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

Postoperative peritoneal adhesions are common, serious complications of general abdominal and gynecologic surgery that can lead to chronic abdominal pain, intestinal obstruction, and infertility. As yet, there are no ideal drugs that may be prescribed for patients to prevent adhesion formation effectively. In this study the effects of escin, a natural drug, on the various steps of adhesion formation were investigated. The effects of escin on increased vascular permeability induced by acetic acid in a mouse model of acute inflammation, granuloma formation in a subchronic inflammatory rat model, gastrointestinal transit in rats with intestinal paralysis, intestinal motility in postoperative patients, and postoperative adhesion formation in a rat model were observed. It was shown that escin could inhibit acute inflammation and granuloma formation, cause acceleration of gastrointestinal transit, help recover intestinal motility, and attenuate the formation of postoperative adhesions. The findings suggest that escin attenuates the formation of postoperative adhesions by inhibiting inflammation and promoting gastrointestinal transit. Thus it may be concluded that both inhibition of inflammation and increased gastrointestinal motility during the early postoperative period have a positive effect on decreasing the formation of adhesions.
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PMID:Escin: inhibiting inflammation and promoting gastrointestinal transit to attenuate formation of postoperative adhesions. 1631 48

The objective of this chapter is to evaluate the magnitude of the problems of adhesions in Gynecology, complications, cost for the health care, and methods to prevent adhesion formation. It contains a review of relevant literature on intra-abdominal adhesion, adhesion-reducing substances, and their related cost. Adhesions can cause infertility, abdominal pain, or bowel obstruction. The impact of adhesions to the health-care system is huge. The total cost of adhesion-related problems in the United States is more than dollar 1 billion dollars annually. Modification in surgical technique, such as the use of laparoscopy, can minimize adhesion formation. Another approach is by using adhesion-reducing substances. Many substances and materials have been used to decrease the adhesion formation; however, there remains no unequivocally effective adhesion-reducing substance. Also, its use is costly. To our knowledge, no study has been published to date that addresses the use of adhesion-reducing substances as relates to the risk of bowel obstruction or long-term costs to the health-care system.
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PMID:Adhesion in gynecology complication, cost, and prevention: a review. 1652 72

Endometriosis is a common, chronic, benign, estrogen dependent gynecological disorder associated to pelvic pain and infertility. Its main characteristic is the presence of endometrial tissue outside the uterus. The prevalence of pelvic endometriosis ranges between 6% and 10% women during their reproductive years. Clinical symptoms of pelvic endometriosis are pelvic pain, dysmenorrhea, dispareunia and infertility. Distal ileum endometriosis is an uncommon cause of intestinal obstruction with a frequency of 7% to 23% of all cases with intestinal involvement. We report two patients, 30 and 34 years old, with terminal ileum endometriosis and intestinal obstruction that required surgery and intestinal resection. Both patients are well one year after the operation.
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PMID:[Ileal endometriosis as a cause of intestinal obstruction. Report of two cases]. 1675 86

Postoperative adhesion formation is a natural consequence of surgical tissue trauma and healing and may result in infertility, pain, and bowel obstruction. Microsurgical principles and minimally invasive surgery may help decrease adhesion formation, but anti-inflammatory agents and peritoneal instillates have no demonstrable benefit. Although some surgical barriers are effective for reducing postoperative adhesions, none has been shown to improve fertility or to decrease pain or the incidence of postoperative bowel obstruction.
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PMID:Control and prevention of peritoneal adhesions in gynecologic surgery. 1705 98

Post-operative peritoneal adhesions can cause pelvic pain, infertility, and potentially lethal bowel obstruction. We have designed and synthesized injectable hydrogels that are formed by mixing hydrazide-modified hyaluronic acid (HA) with aldehyde-modified versions of cellulose derivatives such as carboxymethylcellulose (CMC), hydroxypropylmethylcellulose (HPMC), and methylcellulose (MC). Gelation of these hydrogels occurred in less than 1 min, and had higher shear moduli than that of HA-HA gel (HAX). Hydrogels degraded in the presence of hyaluronidase in vitro, with HA-MC and HA-HPMC degrading more slowly than HAX and HA-CMC. The aldehyde-modified cellulose derivatives showed dose-dependent mild-to-moderate cytotoxicity to mesothelial cells and macrophages in vitro, but all were biocompatible in the murine peritoneum, causing no adhesions for 3 weeks. All the cellulose-derived gels showed efficacy in reducing the area of adhesion formation in a rabbit sidewall defect-bowel abrasion model.
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PMID:The prevention of peritoneal adhesions by in situ cross-linking hydrogels of hyaluronic acid and cellulose derivatives. 1710 54

Postoperative peritoneal adhesions cause pelvic pain, infertility, and potentially lethal bowel obstruction. We have designed and synthesized an injectable hydrogel composed of cross-linkable modified hyaluronic acids (HAs) conjugated to dexamethasone (HAX-DEX), and investigated its anti-inflammatory function. HAX-DEX formed a hydrogel in <1min by cross-linking reactions between aldehyde groups and hydrazide groups. The hydrogel degraded in media over 5 days, releasing dexamethasone slowly over that time, reducing TNF-alpha and IL-6 production from lipopolysaccharide-stimulated primary mouse macrophages in vitro. HAX-DEX was biocompatible on subcutaneous injection, and caused less inflammation than unmodified cross-linked HA.
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PMID:Anti-inflammatory function of an in situ cross-linkable conjugate hydrogel of hyaluronic acid and dexamethasone. 1720 21

Adhesions resulting from gynaecological endoscopic procedures are a major clinical, social and economic concern, as they may result in pelvic pain, infertility, bowel obstruction and additional surgery to resolve such adhesion-related complications. Although the minimally invasive endoscopic approach has been shown to be less adhesiogenic than traditional surgery, at least with regard to selected procedures, it does not totally eliminate the problem. Consequently, many attempts have been made to further reduce adhesion formation and reformation following endoscopic procedures, and a wide variety of strategies, including surgical techniques, pharmacological agents and mechanical barriers have been advocated to address this issue. The present review clearly indicates that there is no single modality proven to be unequivocally effective in preventing post-operative adhesion formation either for laparoscopic or for hysteroscopic surgery. Furthermore, the available adhesion-reducing substances are rather expensive. Since excellent surgical technique alone seems insufficient, further research is needed on an adjunctive therapy for the prevention and/or reduction of adhesion formation following gynaecological endoscopic procedures.
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PMID:Prevention of adhesions in gynaecological endoscopy. 1745 99

Peritoneal adhesions are serious sequelae of surgery, and can cause significant morbidity and/or mortality due to pain, infertility, and bowel obstruction. We have designed and synthesized novel dextran (DX)-based injectable hydrogels for adhesion prevention, which are formed by mixing hydrazide-modified carboxymethyldextran (CMDX-ADH) with aldehyde-modified DX (DX-CHO) or carboxymethylcellulose (CMC-CHO). At high polymer concentrations, hydrogels formed very quickly upon mixing, e.g. 5% CMDX-ADH with 6% DX-CHO (=CMDX-DX; 1.8 s) and 5% CMDX-ADH with 6% CMC-CHO (=CMDX-CMC; 5.8 s). CMDX-DX shrank after gelling, while CMDX-CMC swelled. CMDX-ADH and CMC-CHO showed minimal to mild cytotoxicity to mesothelial cells and macrophages in vitro, while DX-CHO was very cytotoxic. However, all cross-linked gels had very mild cytotoxicity. When applied in a rabbit sidewall defect-bowel abrasion model of adhesion formation, CMDX-CMC greatly reduced the formation of adhesions while CMDX-DX worsened them.
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PMID:Dextran-based in situ cross-linked injectable hydrogels to prevent peritoneal adhesions. 1747 Mar 76

Intra-abdominal adhesions are normally found after most surgical procedures. Many of the adhesions are asymptomatic, but in about 5% they will lead to readmission due to adhesion-related disorders, such as small bowel obstruction, pelvic pain and infertility. This review discusses possible ways to prevent abdominal adhesions and provides an update as comes to where we stand today in research regarding experimental and clinical use of various antiadhesive agents.
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PMID:Prevention of abdominal adhesions--present state and what's beyond the horizon? 1749 76

Postoperative adhesions are a natural consequence of surgical tissue trauma and healing and may result in infertility, pain, and bowel obstruction. Adherence to microsurgical principles, minimally invasive surgery, and use of some peritoneal instillates may help to decrease postoperative adhesions. Some surgical barriers have been demonstrated effective for reducing postoperative adhesions, but there is no substantial evidence that their use improves fertility, decreases pain, or reduces the incidence of postoperative bowel obstruction.
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PMID:Pathogenesis, consequences, and control of peritoneal adhesions in gynecologic surgery. 1900 13


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