• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권4호
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• pp.181-192
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• 2023

Purpose: The development of assistive devices has allowed for the performance of capsule endoscopy in children. Anticipating the capsule's transit time could affect the efficacy of the investigation and potentially minimize the fasting period. This study determined the predictors of small bowel transit time for small-bowel capsule endoscopy in children and adolescents with inflammatory bowel disease. Methods: We retrospectively examined children and adolescents with inflammatory bowel disease who underwent capsule endoscopy by the age 18 at a Japanese tertiary care children's hospital. Small bowel transit time predictors were analyzed using multiple regression with explanatory variables. Results: Overall, 92 patients, aged 1-17 years, with inflammatory bowel disease (63 Crohn's disease and 29 ulcerative colitis cases) were examined for factors affecting small bowel transit time. In the simple regression analysis, diagnosis, age, height, weight, serum albumin, general anesthesia, and small intestine lesions were significantly associated with small bowel transit time. In the multiple regression analyses, serum albumin (partial regression coefficient: -58.9, p=0.008), general anesthesia (partial regression coefficient: 127, p<0.001), and small intestine lesions (partial regression coefficient: 30.1, p=0.037) showed significant associations with small bowel transit time. Conclusion: Hypoalbuminemia, the use of general anesthesia for endoscopic delivery of the capsule, and small intestine lesions appeared to be predictors of prolonged small bowel transit time in children and adolescents with inflammatory bowel disease. Expecting the finishing time may improve examination with a fasting period reduction, which benefits both patients and caregivers.

• Journal of Medicine and Life Science
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• 제16권1호
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• pp.13-16
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• 2019

In a patient with blunt abdominal trauma with small bowel injury, early diagnosis is clinically challenging due to unclear clinical symptoms and signs in the early stage of an injury. On the other hand, a delay of diagnosis of bowel disruption may lead to increased complication and mortality. The diagnostic laparoscopy is very useful for the evaluation of the small bowel injury. Laparoscopy can reduce unnecessary open surgery in a patient with blunt abdominal trauma with subtle symptoms and imprecise findings on abdominal computed tomography. Also it can prevent delay of treatment and be converted immediately to open surgery as soon as bowel damage is revealed. Furthermore, extracorporeal repair of small bowel via mini-laparotomy after a single incision diagnostic laparoscopy in a patient with traumatic small bowel perforation was a feasible and safe alternative to conventional laparoscopy. We are pleased to introduce successfully treated cases by extracorporeal repair of small bowel via mini-laparotomy after a single incision diagnostic laparoscopy in a patient with small bowel perforation after blunt trauma.

• 대한소화기학회지
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• 제72권6호
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• pp.277-280
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• 2018

Although small bowel the mainly occupies the most part of the gastrointestinal tract, small intestine tumors are rare, insidious in clinical presentation, and frequently represent a diagnostic and management challenge. Small bowel tumors are generally classified as epithelial, mesenchymal, lymphoproliferative, or metastatic. Familial adenomatous polyposis and Peutz-Jeghers syndrome are the most common inherited intestinal polyposis syndromes. Until the advent of capsule endoscopy (CE) and device-assisted enteroscopy (DAE) coupled with the advances in radiology, physicians had limited diagnostic examination for small bowel examination. CE and new radiologic imaging techniques have made it easier to detect small bowel tumors. DAE allows more diagnosis and deeper reach in small intestine. CT enteroclysis/CT enterography (CTE) provides information about adjacent organs as well as pictures of the intestinal lumen side. Compared to CTE, Magnetic resonance enteroclysis/enterography provides the advantage of soft tissue contrast and multiplane imaging without radiation exposure. Treatment and prognosis are tailored to each histological subtype of tumors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권1호
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• pp.1-6
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• 2010

The small bowel is the most difficult intestinal segment to examine. Radiologic tests are mostly insensitive and double-balloon enteroscopy is unsuitable for the younger child. Capsule endoscopy is a novel wireless method of investigation of the small bowel. The primary indications for capsule endoscopy include evaluation of obscure gastrointestinal bleeding, small bowel Crohn's disease, and polyposis syndromes. Capsule endoscopy offers an accurate and effective means of investigating the small bowel in children. Capsule retention is a potential complication of capsule endoscopy. This review provides the indications, safety, and limitations of wireless capsule endoscopy in children.

• 대한한방내과학회지
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• 제41권2호
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• pp.233-240
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• 2020

Objectives: This report presents a case using acupuncture and moxibustion to treat postoperative adhesive small bowel obstruction. Case Presentation: A 62-year-old male with two previous intra-abdominal surgeries, complaining of abdominal pain, abdominal distention, and general weakness, visited Korean medicine hospital. He was suffering from small bowel obstruction that had not improve for three weeks. Methods: The patient was diagnosed with postoperative adhesive small bowel obstruction. The patient received acupuncture and moxibustion in addition to intravenous fluid treatment. The patient underwent radiologic testing on a daily basis. Results: The symptoms improved quickly with the treatment, including acupuncture and moxibustion. He was able to start eating three days after he started receiving treatment. The abdomen X-ray also showed rapid improvement. No adverse effect was observed during the nine days of hospitalization. Conclusions: This report demonstrates that acupuncture and moxibustion may be effective in treating adhesive small bowel obstruction. However, further research is needed to confirm these findings.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1093-1101
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• 2023

Objective: Cine magnetic resonance imaging (MRI) has emerged as a noninvasive method to quantitatively assess bowel motility. However, its accuracy in measuring various degrees of small bowel motility has not been extensively evaluated. We aimed to draw a quantitative small bowel motility score from cine MRI and evaluate its performance in a population with varying degrees of small bowel motility. Materials and Methods: A total of 174 participants (28.5 ± 7.6 years; 135 males) underwent a 22-second-long cine MRI sequence (2-dimensional balanced turbo-field echo; 0.5 seconds per image) approximately 5 minutes after being intravenously administered 10 mg of scopolamine-N-butyl bromide to deliberately create diverse degrees of small bowel motility. In a manually segmented area of the small bowel, motility was automatically quantified using a nonrigid registration and calculated as a quantitative motility score. The mean value (MV) of motility grades visually assessed by two radiologists was used as a reference standard. The quantitative motility score's correlation (Spearman's ρ) with the reference standard and performance (area under the receiver operating characteristics curve [AUROC], sensitivity, and specificity) for diagnosing adynamic small bowel (MV of 1) were evaluated. Results: For the MV of the quantitative motility scores at grades 1, 1.5, 2, 2.5, and 3, the mean ± standard deviation values were 0.019 ± 0.003, 0.027 ± 0.010, 0.033 ± 0.008, 0.032 ± 0.009, and 0.043 ± 0.013, respectively. There was a significant positive correlation between the quantitative motility score and the MV (ρ = 0.531, P < 0.001). The AUROC value for diagnosing a MV of 1 (i.e., adynamic small bowel) was 0.953 (95% confidence interval, 0.923-0.984). Moreover, the optimal cutoff for the quantitative motility score was 0.024, with a sensitivity of 100% (15/15) and specificity of 89.9% (143/159). Conclusion: The quantitative motility score calculated from a cine MRI enables diagnosis of an adynamic small bowel, and potentially discerns various degrees of bowel motility.

• 대한수의학회지
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• 제56권3호
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• pp.201-203
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• 2016

Intestinal rupture caused by small bowel volvulus was diagnosed in a captive 13-year-old male American black bear. The animal presented with decreased appetite, depression, lethargy, and mild abdominal distention for 3 days. The animal was treated with antibiotics, hypermetabolites, and digestive medicine daily; however, it died on the third day of treatment. The clinical symptoms included hemorrhagic ascites, gaseous extension of the small intestine, and intestinal rupture caused by small bowel volvulus. Hemorrhagic signs were observed in the lungs and heart. This is the first case to describe small bowel volvulus in mammals of the family Ursidae.

• 대한영상의학회지
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• 제84권1호
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• pp.110-126
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• 2023

영상의학과 의사가 컴퓨터단층촬영 영상을 볼 때, 소장에 생긴 악성 병변은 그 크기가 작아 정상 소장과 유사한 조영증강을 보이거나 비특이적인 조영증강으로 인해 정상 소장으로 오인될 수 있기 때문에 놓치기 쉽다. 또한, 소장의 악성 병변은 자궁, 직장, 대망과 같은 다른 장기에서 발생한 종괴로 오인될 수 있다. 이 임상화보에서, 저자들은 소장에 생긴 다양한 악성 종양과 악성 종양으로 오인할 수 있는 소장 병변의 전형적, 비전형적 CT 소견을 임상 양상과 함께 보여주고자 한다.

• Journal of Digestive Cancer Reports
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• 제9권2호
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• pp.60-67
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• 2021

Tumors of the small intestine are rare and generally asymptomatic or with nonspecific symptoms. The small intestine is difficult to approach using conventional endoscopy, and early diagnosis of the small intestinal tumors is difficult. Therefore, many of the small intestinal tumors are diagnosed at an advanced stage, which makes the prognosis poor. Premalignant lesions of the small intestine or known risk factors of small bowel cancer are sporadic adenoma, adenoma associated with familial adenomatous polyposis, hamartomatous polyp associated with Peutz-Jeghers syndrome, Crohn's disease, and celiac disease. Therefore, it is necessary to recognize that the small bowel cancer can occur in these patients with premalignant lesions or risk factors of small bowel cancer. To reduce the possibility of small bowel cancer or to detect at an earlier stage, attention should be paid to screening and surveillance of these patients with premalignant lesions or risk factors of the small bowel cancer.

• Journal of information and communication convergence engineering
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• 제20권3호
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• pp.153-159
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• 2022

Plain radiographic analysis is the initial imaging modality for suspected small bowel obstruction. Among the many features that affect the diagnosis of small bowel obstruction (SBO), the presence of gas-filled or fluid-filled small bowel loops is the most salient feature that can be automatized by computer vision algorithms. In this study, we compare three frequently applied pixel-clustering algorithms for extracting gas-filled areas without human intervention. In a comparison involving 40 suspected SBO cases, the Possibilistic C-Means and Fuzzy C-Means algorithms exhibited initialization-sensitivity problems and difficulties coping with low intensity contrast, achieving low 72.5% and 85% success rates in extraction. The Adaptive Resonance Theory 2 algorithm is the most suitable algorithm for gas-filled region detection, achieving a 100% success rate on 40 tested images, largely owing to its dynamic control of the number of clusters.