Small bowel diverticular disease occurs in 0.3% to 20% of the population and is much less common than large bowel diverticular disease, which is present in 15% to 40% of adults. Of those with small bowel diverticula, only 4% will…
A fistula is an abnormal communication between two epithelialized surfaces. Over the past half century, the mortality associated with gastrointestinal fistulas has decreased from 40% to 60% to approximately 15% to 20% of patients. This improvement in prognosis is attributable…
Crohn disease is an incurable, chronic disease of unknown etiology, which along with ulcerative colitis comprises inflammatory bowel disease (IBD). Crohn disease is characterized by transmural inflammation that can involve any part of the gastrointestinal tract, from mouth to anus,…
Intestinal obstruction is a commonly encountered surgical condition. The diagnosis is made with a history of nausea, vomiting, abdominal pain, signs of abdominal distention and tenderness, and imaging displaying dilated bowel with air-fluid levels. Adhesive disease is the etiology of…
The term volvulus derives from the Latin word volvere, meaning to turn or roll. Clinically, volvulus refers to a greater than 180-degree twisting of a hollow organ about its mesentery, resulting in luminal obstruction, impaired venous return, and eventually ischemia…
Descriptions of patients with small bowel obstruction (SBO) date back to the earliest medical literature. It was not until the 19th century and the advent of anesthesia and antisepsis, however, that surgery became a recognized and effective treatment. At the…
The small intestine is the longest organ in the gastrointestinal (GI) tract. It is responsible for the absorption of nutrients, maintaining water and electrolyte balance, providing an immunologic barrier, and endocrine secretion. Embryology During the fourth week of gestation, the…
Operations on the stomach and duodenum are performed for six primary reasons: neoplasia, gastroesophageal reflux disease (GERD), obesity, peptic ulcer disease, trauma, and congenital defects. Any operation done for these reasons, whether laparoscopic or open, can result in long-term complications…
Although the small intestine is an infrequent site of gastrointestinal (GI) cancer, the incidence of small intestinal cancer has increased considerably in the past several decades, primarily due to an increase in adenocarcinoma and particularly small bowel neuroendocrine tumors; together,…
Although spanning only 20 to 30 cm, from the pylorus to the ligament of Treitz, the duodenum is the “gate” that controls the passage of food from the stomach to the jejunum. The name is derived from the Latin phrase intestinum…