scholarly journals Small bowel transit of a bran meal residue in humans: sieving of solids from liquids and response to feeding

Gut ◽  
1998 ◽  
Vol 42 (5) ◽  
pp. 685-689 ◽  
Author(s):  
J M Hebden ◽  
P E Blackshaw ◽  
A C Perkins ◽  
M D’Amato ◽  
R C Spiller
Keyword(s):  
Gastric Emptying ◽  
Small Bowel ◽  
Small Bowel Transit ◽  
Motor Patterns ◽  
Solid Meal ◽  
Lower Quadrant ◽  
Distal Small Bowel ◽  
Proximal Small Bowel ◽  
Indium 111 ◽  
Right Lower Quadrant

Background—Ileal motor patterns are adapted to the propulsion of viscous meal residue, such as bran, which accumulates in the distal ileum postprandially.Aims—To examine the effects of a second liquid/solid meal on ileal emptying.Subjects and methods—Eleven healthy fasting subjects consumed a 1.47 MJ pancake containing 15 g bran and 5 MBq Technetium-99m labelled amberlite resin (meal A). Gastric emptying and transit through the left upper quadrant (proximal) and right lower quadrant (distal) small bowel regions and colon were assessed scintigraphically. Transit was compared with and without a second Indium-111 liquid/solid DTPA labelled 2.28 MJ meal (B) given three hours after the first meal.Results—Gastric emptying of meal A was slower than meal B (the time for 50% of the activity to leave the stomach (T50) being 113 (11) minutes versus 48 (3) minutes respectively, p<0.01, n=11). Both meals passed rapidly through the proximal small bowel (T50 meal A = 57 (14) minutes versus T50 meal B = 42 (11) minutes). Transit of meal A through the distal small bowel was much slower (T50 more than 390 minutes versus 176 (29) minutes for meal B, p<0.01), resulting in meal B overtaking meal A and entering the colon earlier. Ingestion of the second meal (B) resulted in significantly less meal A marker entering the colon (5 (3)%) at 11 hours than when meal A was taken alone (18 (4)%) (p<0.05, n=8).Conclusions—The distal small bowel selectively retains bran, allowing liquid phase markers through to the colon. Consuming a second liquid/solid meal does not stimulate ileal transit of bran which seems to be propelled quicker by fasting motor patterns.

Concurrent Spigelian and Grynfeltt-Lesshaft Hernias

2021 ◽  
pp. 000313482110562
Author(s):  
Ryan M. Huttinger ◽  
Matthew S. Kazaleh ◽  
Dylan J. Skinner ◽  
Marsha C. Nelson
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Synthetic Mesh ◽  
Accurate Diagnosis ◽  
Spigelian Hernia ◽  
Lower Quadrant ◽  
Superior Lumbar Triangle ◽  
Lumbar Triangle ◽  
Right Lower Quadrant

Only 0.12% to 2% of diagnosed hernias are Spigelian type. Even less frequently encountered—Grynfeltt-Lesshaft hernias—hernias have unknown incidence. A Spigelian hernia is encountered along the Spigelian fascia and Grynfeltt-Lesshaft hernias are bounded by the superior lumbar triangle. These unique hernias can both be intermuscular, given their anatomical borders which allow concealment and preclusion of accurate diagnosis. Here, an 86-year-old male presented with symptoms consistent with small bowel obstruction. On physical exam, a right lower quadrant hernia and right posterior flank mass were appreciated. Computed tomography revealed obstruction secondary to bowel incarceration within Spigelian hernia and additional Grynfeltt-Lesshaft hernia. The patient underwent reduction and repair of Spigelian hernia with synthetic mesh, while repair of asymptomatic hernia was deferred. These unusual hernias are difficult to distinguish, given their negligible occurrence and unreliable exam findings. Clinicians must remain cognizant of their features to aid in diagnosis and mitigate potential sequelae.

scholarly journals Intraluminal Meckel’s Duplication Cyst Causing Bowel Obstruction in an Infant: A Role for Laparotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mitchell R. Ladd ◽  
Alejandro V. Garcia ◽  
Derek B. Allison ◽  
Jeffrey R. Lukish
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Ileocecal Valve ◽  
Signs And Symptoms ◽  
Duplication Cyst ◽  
Ectopic Gastric Mucosa ◽  
Lower Quadrant ◽  
Intraluminal Mass ◽  
Enteric Duplication ◽  
Right Lower Quadrant

This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel’s diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.

Effect of ileal infusion of lipid on jejunal motor patterns after a nutrient and nonnutrient meal

1988 ◽  
Vol 255 (6) ◽  
pp. G800-G806 ◽  
Author(s):  
I. M. Welch ◽  
P. A. Davison ◽  
J. Worlding ◽  
N. W. Read
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Contraction Rate ◽  
Small Bowel Transit ◽  
Motor Patterns ◽  
Motility Pattern ◽  
Human Small Intestine ◽  
The Mean

To investigate how ileal lipid delays small bowel transit, pressure activity was recorded at multiple sites in the human small intestine during ileal infusion of either lipid or saline. Initial studies showed that ileal lipid reduced the contraction rate in the jejunum but not in the duodenum or ileum. The effect of ileal lipid was further investigated by recording pressures at seven sites in the jejunum after ingestion of either a nutrient or a nonnutrient meal. The nutrient meal induced an irregular motility pattern; ileal lipid significantly reduced the contraction rate, the percentage of contractions involved in propagated events, the mean length of propagation, and the propagation index. The nonnutrient meal induced a pattern containing discrete clusters of contractions. Ileal lipid significantly reduced the occurrence of contraction clusters and the mean length of propagation. Thus, although the delay in small bowel transit observed during ileal infusion of lipid can be explained by reductions in the rate and the degree of propagation of jejunal contractions, the mechanism varies according to the type of meal.

scholarly journals Effect of bran particle size on gastric emptying and small bowel transit in humans: a scintigraphic study.

Gut ◽  
1995 ◽  
Vol 37 (2) ◽  
pp. 216-219 ◽  
Author(s):  
R Vincent ◽  
A Roberts ◽  
M Frier ◽  
A C Perkins ◽  
I A MacDonald ◽  
...  
Keyword(s):  
Particle Size ◽  
Gastric Emptying ◽  
Small Bowel ◽  
Small Bowel Transit ◽  
Scintigraphic Study

Small bowel transit and gastric emptying after biliodigestive anastomosis using the uncut jejunal loop

2003 ◽  
Vol 186 (6) ◽  
pp. 747-751 ◽  
Author(s):  
Alexander Klaus ◽  
Ronald A Hinder ◽  
Justin H.H Nguyen ◽  
Kevin L Nelson
Keyword(s):  
Gastric Emptying ◽  
Small Bowel ◽  
Jejunal Loop ◽  
Small Bowel Transit ◽  
Biliodigestive Anastomosis
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