Intestinal infection has become a common disease in human and endoscopy can be a powerful means in diagnosis of intestinal illnesses. Mathematical models are developed for an inserted endoscope on the flow of chyme in...Intestinal infection has become a common disease in human and endoscopy can be a powerful means in diagnosis of intestinal illnesses. Mathematical models are developed for an inserted endoscope on the flow of chyme in the small intestine considering a Newtonian incompressible fluid flow, under an axisymmetric condition, in a cylindrical annulus between the small intestine and the endoscope. We obtain novel mathematical expressions for the pressure drop, forces exerted by the endoscope on the flow of chyme, and the force exerted by the chyme on the intestine for one wave length of the peristaltic rush wave. We also investigate and calculate the flow velocity and pressure for different flow rates and the wave lengths. The results are presented, and discussed for the cases and conditions under which pressure, pressure drop can be positive or negative and the forces can be acted either by the intestine or endoscope on the flow or vice-versa.展开更多
Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challengi...Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the bowel.Here,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3.Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed.Postoperatively,the patient was transferred to our trauma center for septic shock and hyperbilirubinemia.Following salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was ruptured.Given the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube.Besides,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube.Hyperbilirubinemia was alleviated with the increase in chyme reinfusion.After 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet.For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.展开更多
文摘Intestinal infection has become a common disease in human and endoscopy can be a powerful means in diagnosis of intestinal illnesses. Mathematical models are developed for an inserted endoscope on the flow of chyme in the small intestine considering a Newtonian incompressible fluid flow, under an axisymmetric condition, in a cylindrical annulus between the small intestine and the endoscope. We obtain novel mathematical expressions for the pressure drop, forces exerted by the endoscope on the flow of chyme, and the force exerted by the chyme on the intestine for one wave length of the peristaltic rush wave. We also investigate and calculate the flow velocity and pressure for different flow rates and the wave lengths. The results are presented, and discussed for the cases and conditions under which pressure, pressure drop can be positive or negative and the forces can be acted either by the intestine or endoscope on the flow or vice-versa.
基金Grants from the National Natural Science Foundation of China(Grant No.82270587)the Jinling Hospital Scientific Research Project(Grant No.YYZD2021011).
文摘Blunt bowel injury(BBI)is relatively rare but life-threatening when delayed in surgical repair or anas-tomosis.Providing enteral nutrition(EN)in BBI patients with open abdomen after damage control surgery is challenging,especially for those with discontinuity of the bowel.Here,we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3.Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed.Postoperatively,the patient was transferred to our trauma center for septic shock and hyperbilirubinemia.Following salvage resuscitation,damage control lapa-rotomy with open abdomen was performed for abdominal sepsis,and a temporary double enterostomy(TDE)was created where the anastomosis was ruptured.Given the TDE and high risk of malnutrition,multiple portions EN were performed,including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube.Besides,chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube.Hyperbilirubinemia was alleviated with the increase in chyme reinfusion.After 6 months of home EN and chyme reinfusion,the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet.For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen,the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.
