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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Electrical spike potentials and intrauminal pressure variations were recorded from the human duodenum and distal ileum before and after i.v. administration of 80 log Ivy units of cholecystokinin. In the duodenum, quantitative calculations of motility gave identical values before and after drug administration, and results were identical in patients before and after cholecystectomy as well as in hernia patients without upper gastrointestinal disease. A decrease in amplitude of the spike potentials was observed in the duodenum during the first few minutes after drug administration in all groups. Recordings from the distal ileum in ileostomy patients showed a significant increase in motility after CCK administration whereas the spike potential amplitude was unchanged.
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PMID:The effect of cholecystokinin on electrical spike potentials and intraluminal pressure variations in the human small intestine. 113 27

Two hundred and forty patients, asymptomatic relative to gastrointestinal disease, who applied for elective hernia repair, were tested as outpatients for occult blood in the stool. Thirty-eight patients had one or more positive specimens. Significant pathologic characteristics were identified by lower gastrointestinal evaluation in 23 of these patients. One patient had an adenocarcinoma (Dukes' Stage B). Eight patients had polyps of various types, 11 patients had colonic diverticula, and three patients had anorectal disease. Patient compliance was excellent and the cost-benefit ratio appeared to be acceptable.
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PMID:Hemoccult screening in selected patients. The hernia patient older than age fifty years. 682 50

One hundred patients, asymptomatic relative to gastrointestinal disease, who applied for elective hernia repair were tested as outpatients for occult blood in the stool. Twenty-six had one or more positive specimens. Among this group colonic disease was found in seven, including adenocarcinoma (Dukes' stage A) in one, adenomatous polyps in three, and colonic diverticula in the remainder. The unexpectedly high false-positive rate (33%) was reduced markedly by giving a meat-free diet before stool collection. Patient compliance was excellent and the cost-benefit ratio appeared to be acceptable.
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PMID:Hemoccult screening in selected patients. 724 44

The effect of intraperitoneal sodium carboxymethylcellulose (SCMC) administration on clinical outcome and survival was evaluated in horses undergoing exploratory celiotomy for acute gastrointestinal disease. Comparison of variables was made retrospectively between 44 horses that had SCMC and 92 horses (controls) not treated with SCMC. Mean age, body weight, heart rate, packed cell volume and plasma total protein of horses at admission, and convalescent period were not significantly different between control and SCMC groups. No significant differences were noted between control horses and SCMC horses with respect to incisional infection, hernia formation, recurrent episodes of colic, clinical outcome, and long-term survival (> 6 months). Seventy-six (83%) control horses and 34 (77%) SCMC horses survived long-term. Seventy (76%) control horses and 30 (68%) SCMC horses survived without complications and returned to their previous use. These results suggest that intraperitoneal use of SCMC does not adversely affect abdominal incisional wound healing, clinical outcome or long-term survival, however, the efficacy of SCMC in prevention of postoperative intestinal adhesions in horses requires further investigation.
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PMID:Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy. 777 49

With advances in heart transplantation, a growing number of recipients are at risk of developing gastrointestinal disease. We reviewed our experience with gastrointestinal disease in 92 patients undergoing 93 heart transplants. All had follow-up, with the median time 4.8 years (range 0.5-9.6 years). During the period of the study we progressively adopted a policy of low immunosuppression aiming toward monotherapy with cyclosporine. Nineteen patients (20.6%) developed 28 diseases related to the gastrointestinal tract. Thirteen patients required 18 surgical interventions, five as emergencies: closure of a duodenal ulcer, five cholecystectomies (one with biliary tract drainage), a sigmoid resection for a diverticulitis with a colovesical fistula, a colostomy followed by a colostomy takedown for an iatrogenic colon perforation, appendectomy, two anorectal procedures, and six abdominal wall herniorrhaphies. At the onset of gastrointestinal disease, 8 patients were on standard triple-drug immunosuppression, all of them within 6 months of transplantation; 13 were on double-drug immunosuppression; and 7 were on cyclosporine alone. All the patients with perforations/fistulas were on steroids. Among the 11 infectious or potentially infectious diseases, 10 were on triple- or double-drug immunosuppression. One death, a patient who was on triple-drug immunosuppression, had a postmortem diagnosis of necrotic and hemorrhagic pancreatitis. Except for an incisional hernia following a laparoscopic cholecystectomy, there was no morbidity and, importantly, no septic complications. We concluded that a low immunosuppression policy is likely to be responsible for the low morbidity and mortality of posttransplant gastrointestinal disease, with a lower incidence of viscous perforation/fistula and infectious gastrointestinal disease.
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PMID:Gastrointestinal disease following heart transplantation. 1039 May 81

To identify causes of death (COD) in propositi with Cornelia de Lange syndrome (CdLS) at various ages, and to develop guidelines to improve management and avoid morbidity and mortality, we retrospectively reviewed a total of 426 propositi with confirmed clinical diagnoses of CdLS in our database who died in a 41-year period between 1966 and 2007. Of these, 295 had an identifiable COD reported to us. Clinical, laboratory, and complete autopsy data were completed on 41, of which 38 were obtainable, an additional 19 had autopsies that only documented the COD, and 45 propositi had surgical, imaging, or terminal event clinical documentation of their COD. Proband ages ranged from fetuses (21-40 weeks gestation) to 61 years. A literature review was undertaken to identify all reported causes of death in CdLS individuals. In our cohort of 295 propositi with a known COD, respiratory causes including aspiration/reflux and pneumonias were the most common primary causes (31%), followed by gastrointestinal disease, including obstruction/volvulus (19%). Congenital anomalies accounted for 15% of deaths and included congenital diaphragmatic hernia and congenital heart defects. Acquired cardiac disease accounted for 3% of deaths. Neurological causes and accidents each accounted for 8%, sepsis for 4%, cancer for 2%, renal disease for 1.7%, and other causes, 9% of deaths. We also present 21 representative clinical cases for illustration. This comprehensive review has identified important etiologies contributing to the morbidity and mortality in this population that will provide for an improved understanding of clinical complications, and management for children and adults with CdLS.
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PMID:Causes of death and autopsy findings in a large study cohort of individuals with Cornelia de Lange syndrome and review of the literature. 2206 64

Traditional surgeries involve accessing body cavities, such as the abdomen and thorax, via incisions that divide skin and muscle. These operations result in postoperative pain and convalescence, and a risk of complications such as wound infection and hernia. The development of flexible endoscopy allowed diseases as varied as gastrointestinal bleeding and colon adenomas to be treated without incisions, but this technique is restricted by its endoluminal nature. A novel category of surgical endoscopic procedures has recently been developed that uses flexible endoscopic techniques to enter and access the submucosa of the gastrointestinal tract. Through this approach, the advantages of incisionless endoscopy can be applied to areas of the body that previously could only be reached with surgery. This Review introduces this new class of interventions by describing two examples of such submucosal surgeries for the treatment of benign gastrointestinal disease: per-oral endoscopic myotomy and per-oral pyloromyotomy. The approach to pre-procedure patient evaluation, operative technique, and the published outcomes are discussed, as well as potential future applications of similar techniques and procedures in this so-called third space.
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PMID:Submucosal surgery: novel interventions in the third space. 2935 38