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Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Small intestinal neoplasms are uncommonly encountered in clinical practice. They may occur sporadically, in association with genetic diseases (e.g., familial adenomatous polyposis coli or Peutz-Jeghers syndrome), or in association with chronic intestinal inflammatory disorders (e.g., Crohn's disease or celiac sprue). Benign small intestinal tumors (e.g., leiomyoma, lipoma, hamartoma, or desmoid tumor) usually are asymptomatic but may present with intussusception. Primary malignancies of the small intestine-including adenocarcinoma, leiomyosarcoma, carcinoid, and lymphoma-may present with intestinal obstruction, jaundice, bleeding, or pain. Extraintestinal neoplasms may involve the intestine via contiguous spread or peritoneal metastasis. Hematogenous metastases to the intestine from an extraintestinal primary are unusual and are most typical of melanoma. Because the small intestine is relatively inaccessible to routine endoscopy, diagnosis of small intestinal neoplasms is often delayed for months after onset of symptoms. When the diagnosis is suspected, enteroclysis is the most useful imaging study. Small bowel endoscopy (enteroscopy) is increasingly widely available and may permit earlier, nonoperative diagnosis.
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PMID:Small intestinal neoplasms. 1158 39

The authors presented 4 cases of primary malignant neoplasm of the intestine caused by small intestine obstruction. These patients underwent emergency surgery. In all cases, a segmental resection of the intestine was performed. There were two cases of adenocarcinoma and two cases of carcinoid. Three patients were complementarily treated using chemotherapeutics. One of them died two years post operation. The last three patients survived 0.5-5 years post operation.
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PMID:[Small intestine obstruction caused by primary malignant neoplasms]. 1195 25

A case of perforated sigmoid colon, complicated with peritonitis inside the inguinal hernia scrotal sack is presented. A 91 years old male with reducible inguinal tumor from 4 years ago, that 4 days before hospitalization turns to an unyielding restitution inguinal hernia. Producing an intestinal obstruction. Sigmoidectomy with a Hartman colostomy and inguinal herniorraphy was done. Anatomopatologycal study show adenocarcinoma of colon, tubular type, with moderate differentation. TNM classification: T4 N2 M0. We comment the characteristic of this not very frequent presentation tumoral disease, and comment similar findings. A bibliography review of the subject is made.
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PMID:[IN CARCIRADED INGUINOSCROTAL HERNIA WITHIN SIGMODIAL PERFORATED ADENOCARCINOMA AND PERITONITIS IN THE SCROTAL SAC.A CASE REPORT] 1214 May 89

Laparoscopy, is technique, indications, contraindications, and complications as well as the author's personal experience with it are described. It is a new procedure for diagnosis and treatment of intraabdominal and pelvic conditions. It is a safe and effective method of tubal ligation with shorter hospitalization time. The complete procedure for laparoscopy is discussed in the article. Most patients are able to leave the hospital the day of surgery, and the clips are removed in the office in 72 hours. Laparoscopy is used in sterilization and diagnostically in cases of infertility, pelvic pain, congenital anomalies, second look procedures, and removal of IUD. It should not be used in patients in whom anesthesia is contraindicated, or those with intestinal obstruction, peritonitis, and extensive abdominal scarring. The recovery rate is virtually 100% within 24 to 48 hours following laproscopy. Complications in the author's experience with laparoscopy include, perforation of inferior epigastric artery, postoperative PID, pneumo-omentum failure, pelvic vessel hematoma, and adenocarcinoma of the endometrium.
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PMID:Diagnostic laparoscopy -- a new diagnostic and therapeutic modality. 1225 2

Ectopic pancreas is rare, being found in between 0.6 % and 15 % at autopsy. Heterotopic pancreas is usually an asymptomatic condition which is found incidentally at surgery or at autopsy. Occasionally, significant symptoms arise from complications, such as recurrent upper gastrointestinal bleeding, biliary or intestinal obstruction, or malignant degeneration. Malignant change is very rare. We report a case of malignant change (adenocarcinoma) in an ectopic pancreas in the stomach. In the literature, there are eight reported cases of malignant change in ectopic gastric pancreas. The prognosis in the other reported cases is unknown, but in our patient, the tumor was confined to the muscle of the stomach and there was no lymph node invasion.
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PMID:Adenocarcinoma arising from an ectopic pancreas in the stomach. 1247 49

Long-term survival in patients with cancer of the pancreatic head is disappointing. Surgery is the only curative therapy. Unfortunately the prognosis of patients resected (10-15%) is extremely poor due to loco-regional cancer recurrence (50%). Lymphatic and perineural invasion might account for local recurrence. Japanese studies reported the importance of an extended lymphadenectomy during the classic Whipple exeresis (40% of patients present lymph node metastases). During the period 1996-2000 at our Institution 20 patients (14 M, 6 F, mean age 62.4 years) with pancreatic head cancer (17 adenocarcinoma, 1 lymphoma, 2 carcinoma) underwent Whipple's exeresis with a regional (peripancreatic or R1) and juxta-regional (para-aortic or R2) lymphadenectomy according to Ishikawa technique. R1 nodes consisted of lymph nodes at the pylorus, superior head, common bile duct, anterior pancreaticoduodenal region, inferior head and superior mesenteric vessels. R2 nodes consisted of lymph nodes at the superior body, inferior body, mid colic region, common hepatic duct, coeliac truncus and para-aortic region. This wide dissection was quite easy also in patients with a serious cholestatic disease. Intraoperative mortality was 0%. Operative mortality was 5%. Postoperative complications (20%) were 1 sepsis, 1 hepato-renal syndrome with hepatic coma, 1 mechanical intestinal obstruction, 1 wound infection. Eight patients (40%) died in 6 months in average (neoplastic recurrence 40%). Notwithstanding the advanced disease (stage III 50%; N1+ 50%), twelve patients (60%) have a mean postoperative survival rate of 18.5 (range 1-48) months without neoplastic recurrence. Tumour diameter was less than 4 cm in 83.3% of cases. An earlier diagnosis (with tumour diameter < 4 cm) can improve pancreatic head cancer prognosis. A wide surgical exeresis with a R2 lymph nodes clearance together with surrounding connective and nervous tissue can remove micrometastases with a better control local recurrence.
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PMID:[Extended lymphadenectomy for carcinoma of pancreatic head. Personal experience]. 1261 Dec 61

Perianal mucinous adenocarcinoma is a rare cancer constituting 3 to 11 per cent of all anal carcinomas. It may arise de novo or from a fistula or abscess cavity. We present two cases of this disease process. Case One is a 52-year-old man with a chronic history of perianal abscesses who presented to the emergency room with a large bowel obstruction. He required diversion and wide local excision with lateral internal sphincterotomy for relief of the obstruction. Pathology from the excised material revealed the unexpected diagnosis of invasive mucinous adenocarcinoma of the anus. Case Two is a 59-year-old man with a chronic history of complex fistulas and abscesses who presented to our office with a horseshoe fistula and deep postanal space abscess. Because of the nonhealing nature of the wound, biopsies from the abscess crater, fistulous tract, and the perianal skin opening were taken. The pathology department identified the specimens as invasive mucinous adenocarcinoma of the anal canal. This is an aggressive cancer often misdiagnosed clinically as benign pathology. A high index of suspicion and biopsy of fistulous tracts and abscesses are the keys to early diagnosis and treatment. With combination chemotherapy and radiation therapy in conjunction with aggressive surgical resection long-term survival might be obtained.
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PMID:Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature. 1264 61

Mr Lunn, who is 59 years old, was admitted to hospital with an acute bowel obstruction secondary to an adenocarcinoma of the descending colon. During a laparotomy and colocolonic bypass Mr Lunn was found to have large plaques of cancer in the mesentery, omentum and liver, and a diagnosis of carcinomatosis was made. He declined treatment with chemotherapy. After discharge from hospital, Mr Lunn was referred to the district nursing team for assessment and nursing care of his surgical wound.
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PMID:Nursing a patient with a malodorous fungating non-healing wound. 1271 63

Small intestinal neoplasms are uncommon with reported incidences of less than 1% of GI neoplasms. A retrospective review of cases of small intestinal neoplasms seen by the authors in a ten-year period is presented. Ten cases were seen during the period (8 females and 2 males). Seven patients were aged less than 20 years while the rest were aged above 2 years. Six patients presented with intestinal obstruction, 3 with features of chronic ill-health while 1 was an incidental finding. The ileum was involved in 5 patients, the jejunum in 4 while 1 showed multiple gut involvement. One patient had a benign lesion (Peutz-Jeghers Syndrome). The rest consisted of lymphosarcoma [5],adenocarcinoma [3] while 1 patient had leiomyo-sarcoma. Treatment offered included resection of small gut in 7 patients and ileo-colectomy in 3 patients. Three patients with lymphosarcoma had a full course of cytotoxic chemotherapy. The outcome was poor; 2 patients were alive after 3 years, 3 died within 6 months of surgery while the rest were lost to follow-up at variable periods after surgery. Neoplasms of the small gut presents late in our environment. Lymphosarcoma seems commoner in childhood and carries a better prognosis.
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PMID:Primary jejuno-ileal neoplasms in eastern Nigeria. 1271 60

Ninety-eight patients with 100 different tumors of the small bowel were studied. There were more malignant than benign tumors. Adenocarcinoma was the commonest lesion and the ileum the most frequent anatomical site of all tumors. Except for carcinoid tumors, the lesions were observed more often in male than in female patients. The average age of patients in this series was higher than that reported in most other series. Loss of weight, and abdominal pain were the most constant symptoms. Clinical syndromes of anemia and bleeding, small bowel obstruction, biliary obstruction, perforation with peritonitis, abdominal tumor, melanosis with small bowel polyposis, and cutaneous von Recklinghausen's disease with small bowel neurofibromatosis were encountered either alone or in combination. In the group operated upon, a resection of the involved segment with end-to-end anastomosis was done when feasible. None of the patients operated upon before 1946 lived as much as five years after operation. The most common causes of death were extension of the primary tumor and metastasis, peritonitis due to perforation, associated bronchopneumonia, and hemorrhage.
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PMID:A study of small bowel tumors; with special emphasis on clinical aspects. 1488 43


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