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

Bowel obstruction developing in patients with gynaecological malignancies may present as a therapeutic dilemma. The causes, and results of surgical and conservative management of 92 patients are analysed. The causes of obstruction in the 64 patients who were treated surgically were: tumour recurrence in 42, adhesions in 12, radiation stricture in 9 and pelvic abscess in 1. Surgical palliation was effective in 45 patients in this group, with another 12 patients being palliated initially but subsequently developing further obstructive symptoms. Surgical palliation was ineffective in 7. Conservative management was effective only in 12 of the 41 patients, and even in this group 8 developed further obstructive episodes within the first month of discharge. The median survival in the surgically treated group for benign and malignant causes is 57 and 10 weeks respectively; while it is 4 weeks for those treated conservatively.
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PMID:Intestinal obstruction in patients with gynaecological malignancies. 246 Nov 41

Many gastrointestinal cancers are diagnosed when no curative approach is possible. Patients with these malignancies frequently have dysphagia, jaundice, intestinal obstruction and other severe symptoms which significantly impair their quality of life. We present our experience with two new endoscopic techniques for palliative treatment in these patients: placement of biliary endoprostheses to alleviate malignant obstructive jaundice and destruction of neoplastic tissue by phototherapy with laser rays.
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PMID:New endoscopic palliative treatments in gastrointestinal malignancies. 246 52

Percutaneous gastrostomy was performed in 100 cancer patients. In 67 patients with bowel obstruction, the procedure was performed for gastric drainage with 24-28-F Malecot catheters inserted in one sitting. The remaining 33 patients had supragastric obstructions or fistulas and required 10-14-F pigtail catheters for feeding purposes. Average postgastrostomy hospitalization was 3.6 days. Drainage gastrostomies were ready for use immediately after the procedure, whereas use of feeding gastrostomies started on average within 2 days of tube insertion. There were no major complications or deaths related to the procedure. Percutaneous gastrostomy is a simple and safe procedure even when large-caliber catheters are used, and it does not require gastric fixation to the abdominal wall to prevent spillage into the peritoneum.
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PMID:Percutaneous drainage and feeding gastrostomies in 100 patients. 250 21

Based on a survey of 47 cases of left colonic occlusive cancer operated on at the Emergency Surgery Department-University of Rome "La Sapienza", the authors concluded that in such condition, when the patient is not seriously ill, the Hartmann procedure is a valid alternative to the anastomosis-resection because: a) it solves intestinal obstruction in a short time with consequent improvement of general conditions; b) it allows to perform the second oncologically radical operation early with less risk of neoplastic spread. The latter procedure, therefore, is carried out under better conditions, relative to the stage of the disease and the status of the patient.
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PMID:[Primary resection in occlusions caused by cancer of the left colon]. 251 11

From 1973 through 1985, 49 women received postoperative open-field whole abdominal radiotherapy as primary management for peritoneal metastases from uterine cancer. The 5-year relapse-free rate was 63% in women with endometrial carcinoma, and two prognostic subsets were identified. Five-year relapse-free rates fell from 77% in women with spread to the adnexa or peritoneal fluid to 36% in women with macroscopic spread of cancer beyond the adnexa. Any peritoneal spread of cervical carcinoma yielded a 3-year relapse-free rate of 31%. Although abdominal spread of cervical cancer was associated with other poor prognostic factors, peritoneal metastases frequently occurred in otherwise early endometrial cancer. Four percent of patients developed small bowel obstruction requiring surgical intervention. The utility and limitations of whole abdominal radiation are discussed.
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PMID:Abdominal radiotherapy for cancer of the uterine cervix and endometrium. 254 96

Thirty-six major abdominal operations were performed on 35 Acquired Immune Deficiency Syndrome (AIDS) patients (33 men, two women). Twenty-two elective operations were indicated for diagnosis of abdominal or retroperitoneal mass (6), incomplete bowel obstruction (5), intra-abdominal infection (4), biliary symptoms (3), thrombocytopenia (3), and toxic megacolon (1). Fourteen emergency operations were for perforated viscus or peritonitis (11), massive gastrointestinal bleeding (2), and cecal volvulus (1). In 5 of 22 (23%) elective operations AIDS was unknown to the treating physicians until diagnosed by the surgical pathology; in contrast, all 14 emergency operations were in patients who had a known diagnosis of AIDS. The operative findings were related to AIDS in 34 of 36 (94%) operations. Cytomegalovirus was the most common pathogen, isolated or identified microscopically in 11 patients (eight emergency and three elective operations). Mycobacterial infections presented as retroperitoneal adenopathy or splenic abscess in six patients. Non-Hodgkins lymphoma was the most common malignancy found, presenting as an abdominal mass (4), bowel obstruction (3), or with gastrointestinal bleeding (2). Kaposi's sarcoma was diagnosed at laparotomy in four patients. The 1-month operative mortality rate for elective operation was 9% (2 of 22) and 46% (6 of 13) in emergencies. Postoperative complications included 1 reoperation for sepsis caused by inadequately resected CMV colitis; 1 pancreatic fistula; 1 wound dehiscence, and 2 minor wound infections.
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PMID:Acquired immune deficiency syndrome (AIDS). Indications for abdominal surgery, pathology, and outcome. 255 44

Clinical and microbiologic data of 296 patients with anaerobic bacteremia were reviewed. Anaerobes were isolated with aerobic or facultative bacteremia in 23 instances. The Bacteroides fragilis group accounted for 148 (70%) of 212 isolates of Bacteroides species. B. fragilis accounted for 78% and B. thetaiotaomicron for 14%. Among other species, there were 20 (6%) Fusobacterium organisms, 63 (18%) Clostridium isolates, and 53 (15%) anaerobic cocci. Seventy-five patients died: 40 had B. fragilis group isolates - B. fragilis, 28, and B. thetaiotaomicron, 8 - and 21 had Clostridium organisms isolated. The primary portals of entry were the gastrointestinal tract (42%), decubiti and gangrene (10%), the female genital tract (8%), and the oropharynx (7%). The gastrointestinal tract, decubiti, and gangrene were the predominant sources for B. fragilis and Clostridium organisms, the female genital tract and oropharynx for anaerobic cocci and Fusobacterium species, and the oropharynx for pigmented Bacteroides. Foreign body was associated with Propionibacterium acnes and Clostridium species. Factors predisposing to bacteremia were abscesses, 53; malignancy, 51; surgery, 30; and intestinal obstruction or perforation, 27.
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PMID:Anaerobic bacterial bacteremia: 12-year experience in two military hospitals. 232 34

Experience in combined operations for cholelithiasis on 162 patients is discussed. In 98 patients, cholecystectomy was performed as a simultaneous stage of surgical treatment, the main stage of the operation was gastrectomy or resection of the stomach for cancer in 26 patients, formation of a small stomach for alimentary-constitutional obesity in 19, various types of vagotomy in 33, hemicolectomy, resection of the colon and sigmoid intestine for malignant tumors in 10, and reconstructive manipulations on the stomach, correction of intestinal obstruction, and other operations in 10 patients. Cholecystectomy was the main stage of the operation in 48 patients with hernias, benign tumors of the uterine appendages, breasts, and soft tissues. The authors insist that cholecystectomy must be carried out when cholelithiasis is a concurrent disease; they showed that increase in the extent of the operative intervention had no essential effect on mortality and frequency of postoperative complications (mortality rate, 1.2%). The authors substantiate the expediency of performing combined operations from economical considerations--the economical effect of the operations conducted by the authors came to some 51,000 roubles.
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PMID:[Combined operations in cholelithiasis]. 259 77

Over the last century, the incidence of adhesive small bowel obstructions has increased as the rate of operative management of abdominal conditions has risen. Concurrently, the rate of colonic cancer has also increased. One of the ways in which colonic cancer may present is as an isolated small bowel obstruction. Three cases of resolving small bowel obstruction secondary to occult carcinoma are presented and a survey of the literature is made. The conclusion is that all patients who present with a small bowel obstruction, which resolves, and who are in the cancer age group should be investigated for colonic cancer, especially when the putative causative operation was carried out some years previously; otherwise, large bowel tumours presenting as an isolated small bowel obstruction may pass undiagnosed.
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PMID:Small bowel obstructions: the case for investigation for occult large bowel carcinoma. 264 63

We present a retrospective analysis of 105 instances of small bowel obstruction (SBO) in 80 patients admitted to our hospital over a ten year period. Adhesions accounted for 73% of the cases and secondary involvement by malignancy for 13%. Appendectomy, colorectal and other pelvic procedures were the most frequent surgical antecedents responsible for the adhesions. In the 86% of cases with a temperature over 100 degrees F there was significant morbidity, mortality and/or strangulation, and this sign also foretold a prolonged hospital stay. Leukocytosis, when present along with abdominal tenderness also predicted a prolonged hospital stay. Strangulation occurred in 4.7% of the instances and was accompanied by at least one of the "classical symptoms". Fourty-five percent of the instances were successfully managed by conservative measures alone, whereas 55% had had surgical treatment. The mean hospital stay for all cases was 15.3 days. The morbidity rate for this series was 21% with a mortality of 3.8%. The largest single cause of death was related to malignant disease (three of four cases). When post-operative adhesions were the etiology, the hospital stay was 8.5 +/- 1.3 days for those treated with conservative measures compared with 16.5 +/- 1.8 days for those in whom a surgical procedure was performed (p less than 0.0001). This latter group also has a higher morbidity (32% compared to 5% for the non-operative group).
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PMID:Small bowel obstruction and its management. 265 44


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