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)

Patients with obstructing large-bowel cancer may be treated by primary tumour resection or the conventional staged tumour resection, and a prospective study comparing these two treatments was carried out. The post-operative outcome in 174 patients (of whom 90 underwent primary and 47 staged tumour resection) showed that the overall mortality was similar in both groups but that the duration of hospital stay in patients who underwent primary tumour resection was half that of those who underwent staged tumour resection. The mortality for primary tumour resection, however, was unexpectedly high for lesions proximal to the splenic flexure and unexpectedly low for lesions distal to this point. Of patients with distal tumours in whom a staged resection was planned, 35% died after a loop colostomy. The most striking result was that the ratio of postoperative death for trainee surgeons compared with fully trained surgeons was 3:1. It is concluded that patients with large-bowel cancer who present with intestinal obstruction should be treated by a fully trained surgeon and that immediate resection of the tumour should be considered for every patient.
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PMID:Large-bowel obstruction caused by cancer: a prospective study. 49 69

Forty patients with colorectal schistosomiasis who failed to respond to medical therapy were studied. They had dysentery with bloody mucus and anemia, polyps, pericolic masses, and schistosomal ulcers. Two patients had cecal masses which appeared to be intussusception and appendicitis. Three patients had chronic intestinal obstruction. Diverting transverse colostomy, followed by other surgical procedures, is the safest method of management.
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PMID:Colorectal schistosomiasis: clinicopathologic study and management. 49 94

We have studied two types of emergency cases that occurred in the surgical unit who were found to have gynaecological aetiology: 1) patients with the so-called "morbus acutum dexter", i.e. appendicitis, or a gynaecological disease and 2) late complications in patients who had earlier benign gynaecological disease, usually such as tumour and surgery for it. The material with seven years follow-up consisted of 97 patients, who were treated during the periods 1959--60 and 1969--70. The relative numbers in both groups increased during the latter period. Of the patients in the reproductive age with suspected appendicitis, gynaecological diseases--mostly ovarian tumours with complications--constituted 7.6% of patients who had undergone appendicectomy in the surgical unit during the former period and 9.6% during the latter. The late complications consisted mainly of small bowel obstruction, resulting from adhesions caused by previous gynaecological surgery. The time interval between initial surgery and the obstruction was rather long, 3.5 years on the average. In the surgical unit the surgery was carried out in about two thirds of these patients. Our analysis demonstrates the necessity of recognizing cases with gynaecological aetiology as a significant factor in surgical practice; it has to be taken into consideration both in surgical and gynaecological education.
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PMID:Abdominal gynaecological emergencies in the surgical unit. 50 38

Imperforate anus is one of the most common causes of intestinal obstruction in the newborn and the exact estimation of the level of the blind rectal pouch is of primary importance. We present 11 cases of imperforate anus and demonstrate the accurate location of the rectal pouch by transperineal injection of contrast media. This method shows an advantage in comparison to the classical plain roentgenogram in the inverted position of the baby. No unnecessary colostomies were performed since intraduction of the transperineal injection. The method is simple and there were no complications due to injection 10-15 cc of 20% Hypaque. Further studies are not in progress to demonstrate the presence or absence of an associated internal fistula in all cases.
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PMID:The value of transperineal injection for the diagnosis of imperforate anus. 50 77

The prenatal ultrasonographic demonstration of distal bowel obstruction is described. The diagnosis proved to be intestinal aganglionosis involving colon and distal ileum.
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PMID:Ultrasonic diagnosis of prenatal intestinal obstruction. 51 2

The diagnosis of intestinal obstruction is readily made when a patient presents with typical history and signs, and when plain films of the abdomen display characteristic findings. Some patients, however, constitute diagnostic problems because abdominal roentgenograms are still equivocal, even after repetition in four hours. In the unclear case, use of a barium meal will safely, promptly, and routinely prove or disprove small bowel obstruction. Intestinal obstruction in which the initial abdominal films tend to be either unrevealing or equivocal include high obstructions, including the superior mesenteric artery syndrome; presence of strangulation; partial small bowel obstruction; and fluid-filled proximal bowel. In intestinal obstruction, characteristic roentgenographic findings with use of barium meal are normal to rather rapid transit time to the point of obstruction; homogenous dilution of barium in dilated proximal loops; and inhomogenous, scattered, and fragmented collections of barium in the distal, collapsed loops.
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PMID:How and when to use barium for diagnosis of small bowel obstruction. 51 60

Thirty-four patients with malignant bowel obstruction have been evaluated with particular regard to survival, success of decompression and incidence of reobstruction. In patients with intestinal obstruction caused by peritoneal carcinomatosis the following have been determined: 1) surgery is not urgent, 2) surgical decompression usually is possible, 3) surgical decompression may facilitate additional adjuvant therapy, and 4) death is usually not caused by reobstruction after surgical decompression.
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PMID:The results of surgical treatment of bowel obstruction caused by peritoneal carcinomatosis. 51 71

The clinical presentation and findings in 45 patients with lymphoma of the gastrointestinal tract occurring in an unselected population are described. Nineteen patients presented as emergencies with haemorrhage, perforation, pyloric stenosis or intestinal obstruction. Systemic symptoms, peripheral lymph node enlargement and hepatosplenomegaly were rare, and a preoperative diagnosis of lymphoma was seldom made. Endoscopy was superior to radiology in defining lesions in the stomach and duodenum. Lesions which were multicentric, or of unusual macroscopic appearance, were common in the small bowel, and these should raise the suspicion of lymphoma. Local and systemic recurrence was common, but was not always fatal. Patients with gastric lymphomas survived longer than those with intestinal disease.
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PMID:The presentation of gastrointestinal lymphoma: study of a population. 51 67

Thirty-two patients with Crohn's disease were treated with a fibre-rich, unrefined-carbohydrate diet in addition to conventional management and followed for a mean of four years and four months. Their clinical course was compared retrospectively with that of 32 matched patients who had received no dietary instruction. Hospital admissions were significantly fewer and shorter in the diet-treated patients, who spent a total of 111 days in hospital compared with 533 days in the non-diet-treated control group. Whereas five of the controls required intestinal operation, only one diet-treated patient needed surgery. This is in strong contrast to general experience with this disease. Treatment with a fibre-rich, unrefined-carbohydrate diet appears to have a favourable effect on the course of Crohn's disease and does not lead to intestinal obstruction.
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PMID:Treatment of Crohn's disease with an unrefined-carbohydrate, fibre-rich diet. 51 85

The rationale of "crash induction" in patients with full stomach is reviewed. The technique does not precipitate regurgitation in normal patients having competent cardia, provided respiratory obstruction and IPPV are avoided during induction. On the other hand, in patients with incompetent cardia such as intestinal obstruction or hiatus hernia, excessive material may accumulate in the lower oesophagus. The accumulation will be suddenly released with the cricopharyngeal relaxation subsequent to "crash induction". The stomach and oesophagus should be adequately decompressed pre-operatively, and precautionary measures such as backward cricoid pressure must be taken during induction.
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PMID:"Crash induction" in patients with full stomach. 52 72


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