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)

Crohn's disease (regional enteritis) is a chronic non-specific inflammatory intestinal disorder of unknown etiology. Most commonly the terminal ileum in involved, a segmentary involvement of the bowel wall is rather characteristic. Main symptoms are recurrent abdominal pain, fever, diarrhea and weight loss. Radiological and endoscopic examination confirms the diagnosis, granulomas in the biopsy specimen are pathognomonic. In differential diagnosis ulcerative and ischaemic colitis have to be ruled out. Conservative therapy with prednisolone and salazopyrin is the method of choice, however, complications like small bowel obstruction, toxic megacolon and fistulae ask for surgical intervention.
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PMID:[Morbus Crohn (enteritis regionalis)]. 0 46

The clinical features of the multiple mucosal neuromas (MMN) syndrome permit the recognition of these patients and their potential development of the associated medullary thyroid carcinoma (MTC). The distinctive physical appearance caused by the mucosal neuromas, the Marfanoid habitus and, occasionally, the positive family history aid in establishing the diagnosis. Neurogangliomas are frequently present in the gastrointestinal tract of these patients who may have megacolon, constipation and diarrhea. The third instance of the MMN syndrome is reported in the newborn as intestinal obstruction. It is suggested that the syndrome be considered in the differential diagnosis of Hirschsprung's disease and bowel obstruction in the neonate. Serum calcitonin measurements following stimulation by calcium or pentagastrin infusion reliably detect incipient MTC and may be used to select those MMN patients requiring thyroid surgery. Recognition of patients with the MMN syndrome and subsequent calcitonin screening and early surgical intervention will significantly reduce the chance of their developing terminal MTC. All MMN patients with mucosal neuromas or intestinal neurogangliomas should have such evaluations at least yearly. Relatives who are at risk for inheriting this dominant disease should be similarly evaluated, regardless of their normal appearance.
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PMID:Medullary carcinoma of the thyroid in the multiple mucosal neuromas syndrome. 53 32

The article reports on the newborn of a diabetic mother. Intestinal obstruction (subileus) occurred in the infant as a result of a neonatal small left colon syndrome. Diagnosis was established by radiological examination. Contrast enema with Gastrografin resulted in a permanent curative effect. Follow-up studies showed normalisation of the colonic lumen demonstrating the functional character of the disturbance. The etiology of the syndrome has not yet been clarified. It appears to be of differential diagnostic importance to make a clear distinction between this syndrome and Hirschsprung's disease (congenital megacolon) in newborn, because this involves a different therapy.
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PMID:[Neonatal small left colon syndrome (author's transl)]. 56 91

Comparable histologic alterations of intramural nervous tissue were reported in various diseases of the small and large intestine. In 6 cases, an intestinal obstruction was present which led to secondary intramural inflammation. The obstruction was induced by the spastic segment in Hirschsprung's disease (3 cases), by rectal atresia (2 cases) and by postoperative ischemic damage to the intestinal wall (1 case). In 4 other patients, the inflammation was predominant. The diseases considered were necrotizing enterocolitis (1 case), membranous enteritis (1 case) and Crohn's disease (2 cases). On the one hand, inflammatory infiltration composed primarily of lymphocytes was observed histologically in various degrees proximal to the obstruction in all cases. On the other, comparable alterations were found in splittering of nerve fibers and deterioration of nerve cells (degenerative alterations) in the plexus myentericus as well as hyperplasia and hyperchromasia of ganglion cells. Schwann cell proliferation and fibrosis in nerve fibers (reactive alterations). Until now such alterations were only observed in Chagas' disease and in ulcerative colitis, especially complicated by toxic megacolon. It is suspected that the neurodegenerative alterations in these diseases are toxically induced.
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PMID:Intramural ganglion cell degeneration in inflammatory bowel disease. 91 14

A retrospective analysis of 89 patients who underwent jejunoileal bypass surgery for morbid obesity disclosed 33 complications that were detected radiographically. Intestinal obstruction (10.1% of patients), cholecystitis (5.6%), renal stones (4.5%), peptic ulcer (3.4%), megacolon (6.7%), and elongation of the small intestine with hypertrophy of the mucosal folds of the jejunum (6.7%) were diagnosed solely by radiographic means.
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PMID:Radiographic evaluation of complications after jejunoileal bypass surgery. 97 58

Data for 500 patients with Crohn's disease who underwent operations were analyzed (316 patients, 1966 to 1969; 184 patients, 1972 to 1973) by comparison of various anatomic disease locations (clinical pattern): (1) ileocolic, 225 patients; (2) small intestinal, 130 patients; (3) colonic, 127 patients; (4) anorectal, 18 patients. Indications for surgery were tabulated and compared using statistical analysis for the three large patterns. For patients with ileocolic Crohn's disease, the primary surgical indications were internal fistula and abscess, 44%, intestinal obstruction, 35%, and perianal disease, 12%. For patients with Crohn's disease of the small intestine, the primary surgical indications were intestinal obstruction, 55%, and intestinal fistula and abscess, 32%. Patients with colonic Crohn's disease had a significantly more diverse surgical indication, with poor response to medical therapy, 26%, internal fistula and abscess, 23%, toxic megacolon, 20%, and perianal disease, 19%. These values were highly statistically significant (P less than 0.0001) in all instances but one. This study demonstrates that statistically significant differences occur in the surgical indication depending on the location of Crohn's disease. Patients with ileocolic, small intestinal, and colonic involvement have striking differences in clinical course. It is concluded that Crohn's disease is not a homogeneous entity, but should be recognized as having a varying course depending on clinical pattern.
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PMID:Indications for surgery in Crohn's disease: analysis of 500 cases. 108 41

Hirschsprung's disease or aganglionic megacolon is an anomaly caused by the absence of ganglion cells in the myenteric plexus of the distal colon. It produces intestinal obstruction or lethal enterocolitis in the neonatal period and constipation of varying degree in the older child. The diagnosis can be made by history alone and confirmed by physical findings, barium enema, motility studies, and rectal biopsy. Colostomy may be a life saving measure in the newborn, to be followed by a definitive pull-through procedure before the age of 1 year. Operative correction consists of various techniques all of which aim for excision of the aganglionic segment with preservation of the internal anal sphincter. The major pitfall of these procedures is a too perfectly preserved sphincter which remains spastic and still produces obstruction. Some damage to this muscle must be accomplished either during the procedure or postoperatively by bouginage in order to obtain a satisfactory result.
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PMID:Hirschsprung's disease. 126

An individual who has cystic fibrosis (CF) may suffer from gastrointestinal problems related to inadequately controlled intestinal absorption secondary to the pancreatic insufficiency. These include neonatal meconium ileus, distal intestinal obstruction syndrome (DIOS), constipation and acquired megacolon, rectal prolapse and rarely pancreatitis. If the intestinal malabsorption is well controlled with an effective pancreatic enzyme preparation, DIOS, constipation and rectal prolapse are infrequent. Persisting gastrointestinal symptoms should be investigated thoroughly to exclude other disorders not directly related to the cystic fibrosis; these include cows' milk intolerance, coeliac disease, giardiasis, Crohn's disease and intra-abdominal malignancy. Both appendicitis and intussusception may cause difficult diagnostic problems particularly in patients who may also have distal ileal obstruction syndrome.
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PMID:Cystic fibrosis: gastrointestinal complications. 145 4

Pelvic osteotomy with removal or repositioning of bone was performed as treatment for obstipation in 6 domestic shorthair cats with stenosis of the pelvic canal. Narrowing of the pelvic canal was the result of pelvic fracture or sacroiliac luxation in all cats. Tenesmus and obstipation began shortly after pelvic injury in 3 cats and 5 to 12 months after injury in the remaining cats. The duration of clinical signs ranged from 36 hours to 36 months. The duration of large intestinal obstruction influenced the outcome of surgery. Surgical widening of the pelvic canal helped eliminate signs of obstruction when signs were of less than 6 months' duration (n = 2). When signs of obstipation had continued for a longer period, and megacolon had developed, such treatment was minimally effective (n = 4).
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PMID:Pelvic osteotomy as a treatment for obstipation in cats with acquired stenosis of the pelvic canal: six cases (1978-1989). 155 79

The presentation, operative management and final diagnosis were reviewed in 28 patients with AIDS (27 men and one woman) who underwent emergency laparotomy. On clinical and radiological examination, six patients showed features of toxic megacolon, five patients had small bowel obstruction, six patients had localized peritonitis and three had perforated viscus with generalized peritonitis. The most common disease processes were acute colitis in seven patients (associated with cytomegalovirus (CMV) infection in six), intra-abdominal lymphoma in five patients, acute appendicitis in five patients (associated with CMV infection in two), and atypical mycobacterial (MAI) infection in four patients. Two perioperative deaths occurred; one in a patient with acute pancreatitis and a second with generalized peritonitis. Later deaths were due to progression of AIDS, and patient survival at 1 month, 3 months and 6 months was 89 per cent, 64 per cent and 48 per cent, respectively. Lower operative mortality than in previously reported series may be due to earlier intervention in CMV toxic megacolon. Surgery, however, conferred less benefit in patients with acute abdominal pain from MAI infection or lymphoma. With careful patient selection, emergency laparotomy may achieve worthwhile palliation in patients with AIDS.
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PMID:Emergency laparotomy in patients with AIDS. 131 Jun 34


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