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

The authors report two cases of acquired diverticulae of the small intestine with complications and study of pathological, clinical and therapeutic characteristics of this rare disease. Usually latent, these diverticulae were recognised generally during diverticulitis, intestinal obstruction, perforation or hemorrhage. The treatment was either removal of the diverticulum or segmental resection of the small intestine. Diverticulitis of the terminal ileum may lead to right ileo-colectomy.
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PMID:[Diverticulosis of the small intestine (author's transl)]. 10 64

The Ripstein procedure was used to effect a cure of rectal procidentia in 30 patients. There was no operative mortality, and morbidity was confined to problems related to two patients with intestinal obstruction, one with fecal impaction, and one with wound infection. We believe the operation to be the treatment of choice in patients to control the anatomic and clinical abnormalities related to rectal procidentia. Associated colonic abnormalities, such as an extremely redundant sigmoid or associated diverticulitis, may dictate the choice of a different procedure that does not require introduction of a foreign material.
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PMID:Surgical treatment of complete rectal prolapse. 52 43

A case of distal ileal diverticulosis complicated by diverticulitis causing partial small bowel obstruction is presented. To the author's knowledge, this is the first reported case of such obstruction, and the third reported case of preoperatively diagnosed ileal diverticulitis. This diagnosis should be considered in patients with acute abdominal symptoms and/or small bowel obstruction.
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PMID:Partial small bowel obstruction secondary to ileal diverticulitis. 83 68

Small intestinal obstruction without colonic dilation can be the mode of presentation in a variety of colonic diseases, including carcinoma, diverticulitis, and colitis. Plain abdominal roentgenograms may lead the unwary physician into errors of diagnosis and treatment by suggesting primary small bowel disease. Barium enema examination of the colon will keep the wary physician out of such traps. We describe five patients with small bowel obstruction who had a variety of colonic diseases diagnosed by barium contrast studies. If the reason for intestinal obstruction is not apparent and the need for emergency surgery is not compelling, we recommend an immediate contrast study of the colon to aid in evaluating possible colonic pathology.
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PMID:Isolated small bowel obstruction as the presenting feature of colonic disease. 88 24

Since the left lateral position facilitates the entry of air into the rectosigmoid, it has been employed in the plain-film evaluation of patients with abdominal distension. The value of this view is illustrated by examples of patients with (a) colonic ileus due to imipramine hydrochloride (Tofranil) or chlorpromazine, (b) partial mechanical obstruction due to diverticulitis, (c) involvement of the rectum by Hirschsprung's disease, and (d) sequential evaluation of a patient with clindamycin colitis. This simple maneuver is recommended for (a) evaluation of patients with plain-film evidence of low colonic obstruction, (b) problems of differential diagnosis between bowel obstruction and ileus, and (c) evaluation of patients with conditions affecting the rectosigmoid.
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PMID:The left lateral view in the plain-film assessment of abdominal distension. 126 52

The single-contrast barium enema examination remains useful for patients with acute diseases such as bowel obstruction, diverticulitis, appendicitis, and fistulas. It is also the procedure of choice for those patients who are too elderly, debilitated, or ill to cooperate with the maneuvers necessary for a double-contrast examination. The double-contrast technique is more sensitive than the single-contrast technique for detection of polyps, early inflammatory bowel disease, and lesions of the rectum. In the older population, there has been an increase in the incidence of colonic polyps and carcinomas in the right side of the colon. This emphasizes the need to examine the entire colon in these patients. The double-contrast barium enema is a safe, accurate, and cost-effective tool for accomplishing this. It is also recommended as the initial procedure in the examination of patients with positive results on fecal occult blood testing.
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PMID:The role of barium enema in detecting colorectal disease. A radiologist's perspective. 151 57

There has been a documented shift towards increasing age and severity of illness in the patient population undergoing cardiac surgery. To determine if there was a coincident change in frequency, gastrointestinal (GI) complications were prospectively recorded in a consecutive series of 5,438 patients undergoing cardiac surgery from 1983 to 1991. There were 73 complications in 69 patients (incidence = 1.4%) defined as any GI condition that required transfer to an acute care unit, surgical intervention, blood transfusion, or treatment that prolonged the hospital course. Fourteen patients died, a mortality rate of 20% for patients with GI complications (p less than 0.001 versus patients without GI complications). The most frequent complications were those of gastric ulceration despite routine use of H2-receptor blocking agents. Thirty-six patients had upper GI (UGI) bleeding from gastric ulceration with 4 patients requiring operative intervention to control hemorrhage and 6 fatalities in patients with UGI bleeding. Two additional patients died of septic complications following gastroduodenal perforation or penetration. Six patients experienced bowel obstruction or prolonged bowel dysfunction (three Ogilvie's syndrome) with two requiring laparotomy. There were four cases of cholecystitis, two cases of pancreatitis, and the remaining cases were equally divided among common septic complications (diverticulitis and ischemic injury among others). Three patients with massive intestinal infarction died. GI complications were significantly associated with older patients (p less than 0.01) and valve surgery (p = 0.002) but were not more common in women. When considered as a separate group, patients with acid-peptic complications had longer perfusion times, increased use of vasopressors, and more frequent utilization of the intra-aortic balloon pump. In contrast to prior studies, this investigation indicates that GI complications associated with acid-peptic erosion of the UGI tract tend to occur in a different patient group than those with other GI complications. Older patients and/or those with a prior history of peptic ulcer symptoms, as well as those who experience prolonged perfusion times, low cardiac output, or prolonged ventilatory support, should be under rigorous gastric pH surveillance and receive aggressive prophylactic treatment with high-dose H2 antagonists, antacids, and/or sucralfate.
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PMID:Changing perspective on gastrointestinal complications in patients undergoing cardiac surgery. 157 12

Our experience with 431 patients suffering from diverticular disease is presented. Indications for emergency (severe bleeding, bowel obstruction, sigmoid perforation with peritonitis) and elective surgery (recurrent attacks of diverticulitis or bleeding, painful or obstructing diverticular disease, fistula, impossibility to exclude a cancer) are given. Resection of the perforated sigmoid by the Hartmann procedure helps to reduce mortality markedly for diffuse purulent and fecal peritonitis. A resection with primary anastomosis can be performed with equal safety for a more localised peritonitis. Aggressive indication for elective surgery helps to lower mortality and morbidity in symptomatic diverticular disease.
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PMID:[Surgical therapy of diverticular disease at the Waid City Hospital, Zurich, 1980-1990]. 159 47

Ischaemic colitis is a relatively rare but well-defined disease entity. It is associated with high mortality rate if early diagnosis and adequate surgical treatment is not accomplished. The aim of the present study was a clinical analysis of 7 patients with the verified ischaemic colitis. The delay from admission to the correct diagnosis was 8 days on the average (range 2-15 days). The reasons for delayed diagnosis included suspicion of diverticulitis, Crohn's disease and bowel obstruction as well as poor general condition in one case because of which early colonoscopy was not done. It is concluded that in patients with abdominal pain, rectal bleeding and diarrhoea associated with typical clinical findings, ischaemic colitis should be suspected. This suspicion should be followed by early colonoscopy to detect the gangrenous form of the disease as early as possible. Instant laparotomy and excision of the affected bowel is necessary for cure in these patients.
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PMID:Ischaemic colitis--a clinical study of seven patients with special emphasis on diagnostic problems. 175 91

Meckel's diverticulum occurs in 2% of the population and may present at any age. Its management, when found incidentally at laparotomy, remains controversial, particularly in the pediatric population. From 1970 to 1989, a Meckel's diverticulum was discovered in 164 children at laparotomy. There were 120 boys and 44 girls with a mean age of 5.2 years (range, 0 to 18 years). Forty-seven cases were asymptomatic, representing an incidental finding at laparotomy, 25 were resected, and ectopic gastric mucosa was present in 7 specimens (28%). Three postoperative deaths (6%) that were not related to the resection and 2 complications (4%) (postoperative leak and wound infection) occurred in this group. Of the 117 symptomatic patients, 49 (42%) presented with bowel obstruction, 45 (38%) had rectal bleeding, 16 (14%) had diverticulitis, and 7 (6%) had umbilical pathology. Volvulus (20) and intussusception (19) were the most common causes of obstruction. Predisposing factors for bowel obstruction were fibrous bands to umbilicus or mesentery (37%) and ectopic mucosa (35%). Severe painless rectal bleeding occurred in 45 patients, 30 of whom (67%) required blood transfusion. A nuclear medicine Meckel scan was positive in 32 of 37 patients (85%). Contrast studies were not diagnostic; colonoscopy and gastroscopy ruled out other causes of bleeding. Patients with diverticulitis (16) presented with acute abdominal pain compatible with appendicitis. In the symptomatic group, ectopic mucosa was present in 61% of the resected specimens. Gastric (88%), pancreatic (7%), and gastric with pancreatic (3%) were the most common ectopic tissue. Postoperative morbidity and mortality for symptomatic patients was 8.5% and 0%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Meckel's diverticulum in children: a 20-year review. 181 59


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