Search Results (38)

The accurate segmentation of gastric cancer cells is important in pathology for diagnosing and detecting diseases early. However, current approaches still suffer from limitations such as expensive annotation, fuzzy lesion boundaries, and weak feature expression. In order to solve these problems, we present MSAF-Net, a novel U-Net framework optimized both architecturally and in terms of the loss function. In particular, we incorporate a Multi-scale Dilated Pooling Fusion Block into the encoder stage to achieve enhanced interaction of multi-paths and thus improve features’ diversity and boundary sensitivity. We also introduce a Dual-Channel Attention Block in place of traditional convolution block in the decoder stage to restore better details and reconstruct the fuzzy boundaries. Meanwhile, a Diagonal Mahalanobis Consistency Loss is incorporated into our framework to facilitate class compactness. Experiments performed on the SEED-Gastric Carcinoma Stage 1 dataset show that the designed algorithm can reach 0.776 in Dice score and 0.821 in Accuracy, which outperforms the baseline method U-Net. It is clear that these results have shown the effectiveness and robustness of our proposed approach. The introduced algorithm allows for more precise quantification of gastric cancer cell morphology. Full article

Garlic (Allium sativum) contains organosulfur compounds capable of inducing oxidative damage to erythrocytes in dogs, leading to hemolytic anemia and methemoglobinemia. Although Allium toxicosis is relatively common, fatal cases with detailed histopathological characterization are rarely reported. This case report describes a fatal episode of garlic toxicosis in a 3-year-old female mixed-breed dog. At necropsy, gastric contents included food material and raw garlic cloves (16 g). Gross findings included pulmonary hyperemia and thoracic hemorrhagic effusion. Histopathological examination revealed multifocal myocardial hemorrhages, diffuse pulmonary capillary congestion, hepatic sinusoidal dilation with hemorrhagic areas, splenic hemorrhage, and renal glomerular capillary dilation. These lesions were consistent with systemic hypoxic and vascular injury secondary to oxidative erythrocyte damage. The lower quantity of garlic recovered compared with reported toxic doses suggests possible individual susceptibility or incomplete recovery of ingested material. This case highlights the diagnostic value of histopathology in suspected Allium fatal toxicosis and contributes to increasing the limited literature describing these outcomes in dogs. Full article

Introduction: As multimodal therapy for esophageal cancer advances, addressing immediate and long-term functional outcomes following surgery has become more important. Despite surgical advancements, delayed gastric conduit emptying (DGCE) remains a primary cause of functional impairment after esophageal cancer resection. The literature addressing pylorus management following minimally invasive esophagectomy (MIE) is scarce. The effects of pyloric drainage with pyloromyotomy or postoperative approaches such as intrapyloric Botox injection or dilatation on the incidence and course of DGCE were the focus of this study. Methods: A retrospective analysis of consecutive patients after minimally invasive esophagectomy with thoracic esophagogastric anastomosis and gastric tube reconstruction between 2014 and 2023 was performed. Univariate analyses were used to identify significant patient-, tumor-, and procedure-related factors affecting DGCE. Results: A total of 276 patients were included. DGCE was observed in 80 (28.9%) patients. Demographics did not differ with statistical significance. Postoperative complications were not increased in patients with DGCE. Pyloric intervention (PI) did not reduce postoperative occurrence of DGCE (PI: n = 19/23.75% compared to no PI: n = 62 (30.5%), p = 0.342). Median length of hospital stay was significantly longer, and total costs were significantly higher in patients with DGCE (p = 0.03 and p = 0.047, respectively). Analysis of endoscopic approaches was not associated with a statistically significant difference between botulinum toxin injection and pyloric dilatation with regard to reinterventions. Conclusions: While DGCE is frequent after esophagectomy, it is not associated with short-term morbidity but with prolonged total hospital stay and increased costs. Intraoperative pyloric intervention does not influence the incidence of DGCE after esophagectomy and endoscopic management was associated with therapeutic success, but choice of specific, optimal approach remains elusive. Novel concepts, including preoperative dilatation should be investigated. Full article

Background/Aims: The Mediterranean killifish, Aphanius fasciatus (Valenciennes, 1821), is a small euryhaline and eurytherm cyprinodont. While its ecology and role as a bioindicator are well known, its anatomy remains poorly understood. This study aimed to provide the first detailed description of the digestive tract of A. fasciatus, from the oropharyngeal cavity to the rectum. Methods: An anatomical and morphological approach supported by light microscopy was applied to examine oral, pharyngeal, and intestinal structures in adult specimens. Results: The jaws bear tricuspids incisiform teeth, whereas the pharynx has caniniform teeth. The tongue forms a muscular thickening of the oral floor and aids swallowing. The oropharyngeal tract and esophagus lead to a dilated anterior intestinal region resembling a primitive stomach, with mucosal folds and mucus-secreting epithelium, but lacking gastric glands. This chamber functions mainly for food storage, absorption, and preparation rather than true gastric digestion. The intestine extends to the rectum, showing sexual dimorphism: females have a relaxed anus, males a more toned and folded structure. Conclusions: These findings provide essential baseline information for comparison with other experimental models and reinforce the suitability of A. fasciatus as a reliable model for anatomical and functional studies. Full article

This study describes the clinicopathological features of seven canine cases showing a diffuse cobblestone-like gastric mucosal pattern on endoscopy. Cases were retrospectively retrieved from endoscopic databases (2017–2025). Clinical data, treatment history, endoscopic findings, and histology were reviewed. Endoscopically, all dogs exhibited thickened, irregular, and poorly distensible gastric folds. Histopathologic examination showed mild-to-moderate foveolar hyperplasia, variable cystic dilation of the fundic glands, mild chronic lymphoplasmacytic inflammation, and interstitial fibrosis. Parietal-cell population was variably increased and predominant (hyperplasia). Because these features can overlap widely among reactive and hyperplastic gastropathies, interpretation required correlation with clinical and endoscopic findings in addition to histopathology. All dogs had a history of prolonged omeprazole administration, and most showed clinical improvement after dose reduction or treatment withdrawal. Follow-up endoscopy in two dogs documented divergent outcomes, with marked improvement in one dog and only minimal changes in the other. These findings suggest that this cobblestone-like pattern represents a benign, reactive, and potentially regressive gastropathy, possibly associated with chronic acid suppression. Recognition of this appearance may assist clinicians in differentiating reactive gastropathy from proliferative or neoplastic conditions and supports prudent use of long-term proton pump inhibitors in dogs with chronic gastrointestinal disease. Full article

Background and Clinical Significanc: Congenital duodenal diaphragm (CDD) is a rare congenital condition causing partial or complete obstruction of the duodenum, most frequently located in the second part of the duodenum. It is a rare but important cause of intestinal obstruction in infants and young children. Clinically, it often presents with persistent vomiting and failure to thrive. Diagnosis can be made through abdominal X-ray showing the characteristic “double bubble” sign, upper gastrointestinal (GI) series, or gastroscopy. Case Presentation: A 17-month-old female infant with known psychomotor retardation was admitted for evaluation of inadequate weight gain and intermittent postprandial vomiting, both present since birth. Laboratory investigations, including metabolic and electrolyte panels, were within normal limits. Given the persistent clinical symptoms, an upper gastrointestinal series was performed to assess for possible anatomical abnormalities. Imaging revealed a significant delay in the passage of contrast into the second portion of the duodenum, with marked prestenotic dilatation. Subsequent gastroscopy identified a duodenal diaphragm nearly occluding the duodenal lumen at the same site, impeding the passage of the endoscope. Associated findings included gastritis and the presence of food debris in the stomach and proximal duodenum, indicating impaired gastric emptying. The patient underwent successful surgical management via duodenotomy with resection of the septum. Postoperative recovery was uneventful. Conclusions: In infants or young children with persistent postprandial vomiting and inadequate weight gain, anatomical causes such as duodenal diaphragm/web should be considered in the differential diagnosis. Once identified, treatment should be initiated promptly, either endoscopically or surgically, depending on the severity and anatomical characteristics of the obstruction. Full article

Background and Objectives: Pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ) are the two most frequently employed reconstruction techniques following pancreaticoduodenectomy (PD), yet the optimal method remains debated. The objective of this study was to compare perioperative outcomes of PG versus PJ in patients undergoing PD for resectable periampullary tumors at a high-volume center. Materials and Methods: We conducted a retrospective cohort study including 604 consecutive patients who underwent PD between January 2019 and May 2025. Reconstruction of the pancreatic remnant was achieved by binding PG in 415 patients and duct-to-mucosa PJ in 189 patients. Demographics, intraoperative data, and postoperative outcomes were analyzed using standardized ISGPS/ISGLS definitions. Results: The overall complication rate was similar between groups (43.9% vs. 47.1%; p = 0.481). However, PG was associated with significantly lower rates of postoperative pancreatic fistula (POPF) (12.3% vs. 18.5%; p = 0.042) and postoperative biliary fistula (POBF) (2.9% vs. 6.3%; p = 0.044) compared with PJ. No significant differences were observed in delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), intra-abdominal abscess, relaparotomy, length of postoperative stay, or 90-day mortality. Conclusions: PG was associated with reduced rates of anastomotic fistulas compared with PJ, while other perioperative outcomes were comparable. These findings suggest that PG may be particularly advantageous in patients with a soft pancreatic remnant or nondilated duct, where the risk of fistula is higher, whereas PJ remains appropriate for firm, fibrotic glands with dilated ducts. Tailoring the reconstructive technique to pancreatic texture and ductal anatomy may therefore improve surgical outcomes and reduce postoperative morbidity. Full article

Patients presenting with abdominal pain and/or distension require rapid diagnostics to narrow the differential diagnosis from a long list of obstructive gastrointestinal (GI) pathologies that may appear clinically similar but warrant distinct management. While the workup of abdominal distension currently centers around computed tomography (CT), this modality is costly, requires radiation exposure, and necessitates patient transport, potentially delaying care. In contrast, point-of-care ultrasound (POCUS) avoids ionizing radiation and the need for patient transport while providing some insight into the gastrointestinal size and function. While POCUS cannot currently replace CT in the definitive diagnosis of GI obstructive pathologies, it remains a promising tool to help with the initial triage and monitoring responses to therapy for several causes of functional and/or mechanical GI obstruction, such as gastric dilation, ileus, and small bowel obstruction. Because the obstruction severity and features can evolve over time, POCUS enables serial examinations to monitor the progression or resolution. This manuscript reviews characteristic sonographic findings that help distinguish obstructive GI conditions and highlights practical techniques for integrating gastric and intestinal POCUS to improve diagnostic accuracy and expedite treatment. Full article

A multimodal approach is recommended to optimize perioperative pain control in animals, although opioid use in horses remains limited due to the risks of central nervous system (CNS) stimulation and reduced intestinal motility. A group of 19 healthy, male, mixed-breed horses were divided into two groups and medicated with acepromazine (0.05 mg kg⁻¹) and detomidine (10 µg kg⁻¹), with methadone (0.05 mg kg⁻¹) (ADM) or saline (ADS) administered intravenously (IV). Physiological variables, intestinal motility, gastric distention, and facial pain (EQUUS-FAP) were evaluated one day before (DB), before the surgical procedure (BS), and at 1, 2, 4, 6, and 8 h (T1h–T8h) after administration (ADM-ADS). Results are presented as means with standard deviation or medians with an interquartile range. Analysis of variance, the Mann–Whitney, and Durbin tests were applied (p < 0.05). Intestinal motility was reduced at T1h and T2h, returning to baseline by T6h and T8h in both groups. Ultrasonographic examination revealed reduced motility, with less significant changes in the left ventral colon (LVC), right ventral colon (RVC), and cecum. Gastric dilatation was more pronounced in the ADM group at T1, 4, 6, and 8h. EQUUS-FAP scores were significantly lower in ADM at T2, 4, and 6h. ADM protocol may aid chemical restraint and analgesia without increasing hypomotility. Full article

Prophylactic gastropexy is increasingly recommended in large-breed dogs predisposed to gastric dilatation-volvulus (GDV), particularly when combined with other elective procedures such as ovariectomy to reduce surgical trauma and anesthesia exposure. This prospective clinical study aimed to evaluate the feasibility, safety, and outcomes of a combined laparoscopic ovariectomy (LOVE) and total laparoscopic gastropexy with absorbable fixation straps (TLG-SS) using a standardized three-port minimally invasive approach. Six female dogs of GDV-prone breeds underwent the combined procedure. Surgical times, intraoperative and postoperative complications, and follow-up outcomes were recorded. The mean total operative time was 29.0 ± 3.52 min, with ovariectomy and gastropexy requiring 7.5 ± 1.38 and 9.33 ± 2.58 min, respectively. No major intraoperative complications occurred, and no conversion to open surgery was necessary. Postoperative recovery was uneventful in all cases, with only one minor portal site reaction observed. Owner satisfaction was excellent. The use of absorbable fixation straps simplified the gastropexy procedure and reduced operative time compared to other laparoscopic techniques. These findings suggest that the combined LOVE and TLG-SS procedure is technically feasible and well-tolerated in a small cohort of large-breed dogs, supporting its potential integration into clinical protocols pending further validation. Full article

Short bowel syndrome (SBS) is characterized by insufficient intestinal length to support absorption causing malnutrition. The bowel adapts to SBS via intestinal dilation and delayed gastric emptying but still often requires long-term parenteral nutrition. Current surgical options to lengthen the bowel pose significant risks and often provide limited expansion. ‘Distraction enterogenesis’ has been proposed as a technique to induce intestinal lengthening for SBS. The deployment of the intestinal expansion sleeve (IES) device is hypothesized to result in significant intestinal lengthening in vivo. A Roux-en-Y was created in the jejunum of seven rats for isolated IES deployment. The IES was precontracted over a Bucatini noodle and inserted into the isolated roux limb. After 4 weeks of deployment, rats were sacrificed, Roux-en-Y length recorded, and histology analyzed. A paired t-test was performed to compare initial and final roux limb lengths and histopathological tissue remodeling. Intestinal distraction evaluated at 4 weeks post deployment of the IES resulted in a significant 30.2% elongation in roux limb length (43.6 ± 14.4 mm to 56.4 ± 20.8 mm (p = 0.043, n = 7). IES samples showed changes in mucosal and submucosal integrity and bowel wall thickness in response to IES lengthening. In samples with partial mucosal erosion, the basal/regenerative layers of the mucosa were preserved. Distraction enterogenesis with significant intestinal lengthening in vivo has been achieved with the IES device. Histologic changes suggest all bowel functional layers and attributes are maintained through distraction enterogenesis. Future constructs of the IES may benefit from the addition of immunomodulators. Increasing intestinal mass with these devices may complement the treatment paradigm for SBS. Full article

Background: Gastric dilatation (GD) and heartworm disease (HW) can significantly impact cardiovascular function, necessitating timely intervention. This study evaluated hemodynamic changes in these conditions using impedance cardiography (ICG), a non-invasive technique for real-time monitoring. Methods: Cardiac parameters were measured using ICG in healthy controls, HW, and GD groups at baseline, during intervention, and post-treatment. Statistical analyses involved repeated measures ANOVA with post hoc comparisons, and relative changes (%) quantified hemodynamic improvements. Results: A significant increase in cardiac index (CI) occurred post-treatment in both HW (+14.71%, p = 0.0102) and GD (+28.53%, p = 0.0336) groups. Cardiac output (CO) exhibited an increasing trend, though without significance (p > 0.05). Mean arterial pressure (MAP) remained stable, although the GD group exhibited an upward trend post decompression (p = 0.1213). Conclusions: Heartworm extraction and gastric decompression induced measurable cardiovascular improvements, with distinct recovery patterns. Non-invasive monitoring effectively captured cardiovascular changes, suggesting its utility as an adjunctive tool in clinical assessment. Full article

Background: The current treatment of gastroesophageal reflux disease (GERD) is focused on decreasing gastric acid secretion. However, there is still a group of patients that do not respond to conventional therapy. Proteinase-activated receptors and purinergic receptors have been implicated in inflammation, visceral hyperalgesia and esophageal hypersensitivity. The aim of this study was to evaluate the esophageal expression of PAR2 (F2RL1) and P2RX2, P2RX3 and P2RY2 in GERD patients. Methods: A total of 53 patients with GERD and 9 healthy controls were enrolled in this study. The expression of the studied receptors was quantified using real-time PCR on esophageal biopsies from the patients with GERD and healthy controls. The correlation between the dilated intracellular spaces (DIS) score and patients’ quality of life was investigated. Results: PAR2 receptor expression was higher in ERD compared to NERD and controls (326.10 ± 112.30 vs. 266.90 ± 84.76 vs. 77.60 ± 28.50; NS). P2X2 exhibited the highest expression in NERD compared to ERD and controls (302.20 ± 82.94 vs. 40.18 ± 17.78 vs. 26.81 ± 10.27), similarly to P2Y2, which expression was higher in NERD than in ERD and controls (7321.00 ± 1651.00 vs. 5306.0 ± 1738.00 vs. 3476.00 ± 508.0). Conclusions: We found that the expression of F2RL1, P2RX2 and P2RY2 is positively correlated to the DIS score in GERD patients. Higher PAR2, P2X2 and P2Y2 expression could mediate the sensitization of the esophagus and may be associated with the higher intensity of symptoms perceived by NERD patients. Full article

Gastric dilatation-volvulus (GDV) syndrome is a life-threatening emergency and its physiopathology and treatment have been studied for decades. Despite ongoing research, the mortality rate is still high. The aims of this study are to describe the treatment and outcome of GDV patients treated from 2011 to 2024 at the veterinary teaching hospital of Grugliasco (Turin, Italy); to analyze risk and prognostic factors, comparing the obtained data with current literature; and to evaluate how patients’ management has changed over the years. The study included 130 dogs with a confirmed GDV diagnosis that underwent surgery. The data were extracted from the digital and hardcopy clinical record, combined with the imaging diagnostic software and an interview submitted to the dogs’ owners. The analysis showed the predominance (25.38%) of German Shepherd dogs, as well as of males (59.25%); among the latter, intact dogs were most represented (53.1%). Age between 5–10 years was most frequent in the examined population (54.69%). The surgical technique went through changes during the examined period: the belt loop has been abandoned in favor of the incisional gastropexy. The survival rate of GDV surgically treated dogs was 86.4%. Lactate blood concentration and splenectomy were not assessed as relevant prognostic factors. Full article

Morphine has significant clinical and analgesic effects in horses, but its impact on the gastrointestinal tract requires further understanding. This study assessed the analgesic and gastrointestinal effects of morphine in horses undergoing elective orchiectomy in the quadrupedal position. Thirty uncastrated male horses were randomly assigned to three groups: orchiectomy without morphine and sedation protocol (OSM), orchiectomy with morphine and sedation protocol (OM), and administration of morphine alone in the absence of orchiectomy (M). The anesthetic protocol involved acepromazine (0.05 mg/kg IV) and detomidine (10 mcg/kg IV) sedation in groups OSM and OM, with morphine sulfate (0.05 mg/kg IV) given to OM and M, and NaCl to OSM. The team measured clinical parameters, pain, and sedation using the EQUUS-FAP scale, while they monitored bowel motility and gastric dilation through abdominal ultrasound. These assessments were performed on the previous day (m1), 20 min before surgery (m2), and at various time points following the administration of morphine or saline solution: one hour (m3), two hours (m4), four hours (m5), six hours (m6), and eight hours (m7) post-procedure for all three groups. There was no significant difference in pain score between OSM and OM, though OM had better sedation. Ultrasound revealed decreased colon contractions and minor gastric dilation in OSM and OM, normalizing within 6 h. Group M showed reduced motility and significant gastric dilation lasting 8 h. In conclusion, while morphine enhanced sedation without causing greater gastrointestinal dysfunction than OSM, its administration alone resulted in a more pronounced reduction in gastrointestinal motility and an increased risk of gastric dilation. Full article