GNJ Tytgat
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Diseases in Chronic Non-infective Diarrhea Marcellus Simadibrata; Aziz Rani; Daldiyono Daldiyono; Ari Fahrial Syam; GNJ Tytgat; Vera Yuwono; L A Lesmana; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 1, April 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/51200415-18

Abstract

Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and small bowel X-ray. Result: Chronic non-infective diarrhea was observed in 107 (51.7%) cases from 207 chronic diarrhea cases respectively. The frequently found abnormalities that had caused chronic non-infective diarrhea were carbohydrate maldigestion (62.61%), colorectal cancer (14.01%), Crohn’s disease (11.21%), ulcerative colitis (9.34%), irritable bowel syndrome (8.41%), colorectal polyp (8.41%) etc. Conclusion: The most frequent abnormality found in chronic non-infective diarrhea was maldigestion.   Keywords: Chronic diarrhea, non-infective
Portal Hypertensive Enteropathy in Liver Cirrhosis Marcellus Simadibrata; Vera Yuwono; FJW Ten Kate; GNJ Tytgat; Daldiyono Daldiyono; Laurentius Lesmana; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 3, December 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/73200661-66

Abstract

Background/Aim: Some studies found that portal hypertension cause complication such as portal hypertensive gastroenterocolopathy. This study was done to find any abnormalities in the small intestinal mucosa and villi of the portal hypertensive patients. Method: Thirty patients with liver cirrhosis, portal hypertension and esophageal varices between 2000 - 2001 were included in this study. A duodenoscopic examination was performed to determine any abnormalities. Biopsy specimens were taken from the descending part of duodenum and the duodenal bulb for histopathological examination. The findings were compared to 37 functional dyspepsia patients. Result: In the duodenal bulb and descending part of duodenum: the width of the villous of the portal hypertensive group was larger than the control (p 0.001), the diameter of the mucosal villous vessel was larger than in the control (p 0.001) and the thickness of the mucosal villous vessel wall was thicker than in the control (p 0.001). Conclusion: There were abnormalities of the mucosa in portal hypertensive enteropathy patients including the mucosal vessel diameter, wall thickness, number of goblet cells. Keywords: portal hypertensive enteropathy, liver cirrhosis
Normal Histological Appearances of the Duodenum Jejunum and Terminal Ileum in Indonesian People Marcellus Simadibrata; Vera Yuwono; FJW Ten Kate; GNJ Tytgat; Laurentius Lesmana; Daldiyono Daldiyono; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200771-75

Abstract

Background: There is no literature specifically on the normal appearance of small bowel mucosa amongst Indonesians. Diseases of the small bowel can cause chronic diarrhea. Chronic diarrhea is common in Indonesia. Methods: Thirty seven patients with normal stomach and small bowel on endoscopic and histopathologic examination were included in this study. Biopsies were taken from the duodenal bulb, descending part of duodenum, jejunum and terminal ileum. The scoring Method for the inflammatory cells (lymphocytes, plasma cells and eosinophil cells) was carried out using the symbols 0 (negative), +, ++, and +++. Results: The mean height of the villi of the duodenal bulb was 265.00 ± 81.89 mm, the mean height of the crypts of the duodenal bulb was 196.67 ± 56.01 mm, the mean width of the villi were 59.14 ± 74.14 mm. The mean height of the villi of the duodenum pars descendens was 317.27 ± 99.66 mm and the mean height of the crypts was 218.79 ± 84.66 mm. The mean height of the villi of the jejunum was 341.76 ± 76.06 mm and the mean height of the crypts was 189.41 ± 58.15 mm. The mean height of the villi of the terminal ileum was 235.41 ± 73.32 mm, and the mean height of the crypts was 186.22 ± 64.09 mm. Conclusion: Histologically, the mean height of the villi of the normal small bowel was between 235.41 ± 73.32 to 341.76 ± 76.06 mm and the mean height of the crypts of the normal small bowel was between 186.22 ± 64.09 to 218.79 ± 84.66 mm. Keywords: normal, duodenum, jejunum, terminal ileum, histological appearances, villous height, villous width, crypt height
Abnormalities of the Small Bowel in Chronic Non-Infective Diarrhea: A Histopathological Study Marcellus Simadibrata Kolopaking; Vera Yuwono; Ari Fahrial Syam; FJW Ten Kate; GNJ Tytgat; Daldiyono Daldiyono; L A Lesmana; Nurul Akbar; Chudahman Manan; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/42200329-38

Abstract

Background: The incidence of chronic non-infectious diarrhea cases is increasing in line with the developments of medical technology and science. The objective of this study was to uncover the histopathologic abnormalities of the small bowel in cases of chronic non-infectious diarrhea. Methods: All chronic non-infectious diarrhea patients in Cipto Mangunkusumo Hospital from 1996 until 2000 were included in this study. For the control group, we used 37 endoscopically-normal patients with functional dyspepia with the same characteristics (sex and age). All of the patients underwent gastroduodeno-jejunoscopic and ileocolonoscopic examinations. Patients with infection were excluded from this study. Biopsies were taken from the duodenal bulb, descending duodenum, jejunum near the Treitz ligament, terminal ileum, and colon. Histopathological tests were performed on all of the biopsies. Result: Histopathological examination was carried out on 31 patients and 37 control patients. In the duodenal bulb, the width of villi, lymphocyte infiltration, eosinophil infiltration, stage of inflammation, and polymorphonuclear cells infiltration were all lower in the chronic non-infectious diarrhea group than in the control group (p 0.01). In the descending part of duodenum and jejunum, lymphocyte infiltration, the stage of inflammation, and polymorphonuclear cell infiltration were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Within the terminal ileum, lymphocyte infiltration, the stage of inflammation and lymphoid follicle hyperplasia were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Conclusion: Histopathologically, increased lymphocyte infiltration, inflammation and lymphoid follicle hyperplasia were discovered in specified areas of small intestine in chronic non-infectious diarrhea patients. Keywords: Histopathological examination, chronic non-infectious diarrhea, lymphocyte infiltration, mucosal inflammation, lymphoid follicle hyperplasia