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The paper describes a rare case of pneumocystosis of the small intestine, diagnosed in the surgical material of a 39-year-old man with HIV infection using histological and immunohistochemical methods. After the treatment, the patient was discharged.

A rare case of jejunal lipoma complicated by intestinal intussusception in a 71-year-old man is presented. Abdominal computed tomography revealed intestinal intussusception caused by the jejunal wall lipoma, allowed to timely make a diagnosis and perform surgical treatment.

RELEVANCE Early enteral nutrition is an essential element of intensive care for acute pancreatitis. Its intolerance is manifested by high gastric residual volumes, pain syndrome, bloating, diarrhea, nausea and vomiting. The relevance of our study is determined by the lack of information on how the routes of nutrient delivery affect its tolerability considering the gradual «as­per­protocol» increase in nutrition volumes for patients with moderately severe acute pancreatitis.THE AIM OF THE STUDY Was to identify the key factors that determine intolerance to early nasogastric and nasojejunal enteral feeding in ICU patients with the early phase of moderately severe acute pancreatitis.MATERIAL AND METHODS We conducted an open randomized controlled trial. Out of 64 patients with predicted severe course of acute pancreatitis, we identified a cohort with moderately severe acute pancreatitis, in which 17 (51.5%) patients received early enteral nutrition through a nasogastric tube, and 16 (48.5%) via an endoscopically placed nasojejunal tube. The criteria for nutrition intolerance were as follows: nasogastric tube discharge of more than 500±100 ml at a time or more than 500 ml/day in comparison with the enterally administered during this period, increased pain, bloating, diarrhea, nausea and vomiting. Using the method of logistic regression, indicators with prognostic significance were determined. The null hypothesis was rejected at p

Background. Due to the growing light pollution and the development of new territories, including northern ones, the search for drugs that increase the adaptive capacity of the organism is promising.The aim. We studied the effects of the exogenous melatonin (100 µg/day/animal) on antioxidant status of liver and small intestine in Syrian hamsters (Mesocricetus auratus) in the light conditions of North-West of Russia (Petrozavodsk, northern lighting – NL).Materials and methods. Female hamsters were exposed to a 12/12 light/dark cycle (LD; n = 12) or NL for 3 months. In NL light conditions hamsters were divided into two groups: NL-control (received placebo; n = 12) and NL-mel (received melatonin; n = 12). The study was conducted from the period of the summer solstice – June 25 (NL: 19.36/4.24) to September 25 (NL: 12/12) (autumn equinox).Results. Animals were kept in the NL conditions had decreased the levels of GSH and activities of antioxidant enzymes (superoxide dismutase (SOD) and catalase) at initial stage of experiment as well as increased TBA reactive substances (TBARS) level at the beginning and after a month of the experiment in the liver in comparison to control (LD). It was observed that in the small intestine the activities of SOD and the levels of GSH (initial and intermediate stages) and TBARS (end of the experiment) were significantly higher in NL in comparison to LD. Liver and small intestine TBARS concentrations after one and three months of the experiment were decreased in NL-mel in comparison to NL-control.Conclusion. The results of the study indicate the sensitivity of the antioxidant defense system in the tissues of the liver and small intestine of Syrian hamster to the photoperiod and exogenous melatonin. The present study revealed that exogenous melatonin was able to reduce the level of TBARS and increase the activity of SOD and CAT in the light conditions of North-West of Russia.

Immediacy of the problem of acute adhesive small bowel obstruction (AASBO) is due to its high prevalence and presence of certain difficulties in diagnosis, which affect the choice of the treatment method. In addition, the long-term results of treatment cannot be considered satisfactory due to the large number of AASBO recurrences. In 64-93% of cases, adhesions form on the abdominal organs after surgery. It should be noted that their recurrence after open surgery reaches 30% of cases, and after repeated operations this value increases to 78%. Determination of the main etiological factor is of great importance, which makes it possible to assess the feasibility surgery, since it is known that if adhesions do not develop, treatment can be conservative. In this regard, X-ray methods of investigation can be of great help. Surgical intervention is recommended in the presence of intestinal dysfunction symptoms that do not disappear after conservative treatment or when it worsens. Surgical intervention is recommended if symptoms of intestinal dysfunction do not disappear after conservative treatment or if they deteriorate. n recent decades, specialists in the field of abdominal surgery have been striving to expand the indications for laparoscopic interventions in order to reduce the invasiveness of surgery, which will also decrease the risk of adhesions.

The SARS-CoV-2 virus enters the body through the angiotensin-converting enzyme 2 (ACE-2), which is the entry point of the virus into the cell. The most dense fabric of ACE-2 is the lungs. The small intestine also contains large amounts of ACE-2 in the enterocyte membrane and is often involved in this process. Intestinal symptoms can appear at different stages of the disease. The review describes the mechanisms of interaction of SARS-CoV-2 with enterocytes, the fecal-oral route of infection, diagnosis and treatment of COVID-19 with intestinal symptoms.

Introduction. In the structure of modern injuries in wartime and peacetime the share of gunshot wounds increased significantly. The timeliness of applying a tourniquet is one of the main methods of saving lives on the battlefield. The patterns of formation of enteral insufficiency syndrome in conditions of acute blood loss complicated by ischemia-reperfusion of the limb have not been studied enough. There are no data on the features of violations of the absorption function of the small intestine in these conditions and the effectiveness of correction with Carbacetam, which is able to reduce the manifestations of acute hemic hypoxia and ischemic-reperfusion syndrome.The objective of research: To establish the peculiarities of the absorption function of the small intestine in the pathogenesis of acute blood loss, ischemia-reperfusion of the limb and their combination. To evaluate the effectiveness of Carbacetam in the correction of identified abnormalities.Materials and methods. The experimental studies were conducted on 108 white nonlinear male rats weighing 200-220 g, which were housed in standard vivarium conditions. All animals were divided into five groups: control and four experimental. Under thiopental-sodium anesthesia in the first experimental group was simulated ischemia-reperfusion of the limb, in the second group – acute blood loss, and in the third group – these injuries were combined. In the fourth experimental group, animals with acute blood loss and ischemia-reperfusion of the limb were intraperitoneally administered Carbacetam at a dose of 5 mg per kilogram of animal weight. After 1 and 2 hours, as well as after 1, 7 and 14 days studied the absorption function of the intestines by D-xylose test.The results and discussion. Simulation of limb ischemia-reperfusion compared with the control group causes a decrease in the content of D-xylose in the urine after 1 day of the reperfusion period. Also, acute blood loss is accompanied by a significant decrease in this indicator after 1 day. Until the end of the experiment the rate increases, but up to 14 days does not reach the level of control. The combination of acute blood loss and ischemia-reperfusion of the limb causes a decrease in the content of D-xylose in the urine starting from 1 hour of the experiment, which reaches a minimum after 1 day and remains at the same level until 14 days. In these terms the rate was the lowest compared to other studied groups. The use of Carbacetam for corrective purposes in rats with acute blood loss complicated by ischemia-reperfusion of the limb, compared with animals without correction significantly reduces the detected abnormalities after 7 days and more after 14 days of use.Conclusions. Complications of acute blood loss by ischemia-reperfusion of the limb causes a significant decrease in the absorption function of the small intestine after 1 day of the experiment. The intensity of disorders was significantly higher compared to other experimental groups. The use of Сarbacetam for 7-14 days in the reperfusion period in animals with acute blood loss complicated by limb ischemia-reperfusion, compared with animals without correction, causes a significant increase in the absorption function of the small intestine. This indicates the protective effect of the drug under the conditions of simulated pathology.

Background. Tumors of the small intestine are difficult to diagnose. Their preoperative detection is an exception rather than the rule.Materials and methods. We examined 15 patients preoperatively diagnosed with small bowel tumors. Patients were selected for two-stage enterography according to special criteria. Before examination, patients received prokinetic agents to enhance gastrointestinal motility. After placing the probe in the initial segment of the small intestine, we connected a special device for remote mechanical administration of contrast agent (0.1 kg/cm2, which is equal to 100 mL/min). To prevent overextension of the intestine, we administered contrast by portions. After reaching the middle part of the ileum, we introduced a portion of air. Monitoring of the diagnostic process was performed by short-term radiographic inspection and imaging.Results and discussion. Multislice computed tomography enterography is currently considered as one of the most informative methods. It is a highly sensitive method for the diagnosis of small bowel tumors. However, a tailored approach should be used during examination with the consideration of gastrointestinal motility.Conclusion. Multislice computed tomography enterography has a number of advantages over conventional enterography.Small bowel tumors that are not associated with clinical signs of acute intestinal obstruction may remain undiagnosed for a long time and treated as any other gastrointestinal diseases.Surgical treatment of small bowel tumors remains the main therapeutic measure for patients.

Today considerable attention is paid to the effects of ionizing radiation.chronic exposure in low doses and intensivity to humans and other bio-objects. The changes in the structural characteristics of the genome, nuclear, microsomal, mitochondrial, plasma membranes, cell proliferation, and the processes underlying radioresistance / radiosensitivity caused by irradiation have been experimentally studied. prolonged exposure to ionizing rays in small doses gradually causes a decrease in the endogenous reserve of thiol-dependent systems, and their complete depletion, which negatively affects the body's resistance to adverse environmental factors. There is a possibility of disturbances in the synthesis of thiol disulfide high molecular weight components. The objective: to study the state of thiol disulfide, glutathione redox system and acetylcholinesterase activity in the small intestine of rats of different sexes and ages under physiological conditions and under conditions of prolonged γ-irradiation in a total dose of 0.75 and 1.0 Gy. Results. It has been established that in a small bowel of intact mature rats after prolonged total γ-irradiation with a dose of 1.0 Gy, there were quite significant changes in the content of thiol compounds in the tissues of the small intestine. It was found that the content of SH-groups of protein origin in the tissues of the small intestine decreased relative to the age of control group animals by 28.8% and at the same time was lower than the value of males of the previous stage by 32.8%. The number of disulfide groups of protein origin in the small intestine of males three months after irradiation at a total dose of 1.0 Gy, relative to the same age control group animals, was 85.6% and at the same time was lower than the previous stage by 31.8%. Conclusions: 1.Under physiological conditions there are clear gender and age differences in the functional state of thiol-disulfide, glutathione redox system and acetylcholinesterase activity.Prolonged total γ-irradiation in the total dose of 0.75 and 1.0 Gy causes quite stable and profound changes in the functional state of the systems under study.The dependence of the detected changes on the time elapsed after radiation damage, the dose of γ-irradiation and the sex of the animals is clearly monitored.4. Females have been shown to be more radioresistant than males.

The purpose of the research is studying microstructural changes in the process of adaptation of components during the formation of the “parasite–host” system by the example of Paramphistomum cervi (Zeder, 1790) parasitizing in the small intestine of spontaneously infected sheep.Materials and methods. Peculiarities of changes in the microstructure of the small intestine in the “parasite–host” system were studied using parasitization of P. cervi in the intestines of sheep using well-known histological methods. Pieces of tissue of the small intestine of sheep with P. cervi, after being preserved in 70% alcohol, were processed according to the generally accepted histological procedure and embedded in paraffin. Sections 5–7 μm in thickness were stained with histological stains and examined under a light microscope.Results and discussion. Microstructural analysis of the characteristics of the relationship in the "parasite–host" system showed that the mucous membrane of the small intestine of sheep in the presence of P. cervi looks sharply thickened. Swelling of the epithelium of villi and crypts, its vacuolization and albuminoid degeneration were found. In some places, proliferation of the epithelial layer of the mucous membrane was detected, due to which epithelial hyperplasia is observed, in some cases turning into metaplasia. Proliferation and hyperplasia (metaplasia) in the endostation of the host in the presence of the parasite contribute to: 1. stability of the parasite-host system and the participation of trematodes in trophism; 2. determination of the clinical and morphological picture of trematodose; 3. predicting the effects of this pathology on the host. Adhesion in the microstructural complex “trematode tegument – epithelial tissue of the villi of the small intestine” in ovine paramphistomosis at the contact level of two glycocalyx layers – the tegument of P. cervi and the surface of the epithelial cells of the villi of the host’s intestine, as well as single histological staining of the sites of contact between the parasite and the host as a result of mixing the components of the trematode tegument and the tissue of the host’s small intestine with deep adhesion indicate the established mutual relations between the components of a single system "parasite–host".

Introduction. The relevance of the study is caused by the difficulties in diagnosing diseases of the small bowel (SB). Due to the prevalence and widespread introduction of X-ray computed tomography (CT) into clinical practice, its capabilities in the diagnosis of small bowel diseases are of great interest and potential. Objective. to reveal the possibilities of computed tomography using intravenous bolus contrast enhancement in identifying the symptom of wall thickening of the small bowel and its prognostic significance in various nosologies. Methods. Analysis of the data from MSCT studies performed according to the Protocol for the study of abdominal organs using intravenous bolus contrast enhancement and oral water intake in adult patients from 18 to 87 years of age with small bowel diseases. Results. The article shows the possibilities of multispiral computed tomography performed according to the standard Protocol in detecting thickening of the SB wall. The range of diseases was determined for which thickening of the SB wall was one of the main radiological symptoms of the lesion. The prognostic significance of this radiological symptom is presented. The features of thickening of the intestinal wall in various diseases and other distinctive features that can be used in the differential diagnosis are described. Conclusion. Thickening of the wall is a common sign of SB damage, which is convincingly detected in CT studies with bolus contrast enhancement. In our study, the common causes of thickening of the SB wall in primary disease were: Crohn's disease (37%), lymphoma (20%) and anastomosis (13%). However, we determined thickening of the SB wall as a result of primary tumors (adenocarcinoma, sarcoma) in 7% and as a result of a secondary tumor lesion in 18.6% of cases. The considered diseases were different in the degree of thickening of the intestinal wall (from 6 to 70 mm), its spreading (focal thickening 48%; segmental 52%), number of affected areas (from 1 to 3) of their localization (proximal-middle or distal section), form of the transition area from the affected part of the intestine to the unchanged one (sharply defined or smooth), the presence or absence of symptoms of intestinal obstruction, and the features of contrast enhancement (severity and type).

When breeding minks, a lot of problems are associated with disturbances of reproduction, birth of weak offspring, metabolic disorders, weakening of immunity. Poor knowledge of the morphology of mink and lack of detailed information about their immune system is among appropriate reasons. The largest variety of antigens enter the body with food and water, through the wall of gastrointestinal tract. The first barrier to their penetration is lymphoid tissue associated with mucous membranes, thus causing changes in immune structures. Our purpose was to study the syntopia, morphology and quantitative characteristics of intestine-associated lymphoid tissue in American mink (Neovison vison). A biomaterial for the study was organocomplex of the small and large intestines from 11 American Minks at the age of 8 months, obtained from the fur farm “Vyatka” (Zonikha, Slobodsky district, Kirov region). In the walls of small and large intestines, both single and grouped lymphoid nodules are found. Single lymphoid nodules are detected in lamina propria of the mucous membrane and in the submucosa, along the entire length of the intestines, except of the ileum. Lymphoid nodules are round or oval, distributed diffusely, their density per 1 cm2 is in duodenum – 0.62±0.08; in jejunum – 1.88±0.32; in colon – 9.21±0.28; in rectum – 24.2±0.42. At the border of pyloric part between the stomach and duodenum, single lymphoid nodules form an intestinal-pyloric lymphoid ring; at the site of transition from rectum to the anal sphincter, the rectal lymphoid ring is observed. Abundance of lymphoid nodules in rectal area is associated with semi-voluntary management of animals, and retention of fecal mass in this part of intestine. By two lymphoid plaques are found in the duodenum; 6 to13, in the jejunum; one large striped (lingual) lymphoid plaque is found in the ileal wall; 1 to 3 plaques are found in the colonic wall. Presence of lymphoid plaques in colonic wall of American mink should be considered a protective/adaptive phenomenon, due to absence of coecum in the animals from Mustelid family. The revealed patterns of lymphoid tissue syntopia in American mink are associated with antigenicity of food substances and terms of their presence in the ileum, colon and rectum.

The article reflects current literature data on the epidemiology and risk factors of non - alcoholic fatty liver disease. An important aspect is the description of the modern views of combined lesions of the hepatobiliary tract and small intestine. Disorders of the intestinal microbiota play a special role in the development of non - alcoholic fatty liver disease. The value of enterohepatic circulation of bile acids in the development of intestinal and liver diseases was shown. It seems relevant to further study the comorbidity of the development of non - alcoholic fatty liver disease and enteropathy for the development of pathogenetically substantiated therapy.

Background. In the general bloodstream of the small intestine, it is common to distinguish superficially located main blood vessels that distribute blood throughout the intestinal tube, and intramural networks, represented mainly by microvascular communications of the muscular and mucous membranes. The aim. To study the features of blood supply to the groups of lymphoid nodules (Peyer's patches) of the small intestine of albino rats. Material and Methods. The study was performed on the basis of the injecting of a 5% solution of gelatin, colored with filtered black ink, into the bloodstream of abdominal organs of 20 white male rats. The material for the study was the specimens of the small intestine with Peyer's patches. The specimens were subjected to dehydration in alcohols with transition to pure acetone; after that they were enclosed in epoxy. Photographing of the obtained specimens was carried out using a digital camera, as well as in a binocular magnifier MBS-9, equipped with a digital photo attachment Sigeta DCM-900 9.0MP. Results. The trophism of an individual Peyer's patch of the small intestine is provided by several passing to it from different directions nutritive arteries, which are branches of the corresponding arterial vessels segmented around the perimeter of the intestinal tube. Conclusions. Based on the major principles of microangiology, there is reason to believe that perinodal arterial vessels are the sources of formation of radially oriented metabolic microcirculatory vessels, capillary links of which are located between the subunits of lymphoid nodules.

Aim. To evaluate the qualitative and quantitative composition of the parietal microbiota of the small intestine (SI) and its significance in the disturbance of the digestive and absorption functions of the small intestine in metabolic syndrome (MS). Materials and methods. 67 patients with metabolic syndrome were examined. In addition to clinical data, a comprehensive study of the digestive and absorption function of SI was carried out using exercise tests with carbohydrates. The compositional characteristics of mucosal SI microbiota in MS patients were determined by gas chromatography mass spectrometry. The relationship of enteric disorders with changes in small intestinal microbiocenosis was assessed by correlation analysis. Results. The majority (82.9%) of patients with metabolic syndrome showed clinical local and general signs of small intestinal lesions. Violations of all stages of the hydrolysis - resorption process were revealed against the background of changes in the quantitative and qualitative composition of the parietal microbiota of the small intestine. In patients with MS, excessive bacterial growth is observed in the small intestine mainly due to conditionally pathogenic microbiota strains, and, in comparison with the control group, there is a significant increase in the growth of aerobes, microscopic fungi and viruses. The relationship between the severity of excess bacterial growth and impaired digestion and absorption in the small intestine in MS. Conclusion. The results of our research suggest that the identified changes in the functional state of SI in combination with a violation of mucosal enteral microbiocenosis are an important link in the complex pathogenesis of the MS.

Introduction: Small intestine cancer is a rare gastrointestinal cancer (less than 5%) and makes up 0.3% of all malignancies. The most common clinical symptoms include abdominal pain, vomiting and gastrointestinal bleeding. Aim of study: The aim of the study is to draw attention to the rare cases of SBA.The second aim of the study is to review the literature on the diagnosis and therapeutic process of patients suffering from small intestine cancer. Methods:The research method was an individual case study. The research material was the patient's medical record.An unsystematic review of Polish and English-language scientific literature was conducted. Electronic databases: PubMed, SCOPUS and Google Scholar were searched using the following keywords: adenocarcinoma, small intestine, small bowel obstruction, chronic vomiting. Findings:A 39-year-old patient was diagnosed with G2 stage of the SBA with metastases to the nearby lymph nodes. Due to nonspecific symptoms the correct diagnosis was made at an advanced stage of the disease, and thus the implementation of appropriate treatment was delayed. Conclusions: A small number of cases of the disease and non-specific symptoms make the diagnosis of small intestinal cancer extremely difficult. The disease usually develops insidiously and at the time of diagnosis the cancer is already at an advanced stage. A significant weight loss within a short period of time along with persistent vomiting should prompt the doctor for thorough diagnostic procedures. Key words: adenocarcinoma, small intestine, small bowel obstruction, chronic vomiting

Background. Diverticula of the small intestine are protrusions of the intestinal wall in the form of a blind sac, they are a rare pathology of the gastrointestinal tract. In most cases, they are diagnosed when patients are hospitalized due to complications. With the advent of new radiation and endoscopic methods of research visualization of all parts of the intestine has become more accessible, but mortality in complicated diverticula reaches 50%. Purpose of research. Optimization of diagnosis and treatment of patients with small intestine diverticula. Material and methods. The article presents 3 own clinical cases of diagnosis and treatment of patients with complicated diverticula of the small intestine. All of them were taken to the hospital for emergency indications. Results. In all cases, the diagnosis was made intraoperatively. Two patients underwent diverticulectomy, one patient underwent resection of the intestine with a diverticulum and the formation of a side-to-side anastomosis. Conclusions. Diverticula of the small intestine are characterized by scant clinical symptoms and cause life-threatening complications. Radiographic and endoscopic diagnostic methods enable to visualize diverticula, but most often they are detected by diagnostic laparoscopy or laparotomy. The main methods of treatment are diverticulectomy, wedge-shaped resection of the intestine to ¾ of its lumen or removal of the small intestine with the formation of anastomosis.

Background. The purpose of this work is to calculate the morphometric parameters of isolated Dogiel type II cells from the intermuscular plexus of the small intestine. Materials and methods. 3D models of oval-shaped Dogel type II cells from the intermuscular plexus of a rat (n = 1) were constructed and studied. Neurocytes were identified by the impregnation method on frontal and horizontal sections of the wall of the small intestine. Results. The results showed that the total number of nodes in the virtual model was 36534, and the mesh elements – 156595. The resulting 3D model of the cell and nucleus was reduced 900 times to obtain a three-dimensional cell and nucleus with absolute dimensions with a ratio of 1:1 to their true size. The volume of the Dogiel type II cell was 2785.11 μm³, the volume of the nucleus was 647.7 μm³ and the volume of its perikaryon is 2785.11 μm³. Conclusions. Digital type II cells from the intermuscular plexus of the small the intestine of rats has a three-dimensional structure of an ovoid shape. The cells are flattened in the transverse direction and elongated in the longitudinal direction.

The OBJECTIVE of the study was to clarify the rational program of diagnosis and choice of treatment tactics for patients with neuroendocrine tumors (NET) of the small intestine, taking into account their clinical and morphological characteristics. MATERIAL AND METHODS. We studied the results of examination and treatment of 39 patients. RESULTS. CT is the main method of topical diagnosis, the sensitivity of which in the detection of NET of the small intestine is 96.4 %. Sign of the localization of NET in the small intestine is the tumor conglomerate of its mesentery, which includes diffuse-infiltrative and nodular variant of changes. The diffuse-infiltrative variant of tumor conglomerate is characterized by increased risk of complicated course of tumor process. Cytoreductive surgical treatment allows to increase the survival rate of patients with generalized NET of the small intestine in 1.7 times. CONCLUSION. Treatment of patients with NET of the small intestine should be carried out in specialized medical centers that have the ability to implement a multidisciplinary approach that can significantly increase the duration and quality of life of patients.

The paper presents the clinical case that reflects the difficulties of diagnosis and choice of treatment tactics of patients with neuroendocrine tumors of the small intestine. The sequence of instrumental diagnostic methods made it possible to determine the localization of the tumor in small intestine and to clarify the prevalence of the tumor process. The implementation of active surgical treatment tactics allowed performing cytoreductive surgical intervention, eliminating the risk of complications of the tumor process and improving the quality of life of the patient with generalized neuroendocrine tumor of the small intestine.

The article describes clinical observations of helminthiasis detection in 18 of 208 patients during video capsule endoscopy (VCE). Indications for the appointment of VCE were complex clinical situations associated with the search for inflammatory diseases of the small intestine and sources of small intestine bleeding. Because of the high cost of VCE the diagnosis of parasitic diseases should be based on laboratory techniques in clinical practice. Only in case of anemia of unknown etiology VCE demonstrates high efficiency.

The review summarizes recent findings on the syndrome of small intestine bacterial overgrowth (SIBO) which is not a separate disease. The triggers of SIBO and the impact on gastrointestinal physiology are considered. Treatment approaches are described taking into account the mechanism of occurrence of digestive disorders. The article highlights the therapeutic effect of probiotic medicines and refers to the research profile of L. rhamnosus strain GG.

Resection of certain parts of the small intestine is common in clinical practice for various diseases and traumatic injuries. The significant decrease in bowel functioning leads to the development of a specific “short bowel syndrome” (SBS). There is an opinion that the remaining parts of the intestine after resection perform a compensatory function as a result of the development of morphological changes in the intestinal wall. Histological examination of the intestinal wall with evolved compensatory changes is of undoubted interest from the scientific and clinical point of view.Material and Methods. To create the experimental model of SBS, 107 laboratory Wistar male rats were used, weighing 500–600 g, which underwent resection with removal of 1/2 or 2/3 of the small intestine length in proximal or distal parts. The observation period for the animals was 1, 2, 4 and 6 months. Upon expiration of indicated dates, samples of the small intestine and liver were taken from rats for autopsy to be used for histological examination. At the indicated terms, the animals had signs of SBS (diarrhea, weight loss), as well as morphological changes in the intestinal mucosa.Results and Conclusion. According to the results of the study, we concluded that the loss of 1/2 the length of the small intestine is overcome without consequences, and the loss of 2/3 of its length, especially of its proximal part, is accompanied by a longer period of adaptation and more significant morphological alteration of the mucosa, which has to perform not only digestion, but also absorption.

The article presents first experience of balloon-assisted enteroscopy (BAE) for one year (from December 2015 to December 2016). The total number of patients was 19. In this group performed 28 balloon-assisted enteroscopy. Of these, 12 patients underwent oral BAE, 2 transanal and 14 combined. Diagnostic BAE was 18 and 10 operating. The article analyzes the main and concomitant diseases in this group of patients, the number and types of is operating and diagnostic interventions, their effectiveness. Analyzed further management of patients in the identification of surgical pathology. We present the most interesting clinical cases.

The intestine is an extremely sensitive organ with regard to ischemia/reperfusion damage (I/R) because of its high oxygen reguirement. The aim of this study is to investigate the effects of Peroxiredoxin VI (Prx VI) on preservation of the small intestine after the intestinal ischemia/reperfusion injury in strangulation ileum model. Intestinal ischemia/ reperfusion injury in strangulation model was produced by occlusion of the distal ileum loop and mesentery with its blood vessels for 60 min followed by a 120-min reperfusion period. A group of animals received intravenous injections of 10 mg/kg Prx VI 15 min prior to the intestinal ischemia/reperfusion in the strangulation model. After surgery, part of the intestine was collected for histological analysis. In I/R group a breakdown in the integrity of villi and crypts was revealed, as well as infiltration of lymphocytes, oxidative damage with serious mucosal loss. Prx VI pretreatment to rats with ischemia/reperfusion injury protected the intestine from ischemia/reperfusion injury by reducing oxidative damage and preserving intestinal mucosal composition. These results demonstrated that Prx VI possessed advantageous antioxidant effects as well as effectively attenuated ischemia-reperfusion trauma of the strangulated intestine segment.

Timely and accurate diagnosis of tumors of the small intestine remains a clinical challenge. The article presents own experience of the combined use of video capsule and balloon-assisted enteroscopy in the diagnosis and treatment of tumors of the small intestine complicated by hemorrhage.

Aim. Complex research of the functional condition of the small intestine in different stages of cholelithiasis.Materials and methods. 47 patients with different stages of cholelithiasis were examined. There were 29 patients with the first (prestone) stage and 18 — with the second (stone) stage of cholelithiasis. In an assessment of the functional condition of the small intestine were used clinical data and results of the load tests by sugars. Cavitary digestion was studied by load test with polysaccharide (soluble starch), membrane digestion — with disaccharide (sucrose), absorption — with monosaccharide (glucose). Glucose level in blood was determined on an empty stomach, then after oral reception of 50g of glucose, sucrose or starch in 30, 60 and 120 minutes.Results. Researchers showed that in the most of patients with cholelithiasis there were disturbances in clinical and functional condition of the small intestine. In an assessment of the cavitary digestion the level of glycemia was authentically lowered by 43% in prestone stage and by 66% in stone stage of cholelithiasis in comparison with control. In an assessment of membrane digestion in patients with the stone stage of cholelithiasis the level of glycemia was lowered in comparison with group of control and with the prestone stage by 30% and 19% respectively.Conclusion. In prestone stage of cholelithiasis there were decrease of the cavitary digestion primary, and in stone stage of cholelithiasis — all stages of hydrolysis-resorptive process in the small intestine were disturbed.

Aim. During the life, the organism continuously consumes nutrients that build tissue and produce energy. The source of nutrients is proteins, fats, carbohydrates along with minerals. In this context, the aim of this study was to evaluate the levels of certain elements in the tissue of the stomach, small and large intestine of residents of the Astrakhan region. Materials and methods. We have taken fragments of stomach tissue as material for the study (n = 25), small (n = 25), and large (n = 25), the material has been obtained by sectional study from deaths from acci-dents of healthy individuals aged from 40 to 68 years (average age - 54 ± 0.63 years). The study of features of a cumulative distribution of elements (EM) was performed with atomic absorption spectrophotometry using atomic ab-sorption spectrometer MGA-915. The analysis results are given in mg/kg of dry matter, and were subjected to statis tic processing (Student's t-test, using software Statistica (StatSoft, USA). Identified values were considered signifi-cant at p

Background. High toxicity of anti-cancer drugs limits the efficacy of the treatment of malignant tumors. The most frequent side effects are the injury of highly proliferative cell and tissues: hematologic and gastrointestinal toxicity. Our previous study showed high myeloprotective activity of combination of carbonic enterosorbent and granulocyte colony stimulating factor. The objective of this investigation is to study the morphologic characteristic of small intestine in case of melphalan injection and pharmacocorrection with carbonic granulated enterosorbent C2 and filgrastim. Methods. Histologic structure of jejunum of healthy male inbred rats, after the melphalan injection (4 mg/kg) and its correction with enterosorption and filgrastim apart, and in combination was investigated. Results. Cytostatic melphalan caused the dilation of microcirculatory vessels and expressed perivasal edema leading to enlargement of intestinal villi. It was revealed a large amount of lymphocytes and histiocytes in stroma and signs of increasing secretory activity of glandular cells. Dystrophic changes of the epithelium were seen. The enteral sorptive therapy showed prominent improvement of morphologic characteristic of jejunum. But sighs of increased mucus production were still seen. The granulocyte colony stimulating factor has no effects on small intestine structures. The combination of carbonic enterosorbent and filgrastim improved the histologic picture maximally. Conclusion. Combination of enterosorption and granulocyte colony stimulating factor is a prospective approach to diminish the gastrointestinal toxicity of cytostatic therapy. Citation: Shevchuk OO. [Morphological aspects of protective influence of carbonic enterosorbent and granulocyte colony stimulating factor on small intestine in case of Melphalan administration]. Morphologia. 2015;9(3):117-21. Ukrainian.

The following article describes the case of MALT lymphoma of the small intestine of a woman. The malignant tumors of the small intestine are rare diseases. Symptoms of MALT lymphoma are insignificant, so additional diagnosis methods are required. Aim. The goal of the research is to inform about special features of diagnostics and treatment of the given disease for the patient, treated with operation of small intestine resection followed by anti-helicobacter and cytostatic therapy. Methods and results. The kind of the tumor was identified after data of the histopathological and immunohistochemical stuudies had been received. Sternal punction conduction is necessary in order to exclude a leukemization and identification of the process stage. Conclusion. The given clinical case proves the necessity of the organ resection in order to identify the diagnosis of a rare localization of MALT lymphoma in the small intestine for its further correct treatment to improve the prognosis of the disease.

Background. Modern conceptions about mechanisms of inflammation of the small intestine could not be formed without an understanding of intercellular relationships that are realized by biologically active signaling molecules produced by endocrine cells. Methods. The experimental study has been carried out on the small intestine extracted from 140 adult male rats. Electron and light microscopy methods were used. Acute aseptic inflammation was modeled by intraperitoneal carrageenan injection; influence of subcutaneously cryopreserved placenta injection was analyzed. Results. After modeling of the acute aseptic peritoneal inflammation the maximal increase of ECL-cells was noted on the 21st day. The slowest restoration of endocrine cells number occurred on all measured parameters and was observed on day 30th of the observation. In case of administration of cryopreserved placenta at the early stages (days 3rd – 7th) the increase of average number of EC- and ECL-cells promoted the enhanced permeability of vessels in the lamina propria. The decrease in number of P-cells prevented the development of hyperacid gastritis. Reduction in the average number of D1- cells prevented the excessive vasodilatation and facilitated the excretion of excess fluid from the foci of inflammation. In simultaneous subcutaneous administration of cryopreserved placenta and modeling of acute aseptic peritoneal inflammation the number of ЕС- and ЕСL-cells increased, accelerating the vascular response to inflammation. Conclusion. Active appearance of low-differentiated cells including those with “shapes of mitosis” on the day 14th indicates restoration of structural components of the small intestine mucosa and processes of absorption and parietal digestion after placenta administration during acute aseptic inflammation. Citation: Shepitko KV. [Characteristic of endocrine cells of rat small intestine after administration of cryopreserved placenta on the background of acute aseptic peritoneal inflammation]. Morphologia. 2015;9(2):91-4. Russian.

The pathogenetic and clinical association between spondyloarthritis (SpA) and inflammatory bowel diseases (IBD) is well known. Ulcerative colitis and Crohn's disease are more common in patients with SpA than in general population. In turn, the involvement of the spine and peripheral joints is a typical systemic manifestation of IBD. But at the same time at least half of patients with SpA have endoscopic and histological signs of chronic inflammation of the small and large intestine mucosa, which are unaccompanied by characteristic clinical manifestations and cannot considered within a specific nosological entity. The importance of this pathology has been unknown until the present time. Should asymptomatic bowel inflammation be considered as a precursor of true IBD, which methods should be used to diagnose bowel involvement and how the presence of this pathology affects the choice of rational pharmacotherapy for SpA? This review analyzes the basic literature data concerning this problem.

Purpose: to estimate clinical and morphological features and results of treatment of the complicated forms of non-Hodgkin’s lymphomas of small intestine and colon.Material and methods. Non-Hodgkin’s lymphomas of small intestine and colon are studied at 189 patients treated in N. N. Blokhin Russian Cancer Research Center during 1985–2010, in 64 cases tumor localized in colon.Results. 20 were treated by chemotherapy, 9 were operated on for intestinal obstruction in other hospitals and 18 patients were operated on for a tumor of colon without morphological verification, and 17 patients were operated on for tumor complications in N. N. Blokhin Russian Cancer Research Center; tumor was localized in ileum in 74 cases, 26 of them received conservative treatment, 23 patients were operated due to complications in N. N. Blokhin Russian Cancer Research Center, 25 patients was operated on for ileus in other hospitals; tumor was localized in jejunum in 26 patients who all were operated on for ileus; in duodenum lymphoma was located in 25 patients from whom 18 patients were treated conservatively, and 7 had surgery because of complications. Thus, surgical interventions for ileus, bleeding or perforation on primary tumor were made in 92 (48.7 %) patients. Intestinal tumor lesion was primary in 41.0 % and secondary tumor lesion was observed in 58.9 %. 3-year overall survival in patients with uncomplicated lymphomas was 82.5 %, with complicated lymphomas – 70.1 % (p < 0,05).Conclusions. Development of complications worsens the forecast of the overall survival in non-Hodgkin’s lymphomas of a gastrointestinal tract. It demands special approach to patients with non-Hodgkin’s lymphomas of a gastrointestinal tract because of high risk of development of surgical complications.

Processes of hydrolysis and absorbtion in small intestine were assessed with 60 of patients using amoxicillin/ clavulanate for treatment of out-hospital pneumonia. It is established that when carrying out an antibiotikoterapiya band digestion and absorption at the kept parietal digestion is broken. Further analysis of the factors presented will allow to work out practical recommendations on prevention of side effects of antibiotics usage in small intestine.

Introduction Crohn’s disease and ulcerative colitis are the main clinical phenotypes of inflammatory bowel disease (IBD). Both forms of IBD can increase the incidence of gastrointestinal and colon cancers, and both ones are associated with significant morbidity and mortality worldwide. In addition, they can begin early in life and persist for long periods. The pathogenesis of IBD is complex and multifactorial. Differential alteration of Toll-like receptor (TLR) expression in inflammatory bowel disease was first described 15 years ago. Studies have led to the current concept that TLRs represent key mediators of innate host defense in the intestine, and they are involved in mucosa maintaining as well as commensal homeostasis. Recent findings in diverse murine models of ileitis have helped to reveal the importance of TLR dysfunction mechanisms in IBD pathogenesis. The aim of research The aim of this study was to investigate the effect of acute ileitis on expression intensity of TLR-2 in lymphocytes of small intestine. Materials and methods Male Wistar rats with weight 200–250 g were housed in standard wire-mesh bottom cages at constant temperature of 25°C and 12/12 h light/dark cycles. The rats were given water and standard laboratory diet with no restriction prior to indomethacin injection. A total number of 20 rats were examined, including control group (n = 10). For induction of acute ileitis, rats received one subcutaneous dose of indomethacin (Sigma, 15 mg/kg). Tissue was examined on the fifth day. For histological examination sections were colored with haematoxylin and eosin. The TLR-2+cells were determined using a direct immunofluorescence technique with using monoclonal rat anti-TLR-2 antibodies. Images were taken by using a fluorescence microscope PrimoStar (ZEISS, Germany) with a computer-assisted video system AxioCam 5c (ZEISS, Germany) including the NIH-Image software (NIH Image version 1·46). All statistical analyses were performed using EXCEL MS Office 2010 (Microsoft Corp., USA), STATISTICA 6.0 (Stat-Soft, 2001) software. Results are expressed as mean values ± SEM. Differences were considered statistically significant if the p value was

The research work presents modern questions of Peyer's plaques on macro- and microscopical levels. Structures responsible for local immunity of digestive system have been described.

Aim of investigation. Analysis of phenotypical and genotypical signs in neonates with atresia of duodenum and other parts of the small intestine.Material and methods. The comparative characteristic of phenotypical and genotypical signs in 68 neonates with atresia of duodenum (the first group) and 67 children with atresia of other parts of the small intestine (the second group) was carried out. Main anthropometric parameters were investigated at birth (body weight, body height, circumference of head and chest), concomitant malformations, genic frequencies and phenotypical combinations of ABО and rhesus blood groups systems.Results. For these patients intra-uterine development disorders are typical, manifesting by decrease of all anthropometric scores, presence of various hypoplastic malformations of other organs and systems. The spectrum and location of congenital malformations in studied groups was different.Conclusions. The atresia of duodenum and other parts of the small intestine has polygenic mode of inheritance. Disorders of intra-uterine development are typical for investigated patients. The spectrum and localization of congenital malformations in children with atresia of duodenum and atresia of other regions of the small intestine is different.

The aim of clinical case presentation. To draw attention of specialists to rare neoplastic bowel diseases.Original points. Article presents the case of small intestinal neurilemoma in 69 years-old woman with incidental abdominal pain. Abdominal ultrasound investigation (US) was diagnostic (it demonstrated the volume lesion located at the loops of ileum with thickened vascularized walls) and helical computer tomography – CT (tumor with irregular outlines ileum, with the lobular heterogeneous structure was revealed, contrast agent accumulation was uneven). Ileectomy with formation of end-to-end anastomosis was carried out. The resected speciemen revealed signs of neurilemoma at histological study.Conclusion. It was possible to detect ileal tumor at abdominal US and CT. The diagnosis was verified at histological investigation.

Studied were morphological, physiological and ultrastructural changes in the cell culture L-929 and in the intestine of suckling mice in the presence of Cef (CHO cell elongating factor) of Vibrio cholerae. Registered were cellular elongation, cytoplasm vacuolization, an increase in the number of lysosomes, retraction and nuclei deformation in the L-929 cell culture. Statistical significance test confirmed that in vivo Cef caused the accumulation of fluid in suckling mice. Electron microscopy of the epithelial cells of small intestine revealed vacuolization and myelin-like structures formation in cytoplasm and nuclei, swelling of mitochondria, clarification of their matrix and destruction of cristae. Cristae were filled with mucus. The involvement of mast cells caused the increasing of capillary permeability which enhanced dehydration. These changes confirmed Cef participation in manifestation of Vibrio cholerae pathogenic properties.