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  • 1
    Electronic Resource
    Electronic Resource
    Pyloric deformation from peptic disease (1990)
    Springer
    Digestive diseases and sciences 35 (1990), S. 1459-1467 
    Details
    ISSN: 1573-2568
    Keywords: peptic ulcer ; incompetence ; radiographic techniques
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have used double-contrast radiographic techniques to clarify what changes in the configuration and movements of the gastroduodenal junction result when peptic lesions involve the distal gastric segment between the proximal (PPL) and the distal pyloric muscle loop (DPL). Among 50 cases of pyloric ulceration diagnosed during a four-year study period, 18 cases fulfilled all study criteria. Ulcers maintained a consistent location with regard to the muscular structures of the pylorus, and by affecting these structures, led to many strange deformations of the gastric outlet including permanent pseudodiverticula and reversal of pyloric angulation. The most common site for peptic lesions in the pyloric segment was the protuberance of the lesser curvature called the pyloric torus; many torus lesions extended into and destroyed the DPL. This led to widening of the gastric outlet and radiographic evidence of increased duodenogastric reflux. Pyloric closure was further impaired in this setting because the mucosa no longer prolapsed into the gastric outlet and did not occlude the pyloric lumen as it normally does. Less common lesions involved the greater curvature and the PPL. In one patient, scarring of the PPL led to an antrat web and gastric hyperperistalsis. This was the only patient who required operation for chronic gastric outlet obstruction. One-third of the 18 patients had reflux esophagitis in addition to peptic pyloric disease. In most patients without additional ulcerogenic risk factors, treatment with antisecretory agents led to the healing of ulcer craters. We conclude that the morphologic and functional changes of the gastric outlet caused by peptic lesions depend, in part, on the effect the ulcer has on the underlying pyloric musculature. We also propose that pyloric incompetence (and hence possibly dumping and bile reflux gastritis) may be a more common complication of pyloric ulceration than hitherto appreciated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01540562
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  • 2
    Electronic Resource
    Electronic Resource
    Chronic esophagitis in two sisters (1983)
    Springer
    Digestive diseases and sciences 28 (1983), S. 1101-1105 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two sisters developed symptoms of gastroesophageal reflux and gastric stasis during adolescence. Both developed severe erosive esophagitis and epithelial hyperplasia of the esophagus before 35 years of age. Both had a hiatal hernia, and esophageal motor function was poor in both. One of the sisters had also a peptic stricture of the esophagus, the other one a gastric bezoar. Jejunal motility was normal in both. Among 28 close family members surveyed, seven additional individuals out of three generations had frequent and severe reflux symptoms since adolescence. It is unlikely that the occurrence of chronic esophagitis at such young age in the two sisters is mere coincidence. It is conceivable that the two sisters and their family shared a defect similar to the one that has previously been made responsible for the familial occurrence of hiatal hernias and Barrett's esophagus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01295809
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  • 3
    Electronic Resource
    Electronic Resource
    Cecum of guinea pig is a reservoir and sigmoid is a high-resistance conduit (1995)
    Springer
    Digestive diseases and sciences 40 (1995), S. 1015-1023 
    Details
    ISSN: 1573-2568
    Keywords: cecum ; sigmoid ; guinea pig ; filling response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the filling responses of the cecum and the sigmoid of the guinea pig using volumes up to 60 ml and 2.5 ml, respectively. In the isolated cecum, each 1-cm increment of hydrostatic pressure above zero led to accommodation of 10 ml volume; in the sigmoid, the yield pressure (at which accommodation first occurred) was 6 cm H2O, and pressure increments up to 20 cm H2O produced volume increments of less than 0.5 ml. Resting pressure at half-maximal filling was 5.0±0.7 cm H2O for the sigmoid and 1.7±0.6 cm H2O for the cecum. K+ depolarization led to a significant upward shift in the pressure curves of both segments. Ca2+ withdrawal decreased sigmoid and cecal pressures at some volumes. Distension of the cecum triggered intermittent contractions, which began with the shortening of the teniae and were associated with low-amplitude pressures and expulsion of a 5- to 10-ml volume. Distension of the sigmoid produced propagating contractions that were associated with high-amplitude pressures and lengthening; compartmentalization in the sigmoid prevented efflux from it, and volume inflow was not affected by pressure waves. Our observations indicate that its large capacity and great distensibility make the cecum suitable for reservoir functions, whereas its narrowness and lack of distensibility make the sigmoid a high-resistance conduit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02064191
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  • 4
    Electronic Resource
    Electronic Resource
    Volume accommodation by distension of gastric fundus (rabbit) and gastric corpus (cat) (1983)
    Springer
    Digestive diseases and sciences 28 (1983), S. 625-632 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In attempts to identify the structures of the proximal stomach responsible for volume accommodation, the dimensions of a herbivore (rabbit) were compared to those of a carnivore (cat) stomach at various degrees of filling. The total gastric surface area was similar in both species, but the proximal stomach of cats consisted primarily of the segment between the incisura angularis and the cardia (gastric corpus), while the proximal stomach of the rabbit was represented largely by the true fundus (segment orad to cardia). In both species, the muscle coat of the proximal stomach was thinner than that of the distal stomach, but this difference was more prominent in rabbits than in cats. In both species, the length and the angulation of the lesser curvature were little affected by filling of the stomach. Most length increases of the greater curvature occurred proximal to the cardia in the rabbit and proximal to the incisura angularis in the cat. Filling the stomach increased the length of the gastric circumference more steeply in the cat than in the rabbit. In both species, the stomachs shortened in their longitudinal axis in response to a drug that excites gastric smooth muscle (carbachol). A drug that inhibits gastric smooth muscle (isoproterenol) gave the stomach a more elongated shape. Cat stomachs ruptured at higher volumes and intragastric pressures than rabbit stomachs. In the cat, volume accommodation takes place in the transverse axis of the stomach, and parallel to the circular muscle fibers of the gastric corpus. In the rabbit, volume unfolds the gastric fundus in the longitudinal and transverse axes in parallel to the radiating course of the oblique muscle fibers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01299923
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