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)

We report on an 89-year-old female admitted with signs of intestinal obstruction in whom three independent adenocarcinomas of the proximal jejunum were found. Multiple foci of pyloric gland metaplasia, glandular hyperplasia and dysplasia, carcinoma-in-situ, and several varieties of adenocarcinoma were identified on microscopic examination of 14 cm of excised jejunum. Multifocal adenocarcinoma of the small intestine is extremely rare. We are not aware of any case harboring the complex changes described herein.
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PMID:Multifocal adenocarcinoma of the jejunum. 38 70

Two patients, members of one family, with Peutz-Jeghers syndrome are described who underwent surgery for bowel obstruction. Both had multiple polyps in the gastrointestinal tract. Severe dysplasia and adenomatous change were present in two hamartomatous polyps adjacent to a stenosing colonic carcinoma in one patient and moderate dysplasia and adenomatous change were observed in two hamartomatous rectal polyps in his son. These changes support recent reports in the literature of progression towards neoplasia in these lesions.
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PMID:Do dysplastic and adenomatous changes in large bowel hamartomas predispose to malignancy?--A report of two cases. 133 70

Total colectomy with mucosal protectomy and ileal pouchoanal anastomosis (IPAA) is a promising surgical development for the treatment of ulcerative colitis and familial polyposis. It avoids the need for an ostomy to the exterior, removes all affected tissue and maintains reasonable bowel control by the anal sphincter. 58 patients who underwent IPAA (Group A) were compared with 40 who underwent total proctocolectomy with Kock's pouch (KP) or Brooke's ileostomy (BI), or ileorectostomy (Group B). The indications for surgery were intractable disease, recurrent acute colitis, nonresolving acute colitis, dysplasia, toxic megacolon, perforation, hemorrhage and malnutrition. In Groups A and B duration of operation was, respectively, 6.9 and 5 hours (p less than 0.001); postoperative complications were intestinal obstruction (8 cases versus 14, p less than 0.05), pelvic inflammation (4 vs 3), pouchitis (4 vs 2), and wound infection (3 vs 1). Additional complications in Group A were pouchovaginal fistula (2), and single cases of transient brachial plexus palsy, anastomal stenosis, and rectal prolapse. There were no sexual or urinary complications, no cases in which pouch resection was necessary, nor was there any postoperative mortality. Additional complications in Group B were pouchocutaneous fistula (3) and neurogenic bladder (1?). Among those with KP, there were 9 cases of nipple slippage and 2 cases needed total pouch resection. Among those with BI there were 3 cases of ileostomal prolapse. Mortality in Group B was 4. Total hospital stay in groups A and B, respectively, were 30 and 56 days (p less than 0.0005). Fecal output was 6.3 and 5.9 movements per day in Groups A and B, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of ulcerative colitis and familial polyposis]. 166 68

An 86-year-old woman who developed small bowel adenocarcinoma 40 years following in-continuity bypass of a 60-cm segment of regional ileitis represents the 22nd reported patient with this complication of bypassed Crohn's disease. Her case demonstrates several of the typical clinical features of such cancers: late recrudescence of disease following a 40-year period of relative quiescence; delayed diagnosis due to misinterpretation of the clinical picture (intestinal obstruction, abdominal mass, intraabdominal abscess, and fistula formation) as due to inflammatory bowel disease; and an exceedingly poor prognosis with rapid widespread local dissemination and death. Histologically, severe dysplasia was demonstrated both in close proximity to and at a distance from the lesion. The increasing number of case reports of adenocarcinoma arising at the site of long-standing Crohn's disease, many with dysplasia within areas of diseased bowel, is further evidence that Crohn's disease is a precancerous condition. Physicians must continue to search for methods of earlier diagnosis to improve the prognosis of small bowel carcinoma in Crohn's disease.
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PMID:Small bowel carcinoma in Crohn's disease. Distinguishing features and risk factors. 291 Apr 43

We describe two cases of short-segment Hirschsprung's disease associated with neuronal colonic dysplasia. The recurrence of postoperative symptoms of bowel obstruction may be due to the combined occurrence of these two disorders.
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PMID:Neuronal colonic dysplasia associated with short-segment Hirschsprung's disease. A possible cause of therapeutic failure. 383 82

A case of carcinoma of the small intestine arising in a patient with regional enteritis (Crohn's disease) of the ileum is reported. The patient, a 54-year-old woman, had a 21-year history of regional enteritis which was treated intermittently with sulfasalazine and prednisone. Segmental resections of the ileum had been performed on two previous occasions. Because of recurrent low-grade intestinal obstruction, another segment of ileum was resected. The bowel demonstrated the typical gross and histologic appearance of regional enteritis. Histologic examination also disclosed a carcinoma that was confined to the ileal mucosa. This case is the first reported in which a small bowel carcinoma arising in regional enteritis has been found only in the mucosa. Adjacent to the carcinoma, the mucosa showed varying degrees of dysplasia consistent with the "precancerous" changes that have been described in inflammatory bowel disease. Using a peroxidase-antiperoxidase immunoperoxidase technique, carcinoembryonic antigen was identified in normal, hyperplastic, dysplastic, and carcinomatous mucosa, but the most intense staining was seen in hyperplastic and dysplastic cells. Carcinoembryonic staining, however, did not aid in differentiating between hyperplasia, dysplasia, and carcinoma because of an overlap in staining frequency and intensity.
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PMID:Intramucosal carcinoma of the small intestine arising in regional enteritis (Crohn's disease). Report of a case studied for carcinoembryonic antigen and review of the literature. 637 85

Colonic diverticula are generally multiple and occur most commonly in the descending and sigmoid colon. Solitary ascending colonic diverticulum is a rare pathology and presents several features which separate it from colonic diverticulosis. It is a true diverticulum. It is a congenital dysplasia that generally runs an asymptomatic course and becomes clinically important only when inflammatory, perforating, or hemorrhagic complications occurs and presents a difficult problem in diagnosis and management. An unusual case of 4 year old girl with solitary ascending colonic diverticulum was reported here. It caused internal intestinal herniation by forming an adhesion band with mesentery and the clinical course manifested as an acute intestinal obstruction.
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PMID:[Solitary diverticulum of ascending colon induced internal intestinal herniation: report of one case]. 818 94

From 1987-1994 we performed 35 proctocolectomies with ileal pouch anal anastomosis. The indication for operation was ulcerative colitis in 29 and familial polyposis in 6. The mean ages at operation were 35 and 25 years, respectively. The most common postoperative complication was small bowel obstruction in 25% of the patients, requiring re-operation in half of them. The incidence of this complication may be reduced by operating in only 1 stage when possible, without creating a protective ileostomy. The second serious complication was pouchitis, in 17%, which was controlled by antibiotics. There has been no mortality. All patients, except for 2 with an S-shaped pouch, evacuate spontaneously a mean of 5 bowel movements a day. Continence was mildly impaired (usually night-staining of a pad) in 30% of patients in whom the pouch-anal anastomosis was performed after stripping the mucosa of the rectal remnant. In those in whom the pouch-anal anastomosis was performed by means of the double stapling technique, continence was almost completely preserved. We therefore recommend that proctocolectomy with ileal pouch-anal anastomosis be performed in 1 stage when possible, using the double stapling technique. Staged operation should be reserved for severely ill patients, or when stripping of the rectal mucosa is performed for familial polyposis and ulcerative colitis with severe dysplasia.
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PMID:[Restorative proctocolectomy for ulcerative colitis and familial polyposis]. 854 54

Children and adolescents with colitis present specific problems for surgeons. There has been a fashion, particularly in North America, for restoring continuity after colectomy by a direct ileo-anal anastomosis. The authors reviewed their experience with restorative proctocolectomy with ileal reservoir (RPC) in patients under 18 years of age to evaluate the outcome and to discuss the problems and challenges associated with the procedure in this age group. Fifteen patients (6 boys, 9 girls) were operated on between 1984 and 1995. The diagnoses included 12 patients with ulcerative colitis (UC), two with familial adenomatous polyposis (FAP), and one with total colonic neuronal dysplasia. The median age of the patients at the time of ileal pouch formation was 15 years, and follow-up data were available for all patients at a median of 43 months. Ten patients with UC underwent pouch surgery 4 to 14 months after initial total abdominal colectomy (7 for acute severe disease, 3 for chronic disease). Four patients (2 with chronic UC, 2 with FAP) underwent primary RPC. There were no deaths in this series. Three (20%) patients suffered serious early morbidity (pouch hemorrhage, pelvic sepsis, severe psychological crisis). Late morbidity included three patients who had small bowel obstruction, one who required laparotomy, two who required pouch revision, and five of 12 (42%) patients with UC who presented with a documented episode of pouchitis between 2 and 72 months after ileostomy closure. All patients had acceptable bowel frequency and quality of continence. This experience suggests that RPC provides an important surgical option for children and adolescents with UC or FAP.
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PMID:Restorative proctocolectomy in children and adolescents. 898 80

A two-year-old boy presenting with the signs and symptoms of partial intestinal obstruction caused by a mucosal web in the ileum is presented. Histopathological evaluation following resection and primary anastomosis revealed neuronal intestinal dysplasia associated with fibromuscular arterial dysplasia limited to the segment proximal to the web and normal findings in the distal part. These findings and a brief review of the literature support the hypothesis that neuronal and fibromuscular dysplasias may develop on the basis of congenital obstructive lesions of the bowel.
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PMID:Neuronal intestinal and fibromuscular arterial dysplasias associated with intraluminal mucosal web. 908 13


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