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

A 32 years old male patient with recurrent abdominal pain was admitted to the hospital with the clinical picture of intestinal obstruction. An emergency laparotomy was performed and the diagnosis of intestinal non-rotation and cecum volvulus was done. Right hemicolectomy and terminoterminal ileocolic anastomosis was performed. Pathology showed ischemia and necrosis in the resected segment. Clinical presentation, diagnosis methods and therapeutic options of intestinal malrotation and non-rotation are discussed.
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PMID:[INTESTINAL NON-ROTATION AS CAUSE OF RECURRENT ABDOMINAL PAIN:REPORT OF A CASE AND LITERATURE REVIEW] 1214 May 78

We present a case of a 78 year-old man with the pathological antecedent of chronic constipation that comes to our emergency room at the Victor Lazarte Echegaray Hospital. He presented abdominal pain and progressive abdominal distension, nausea and bilious vomits of two days of evolution. The clinical examination showed an evident abdominal distension, and some metallic intestinal noises. A frontal and lateral simple abdominal x- ray showed a considerable distension of the gastric camera and intestinal loops and free fluid all over the abdominal cavity, all of which was compatible with the diagnosis of intestinal obstruction. At the operating room we proceeded with a exploration and we founded an intestinal obstruction at the ascending colon (Ladd's Bands) of high location with bloody fluid in the abdominal cavity, multiple fecalomas in the descending colon, and intestinal ischemia in the distal small bowel, the color, tone and coiling of the intestine recovered after section of the Ladd's bands. The patient evolved favorably.
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PMID:[Intestinal obstruction for malrotation in an adult patient. Report of a case]. 1217 Feb 88

Bowel ischemia may be caused by many conditions and manifest with typical or atypical and specific or nonspecific clinical, laboratory, and radiologic findings. It may mimic various intestinal diseases and be confused with certain nonischemic conditions clinically and at computed tomography (CT). Bowel ischemia severity ranges from mild (generally transient superficial changes of intestinal mucosa) to more dangerous and potentially life-threatening transmural bowel wall necrosis. Causes of critically reduced blood flow to the bowel are diverse, ranging from occlusions of mesenteric arteries or veins to complicated bowel obstruction and overdistention. CT can demonstrate changes in ischemic bowel segments accurately, is often helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications. Unfortunately, common CT findings in bowel ischemia are not specific, and specific findings are rather uncommon. Therefore, it often is a combination of nonspecific clinical, laboratory, and radiologic findings-especially detailed knowledge about the pathogenesis of acute bowel ischemia in different conditions-that helps most in correct interpretation of CT findings. To improve understanding of this complex heterogeneous entity, this article provides an overview of the anatomy and physiology of mesenteric perfusion and discussions of causes and pathogenesis of acute bowel ischemia, CT findings in various types of acute bowel ischemia, and potential pitfalls of CT.
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PMID:CT of acute bowel ischemia. 1260 Dec 5

Radiologists have played an important role in evaluation of patients with small bowel pathology. The small bowel series and, later, enteroclysis were the mainstays in radiologic diagnosis of many small bowel diseases, because the resolution and speed of CT was limited. Continued improvements in CT technology over the last 2 decades have resulted in a expanding role of CT for evaluation of the gastrointestinal tract, including the small intestine. Many conditions, such as small bowel obstruction and ischemia, that would traditionally be imaged with other modalities (small bowel series or angiography) are now routinely imaged with CT. The development of MDCT and improvements in 3D imaging systems have greatly improved the ability to examine the small bowel and mesenteric vasculature. With the introduction of new CT oral contrast agents and faster 32-detector row CT scanners, the diagnosis and evaluation of patients with small bowel disease will continue to improve.
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PMID:The current status of multidetector row CT and three-dimensional imaging of the small bowel. 1265 34

A girl with malrotation underwent a Ladd's operation at 35 days of age and later had an adhesiotomy at 115 days of age. After the adhesiotomy, she suffered from sepsis and subsequent disseminated intravascular coagulation (DIC). At 178 days of age, she developed an intestinal obstruction because of a rectosigmoid stricture probably caused by DIC-associated ischemia. As a result, an ileostomy was performed. At one year, 4 months of age, she underwent a resection of the proximal part of the rectosigmoid stricture and a reconstruction by means of a Z-shaped anastomosis. Based on our experience, Z-shaped anastomosis appears to be an excellent treatment not only for Hirschsprung's disease but also for benign rectosigmoid stricture.
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PMID:Z-shaped anastomosis for the treatment of a benign rectosigmoid stricture. 1267 78

The diagnosis of necrotizing enterocolitis (NEC) is made from a combination of clinical and radiographic findings. There are no useful screening biochemical markers of intestinal injury. The serum concentration of cytosolic beta-glucosidase (CBG), an enzyme found primarily in enterocytes, is markedly elevated in animal models of ischemia and bowel obstruction. We hypothesized that in a rat model of NEC, serum CBG activity would significantly increase before microscopic evidence of severe intestinal injury. Cohorts of 2-wk-old Sprague-Dawley rats (n = 10/cohort) were anesthetized and underwent laparotomy with occlusion of the superior mesenteric artery (SMA). Platelet-activating factor (200 microg/animal) was injected in the proximal duodenum. Serum and intestinal samples were obtained at time 0 (control) and 30, 60, and 90 min of ischemia (I) and after 90 min of I followed by 60 min of reperfusion (I/R). Histopathologic injury was categorized as either no or minimal injury or mural necrosis by two masked investigators and CBG activity was measured by ELISA. Data were analyzed with Fisher's exact test and ANOVA. Only the I/R group had significantly greater mural necrosis compared with the control group (90% versus 0%, respectively, p < 0.001). In contrast, CBG activity was significantly elevated after only 90 min of I and after I/R (15.1 +/- 5.6 and 16.4 +/- 4.3 units/mL, respectively, p < 0.05). We conclude that serum CBG is elevated before transmural intestinal injury in this model and may have utility as an early marker of ischemia in patients at risk for NEC.
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PMID:Serum cytosolic beta-glucosidase activity in a rat model of necrotizing enterocolitis. 1286 98

The term spontaneous intestinal perforation suggests a perforation in the gastrointestinal tract of a newborn of no demonstrable cause. Only a few cases have been described in full-term newborns. The aetiology and pathogenesis of the disease are unknown although multiple theories have been proposed. Some authors suggest ischemia as the most likely cause. Conditions associated with fetal or neonatal hypoxia are important antecedents for this emerging distinct entity. We present a case of a spontaneous, intestinal perforation in a full-term neonate with urinary tract infection. There was no clinical evidence of necrotizing enterocolitis or bowel obstruction. Radiological images revealed a pneumoperitoneum. An emergency explorative laparotomy was performed. A localized linear perforation was identified in the transverse colon. Pathological examination of the resected specimens failed to reveal any etiology for the perforation. The neonate recovered rapidly, with no gastrointestinal complications. In our case none of the factors which have previously been associated with intestinal perforation could be implicated. We suggest that focal intestinal perforation is possibly the result of infection. Further studies, including careful recording of cases and close histopathological examination of resected specimens, are required in order to provide more information and improve our understanding of the aetiology of this rare occurance.
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PMID:Spontaneous intestinal perforation in a full-term infant: association with infection. 1290 Jul 15

Although traditionally regarded as a disease of distal extremities, mesenteric vasculature can also manifest thromboangiitis obliterans (TAO). There are 31 cases of intestinal TAO in the English literature and the majority of subjects are male. However, cases of women with TAO are becoming more common, coinciding with an increased incidence of smoking in this sex. We describe the sixth case of a female patient with classic extremity manifestations paralleled by paroxysms of abdominal angina. Intestinal TAO can mimic extremity disease of smoldering chronic ischemia punctuated by unpredictable acute episodes of gangrene. In the present case, chronic ischemia manifested as partial bowel obstruction due to stricture deformity of the ileum and profound adipocyte atrophy of mesentery.
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PMID:Intestinal thromboangiitis obliterans in a woman: a case report and discussion of chronic ischemic changes. 1453 31

Intestinal obstruction is a relatively common condition with diagnosis based on the clinical signs, patient history, and radiographical findings. Once suspected, its presence should be determined and if present, the site and cause of obstruction, and presence of strangulation should be assessed for the appropriate patient management. With the recent technological developments, the role of computed tomography (CT) in the diagnosis of bowel obstruction has expanded. The examination should be performed with intravenous contrast administration and thinner sections and multi-planner image reformation are recommended to evaluate a site of particular interest. CT is reported to have a sensitivity refer to detection of a small bowel obstruction at over 90% for complete or high-grade obstruction and to disclose causes of obstruction in 70% to 95% of cases. CT also provides characteristic findings indicating the presence of closed-loop obstruction and intestinal ischemia, which leads to appropriate and timely management for these emergent cases.
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PMID:CT diagnosis of small bowel obstruction: scanning technique, interpretation and role in the diagnosis. 1462 Jul 16

Small bowel ischemia is a disorder related to a variety of conditions resulting in interruption or reduction of the blood supply of the small intestine. It may present with various clinical and radiologic manifestations, and ranges pathologically from localized transient ischemia to catastrophic necrosis of the intestinal tract. The primary causes of insufficient blood flow to the small intestine are various and include thromboembolism (50% of cases), nonocclusive causes, bowel obstruction, neoplasms, vasculitis, abdominal inflammatory conditions, trauma, chemotherapy, radiation, and corrosive injury. Computed tomography (CT) can demonstrate changes because of ischemic bowel accurately, may be helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications. However, common CT findings in acute small bowel ischemia are not specific and, therefore, it is often a combination of clinical, laboratory and radiologic signs that may lead to a correct diagnosis. Understanding the pathogenesis of various conditions leading to mesenteric ischemia and being familiar with the spectrum of diagnostic CT signs may help the radiologist recognize ischemic small bowel disease and avoid delayed diagnosis. The aim of this article is to provide a review of the pathogenesis and various causes of acute small bowel ischemia and to demonstrate the contribution of CT in the diagnosis of this complex disease.
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PMID:Acute small bowel ischemia: CT imaging findings. 1462 Jul 18


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