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

Primary lymphomas of the small intestine (PIL) show definite racial and geographic distribution. Clinical and laboratory data on 132 patients with PIL treated and followed up over a 14-year period in Baghdad, Iraq, are presented. Based on the pattern of involvement of the bowel and the histopathologic appearance of the tumor, the patients can be divided into three main groups. Ninety-seven patients had diffuse lymphoplasmacytic infiltration affecting large segments of the upper bowel. Abdominal pain, anorexia, weight loss, diarrhea, malabsorption, and clubbing of the fingers are the most common clinical findings. The barium appearance of the small intestine and peroral jejunal biopsy specimens are abnormal in nearly all cases. This clinicopathologic entity has been referred to in the literature as Mediterranean lymphoma (ML). Ten of 34 patients tested had free alpha-heavy chain in the serum. Twenty-three cases had other "Western" variants of lymphoma (18 lymphocytic and 5 plasmacytic). The lesions were localized, occurring most frequently in the lower ileum or ileocecal area. The most common presentation was intestinal obstruction. Twelve children had Burkitt's lymphoma (BL), presenting most commonly with abdominal masses and/or intestinal obstruction. These patients responded poorly to cyclophosphamide, and the disease disseminated early and extensively. None of the patients with the localized lymphomas or BL had free alpha chain in the serum.
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PMID:Clinical and pathologic subtypes of primary intestinal lymphoma. Experience with 132 patients over a 14-year period. 641 50

This study describes, in 6 patients with a flat small intestinal mucosa and splenic atrophy, a particular lesion of the mesenteric lymph nodes termed "cavitation." In 4 women and 2 men with abdominal mass, intestinal obstruction, or suspected celiac disease-associated lymphoma, unusual pseudocystic lymph node lesions were found in the jejunal or jejunoileal mesentery. These lesions consisted histologically of a large central cavity occupied by hyaline-type material and surrounded by fibrous tissue and remnants of lymph node structures. There was no histologic evidence of malignant lymphoma or mesenteric panniculitis. Diffuse subtotal villous atrophy involving at least the jejunum was found in each case, together with unequivocal biological and morphological evidence of splenic atrophy, severe malabsorption, and a history of chronic or childhood diarrhea. HLA B8 or DR3, or both, was present in 4 of 4 cases; dermatitis herpetiformis was present in 1 case. An unequivocal mucosal response to a gluten-free diet was observed in 2 cases. Four patients died of cachexia or hyposplenism-related infections. We conclude that cavitation of mesenteric lymph nodes is an original feature which may be associated with splenic atrophy and a flat small intestinal mucosa; some of these patients may have celiac disease. Pathogenesis is unknown.
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PMID:Cavitation of mesenteric lymph nodes, splenic atrophy, and a flat small intestinal mucosa. Report of six cases. 674 13

Various reviews documenting the rarity, diagnostic problems, and poor survival statistics prompted this retrospective clinicopathological study of 58 cases of primary small bowel tumors, periampullary and mesenteric tumors excluded, over a 14-year period between 1966 and 1979 inclusive. Of these cases 36 were male and 22 were female, ranging in age from 13 to 65 years. Initially, the symptoms were vague and ill defined. Prominent clinical features were: intermittent abdominal pain (6+%), loss of weight (62%), abdominal lump (53%), and chronic bleeding (7%). Routine barium meal examination and laboratory investigations were not helpful in preoperative diagnosis. Of these tumors 28 were benign and 30 malignant, with the commonest benign and malignant tumors being leiomyoma and lymphoma, respectively. The commonest site of involvement was the ileum both for benign and malignant lesions. None of the benign tumors was found in the duodenum. All patients with benign tumors, discovered either at laparotomy for intestinal obstruction or during surgical procedures for other diseases, had excision of the tumor through enterotomy or resection of small bowel with end-to-end anastomosis. Of 30 patients with malignant tumors, 12 underwent resection of the growth and end-to-end anastomosis. Of the remaining 18 unresectable cases, 7 had by-pass procedures and 11 had only biopsy. All patients of benign tumors are well without any gastrointestinal symptoms. All the malignant cases, except three cases of adenocarcinoma and two of lymphoma who underwent resection, died within 5 years. The 5-year survival of only 8.6% in malignant tumors indicates the necessity of an early exploratory laparotomy in doubtful cases with vague abdominal symptoms. A bold interventionist approach should improve the otherwise dismal outlook of malignant small bowel tumors.
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PMID:Primary tumors of the small bowel: a clinicopathological study of 58 cases. 708 85

Surgeons operating on patients with an obscure peritonitis should be aware of the diverse etiologies of small intestinal perforation and the general principles of management of each. A series of 16 adult patients with free perforation of the small intestine and spreading peritonitis in the absence of bowel obstruction, incarcerated hernia, or trauma is reviewed. Etiologies were as follows: Crohn's disease, four patients; foreign body ingestion, two patients; jejunal diverticulosis, one patient; lymphoma, two patients; cancer chemotherapy, one patient, amyloidosis, one patient; idiopathic, five patients. Although all patient presented with diffuse peritonitis, the findings of fever and leukocytosis were inconstant. Free air was demonstrated on radiographs in only eight of 16 patients, and the correct preoperative diagnosis was not made except in the four patients with Crohn's disease. Resection and primary anastomosis were utilized successfully in ten patients, the remainder of the patients undergoing oversewing the the perforation. Four patients (25%) died.
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PMID:Free perforation of the small intestine. 712 43

The results of 88 consecutive small-bowel enemas were compared retrospectively with the results of 52 routine small-bowel series and 50 barium enemas done in the same patients. Ninety-six percent of the diagnoses made by small-bowel enema were correct, as compared to only 65% made by routine small-bowel series. The incorrect studies were mostly false negatives and the abnormalities missed included regional enteritis, small-bowel obstruction, and intestinal lymphoma. The barium enema failed to achieve ileal reflux in 26% of patients and had a 23% false negative rate when reflux was achieved. Because small-bowel series as done by conventional methods was significantly less accurate, we believe small-bowel enema should be considered in patients with suspected small-bowel disease when other studies are negative.
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PMID:Small-bowel enema. An underutilized method of small-bowel examination. 717 60

Five patients with non-specific small intestinal ulceration and malabsorption are presented. Four of these patients had subtotal villous atrophy of jejunal mucosa but none showed a morphological improvement after gluten withdrawal from the diet. Intestinal ulceration caused the complications of melaena, intestinal obstruction and perforation which resulted in the death of three patients. A review of the English literature reveals twenty-seven similar cases for which the term idiopathic chronic ulcerative enteritis is recommended. The condition is of unknown aetiology, diagnosis only being firmly established by laparotomy and histological examination of resected bowel. The relationship of this syndrome to coeliac disease, intestinal lymphoma and Crohn's disease is discussed. Management is extremely difficult and the long-term prognosis poor. Gluten withdrawal should be tried in the presence of villous atrophy but the value of steroid therapy in unresponsive cases is unproven. Surgical excision of the worst affected segments of small bowel has so far proved to be the most effective course of action.
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PMID:Idiopathic chronic ulcerative enteritis. Report of five cases and review of the literature. 743 32

Strongyloides stercolaris infestation is rather rare in Iraq. Individuals with infection confined to the intestinal tract are often asymptomatic. Symptoms include abdominal pain, diarrhea, weight loss and other non-specific complaints. The diagnosis depends upon repeated examination of stool and duodenal aspirate. Two cases presenting as sub-acute intestinal obstruction and mimicking primary intestinal lymphoma (PIL) on presentation are presented. Differentiation between the two conditions regarding presenting features, barium studies and pathology are discussed.
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PMID:Sub-acute intestinal obstruction by Strongyloides stercolaris. 870 86

Mucormycosis is an infection caused by a ubiquitous fungus in immunocompromised individuals. Typically, it invades blood vessels, producing thrombosis and tissue infarction. This infection spans all pediatric age groups and can lead to hollow viscus perforation and bowel obstruction. A 30-month old male with large cell anaplastic lymphoma had a bowel obstruction. During emergency laparotomy, an ileoileal intussusception was identified, which required resection and anastomosis. In the pathological specimen, fungi of the Mucorales order were found to be associated with tissue necrosis. On the eighth day of life, a premature infant had abdominal distension secondary to bowel perforation. Partial gastric resection and multiple intestinal stomas were performed. Death occurred soon after, secondary to multiorgan failure. The autopsy and surgical specimens showed widespread mucormycosis. An adolescent had meningococcemia-induced septic shock. During recovery, hemorrhagic colitis developed, which led to perforation. The subtotal colectomy specimen showed widespread mucormycosis. The laparotomy findings are typical (black necrotic tissue involving the bowel), and when seen in the immunocompromised patient, should make one suspect gastrointestinal mucormycosis. Aggressive surgical debridement of devitalized tissue augmented by intravenous antifungal medication is the mainstay of treatment.
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PMID:Gastrointestinal mucormycosis causing an acute abdomen in the immunocompromised pediatric patient--three cases. 780 59

A 70-year-old patient with a 6 x 6 x 12 cm mass involving the mesentery root is discussed. The pseudotumorous infiltration was detected by ultrasound done because of nonspecific abdominal symptoms and weight loss. Laparoscopic biopsy confirmed the diagnosis of mesenteric panniculitis. The primary histologic criterion is infiltration of the mesenterium by foamy lipid-laden macrophages, clusters of lymphocytes and fibrosis. The majority of cases follow a benign course and need no therapy, but co-existence of lymphoma has been reported. There have been few cases where panniculitis with progressive fibrosis changed into retractile mesenteritis with shortening of the mesenterium and compression of mesenteric vessels with partial or complete intestinal obstruction or ischemia requiring surgery. Few reported cases of severe and progressive disease have been treated with prednisone and azathioprine or cyclophosphamide.
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PMID:[Mesenteric panniculitis]. 834 99

A 46-yr-old multiparous cachetic woman presented with severe hypoalbuminemia in the absence of liver disease, proteinuria, and/or protracted starvation. The clinical presentation and work-up was indicative of protein-losing enteropathy. She developed an acute partial small bowel obstruction, and a presumptive diagnosis of lymphoma of the small intestine was entertained. Surgical resection of the terminal ileum revealed transmural involvement of the bowel by endometriosis. Her postoperative recovery was uneventful, with return of her serum albumin levels to normal.
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PMID:Endometriosis of the small intestine presenting as a protein-losing enteropathy. 842 Feb 54


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