small bowel

小肠
  • 文章类型: Journal Article
    腹部超声和肠道超声被广泛用作调查腹部症状患者的首选诊断工具。主要用于排除器质性疾病。然而,胃肠超声(GIUS),作为一种实时诊断成像方法,还可以提供有关运动性的信息,流量,灌注,蠕动,器官填充和排空,具有较高的时间和空间分辨率。由于它的非侵入性和高可重复性,GIUS可以通过研究功能性胃肠过程和功能性胃肠疾病(FGID)随时间的行为及其对治疗的反应并提供对其病理生理机制的见解。欧洲医学和生物学超声协会联合会(EFSUMB)成立了一个由GIUS专家组成的工作组,它提出了关于GIUS在几种急性和慢性胃肠道疾病中的作用的临床建议和指南。这篇综述致力于GIUS在辅助FGID诊断中的作用,特别是在调查有功能障碍症状的患者中。比如吞咽困难,反流障碍,消化不良,腹痛,腹胀,改变了排便习惯.GIUS检测的现有科学证据,评估,这里报道了调查FGID,在强调超声检查结果及其在临床环境中的有用性的同时,定义GIUS在患者管理中的实际和潜在作用,并提供有关未来应用和研究的信息。
    Abdominal ultrasonography and intestinal ultrasonography are widely used as first diagnostic tools for investigating patients with abdominal symptoms, mainly for excluding organic diseases. However, gastrointestinal ultrasound (GIUS), as a real-time diagnostic imaging method, can also provide information on motility, flow, perfusion, peristalsis, and organ filling and emptying, with high temporal and spatial resolution. Thanks to its noninvasiveness and high repeatability, GIUS can investigate functional gastrointestinal processes and functional gastrointestinal diseases (FGID) by studying their behavior over time and their response to therapy and providing insight into their pathophysiologic mechanisms. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has established a Task Force Group consisting of GIUS experts, which developed clinical recommendations and guidelines on the role of GIUS in several acute and chronic gastrointestinal diseases. This review is dedicated to the role of GIUS in assisting the diagnosis of FGID and particularly in investigating patients with symptoms of functional disorders, such as dysphagia, reflux disorders, dyspepsia, abdominal pain, bloating, and altered bowel habits. The available scientific evidence of GIUS in detecting, assessing, and investigating FGID are reported here, while highlighting sonographic findings and its usefulness in a clinical setting, defining the actual and potential role of GIUS in the management of patients, and providing information regarding future applications and research.
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  • 文章类型: Journal Article
    The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.
    Estas recomendações baseadas na evidência detalham o uso da enteroscopia assistida por dispositivo no manejo clínico das doenças do intestino delgado. Um conjunto de Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e Portugués de intestino delgado para rever a evidência disponível sobre as principais indicações desta técnica, o seu papel nos algoritmos de manejo de cada indicação e sobre o seu rendimento diagnóstico e terapêutico. Foi gerado um conjunto de recomendações pelos autores.
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  • 文章类型: Journal Article
    OBJECTIVE: The goal of this work was to analyse small bowel (SB) dose-volume following the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) guidelines for rectal cancer patients treated using a couch top inclined belly board (iBB). As part of this, the consistency in SB displacement was evaluated using on-treatment cone-beam computed tomographic (CBCT) imaging.
    METHODS: Twenty-four patients with rectal cancer were treated on a commercially available iBB. All patients went through the standard radiochemotherapy protocol in either a pre- or postoperative setup. All patients underwent weekly CBCT imaging during the course of radiation treatment. The planning computed tomographic data sets were used to analyze the quality of SB displacement, and the CBCT data sets were used to assess the reproducibility in SB displacement during treatment. The SB dose volume was evaluated and compared with QUANTEC-recommended dose limitations. Similarly, the impact of body mass index on dose volume and SB displacement was evaluated.
    RESULTS: The SB displacement was assessed respectively as \"good\" and \"very good\" by both independent evaluating radiation oncologists. The consistency of SB displacement through the course of radiation treatment was scored as \"excellent\" for 22 of 24 and 23 of 24 patients by both radiation oncologists, respectively. The QUANTEC recommendation was met for all patients without bowel adhesions; however, the most benefit was observed for patients with body mass index > 23 kg/m2.
    CONCLUSIONS: Our study has shown that QUANTEC recommendations for SB dose during rectal cancer treatment can easily be met by treating patients on a couch top iBB. This technique is robust and produces consistent SB displacement.
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  • 文章类型: Journal Article
    Anaemia is a common pathologic condition, present in almost 5% of the adult population. Iron deficiency is the most common cause; other mechanisms can be involved, making anaemia a multi-factorial disorder in most cases. Anaemia being a frequent manifestation in the diseases of the gastrointestinal tract, patients are often referred to gastroenterologists. Furthermore, upper and lower endoscopy and enteroscopy are pivotal to the diagnostic roadmap of anaemia. In spite of its relevance in the daily clinical practice, there is a limited number of gastroenterological guidelines dedicated to the diagnosis of anaemia. For this reason, the Italian Association of Hospital Gastroenterologists and Endoscopists and the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition commissioned a panel of experts to prepare a specific guideline on anaemia and its diagnostic roadmap in the gastroenterological scenario. The panel also discussed about the potential involvement of gastroenterologists and endoscopists in the management of patients with anaemia, with particular attention to the correct use of investigations. The panel paid particular attention to practical issues with the aim to support gastroenterologists in their clinical practice when dealing with patients with anaemia.
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  • 文章类型: Consensus Development Conference
    OBJECTIVE: To develop guidelines describing a standardised approach to patient preparation and acquisition protocols for magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) of the small bowel and colon, with an emphasis on imaging inflammatory bowel disease.
    METHODS: An expert consensus committee of 13 members from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Paediatric Radiology (ESPR) undertook a six-stage modified Delphi process, including a detailed literature review, to create a series of consensus statements concerning patient preparation, imaging hardware and image acquisition protocols.
    RESULTS: One hundred and fifty-seven statements were scored for agreement by the panel of which 129 statements (82 %) achieved immediate consensus with a further 19 (12 %) achieving consensus after appropriate modification. Nine (6 %) statements were rejected as consensus could not be reached.
    CONCLUSIONS: These expert consensus recommendations can be used to help guide cross-sectional radiological practice for imaging the small bowel and colon.
    CONCLUSIONS: • Cross-sectional imaging is increasingly used to evaluate the bowel • Image quality is paramount to achieving high diagnostic accuracy • Guidelines concerning patient preparation and image acquisition protocols are provided.
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  • 文章类型: Journal Article
    OBJECTIVE: Small bowel or multivisceral transplant is a relatively new treatment for irreversible intestinal damage, and no published practice guidelines exist. The purpose of this article is to report evidence regarding the best plan of care to achieve adequate nutrition and appropriate development for children.
    METHODS: An integrative review was conducted with 54 articles related to management of this transplant population. A nine-member nursing team integrated the findings.
    CONCLUSIONS: This resulting guideline represents the best research and best practices on which to base staff education and competency validations to manage this medically fragile patient population.
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