Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Duodenal diverticula are not uncommon. Uncomplicated diverticula require no treatment. In the period 1970 to 1980, 104 patients with symptoms presented at the Vancouver General Hospital and the Swedish Hospital in Seattle. Of these, 26% presented with pain and 24% with anemia. Malabsorption and benign tumours were noted infrequently. Fifteen patients were treated surgically for pain, perforation, hemorrhage, tumour, blind loop syndrome and obstruction of the duodenum, biliary tract or pancreatic duct. Two patients died. The second part of the duodenum was involved in 82% and the third part in 10%. Anatomical variations are common in the area of the ampulla; these should be anticipated before operation. Surgical procedures in the area may be technically demanding and associated with high mortality and morbidity. The choice of procedure depends on the urgency and nature of the complication of the diverticulum. Endoscopic retrograde cholangiopancreatography can play a role in evaluating the possible significance of the diverticulum and the anatomy of the area. In some cases endoscopic sphincterotomy may be possible. In some situations diverticulectomy is contraindicated.
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PMID:Management of duodenal diverticula. 680 32

Effective treatment of malabsorption due to severe pancreatic exocrine insufficiency requires delivery of sufficient enzymatic activity into the duodenal lumen simultaneously with meal nutrients. To achieve this, modern therapeutic concepts recommend administration of 25,000 to 40,000 units of lipase per meal using pH-sensitive pancreatin microspheres. In case of treatment failure, dosage should be increased two to three times. If this still is not successful, compliance may be checked by measurement of fecal chymotrypsin, although this is not a standardized procedure. In the compliant patient, diagnosis of pancreatic exocrine insufficiency needs to be reviewed, particularly cases of celiac disease, (concomitant) bacterial overgrowth, and blind loop syndrome, as well as giardiasis, which need to be excluded or otherwise be treated specifically. Finally, additional acid suppression with application of unprotected pancreatin and/or reduced fat intake may help to control malabsorption. Still, in most patients, lipid digestion cannot be completely normalized by current standard therapy. On the one hand, this leads to loss of energy that may only partly be compensated for by increased nutrient intake. On the other hand, increased nutrient exposition of distal intestinal sites may release excessive amounts of mostly inhibitory distal intestinal neurohumoral mediators, and thereby disturb gastrointestinal secretory and motor functions. Consequently, future developments are needed for optimizing treatment.
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PMID:Pancreatic Enzyme Supplementation Therapy. 1295 43

Jejunal diverticuli are rare and usually asymptomatic. More commonly, they are seen as incidental findings on CT images, enteroclysis, or during surgery. Complications such as bleeding, perforation, obstruction, malabsorption, diverticulitis, blind loop syndrome, volvulus, and intussusception may warrant surgical intervention. An interesting case of an unborn enterolith (enclosed calculus) from a jejunal diverticulum presenting as a small bowel obstruction is presented. The patient is a 66-year- old woman with no prior history of abdominal surgery who presented with a high-grade bowel obstruction. CT with intravenous barium contrast confirmed the presence of a transition point from dilated to decompressed small bowel in the mid jejunum. At laparotomy, a freely mobile mass was found in this area leading to the bowel obstruction. The mass was removed by making a small enterotomy in the jejunum. While running the small bowel proximally, a small segment of jejunum, approximately 8 cm, containing several diverticuli was found. This bowel obstruction was the result of an unborn enterolith from this segment of bowel. The patient's hospitalization was benign and she was discharged home on postoperative day 4.
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PMID:Jejunal diverticular disease with unborn enterolith presenting as a small bowel obstruction: a case report. 1767 45


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