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Equine proximal enteritis : ウィキペディア英語版 | Equine proximal enteritis Proximal enteritis, also known as anterior enteritis or duodenitis-proximal jejunitis (DPJ), is inflammation of the duodenum and upper jejunum. It produces a functional stasis of the affected intestine (ileus) and hypersecretion of fluid into the lumen of that intestine. This leads to large volumes of gastric reflux, dehydration, low blood pressure, and potentially shock. Although the exact cause is not yet definitively known, proximal enteritis requires considerable supportive care. ==Pathophysiology== The cause of proximal enteritis is not definitively known. Both ''Salmonella'' and ''Clostridial'' species have been isolated from gastric reflux contents of affected horses. ''Salmonella'' has not been consistently found in all horses with DPJ, although one study cultured toxigenic ''Clostridial'' species in 100% of affected horses.〔 Other potential causes include ''Fusarium'' infection and recent increase in dietary concentrate levels, which can alter the microbial population within the intestinal lumen.〔 Inflammation of the intestine leads to the secretion of a large amounts of electrolytes, primarily sodium and chloride, into its lumen, resulting in the osmotic movement of water.〔 The production of fluid is thought to be due to active hypersecretion, passive secretion of proteins secondary to damage to epithelium of the mucosa and capillaries, and a functional ileus which prevents removal of this fluid.〔 Massive fluid production results in extensive reflux, usually produced at a rate of 50-100 mL/min,〔 in addition to distention of the proximal small intestine, dehydration, and possible shock secondary to hypovolemia.〔 Proximal enteritis can also occur with inflammation of other organs in the gastrointestinal tract, including gastritis, ileitis, typhlitis, and colitis.〔
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