Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective review was conducted of 326 patients undergoing intersphincteric rectal excision for ulcerative colitis. Seventy-five patients (Group A) had rectal excision with closure of the pelvic peritoneum and packing of the pelvic space via an open perineal wound. One hundred sixty-nine patients (Group B) had excision without pelvic peritoneal closure, but with the levators and subcutaneous tissue closed and with transabdominal sump suction drainage of the pelvic space. Complete healing for Groups A and B occurred by three months in 42 and 79 percent, respectively, and by six months in 56 and 89 percent. Thirty-one percent of Group A and 9 percent of Group B were unhealed at one year, and/or required further surgery. When all 326 patients were considered, healing was achieved at three, six, and 12 months, for packed and for closed wounds, in 42 percent and 79 percent, 55 percent and 89 percent, 66 percent and 91 percent, respectively. All these differences are highly significant (P less than 0.0001). The incidence of small-bowel obstruction requiring surgery during follow-up was similar whether the pelvic peritoneum was closed (15.5 percent) or left open (15.7 percent). Other factors which adversely affected perineal wound healing were younger age, a short history of disease, a two-stage proctocolectomy especially for persistent severe rectal disease, and the presence of perianal disease.
Dis Colon Rectum 1985 Dec
PMID:Management of the perineal wound after rectal excision for ulcerative colitis. 406 46

Primary linitis plastica of the colon is an uncommon tumor, with only 22 cases having been previously reported. Experience with two men and one woman between 17 and 55 years of age, portraying a spectrum of clinical presentations ranging from rectal bleeding to large-bowel obstruction, is reviewed. Clinical and radiologic characteristics and histologic features helpful in making the diagnosis are detailed. Though the prognosis is grim, resective surgery, including oophorectomy in women, should be undertaken. Adjuvant therapy has been disappointing.
Dis Colon Rectum 1982 Apr
PMID:Colorectal linitis plastica. 627 69

Radiation therapy, often used to treat gynecologic and urologic pelvic malignancies, has varying, adverse effects on the bowel. Radiation enteritis may occur from one month to 20 years after irradiation, and disabling symptoms may require surgery in 10 to 20 per cent of patients. From our experience with 20 patients who required surgery for radiation enteritis and who were followed for up to 20 years, we were able to identify three clinical groups. Patients in the first group need only medical treatment for their symptoms, and observation, whereas patients in the second group may present with acute, debilitating, life-threatening symptoms that may require emergency surgery. Patients in the third group have a long-standing history of intermittent bowel obstruction and/or enteric fistulas that are best treated with adequate nutritional support followed by timely surgical intervention.
Dis Colon Rectum 1983 Sep
PMID:The spectrum of radiation enteritis. Surgical considerations. 640 69

A case of giant localized pseudopolyp causing partial large-bowel obstruction and occurring in granulomatous colitis is reported. This represented the first manifestation of the patient's disease. The role of surgery in certain patients is discussed.
Dis Colon Rectum 1984 Sep
PMID:Giant pseudopolyps in granulomatous colitis. Report of a case. 646 6

After colonic resections, peritoneal defects exposed to colonic flora and blood may become the seat of localized peritonitis and cause small-bowel adhesions and obstruction. In the past five years, we have seen 14 patients where one or both of these complications was anticipated for one of the following reasons: presence of an abscess cavity, local infection or accidental tear of the colon. In these patients a rubber sheet was stitched to the edges of the peritoneal defect with absorbable sutures and brought out through the abdominal wall. In all patients the rubber dam functioned as a passive drain and as a barrier between the peritoneal defect and the small bowel. Three weeks later the rubber dam was removed by traction. None of these patients developed small-bowel obstruction and no adverse effects from the rubber sheet were seen. The working mechanism of the rubber dam was investigated in female Wistar rats. After removing the peritoneum between the left kidney and pelvis, the defect was covered with a rubber dam. A capsule with a standard solution of Escherichia coli, Bacteroides fragilis, and autoclaved feces was used to initiate peritonitis under the rubber dam. The rubber proved to act as an efficient drain and barrier. No abscesses or small-bowel adhesions were seen. In the control group, 75 per cent of the animals died from generalized peritonitis or developed an abscess.
Dis Colon Rectum 1984 Nov
PMID:The rubber dam as a means to isolate contaminated peritoneal defects after colonic resection. 649 3

The case records of 12 patients with cecal volvulus over a 20-year period were reviewed. The patients averaged 46.7 years old; 75 per cent were white and 67 per cent were male. Patients presented with signs and symptoms of intestinal obstruction. Pain and distention were present in more than half of the patients. X-rays assisted in making the diagnosis of cecal volvulus in only five of the patients. Diagnosis was made in the remainder at the time of surgical exploration. At operation, one cecum was necrotic and required resection. Five patients underwent cecostomy, two cecopexy, and four simple detorsion. Post-operatively, one patient developed a wound infection. There were no deaths. Follow-up for seven patients averaged 75 months each. One patient who had undergone simple detorsion developed another cecal volvulus. All who were contacted were alive and well. At St. Luke's Hospital, cecal volvulus generally occurs in middle-aged white males. Cecostomy or cecopexy adequately treats cecal volvulus when the cecum remains viable. This study demonstrates that prompt surgical intervention, before strangulation of the colon occurs, results in low mortality even in city hospital patients.
Dis Colon Rectum 1984 Nov
PMID:Cecal volvulus. Low mortality at a city hospital. 649 9

Two hundred thirty-two cases of colorectal malignancy were studied between January 1975 and March 1981. The material was analyzed with respect to various epidemiologic features such as age, sex, residence, religion, socioeconomic status, diet, bowel habits, site of bowel involved, acute obstructive symptoms, and histopathology. The disease afflicted predominantly old people but at an age earlier than is reported in most western studies. Rectal cancer was more common in males, while colonic cancer involved the two sexes equally. Acute large-bowel obstruction was found in 19.4 per cent of patients. The rectum was the most common site (41.8 per cent). Of all the colonic malignancies, 63.4 per cent were in the right colon. Simultaneously, normal gut transit studies using radiopaque markers were conducted in 30 healthy volunteers. The colonic transit rate was 3.09 cm/hour. The markers had a faster gut transit but, interestingly, exhibited pronounced stasis in the right colon, which correlates well with the significantly higher incidence of right-sided malignancy.
Dis Colon Rectum 1984 Jan
PMID:Large-bowel malignancy. Epidemiology and gut motility studies in South Asia. 669 Feb 60

Mesenteric desmoid tumors are a recognized sequela of colectomy for polyposis coli of Gardner's type. Relentless growth and recurrence carry a poor prognosis. Recently, nonsteroidal anti-inflammatory drugs have been used to halt the growth of these tumors, presumably by interfering with prostaglandin metabolism. A 36-year-old man presented with small-bowel obstruction secondary to a large, diffuse mesenteric desmoid six years following colectomy and ileoproctostomy. Laparotomy revealed it to be unresectable. Postoperatively, he was started on sulindac (Clinoril) 100 mg twice a day. His obstruction resolved, and he remains well at 11 months. A CT scan shows diminution in the size of the tumor. Nonsteroidal anti-inflammatory agents may be an alternative to chemotherapy and radiotherapy in treating mesenteric desmoids.
Dis Colon Rectum 1984 Jan
PMID:Mesenteric desmoid tumor in Gardner's syndrome treated by sulindac. 669 Feb 65

The role of ultrasound scanning in the diagnosis of cancer of the colon under emergency conditions such as intestinal obstruction, perforation or, more rarely, heavy colonic bleeding, is discussed. In any case, ultrasound scanning can quickly and rationally indicate choices for further assessment when possible. Characteristic ultrasonic images are described, and possible differential diagnoses are discussed briefly. The method seems significantly sensitive, although nonspecific, as it can give analogous images in cases of inflammatory pseudo-tumors, Crohn's disease, and adult intussusception.
Dis Colon Rectum 1984 Mar
PMID:Ultrasonic detection of colonic carcinoma in emergency. 669 43

Acute intestinal obstruction was the presenting feature in 124 (19 per cent) of 646 patients with colorectal carcinoma seen over a six-year period. Forty-two per cent of tumors were incurable at presentation. Obstruction was complicated by perforation in 22 patients (18 per cent). Only 15 per cent of tumors occurred in the rectum. Although the postoperative mortality rate was higher in patients with coincidental perforation than in those without (52 vs. 26 per cent: P = 0.03), five-year survival rates were the same: 18 per cent overall, rising to 29 to 34 per cent after "curative" resection. Five-year survival rates were best for right colon tumors and worst for rectal tumors (36 vs. 5 per cent: P = 0.01). The overall hospital mortality rates for colostomy and delayed resection, resection with colostomy, and resection with anastomosis were equivalent (18 to 22 per cent), but following "curative" resection the hospital mortality rate was higher for resection with colostomy than with other treatments (29 vs. 15 per cent), since two patients died following early closure of colostomy. Five-year survival was better following resection with anastomosis (48 per cent) than staged procedures (18 per cent: P = 0.01), since two patients died following late closure of colostomy.
Dis Colon Rectum 1984 May
PMID:Survival in acute obstructing colorectal carcinoma. 671 46


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>