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Query: UMLS:C0020505 (hyperphagia)
6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of the paper is to demonstrate the usefulness of total parenteral hyperalimentation in a lactant, 4 months old patient with ulcerative colitis. At admission the lactant had diarrhea, dehydratation, anemia, malnutrition, and edema in the ankles. Proctoscopy and barium enema, and rectal biopsy were typical of ulcerative colities. Treatment included steroids and azulfidine. Evolution was poor and signs of perforation appeared. Total intravenous hyperalimentation was used and after one month the diarrhea disappeared and the patient gained weight. Ulcerative colitis is rare in lactants and usually appeares a chronic diarrhea. The diagnosis should be based on radiology, endoscopy, and biopsy. Parenteral hyperalimentation is the only treatment that permits to keep the colon at total rest while simultaneously maintaining nutrition.
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PMID:[Ulcertive colitis: clinical picture and treatment with total parenteral nutrition in a newborn]. 82 75

Five cases of malignant duodenocolic fistula seen at the Massachusetts General Hospital in the past thirty years are reviewed. Rarely encountered, these lesions are characterized by diarrhea, weight loss, abdominal pain, anemia, and sometimes feculent vomiting. Barium enemas are more likely to demonstrate the fistula tract than upper gastrointestinal series. Nutritional deficiencies may be profound, and the use of preoperative hyperalimentation is encouraged. Operations that accomplish only bypass of the fistula are of minimal palliative value, and the fistula should be divided or resected if possible. When feasible, wide resection is the procedure of choice, and a fourteen year survival is reported after this operation.
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PMID:Malignant duodenocolic fistulas. 86 13

A 10-year-old girl who had a pelvic and femoral osteotomy for congenital dislocation of her right hip was immobilized with a hip spica. On the 28th postoperative day, she had upper abdominal pain, distention and bilious vomiting. An upper GI series demonstrated complete obstruction of the duodenum at the third portion of the duodenum in a supine position; however, the barium passed the obstruction site slowly when the patient assumed a lateral or prone position. She was successfully treated conservatively with nasogastric decompression, fluid replacement, proper positioning and hyperalimentation. Superior mesenteric artery syndrome is a rare complication in patients immobilized in a body cast or hip spica. Early diagnosis and proper treatment usually leads to an uneventful convalescence.
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PMID:Superior mesenteric artery syndrome as a complication in hip spica application for immobilization: report of a case. 136 Mar 6

Evidence has been presented to suggest that the patient with an obstructed carcinoma of the colon may have a more malignant form of the disease independent of lymph node status or tumor encirclement of the bowel. Rate of tumor growth is never consistent in patients with this disease. Patients who develop colon obstruction early in the course of the disease seem to have more aggressive tumors with rapid growth and a much poorer long-term prognosis. Perforations frequently accompany obstructions of the colon. Patients in this group have a dismal prognosis. Individuals with obstructed carcinoma of the colon have a higher operative mortality and morbidity and a shorter long-term survival. The higher operative mortality and morbidity may depend entirely on the choice of operative procedures. Tumor location affects prognosis. Obstructing tumors in the left colon have a more favorable prognosis than those in the right colon. Obstructing right colon tumors have a much poorer survival (three times worse) than nonobstructing carcinomas of the right colon. Obstructing tumors in the rectum have a very poor prognosis. Evidence exists that resection of the tumor without preliminary proximal decompression may reduce hospital mortality and morbidity and increase long-term survival. In selected cases, primary resection can be done as safely as staged operative procedures. Primary anastomosis with resection of the left colon carries a higher operative mortality because of anastomotic leaks. Resection without anastomosis is much safer. Primary resection with anastomosis is the procedure of choice in obstructing lesions of the right colon. This has a lower operative mortality and morbidity than a staged procedure. This primary resection with anastomosis is certainly as safe as an ileotransverse colostomy. It is important not to abandon the time-honored surgical principle of never suturing obstructed bowel. Primary resection without anastomosis confirms this surgical principle. Meticulous preoperative and postoperative care employing physiological monitoring, multiple antibiotics, total parenteral hyperalimentation, and respiratory and circulatory support will further reduce the hospital mortality and morbidity. Patients who initially appear to be obstructed on barium enema, but who in truth are only partially obstructed, can be properly managed so that an elective primary resection with anastomosis can be done with the same operative mortality and morbidity as in other elective colon cancer patients.
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PMID:Obstructing malignant lesions of the colon. 373 1

Surgical management of squamous cell carcinoma of the esophagus continues to be a controversial area in thoracic surgery. In a series of 20 patients, 15 received preoperative chemotherapy with cis-platinum (cisplatin), 2 received cisplatin plus 5-fluorouracil, and 3 received cisplatin plus vinblastine sulfate. Eighteen patients underwent en bloc esophagogastrectomy and postoperative radiation therapy. All patients were staged preoperatively by thoracoabdominal computed axial tomographic scan, bone scan, bronchoscopy, esophagoscopy, and barium swallow. Patients with liver or bone metastasis were excluded. The majority of patients received preoperative enteral hyperalimentation. Eighteen of the 20 patients completed the study with a follow-up of 12 to 24 months. There was 1 operative death, and 3 patients were in the hospital for more than three weeks after operation before they were discharged. Fourteen of the 18 patients survived for a year, and 11 survived for 12 to 24 months. Substantial reduction in mucosal disease and tumor burden based on preoperative barium swallow and endoscopy was evident in 11 of 18 patients, but in no patient was the tumor completely eradicated by preoperative chemotherapy. Although follow-up is short, this treatment regimen involving a combined treatment offers hope in the palliation of this disease.
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PMID:Combined treatment approach in surgical management of carcinoma of the esophagus: a preliminary report. 392 6

An unusual case of congenital lower oesophageal diaphragm (web) associated with achalasia is described. An 18-year-old nulliparous girl presented with severe cachexia and aphagia following progressive dysphagia. A barium swallow demonstrated the achalasia, and the oesophageal diaphragm with a central pinhole opening was seen at endoscopy. Parenteral hyperalimentation was required for ten weeks prior to surgery. Circumferential excision of the oesophageal diaphragm in conjunction with Y-V advancement oesophagoplasty gave a good result.
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PMID:Lower oesophageal diaphragm and achalasia in an adult. An unusual association. 652 77

Fifteen cases of gunshot wounds of the esophagus seen between the years 1970 and 1978 were reviewed, eight involving the cervical esophagus and seven involving the thoracic portion. Most common symptoms were pain, neck tenderness, dyspnea, and dysphagia. Signs observed were subcutaneous emphysema, crepitations, fever, and leukocytosis. Plain X-rays showed pneumomediastinum, hydrothorax, and pneumothorax. Perforations were confirmed by barium studies in 12 patients. Injuries in the cervical portion were treated by prompt exploration, closure of the defect, and drainage. There were no deaths in this group. Thoracic injuries were treated by prompt thoracotomy except in one patient, for whom the diagnosis was not made until 22 hours after the injury; his was the only death in this series. Because of the extensive tissue involvement in gunshot wounds, primary repairs of thoracic esophageal perforations have a high incidence of failure. Defunctionalization of the esophagus, through ligation of the distal esophagus, gastrostomy, and cervical esophagostomy, has provided a safer method. Use of a double strand of absorbable Dexon to ligate the distal esophagus made a second thoracotomy for removal of the ligature unnecessary. We have adopted routine use of hyperalimentation, avoiding the need for feeding jejunostomy.
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PMID:Perforations of the esophagus from gunshot wounds. 670 55

Three patients with Boerhaave syndrome were successfully managed with nonoperative treatment. The diagnosis was delayed 5 days in one patient and 10 days in the other two. None of the patients appeared septic. Their conditions had been misdiagnosed as myocardial infarction, pneumonia and pulmonary embolism. Treatment consisted of intravenous hyperalimentation and administration of antacids and antibiotics. Cimetidine was also used in one patient. Two patients were discharged 14 days after diagnosis and the third on the 20th hospital day. Follow-up barium swallows showed complete healing in 2 months in all three patients. Conservative management of spontaneous esophageal perforation is feasible when (1) the perforation is already 5 days old, (2) there are no signs of severe sepsis, (3) esophageal barium study shows a wide-mouthed cavity draining freely back into the esophagus, and (4) the pleural space is not contaminated. When the diagnosis is made promptly, surgical therapy remains the treatment of choice, and patients managed conservatively who show signs of sepsis should be operated on without hesitation. Follow-up esophageal evaluation should be performed to confirm complete healing and to evaluate underlying disease.
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PMID:Boerhaave syndrome. Successful conservative management in three patients with late presentation. 678 84

The authors experienced a case of spontaneous intramural hematoma of the esophagus (SIHE). This 44-year-old Japanese woman was admitted to our hospital because of chest pain accompanied by minimal hematemesis. Endoscopy revealed an elevated intraluminal bleeding bulge. Barium esophagograms showed a smooth and giant elevated intraluminal lesion. CT and MRI also revealed thickening of the esophageal wall. Fasting and intravenous hyperalimentation were prescribed on admission. The conditions improved and she became asymptomatic on the fifth day of hospitalization. Subsequent examinations by esophagography and endoscopy showed that the elevated lesion had disappeared and that the inflamed mucosal lesion had improved. The prognosis of cases of SIHE is excellent under conservative therapy, but close follow-up care is necessary.
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PMID:A case of spontaneous intramural hematoma of the esophagus. 844 Apr 26

Two patients developed duodenal obstruction, believed to be due to collagenous adhesions between the duodenum and the Dacron graft itself, following repair of an abdominal aortic aneurysm. The diagnosis was suspected because of a continuous copious bile stained nasogastric aspirate and was confirmed by upper gastrointestinal barium studies. Conservative management for several days with nasogastric aspiration and intravenous hyperalimentation led to resolution of the obstruction. We believe this complication is probably under-reported but will generally resolve with conservative measures.
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PMID:Duodenal obstruction following reconstruction of abdominal aortic aneurysm. 845 90


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