A case report of abdominal distention caused by herpes zoster

Gastrointestinal complications caused by herpes zoster are extremely rare. Here, we described a case of abdominal distention caused by herpes zoster. The patient was a 59-year-old female who suffered from unexplained paroxysmal and a burning pain on the right part of her waist and abdomen, accompanied by abdominal distention. Intestinal pseudo-obstruction was diagnosed by abdominal radiography. Distention of the right abdominal wall was still apparent after one month. In this report, we found that recovery from abdominal distention caused by herpes zoster is difficult and may require surgical intervention.

Experimental Study on the Treatment of Gallbladder Distention by Dahuang Lingxian Prescription

Objective: To investigate the mechanism of inhibiting the secretion of “lithogenic bile” and treating gallbladder distention with the TCM prescription Dahuang Lingxian. Methods: Forty SPF-grade SD male mice were randomly divided into blank control group, model group, ursodeoxycholic acid group and TCM group, 10 mice in each group. The blank control group was kept normally, and the model group, ursodeoxycholic acid group and TCM group were established as gallbladder distention models. The blank control group and the model group were given 1.5 ml of saline by gavage daily;the ursodeoxycholic acid group was given 100 mg/kg/d of a mixture of saline and ursodeoxycholic acid capsules by gavage daily;the TCM group was given 39 g/kg/d of aqueous decoction of Dahuang Lingxian Prescription by gavage daily. After 6 weeks of continuous intervention, all mice were executed and the lithogenesis rate, ultrastructure and mRNA expression were observed. Results: The lithogenesis rate of mice in the TCM group was significantly reduced (P β1/Smads pathway was significantly improved (P < 0.05), which could achieve the same therapeutic effect as ursodeoxycholic acid capsules. Conclusion: Dahuang Lingxian Prescription can reduce the secretion of “lithogenic bile” by inhibiting the inflammatory reaction and fibrosis of biliary system. Dahuang Lingxian Prescription has certain advantages in the treatment of gallbladder distention.

Gastric rupture caused by acute gastric distention in non-neonatal children: clinical analysis of 3 cases

To study gastric rupture, a progressive, rapid and high mortality condition, caused by acute gastric distention (GRAGD) and its appropriate diagnosis and treatment Methods The etiology, pathology, clinical manifestations and experiences in 3 children with GRAGD were reviewed Results Case 1: After diagnosising GRAGD and stabilizing her shock with massive fluid replacement, gastrostomy was performed Her postoperative course was uneventful because of fasting, suction, fluid infusion, correction of acidosis and supporting nutrition Case 2: After diagnosising gastric distention which subsided with conservative therapy for 9 days, she suddenly had gastric rupture when she had not eaten for 6 days She died of shock and had no chance for surgery Case 3: The patient had sudden abdominal pain, distention and vomitting with severe shock for 4 days Emergency surgery found gastric rupture and the method was the same as Case 1 The patient survived but has brain impairment Case 1 and 3 showed multifocal transmural necrosis Conclusions Symptoms like overeating, bulimia, changes in kind of food, X ray showing large distended stomach and massive pneumoperitoneum were seen after gastric rupture and can help to diagnose this condition Clinical course of gastric distention with toxic shock progresses rapidly, however subsequent gastric rupture exacerbates the shock and makes the treatment difficult treatment It is extremely important that a laparotomy be performed at once after stabilizing shock with massive fluid replacement Postoperative nutritional support and fluid replacement will increase survival It is very important that when gastric distention disappears after conservative therapy, the doctor should assess carefully whether the gastric wall recovery is under way by using effective methods of examination

Effect of acupuncture at three different acupoints on electrical activity of gastric distention-affected neurons in rat medial vestibular nucleus

OBJECTIVE: To observe the effect of gastric distention(GD) and acupuncture at three different acupoints on the spontaneous discharge of neurons in the medial vestibular nucleus(MVN), and to clarify the specific function of the MVN in the central integration mechanism underlying acupuncture regulation.METHODS: GD was conducted using a balloon inserted in the stomach cavity, and acupuncture was performed separately at each of three acupoints:Zusanli(ST 36), Quchi(LI 11), and Weishu(BL 21).The effect of acupuncture and GD on the spontaneous discharge of MVN neurons was assessed using a glass microelectrode filled with a sodium acetate electrolyte solution containing 1% pontamine sky blue; the discharge signals from the neurons were amplified by the microelectrode amplifier and recorded in the Spike2 system.RESULTS: GD and acupuncture significantly affected the spontaneous discharge of MVN neurons. Furthermore, acupuncture at Zusanli(ST 36) and Weishu(BL 21) was significantly more effective at altering the discharge of GD-responsive MVN neurons compared with GD-nonresponsive neurons.CONCLUSION: GD and acupuncture at three different acupoints affected the electrical activity of MVN neurons. The MVN is involved in the central integration mechanism underlying acupuncture regulation of gastric functions. The effects of acupuncture on gastric function may therefore be mediated via these particular MVN neurons.

Packed with pills-obstructing duodenal web in the setting of intestinal malrotation:A case report

BACKGROUND The incidence of intestinal malrotation in adults has been reported to only be about 0.2%.Duodenal web as a cause of intestinal obstruction is rare,with an incidence of about 1:20000-1:40000.Furthermore,when described,these conditions are usually seen in early life and very infrequently in adulthood.CASE SUMMARY We report a case of a middle-aged woman with intestinal malrotation who presented with a three-month history of right-sided abdominal pain,early satiety,and a 22-pound weight loss.Patient underwent an esophagogastroduodenoscopy,which demonstrated numerous retained pills in a deformed first portion of the duodenum,concerning for a partial gastric outlet obstruction.An upper gastrointestinal series showed marked distention of the proximal duodenum with retained debris and the presence of a windsock sign,increasing the suspicion of a duodenal web.The patient subsequently underwent surgical intervention where a duodenal web with two lumens was noted and resected,opening the duodenum.There were over 150 pill capsules that were removed.The patient is doing well after this intervention.CONCLUSION Both intestinal malrotation and duodenal webs are infrequently encountered in the adult population.These pathologies can also present with nonspecific abdominal symptoms such as chronic abdominal pain and nausea.Hence,providers might not consider these pathologies in the differential for patients who present with vague symptoms which can lead to delay in management and increased mortality and morbidity.

Apatinib for treatment of a pseudomyxoma peritonei patient after surgical treatment and hyperthermic intraperitoneal chemotherapy:A case report

BACKGROUND Pseudomyxoma peritonei(PMP)is a rare benign,but progressive,disease according to myxoma histopathology.Surgical resection is the preferred and most effective treatment,but the outcomes are often unsatisfactory.CASE SUMMARY A 63-year-old Chinese woman with PMP received apatinib at a daily dose of 0.5 mg for 15 d per cycle and at a daily dose of 0.4 mg to date for recurrent abdominal distension after surgical treatment and hyperthermic intraperitoneal chemotherapy.During the follow-up period,apatinib was the maintenance treatment with a progression-free period of 10 mo and the toxicity of apatinib was controllable and tolerable.Unfortunately,recurrence occurred 10 mo after administration.After two operations,the patient gave up treatment at the 18th mo and eventually died of intestinal obstruction and multiple organ failure.CONCLUSION Apatinib may be an option for recurrent PMP after surgical treatment,but this conclusion remains to be confirmed.

Treatment of pediatric Ogilvie’s syndrome with low-dose erythromycin:A case report

Acute colonic pseudo-obstruction is a poorly understood syndrome, characterized by the signs, symptoms and radiological pattern of a large bowel obstruction without evidence for a mechanical obstruction. We report a case of a 2-year old boy who presented with progressive abdominal distention, vomiting and abdominal pain on postoperative d 3. Plain abdominal X-ray showed markedly dilated large bowel. Mechanical colonic obstruction was ruled out with hypaque enema. Ogilvie＇s syndrome was suspected. The patient received treatment with oral erythromycin which had an immediate beneficial effect. During the 6 mo follow-up, no recurrences of symptoms were observed. We provide a safe and effective therapy for Ogilvie＇s syndrome in pediatric individuals.

Case Series of 10 Drug-Refractory IBS Patients Who Respond to Oral Serum-Derived Bovine Immunoglobulin/Protein Isolate (SBI)

Aim: The responses of 10 patients with long-standing, symptomatic, intractable drug-refractory histories of irritable bowel syndrome with diarrhea (IBS-D) and with abdominal pain, gas/bloating and distention, termed IBS undefined (IBS-U), were evaluated when administering a medical food product containing serum-derived bovine immunoglobulin/protein isolate (SBI). Methods: Patients in this case series were chosen based on their lack of satisfactory response to a variety of drugs, including antidiarrheal and antispasmodic medications, serotonin 5-HT3 receptor antagonists, selective serotonin re-uptake inhibitors (SSRIs), proton pump inhibitors (PPIs), antibiotics, and antidepressive drugs. Patients met Rome III criteria and were administered 5 g/day of SBI as standard-of-care nutritional support. A scale of 0% - 25%, 25% - 50%, 50% - 75%, 75% - 100% response to SBI was used for patient-reported improvement in overall IBS symptoms following administration for one month. Exact methods for calculating confidence intervals and p-values were used to assess complete management of symptoms and response to therapy. Adverse events were also monitored for this nutritional product. Results: The onset of gastrointestinal (GI) symptom reduction utilizing nutritional management with SBI occurred within an average time of 2-4 weeks with improved or near complete management in all 10 patients who were refractory to previous drug therapies by 4 weeks. When prompted, patients reported significant IBS symptom improvement which averaged between 50% - 100% (p = 0.002) with an average for complete management in all patients of 69%. No side effects were reported after SBI administration even when taken for up to 28 weeks. Conclusion: Based on the safety profile and reported outcomes in this case report, SBI should be considered as a nutritional option for management in IBS-D and IBS-U.

Effect of self-made exhaust plaster on patients with gastrointestinal dysfunction after gynecological operation

Objective:To explore the effect of self-made exhaust patch(SMEP)on gastrointestinal dysfunction after gynecological operation.Methods:A total of 200 patients with gynecological operation in the gynecological ward of Shandong Changle People's Hospital were randomly divided into the control group(n=100)and the treatment group(n=100).The recovery time of bowel sounds,the time of first anal exhaust,the duration of abdominal distention,the duration of abdominal pain,the incidence of abdominal distention and abdominal pain and linical efficacy of SMEP were observed.Results:Compared with the control group,the recovery time of gastrointestinal function and the first anal exhaust time in the treatment group were shorter;the duration of abdominal distention and abdominal pain in the treatment group were shorter than those in the control group(P<0.05);Cure rate of abdominal distention in the treatment is 62.5%and cure rate of abdominal pain in the treatment is 60%within 72 hours after operation,which is higher than that in the control group(44.%,45.9%).Conclusion:The results showed that the self-made exhaust patch can improve the clinical symptoms of patients after gynecological abdominal surgery,and the self-made exhaust patch had a significant effect on gastrointestinal dysfunction after gynecological surgery,which was worthy of clinical promotion.

Effect Observation on Heat-sensitive Moxibustion for Abdominal Distension Following Laparoscopic Cholecystectomy

Objective: To observe the clinical effect of heat-sensitive moxibustion on abdominal distension following laparoscopic cholecystectomy. Methods: A total of 240 cases were randomly allocated into an observation group and a control group according to their admission sequence, 120 in each group. Cases in the observation group were treated with conventional care, glycerol enema and heat sensitive moxibustion, whereas cases in the control group were only treated with conventional care and glycerol enema. Then the passage of gas by anus within 24 h and improvement of abdominal distension were observed in both groups. Results: There were statistical differences in the emergence time of bowel sounds and the initial passage of gas by anus between the two groups(both P<0.05). The therapeutic effect in the observation group was better than that in the control group(P<0.05). Conclusion: Heat-sensitive moxibustion has reliable effect for abdominal distension following laparoscopic cholecystectomy.