A model for the cinefluoroscopic and manometric study of chronic intestinal obstruction

deLorimier, Alfred A.; Norman, Daniel; Gooding, Charles A.; Preger, Leslie

doi:10.1016/0022-3468(73)90422-3

Cited by 34 publications

(6 citation statements)

References 2 publications

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“…Rapid intestinal transit is a nearly universal clinical challenge in SBS and should elicit prompt investigation into underlying structural causes. Segmental bowel dilatation with poor peristalsis is a frequent finding in patients with SBS and rapid transit, and it often results in clinical features of small bowel bacterial overgrowth 17 – 19 . In our experience, small intestinal bacterial overgrowth against a background of structural bowel abnormality is often refractory to conventional medical treatment and requires surgical correction of the underlying cause.…”

Section: Definitive Surgical Management Of Intestinal Failurementioning

confidence: 80%

Surgical Management of Short Bowel Syndrome

Iyer

2014

J Parenter Enteral Nutr

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For patients with short bowel syndrome (SBS), surgery can play an important role in preventing, mitigating, and, in some cases, reversing intestinal failure (IF). During intestinal resection, bowel length should be conserved to the fullest extent possible to avoid dependence on parenteral nutrition (PN). Bowel salvage may be improved by initially preserving tissue of questionable viability and later reevaluating during “second‐look” procedures. Once the patient is stabilized, ostomy reversal and recruitment of distal unused bowel should be prioritized whenever feasible. Following progression to IF, surgical management of SBS depends on the symptoms and anatomical characteristics of the individual patient. For carefully selected patients with rapid intestinal transit and dilated bowel, longitudinal intestinal lengthening and tailoring (LILT) and serial transverse enteroplasty (STEP) procedures may provide benefit. Outcomes following STEP and LILT are generally similar, and the choice between these procedures may rest on surgeon preference. For patients with rapid intestinal transit in the absence of bowel dilation, segmental reversal of the small bowel may reduce PN requirements. Intestinal transplantation is the standard of care for patients in whom intestinal rehabilitation attempts have failed and who are at risk of life‐threatening complications of PN. Because patients awaiting isolated intestine transplant show increased survival compared with patients awaiting combined intestine‐liver transplant, early referral of appropriate patients, before the development of advanced liver disease, is critical to enhancing patient outcomes.

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Section: Definitive Surgical Management Of Intestinal Failurementioning

confidence: 80%

Surgical Management of Short Bowel Syndrome

Iyer

2014

J Parenter Enteral Nutr

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“…Failure to do so may result in functional obstruction and abnormal motility in the retained dilated proximal atretic bowel. 7,15,30,31 In instances of short bowel length, a proximal tapering enteroplasty or intestinal plication has been proposed as an alternative to resection in an effort to preserve bowel length. [32][33][34][35] Our current practice is to taper the dilated proximal bowel after a minimal resection of the end of the atretic segment and then perform a primary end-to-oblique anastomosis.…”

Section: Commentmentioning

confidence: 99%

Intestinal Atresia and Stenosis

Vecchia¹,

Grosfeld²,

West³

et al. 1998

Arch Surg

441

108

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“…Tapering of the dilated part on the antimesenteric border reportedly was performed using a stapler or hand sewn with end-to-end anastomosis [11,12]. De Lorimier and Harrison brought to attention that intestinal imbrication reduces the luminal diameter and restores function while preserving the mucosal surface area [13,14], which was subsequently reported for megaduodenum as well [15]. This concept evolved into seromuscular stripping of an ellipse of the proximal dilated bowel, as described by Kimura et al (1996) [16], aiming to improve the motility of the dysfunctional proximal bowel, which is the basis for our technique.…”

Section: Introductionmentioning

confidence: 99%

Early outcomes of tapering jejunoplasty by antimesenteric seromuscular stripping and mucosal inversion for proximal jejunal atresia

Marei

Abou-Elfadl

Rawwash

et al. 2019

Egypt Pediatric Association Gaz

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Background: High jejunal atresia is associated with significant dilatation of the proximal segment. This poses two problems: (a) calibre discrepancy with the distal unused segment and (b) hypomotility causing stasis. Tapering jejunoplasty/enteroplasty could offer a practical solution in selected cases, leading to early establishment of feeds. This work aims to evaluate the outcome of tapering jejunoplasty including its effect on establishing enteral feeding in neonates with proximal jejunal atresia. Results: Twenty-two neonates with jejunal atresia (types I, II and IIIa) were reviewed. Cases with multiple atresia, apple-peel variant and meconium ileus were excluded. The included cases fell retrospectively into two groups: group A (13 cases)-very proximal atresia and significant dilatation and group B (9 cases)-mid/distal jejunal atresia. For group A, we excised only the distal tip of the dilated bowel and stripped a seromuscular triangle up to the duodenojejunal flexure and inverted the mucosa along the antimesenteric border, followed by an end-to-oblique anastomosis. For group B, we performed a standard excision of a short proximal segment and an end-to-oblique anastomosis. There was no significant difference in the gestation age or birth weight between both groups. The mean operative time was 90 min for group A and 60 min for group B. The duration until full enteral feeds became tolerated, and parenteral nutrition was weaned accordingly was shorter in group A (mean 10.8 days) as compared to group B (mean 14.5 days), p = 0.045. Conclusion: Tapering jejunoplasty by seromuscular stripping and mucosal inversion facilitates early establishment of feeds in proximal jejunal atresia.

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A model for the cinefluoroscopic and manometric study of chronic intestinal obstruction

Cited by 34 publications

References 2 publications

Surgical Management of Short Bowel Syndrome

Surgical Management of Short Bowel Syndrome

Intestinal Atresia and Stenosis

Early outcomes of tapering jejunoplasty by antimesenteric seromuscular stripping and mucosal inversion for proximal jejunal atresia

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