Up until now, aside from small bowel adhesive pathology and Crohn’s disease, disease of the small intestine has remained understudied and elusive for many reasons. Foremost, has been the lack of methods to study the structure and function of this part of the alimentary tract with any degree of precision and ...
Up until now, aside from small bowel adhesive pathology and Crohn’s disease, disease of the small intestine has remained understudied and elusive for many reasons. Foremost, has been the lack of methods to study the structure and function of this part of the alimentary tract with any degree of precision and detail. In the last decade, however, our understanding of surgical diseases of the small bowel has been improved by developments in ultrasound technology, cross sectional and longitudinal imaging using magnetic resonance and computed tomographic enteroclysis, improved access to the small intestine in the case of direct visual access (capsule enteroscopy) and enhancement of therapeutic access using direct vision enteroscopy and hybrid techniques such as laparoscopic assisted enteroscopic therapies. Positron imaging tomography with specific localising techniques for such receptors as the somatostatin receptor in small bowel has opened up our ability to study and treat neuroendocrine tumours better than ever before. Likewise, small bowel motility studies, our improved knowledge of specific receptors in the small intestine such as motilin receptors and receptors sensitive to such hormones as peptide YY, have changed the way we look at disorders of small bowel function, return of small bowel function following abdominal surgery and the impact of co-morbid conditions such as type 2 diabetes on return of bowel activity.
We propose a series of update articles comprising of reviews, meta-analyses and expert commentaries in the areas of small bowel diagnosis and therapy to bring the reader up to date with current methods available to manage small bowel disease. Below is a suggested list:
1. An overview of ultrasonography in the evaluation of small bowel in health and disease.
2. Computerised tomography and magnetic resonance imaging of small bowel.
3. Capsule enteroscopy and fibre-optic enteroscopy in evaluation of small bowel.
4. Current methods in prevention and management of small bowel adhesive disease.
5. Management of Crohn’s disease of the small bowel.
6. Malignancy of small bowel – adenocarcinoma.
7. Management of small bowel gastrointestinal stromal tumours (GIST).
8. Small bowel lymphoma.
9. Neuro-endocrine tumours (NET) of small bowel.
10. The “small bowel vascular attack” – management of acute mesenteric ischaemia.
11. Short bowel syndrome and small bowel transplantation.
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