Afferent loop syndrome caused by an impacted enterolith is very rare, and endoscopic removal of the enterolith may be difficult if a stricture is present or the normal anatomy has been altered. Electrohydraulic lithotripsy is commonly used for endoscopic fragmentation of biliary and pancreatic duct stones. A 64-year-old man who had undergone subtotal gastrectomy and gastrojejunostomy presented with acute, severe abdominal pain for a duration of 2 hours. Initially, he was diagnosed with acute pancreatitis because of an elevated amylase level and pain, but was finally diagnosed with acute afferent loop syndrome when an impacted enterolith was identified by computed tomography. We successfully removed the enterolith using direct electrohydraulic lithotripsy conducted using a transparent cap-fitted endoscope without complications. We found that this procedure was therapeutically beneficial.
Abdominal Pain ; Afferent Loop Syndrome* ; Amylases ; Constriction, Pathologic ; Endoscopes ; Gastrectomy ; Gastric Bypass ; Humans ; Lithotripsy* ; Middle Aged ; Pancreatic Ducts ; Pancreatitis

The purpose of this study was to develop effective dental hygiene chews for cats based on the anatomical features of the dentition and patterns of chewing motion. All cats were volunteered for dental prophylaxis followed by dental impressions using yellow stone and alginate under general anesthesia. Twenty parameters related to dentition were defined in order to compare dental impressions using digital caliper. For the chewing motion study, patterns of chewing motion were identified based on recordings made with a digital camera. Ten cats (4 domestic shorthairs, 2 Russian blues, 1 American shorthair, 1 Persian, 1 Turkish Angora, and 1 Devon Rex) were recruited for the study. The parameters related to teeth and oral size were similar among the studied cats. Chewing motion can be described as more of a guillotine-like motion rather than a crushing motion, with cats chewing 3–7 times before swallowing. The chewing pattern of cats involves shearing for a short period of time followed by immediate swallowing. Therefore, the overall size of the dental hygiene chew could be determined based on the measurement of the oral size for inducing chewing. The surface details of the dental hygiene chew could be designed for prevention and removal of dental calculus and plaque in cats considering the anatomical teeth parameters. Dental hygiene chews customized for cats considering the different anatomical features of their teeth might be effective for oral care.
Anesthesia, General ; Animals ; Cats ; Deglutition ; Dental Calculus ; Dental Prophylaxis ; Dentition ; Gingiva ; Mastication ; Oral Hygiene ; Periodontal Diseases ; Tooth