of the colon were found as multiple lesion(69.2%).
Barium ; Cecum ; Colon ; Diverticulum ; Duodenum ; Enema ; Esophagus ; Gastrointestinal Tract ; Hand ; Humans ; Jejunum ; Jeollabuk-do ; Ligaments ; Male ; Pharynx ; Stomach

The local arrangement of sensory nerve cell bodies and nerve fibers in the brain stem, spinal ganglia and nodose ganglia were observed following injection of cholera toxin B subunit(CTB) and wheat germ agglutinin-horseradish peroxidase(WGA-HRP) into the rat intestine. The tracers were injected in the stomach(anterior and posterior portion), duodenum, jejunum, ileum, cecum, ascending colon or descending colon. After survival times of 48-96 hours, the rats were perfused and their brain, spinal and nodose ganglia were frozen sectioned(40microM). These sectiones were stained by CTB immunohistochemical and HRP histochemical staining methods and observed by dark and light microscopy. The results were as follows: 1. WGA-HRP labeled afferent terminal fields in the brain stem were seen in the stomach and cecum, and CTB labeled afferent terminal fields in the brain stem were seen in all parts of the intestine. 2. Afferent terminal fields innervating the intestine were heavily labeled bilaterally gelalinous part of nucleus of tractus solitarius(gelNTS), dorsomedial part of gelNTS, commissural part of NTS(comNTS), medial part of NTS(medNTS), wall of the fourth ventricle, ventral border of area postrema and comNTS in midline dorsal to the central canal. 3. WGA-HRP labeled sensory neurons were observed bilaterally within the spinal ganglia, and labeled sensory neurons innervating the stomach were observed in spinal ganglia T2-L1 and the most numerous in spinal ganglia T8-9. 4. Labeled sensory neurons innervating the duodenum were observed in spinal ganglia T6-L2 and labeled cell number were fewer than the other parts of the intestines. 5. Labeled sensory neurons innervating the jejunum were observed in spinal ganglia T6-L2 and the most numerous area in the spinal ganglia were T12 in left and T13 in right. 6. Labeled sensory neurons innervating the ileum were observed in spinal ganglia T6-L2 and the most numerous area in the spinal ganglia were T11 in left and L1 in right. 7. Labeled sensory neurons innervating the cecum were observed in spinal ganglia T7-L2 and the most numerous area in the spinal ganglia were T11 in left and T11-12 in right. 8. Labeled sensory neurons innervating the ascending colon were observed in spinal ganglia T7-L2 in left, and T9-L4 in right. The most numerous area in the spinal ganglia were T9 in left and T11 in right. 9. Labeled sensory neurons innervating the descending colon were observed in spinal ganglia T9-L2 in left, and T6-L2 in right. The most numerous area in the spinal ganglia were T13 in left and L1 in right. 10. WGA-HRP labeled sensory neurons were observed bilaterally within the nodose ganglia, and the most numerous labeled sensory neurons innervating the abdominal organs were observed in the stomach. 11. The number of labeled sensory neurons within the nodose ganglia innervating small and large intestines were fewer than that of labeled sensory neurons innervating stomach These results indicated that area of sensory neurons innervated all parts of intestines were bilaterally gelatinous part of nucleus tractus solitarius(gelNTS), dorsomedial part of gelNTS, commissural part of NTS(comNTS), medial part of NTS, wall of the fourth ventricle, ventral border of area postrema and com NTS in midline dorsal to the central canal within brain stem, spinal ganglia T2-L4, and nodose ganglia. Labeled sensory neurons innervating the intestines except the stomach were observed in spinal ganglia T6-L4. The most labeled sensory neurons from the small intestine to large intestine came from middle thoracic spinal ganglia to upper lumbar spinal ganglia.
Animals ; Area Postrema ; Brain ; Brain Stem ; Cecum ; Cell Count ; Cholera Toxin* ; Cholera* ; Colon, Ascending ; Colon, Descending ; Duodenum ; Fourth Ventricle ; Ganglia, Spinal ; Gelatin ; Ileum ; Intestine, Large ; Intestine, Small ; Intestines* ; Jejunum ; Microscopy ; Nerve Fibers ; Neurons ; Nodose Ganglion ; Rats* ; Sensory Receptor Cells* ; Stomach ; Triticum* ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate

Dieulafoy's lesion (DL) is an uncommon but important cause of massive upper gastrointestinal bleeding that has been reported to be involved in 0.3~6.7% of cases of major gastrointestinal bleeding. The lesion usually occurs in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction. Similar lesions have also been observed in the esophagus, duodenum, small intestine, colon, and rectum. Most DLs encountered in the duodenum occur in the bulb. Recently, with the advances in endoscopic techniques, the successful management of DL has been achieved through the application of a hemoclip or elastic band ligation. In particular, the application of a hemoclip is considered to be a safe and effective treatment for DL located on a relatively narrow and thin walled canal such as the duodenum. We report the successful application of endoscopic hemoclipping for the treatment of a rare Dieulafoy-like lesion on a hyperplastic polyp in the 2nd portion of the duodenum.
Colon ; Duodenum* ; Esophagogastric Junction ; Esophagus ; Hemorrhage ; Intestine, Small ; Ligation ; Polyps* ; Rectum ; Stomach

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract, and they represent about 2% of all neoplasms of the gastrointestinal tract. GISTs primarily affect the stomach (50~60%), but they can also affect the small intestine (20~30%), large intestine (7%) and esophagus (1%). The clinical manifestations of GISTs vary according to the location and size of the mass. GISTs are generally KIT (CD117)-positive and are diagnosed by immunohistochemistry. Tumor size and mitotic activity are the best predictive prognostic features. The treatment of choice for primary GIST is complete surgical resection with a negative margin. A 78-year-old man who presented with melena and diffuse abdominal pain was admitted to our hospital. Esophagogastroduodenoscopy, colonoscopy, angiography and an RBC scan were performed but we were unable to locate the focus of the hemorrhage. A gastrointestinal stromal tumor (GIST) of the jejunum was diagnosed after laparotomy.
Abdominal Pain ; Aged ; Angiography ; Colonoscopy ; Endoscopy, Digestive System ; Esophagus ; Gastrointestinal Hemorrhage* ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Immunohistochemistry ; Intestine, Large ; Intestine, Small ; Jejunum* ; Laparotomy* ; Melena ; Stomach

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

Umbilical anomalies arie from fetal structures such as the omphalomesenteric duct (OMD) or urachus, or from the failure to closure the umbilical fascial ring. The persistence of OMD may lead to several anomalies including umbilical sinus, umbilical cyst, Meckel's diverticulum, or patent OMD (POMD). The clinical signs are local swelling, redness, inflammation, umbilical discharge, and bleeding. The passage of the intestinal contents, through the umbilicus i.e., meconeum or gas, implies a fistula to some part of the intestine. A patent omphalomesenteric duct (OMD) is usually associated with the ileum, but rarely with the cecum or appendix. There have only been eight reports of a neonatal appendicoumbilical fistula. Here the authors report a rare and interesting example of an umbilico-appendiceal fistula, and discuss its etiology and treatment.
Appendix ; Cecum ; Fetus ; Fistula* ; Gastrointestinal Contents ; Hemorrhage ; Ileum ; Inflammation ; Intestines ; Meckel Diverticulum ; Umbilicus ; Urachal Cyst ; Urachus ; Vitelline Duct

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.
Abdominal Pain ; Adult ; Aged ; Colon ; Diverticulitis* ; Diverticulum ; Duodenum ; Esophagus ; Female ; Fever ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Intussusception* ; Jejunum ; Leiomyoma* ; Mortality ; Pathologic Processes ; Polyps* ; Stomach ; Tomography, X-Ray Computed

Cytomegalovirus (CMV) infection is prevalent worldwide, although the symptomatic illness is usually confined to immunocompromised individuals. It can produce stomatitis, esophagitis, gastritis, duodenitis, and ulceration of the esophagus, stomach, duodenum, ileum, and colon within the gastrointestinal tract. Bleeding and perforation can also occur at these sites. The most common site of intestinal perforation is the colon, followed in frequency by the distal ileum and appendix. Herein, a recently experienced case of ileal perforation due to a CMV infection, in a patient with acquired immunodeficiency syndrome is reported, with a review of the literature.
Acquired Immunodeficiency Syndrome* ; Appendix ; Colon ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Duodenitis ; Duodenum ; Esophagitis ; Esophagus ; Gastritis ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestinal Perforation ; Stomach ; Stomatitis ; Ulcer