Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several hemodynamic abnormalities in the patient with cirrhosis comprise a unique distributive circulatory disturbance that causes intractable ascites and that is, in turn, worsened by the resulting ascites. Ascites is promptly alleviated by drainage of the ascitic fluid into the intravascular compartment. The circulatory abnormalities improve in part because of elimination of the ascites, and also because of a compensatory hypervolemia. The consequences of the latter, especially in the immediate postoperative period, are increased likelihood of pulmonary edema and of gastrointestinal bleeding from heightened portal vein pressure. Postoperative coagulopathy is also a significant problem. Careful selection of patients for the procedure, close postoperative observation and vigorous use of diuretics and other agents will usually enable these complications to be obviated or successfully treated. Increases in body muscle and fat masses and serum albumin concentrations indicate nutritional improvement. Despite evidence of benefits from the procedure, these patients continue to die from the complications that threaten other cirrhotics: effects of return to alcoholism, gastrointestinal hemorrhage, recurrent infections and intestinal obstruction. Thus, it is not yet clear that the benefits include prolongation of life.
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PMID:Treatment of intractable ascites in patients with alcoholic cirrhosis by peritoneovenous shunting (LeVeen). 44 38

Four cases of gastrointestinal perforation by chicken bones are presented. Variability in the clinical manifestations generally precludes a correct preoperative diagnosis of intraabdominal chicken bone abscess. However, in 2 patients, a diagnosis was possible with plain abdominal radiographs. Although the abnormalities seen were nonspecific, the identification of a chicken bone with an associated mass or extraluminal gas collection in a patient with signs of peritonitis, mechanical bowel obstruction, or pneumoperitoneum strongly suggests the diagnosis. A history of alcoholism or wearing dentures strengthens it.
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PMID:Gastrointestinal perforation by chicken bones. 57 Jul 15

Five hundred patients with the isomorphic pattern of the isoenzymes of serum lactate dehydrogenase (LDH) were surveyed. The isomorphic pattern of LDH isoenzymes is defined as a significant increase of total LDH with normal or low percentage of individual fractions, but with the LDH1:2 ratio less than unity. Diagnoses were, in descending order of frequency, cardiorespiratory diseases, malignancy, fracture, diseases of the central nervous system, infection/inflammation, hepatic cirrhosis and/or alcoholism, trauma without fracture, infectious mononucleosis, hypothyroidism, uremia, necrosis, pseudomononucleosis, viremia and intestinal obstruction. Incidence of increased serum activity in individuals without evidence of disease or drug explanation was 3 percent. Low PaO2 was observed in 88 percent of the 67 patients in whom it was measured.
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PMID:Clinical significance of the isomorphic pattern of the isoenzymes of serum lactate dehydrogenase. 90 Aug 65

The syndrome of pseudo colonic obstruction consists of acute or subacute colonic dilatation which presents the diagnostic and therapeutic problems of any low bowel obstruction. Our experience is based on a series of 22 cases and is similar to data in the literature. There is a specific aetiological context: elderly subjects, vascular and neurological diseases, severe infection, trauma, alcoholism. The exclusion of an organic occlusion is not always an easy diagnosis and may require an exploratory laparotomy. The clinical course is dominated by the risk of diastatic perforation which carries a heavy mortality. In the majority of cases, the colonic peristalsis is restored by early diagnosis, repeated decompression with a rectal catheter, together with general measures of rehydration, control of infection and maintenance of satisfactory haemodynamic conditions. In the other cases, a draining colostomy may be required. The pathophysiological mechanism of this form of colonic ileus remains hypothetical, in which various neurogenic, vascular, toxic or metabolic factors may be involved.
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PMID:[Colonic pseudo-occlusion syndrome. Ogilvie's syndrome Apropos of 22 cases]. 654 73

Partial gastrectomy for benign ulcer disease may influence future risk of death, eg, through changes in life-style or metabolism. To reveal such possible long-term effects, we analyzed a population-based cohort of 6459 patients operated on from 1950 through 1958 and followed through 1985. We found a lower overall mortality than in the general Swedish population (standardized mortality ratio = 0.94; 95% confidence interval 0.91-0.97). Mortality was decreased among those with duodenal ulcers, Billroth II operations, and older age at operation but increased as time passed after operation. Mortality was significantly (P < 0.05) increased from tuberculosis, alcoholism, emphysema, stomach ulcer, intestinal obstruction, gallbladder or biliary disease, suicide, and accidental falls but decreased from ischemic heart disease and cerebrovascular disease. Preoperative selection of healthy patients and the probable increased prevalence of risk factors for ulcer disease (smoking, alcoholism, and lower socioeconomic status) in this cohort explain most of these findings. Apart from intestinal obstruction, gallbladder or biliary tract diseases, and tuberculosis, the surgical procedure did not appear to increase mortality beyond one year after operation.
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PMID:Mortality among patients with partial gastrectomy for benign ulcer disease. 831 16

We report a case of a 64-year-old lady who developed clinical features of Wernicke-Korsakoff syndrome following a laparotomy for small bowel obstruction. Following the operation she developed paralytic ileus and required total parenteral nutrition for one month. A suspected history of average 40 units of weekly alcohol consumption prior to the operation could not be confirmed and the patient did not show any sign of alcohol dependence. Within a few months of treatment with a daily oral dose of thiamine 200 mgs supplemented by multivitamins the patient showed subjective evidence of improvement in confusion, confabulation, and anterograde amnesia, although objective tests showed residual deficits in many areas of cognitive functioning, including immediate and delayed recall of verbal and non-verbal materials, planning and switching of attention.
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PMID:Wernicke-Korsakoff syndrome following small bowel obstruction. 1244 48

A 53-year-old man developed a Legionella pneumophila pneumonia complicated by rhabdomyolysis, acute kidney injury, and protracted ileus. Risk factors were smoking and chronic alcoholism, but the patient had no history of previous abdominal surgery. Hemodialysis was required for a period of 5 weeks with a full renal recovery. Pneumonia required respiratory support but for a limited period of 6 days. The protracted course of the ileus led to explorative laparotomy despite negative computed tomography findings. No cause of mechanical obstruction was found at surgery and common etiologies of intestinal obstruction were excluded. Parenteral nutrition was needed for a total of 4 weeks, before recovery of intestinal motility. This case illustrates the apparent discrepancy between the pulmonary symptoms and the extrapulmonary manifestations that could be seen as a consequence of an exaggerated immune response.
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PMID:Extreme Rhabdomyolysis, Acute Renal Failure, and Protracted Ileus in a Case of Legionella Pneumonia. 3083 38

Wernicke encephalopathy (WE) was first described by Carl Wernicke in 1881. WE is caused by thiamine deficiency. Alcoholism is the most common etiologic factor associated with WE in the United States, but it can occur in any patient with a nutritional deficiency state such as hyperemesis gravidarum, intestinal obstruction, and malignancy. WE is a clinical diagnosis. The common findings include mental status changes, ocular dysfunction, and a gait apraxia, present in only 10% of cases. Only a few cases of WE are diagnosed before death. Approximately 80% of patients with untreated WE have development of Korsakoff syndrome, which is characterized by memory impairment associated with confabulation. The initial clinical diagnosis of WE is critical, keeping in mind that the classic triad of symptoms is often absent. Recognition of nutritional deficiency and any portion of the classic triad should prompt treatment. Additionally, hypothermia, hypotension, and coma should raise clinical suspicion for the disease. Primary treatment includes timely administration of thiamine, for which the route and dosage remain controversial. Clinical judgment should be exercised in diagnosis and treatment (dosage, frequency, route of administration and duration) in all cases of WE. Overdiagnosis and overtreatment may be preferred to prevent prolonged or persistent neurocognitive impairments given the excellent safety profile of thiamine. Further prospective research is warranted to better understand the disease biology, risk factors, and treatment recommendations.
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PMID:Wernicke Encephalopathy-Clinical Pearls. 3117 Nov 16