Duodenal Fossae and Ligament of Treitz: Anatomy, Location and Clinical Significance

Duodenal Fossae and Ligament of Treitz: Anatomy, Location and Clinical Significance

pediagenosis    September 29, 2026    Comment   

DUODENAL FOSSAE AND LIGAMENT OF TREITZ

The duodenojejunal flexure lies left of the midline at the level of the first and second lumbar vertebrae. The suspensory muscle of the duodenum (ligament of Treitz, suspensory ligament of the duodenum) is a flat, fibromuscular ligament arising from the right crus of the diaphragm near the aortic hiatus. It passes, with individual variations, inferior to the left of the celiac trunk and superior mesenteric artery, posterior to the pancreas, to reach the duodenojejunal flexure. The smooth muscle cells of the ligament are largely continuous with the musculature of the celiac and superior mesenteric arteries; at the intestinal attachment they are connected with the longitudinal muscular layer of the gut, some extending as far as the mesentery of the small intestine. The attachment of the ligament to the duodenum may be quite narrow or it may extend over a considerable portion of the third part of the duodenum. If the suspensory ligament of the duodenum is short, the duodenojejunal flexure is high; if it is long, the flexure may lie so low that the terminal duodenal segment does not take the usual ascending course.

Stomach Anatomy: Parts, Relations, Normal Variations, and Functions

Stomach Anatomy: Parts, Relations, Normal Variations, and Functions

pediagenosis    September 27, 2026    Comment   

Anatomy, Normal Variations, and Relations of Stomach

The stomach is an enlarged reservoir of the proximal digestive tract, in which ingested food is soaked in gastric juice containing enzymes and hydrochloric acid and then released spasmodically into the duodenum by gastric peristalsis. The form and size of the stomach vary considerably, depending on the position of the body and the degree of filling.

Gastric Analysis: Procedure, Gastric Acid Output, and Clinical Uses

Gastric Analysis: Procedure, Gastric Acid Output, and Clinical Uses

pediagenosis    September 18, 2026    Comment   

GASTRIC ANALYSIS

Gastric analysis is a technique for measuring acid production of the stomach. Gastric analysis may, in this context, be classified as qualitative or quantitative. A qualitative gastric analysis is undertaken to ascertain whether the gastric glands can secrete acid. A quantitative gastric analysis seeks to determine the amount of HCl secreted by the stomach and is carried out by determining the basal secretion level or the secretory response to insulin hypoglycemia.

Meckel Diverticulum: Symptoms, Complications, Diagnosis, and Treatment

Meckel Diverticulum: Symptoms, Complications, Diagnosis, and Treatment

pediagenosis    August 22, 2026    Comment   

VARIANTS OF VITELLINE DUCT REMNANTS

Meckel Diverticulum

The vitelline, or omphalomesenteric, duct connects the yolk sac with the primitive tubular gut in the early embryonic stages and normally involutes at about the 7th week of fetal life, leaving no trace of its existence. Failure of the vitelline duct to disappear in its entire extension results in a variety of remnants, which include a diverticulum (Meckel diverticulum) attached to the ileum, omphalomesenteric cysts (enterocysts), omphalomesenteric fistulae that drain through the umbilicus, and fibrous bands from the diverticulum to the umbilicus that predispose to bowel obstruction. The most common form is Meckel diverticulum.

Esophagoscopy and Endoscopic Ultrasound (EUS): Advanced Technology for Early Detection of Esophageal Cancer

Esophagoscopy and Endoscopic Ultrasound (EUS): Advanced Technology for Early Detection of Esophageal Cancer

pediagenosis    June 13, 2026   

Esophagoscopy and Endoscopic Ultrasound

The ability of being able to introduce a flexible instrument with a charge­coupled device safely into the gastrointestinal tract has revolutionized the practice of gastroenterology. Endoscopic examination of the esophagus shows extensive detail of the mucosal lining, some imaging of abnormalities that lead to intramural or extramural indentation or compression of the lumen, respectively, and esophageal motility abnormalities as estimated by sphincter tone and esophageal diameter. Mucosal abnormalities seen are best characterized as inflammatory or neoplastic. Inflammatory lesions may vary in intensity from mild superficial erythema to frank ulceration with complete destruction of the mucosa. 

Manifestations of Disease of Tongue

Manifestations of Disease of Tongue

pediagenosis    May 02, 2026   

Manifestations of Disease of Tongue

As a consequence of the easy accessibility to clinical inspection, the tongue, in the course of medical history, has played a rather special role as a diagnostic indicator of systemic disease. The degree of moisture or dryness of the lingual mucosa may indicate disturbances of fluid balance. Changes in color and the appearance of edema, swelling, ulcers, and inflammation or atrophy of the lingual papillae may represent signs of endocrine, nutritional, hematologic, metabolic, or hepatic disorders, infectious diseases, or aberrant ingestions. On the other hand, it should be recognized that the tongue participates with the gingivae and the buccal mucosa in localized pathologic processes of the oral cavity, and that a number of conditions exist in which the surface or the parenchyma of the tongue itself is exclusively involved.

Benign Tumors of Oral Cavity

Benign Tumors of Oral Cavity

pediagenosis    May 02, 2026   

Benign Tumors of Oral Cavity

Tumors of the oral cavity are very diversified. Only a select few can be discussed here. A fibroma may be found on the gingiva, lips, palate, and buccal mucosa. It is hard or soft and pale or reddish, depending on the density of collagen and the abundance of vascular elements. The gingival fibroma (fibrous epulis) is usually derived from the periosteum. It is sessile or pedunculated, well defined, and slow growing.

CARBOHYDRATE MALABSORPTION, INCLUDING LACTOSE MALABSORPTION

CARBOHYDRATE MALABSORPTION, INCLUDING LACTOSE MALABSORPTION

pediagenosis    February 19, 2026    Comment   

CARBOHYDRATE MALABSORPTION, INCLUDING LACTOSE MALABSORPTION

Carbohydrate malabsorption is a frequent clinical condition caused by fermentation of unabsorbed carbohydrates by colonic flora and giving rise to symptoms. Although lactose is the most commonly malabsorbed sugar, other carbohydrates, including oligosaccharides, disaccharides, and monosaccharides such as fructose, can cause symptoms related to malabsorption.

LYMPHANGIECTASIA AND ABETALIPOPROTEIN DEFICIENCY

LYMPHANGIECTASIA AND ABETALIPOPROTEIN DEFICIENCY

pediagenosis    February 19, 2026    Comment   

LYMPHANGIECTASIA AND ABETALIPOPROTEIN DEFICIENCY

Intestinal Lymphangiectasia

Intestinal lymphangiectasia is an unusual disorder characterized by dilated lymphatic channels in the mucosa, submucosa, or subserosa of the small intestine, leading to protein-losing enteropathy. Waldman originally described an idiopathic form, primary intestinal lymphangiectasia; however, obstruction to the flow of lymph in certain cardiac diseases or hematologic malignant diseases and retroperitoneal lymph node enlargement due to chemotherapeutic, infectious, or toxic agents can secondarily lead to lymphangiectasias that present in the same manner as primary intestinal lymphangiectasia.

EOSINOPHILIC GASTROENTERITIS

EOSINOPHILIC GASTROENTERITIS

pediagenosis    February 19, 2026    Comment   

EOSINOPHILIC GASTROENTERITIS

Eosinophilic gastroenteritis is a rare primary eosinophilic gastrointestinal disorder of unknown cause characterized by the presence of an intense eosinophilic infiltrate in one or more gastrointestinal layers.

CRONKHITE-CANADA SYNDROME AND OTHER RARE DIARRHEAL DISORDERS

CRONKHITE-CANADA SYNDROME AND OTHER RARE DIARRHEAL DISORDERS

pediagenosis    February 19, 2026    Comment   

CRONKHITE-CANADA SYNDROME AND OTHER RARE DIARRHEAL DISORDERS

Cronkhite-Canada Syndrome

Cronkhite-Canada syndrome is a rare, nonfamilial gastrointestinal polyposis syndrome that commonly presents with diarrhea. It is characterized by hyperpig-mentation, hair loss, and dystrophic changes in the fingernails. Individuals of European and Asian descent are most frequently affected, but the syndrome has been reported in all ethnic groups. The cause is not known, but the frequent association with hypothyroidism, systemic lupus erythematosus, rheumatoid arthritis, and scleroderma suggests an autoimmune origin. The syndrome is characterized by development of innumerable polyps throughout the gastrointestinal tract except in the esophagus. The polyps are hamartomas; there is an increased risk of colorectal cancer (25%), however. Patients commonly present with diarrhea and weight loss accompanied by typical dermatologic manifestations that include hyperpigmentation and onychodystrophy. Management is largely supportive, with nutritional support, accompanied by antisecretory and antiinflammatory treatment. Immunosuppressive therapy with glucocorticosteroids and azathioprine has also been reported to ameliorate symptoms, but the duration of treatment is not known.

CROHN DISEASE

CROHN DISEASE

pediagenosis    February 19, 2026    Comment   

CROHN DISEASE

IMAGING AND REGIONAL VARIATIONS

In the United States, approximately 1.5 million individuals have Crohn disease. Crohn disease is one disease in a larger group of inflammatory bowel disorders, which includes ulcerative colitis, indeterminate colitis, and microscopic colitis. Crohn disease is a progressive illness characterized by transmural inflammation within the digestive tract that may occur anywhere from mouth to anus. Skip lesions of normal and inflamed, “cobblestoned” mucosa describe its classic luminal appearance. The phenotype is characterized by the disease’s severity, site, and type of manifestation, whether inflammatory, fibrostenotic, or fistulizing.

TYPHOID FEVER

TYPHOID FEVER

pediagenosis    October 05, 2025    Comment   

TYPHOID FEVER

TYPHOID FEVER: TRANSMISSION AND PATHOLOGIC LESIONS

In popular culture, the potential devastation of typhoid fever has been best illustrated by the story of Typhoid Mary, also known as Mary Mallon, the personal chef to numerous affluent families in the greater New York City area in the early 20th century. She was an asymptomatic chronic carrier of the Salmonella enterica serotype typhi (previously, S. typhi) and caused approximately 50 deaths as she moved between families, rejecting the notion that she had a role in their demise. She spent the bulk of her last 30 years of life in and out of quarantine.

INFECTIOUS ENTERITIS

INFECTIOUS ENTERITIS

pediagenosis    October 05, 2025    Comment   

INFECTIOUS ENTERITIS

VIRAL ENTERITIS

Infectious enteritis is a common worldwide illness with a multitude of underlying pathogens at play. The majority of infectious diarrheal diseases are acute in onset duration (< 2 weeks). Globally, acute enteritis is the fifth leading cause of death across all ages. Innumerable studies demonstrate that approximately 70% to 75% of acute diarrhea cases are viral in cause. Previously, culture techniques could not isolate most bacteria. With the advent of deep 16S ribosomal polymerase chain reaction sequencing techniques, genetic signatures can now identify bacteria, so it is not necessary to rely on tedious culture techniques. These technologies have isolated a bacterial source in approximately 15% of acute enteritis cases. Protozoal organisms are responsible for a lesser fraction of these cases.

HIV/AIDS Enteropathy

HIV/AIDS Enteropathy

pediagenosis    October 05, 2025    Comment   

HIV/AIDS Enteropathy

Up to 50% of HIV patients in the United States report diarrhea, but a distinct cause is identified in only 60% to 70% of these cases. HIV enteropathy is characterized by chronic diarrhea lasting more than 4 weeks and accompanied by malabsorption and abdominal discomfort. As is characteristic of small bowel diarrhea, stools are typically voluminous and may occur postprandially. There may be marked electrolyte disturbances, severe dehydration, and unintentional weight loss.

POST TRANSPLANT LYMPHOPROLIFERATIVE DISORDER

POST TRANSPLANT LYMPHOPROLIFERATIVE DISORDER

pediagenosis    September 28, 2025    Comment   

POST TRANSPLANT LYMPHOPROLIFERATIVE DISORDER

Solid-organ and allogeneic hematopoietic cell transplantation have revolutionized our ability to treat disease. Immunosuppression may have negative consequences, however, such as an earlier onset and an increased frequency of malignant tumors of the skin, cervix, and colon. A new entity, a group of disorders collectively known as post-transplant lymphoproliferative disorders (PTLDs), has emerged. The group contains primarily of B-cell–mediated lymphoid and/or plasmacytic cell proliferations that have the potential for malignant transformation to lymphoma. They are the most common causes of malignancy, following solid- organ transplantation. Conversely, PTLDs account for only a minority of cancers following hematopoietic cell transplantation. The risk is highest in the first year and then drops significantly. PTLDs remain a significant cause of early graft failure and death, however.

ABDOMINAL AND INTESTINAL TUBERCULOSIS

ABDOMINAL AND INTESTINAL TUBERCULOSIS

pediagenosis    September 28, 2025   

ABDOMINAL AND INTESTINAL TUBERCULOSIS

APPEARANCE OF MUCOSA

Worldwide, tuberculosis presents with an incidence of 7 to 10 million new cases per year, with a prevalence of approximately 2 billion people. Tuberculosis accounts for 6% of global deaths. Intestinal tuberculosis is the sixth most prevalent extrapulmonary manifestation (EPTB); it mimics primary disease of the entire digestive tract presenting as Crohn ileocolitis. Tuberculosis can also manifest as a disease affecting the peritoneum, presenting as peritonitis. Multiple factors additively contribute to propagating tuberculosis, including poverty, malnutrition, overcrowding, immigrant status, and the presence of HIV coinfection. Patients with HIV coinfection demonstrate a deficient cellular immune response, poor immune reconstitution, and a risk for latent tuberculosis reactivation. Hence, a higher incidence of EPTB, increased severity of disease, and more rapid progression of disease may be observed.

MYCOBACTERIUM AVIUM INTRACELLULARE INFECTION

MYCOBACTERIUM AVIUM INTRACELLULARE INFECTION

pediagenosis    September 28, 2025    Comment   

MYCOBACTERIUM AVIUM INTRACELLULARE INFECTION

Historically, Mycobacterium tuberculosis infection was common throughout the world, particularly in underprivileged societies. Fortunately, the advent of antitubercular regimens dramatically eradicated the illness. A distinct cohort of nontuberculous mycobacterial pathogens was revealed to exist, however. Nontuberculous mycobacterial illness is predominantly caused by Mycobacterium avium-intracellulare (MAC) and Mycobacterium kansasii, with over 140 distinct species identified. Interestingly, before antiretroviral therapy was available for AIDS, MAC infection was more common in developed nations than underprivileged nations; this fact prompted the hypothesis that bacillus Calmette-Guérin vaccination or a history of tuberculosis may confer immunity. Intradermal reactivity rates were demonstrated to be equal in MAC patients in both developed and underdeveloped nations, however. The pathogenesis of the disease is poorly understood, but several mechanisms have been revealed.

SMALL BOWEL MANIFESTATIONS OF SYSTEMIC DISEASES

SMALL BOWEL MANIFESTATIONS OF SYSTEMIC DISEASES

pediagenosis    September 24, 2025    Comment   

SMALL BOWEL MANIFESTATIONS OF SYSTEMIC DISEASES

CONNECTIVE TISSUE DISORDER AND DERMATOLOGIC DISEASES

Connective Tissue Disorders

Scleroderma frequently involves the small bowel, primarily causing dysmotility. It is characterized by a dilated bowel, associated with scattered wide-mouthed diverticula and even intestinal pseudoobstruction, and small intestinal bacterial overgrowth.

INTESTINAL OBSTRUCTION

INTESTINAL OBSTRUCTION

pediagenosis    September 24, 2025    Comment   

INTESTINAL OBSTRUCTION

OBSTRUCTION AND ADYNAMIC ILEUS OF SMALL INTESTINE

Small intestinal obstruction occurs when the normal propulsion of luminal contents is hindered by either mechanical obstruction or abnormal intestinal motility. The obstruction may be partial or complete and can occur at any level of the small bowel.