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

Malignant tumors of the small bowel are rare but carry a grave prognosis. Thirty-seven cases from the Tumor Registries of Brooke Army Medical Center. Fort Sam Houston, Texas, and Fitzsimons Army Medical Center, Denver, Colorado, were retrospectively studied. Twenty-nine males and eight females ranging from five to 86 years were included in the combined series. Thirteen carcinoid tumors, eight adenocarcinomas, seven lymphosarcomas, five leiomyosarcomas, two reticulum cell sarcomas, one liposarcoma, and one mesenchymal cell sarcoma were found. Symptoms included intermittent crampy abdominal pain, intestinal obstruction, intestinal bleeding with anemia, and weight loss. The diagnosis was made on the basis of the clinical picture in addition to physical findings and pertinent x-ray contrast studies. The overall survival rate was 25%. The treatment of choice is surgical extirpation of the tumor whenever possible followed by appropriate adjunctive modalities.
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PMID:Malignant tumors of the intestine: a review of 37 cases. 57 64

One hundred patients undergoing pelvic exenteration (total 69, anterior 13, posterior 18) at the University of Michigan Medical Center from 1964-1984 are reported. All patients were followed for at least 5 years or until time of death. The overall cumulative survival was 66% at 3 years and 61% at 5 years. The age of the patients ranged from 21-74 years (median 53). The type of pelvic neoplasm included squamous cell of the cervix, 57; adenocarcinoma of the cervix, nine; squamous cell carcinoma of the vulva, 12; squamous cell carcinoma of the vagina, eight; vaginal sarcoma, four; adenocarcinoma of the vagina, one; adenocarcinoma of the endometrium, four; uterine sarcoma, four; and adenocarcinoma of the ovary, one. The cumulative 5-year survival was significantly related to the presence of metastatic disease to the regional lymph nodes (8% 3-year and 0% 5-year survival), time interval from primary diagnosis to exenteration (within 1 year 44%, 1-10 years 60%, and over 10 years 95%), and cell type (squamous cell 68%, sarcoma 62%, and adenocarcinoma 26%). Patients with squamous cell carcinoma of the cervix (N = 57) had a cumulative 5-year survival of 73%, compared with nine patients with adenocarcinoma of the cervix, who had a 22% 5-year survival. No significant difference in survival existed for the type of exenteration, original stage of squamous cell cervical carcinoma, size of recurrent squamous cell lesion, or age of the patient. Early or late complications occurred in 49 patients. Two patients died in the postoperative period. Small-bowel obstruction was the most common complication seen in this series.
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PMID:Pelvic exenteration, University of Michigan: 100 patients at 5 years. 258 60

Primary tumors of the small bowel are relatively rare. The 24 cases reported in this paper have been confirmed by operation and pathology. Based on clinical and radiologic findings and review of literature, the main X-ray manifestations of primary tumors of the small bowel were as follows: (1) Stenosis; (2) Filling defect; (3) Stiffness of involved intestinal wall with destruction of mucosa and loss of valvulae conniventes; (4) Intestinal obstruction or intussusception; (5) Dynamic dilatation and reversed peristalsis of the bowel segment proximal to the tumor. The causes of misdiagnosis and failure of detection and the site of predilection of the tumor were discussed. The differential points between benign and malignant tumors, sarcoma and carcinoma, metastatic tumor and primary tumor, Crohn's disease and carcinoma were mentioned.
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PMID:[X-ray diagnosis of primary tumors of the small bowel (report of 24 cases)]. 262 18

We describe a case of solitary fibromatosis of the ileum in an infant. Intestinal fibromatosis is a rare cause of intestinal obstruction in the newborn. The disease is poorly characterized and has been rarely reported under this name. The differential diagnosis is discussed with particular attention to inflammatory fibroid polyps, neurofibromatosis, and sarcoma. Reasons of a theoretical and practical nature are outlined that recommend the term "solitary intestinal fibromatosis" as the most appropriate name for this disease.
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PMID:Solitary intestinal fibromatosis in the newborn. Rare cause of neonatal intestinal obstruction. 383 45

A young man presented with intestinal obstruction. Laparotomy revealed a large mass encircling the cecum and terminal ileum which histologically proved to be a granulocytic sarcoma. No evidence of leukemia was present in peripheral blood or bone marrow. Initial therapy consisted of abdominal irradiation. Two months following completion of irradiation, widespread systemic involvement without leukemia was evident. Systemic chemotherapy with doxorubicin, cytosine arabinoside, vincristine, and prednisone was initiated. Chemotherapy was continued for 18 months. The patient has remained without evidence of disease for 49 months following discontinuation of treatment, and 67 months after initial diagnosis. Systemic therapy for granulocytic sarcoma presenting without evidence of leukemia is reviewed.
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PMID:Granulocytic sarcoma treated as an acute leukemia. Report of a case. 658 98

The surgical insertion of an absorbable sling mesh has become the most promising technique for excluding the small bowel from the pelvis prior to radiotherapy. Both human and animal studies suggest that this procedure is very safe. The author reports what appears to be the first significant mesh-related complication. A 69-year-old man suffered early postoperative complete mechanical small bowel obstruction after insertion of a polyglactin 910 (Vicryl) surgical sling mesh at the time of low anterior resection for a stromal sarcoma of the rectum. Urgent laparotomy was required and revealed that the Vicryl mesh was associated with an intense inflammatory reaction. Radiation therapy is a critical component of contemporary multimodal treatment of patients with rectal cancer. This case suggests that inserting biodegradeable mesh to protect the small bowel from radiation effects is not without complications.
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PMID:Complete small bowel obstruction in the early postoperative period complicating surgical sling procedure. 812 51

Intussusception secondary to metastatic sarcoma is an unusual cause of small bowel obstruction. When a patient who has no history of a previous laparotomy, and has a known malignancy which metastasized hematogenously, presents with small bowel obstruction, the diagnosis of intussusception should be considered. The patient should be evaluated and treated accordingly.
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PMID:Enteroenteric intussusception due to a metastatic malignant fibrous histiocytoma. 841 81

We report the case of a 40-yr-old man presenting with symptoms of small bowel obstruction. Small bowel x-rays revealed a stricture of the mid-jejunum. Push enteroscopy found a polypoid mass at 1 meter of the ligament of Treitz. Histopathological examination of the biopsy and surgical specimens showed a diffuse infiltrate of the mucosa made of medium to large cells, which were stained on immunohistochemistry by the leucocyte marker CD45 and the histiocyte/monocyte marker CD68 but were negative for the B and T cell markers. Cytological examination of the ascitic fluid revealed many myelobasts with cytoplasmic Auer rods and positive myeloperoxidase staining. There was no evidence of blood or bone marrow involvement suggestive of acute leukemia or myeloproliferative disorders. These findings were consistent with the diagnosis of preleukemic granulocytic sarcoma (or chloroma). Chemotherapy led to complete remission, but 21 months later the patient developed an acute myeloid leukemia. He died from aspergillus pneumonitis, 10 months after bone marrow allograft. Preleukemic granulocytic sarcoma of the small bowel is a rare condition and its diagnosis is usually not easy, requiring histochemical or immunohistochemical studies. Most cases have progressed to acute myeloid leukemia.
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PMID:Granulocytic sarcoma of the jejunum: a rare cause of small bowel obstruction. 986 Apr 34

A 51-year-old male patient presented with characteristic radiologic features of Crohn's disease in the terminal ileum plus a large tumorous lesion in the right lower abdomen. Because of rapid crescent symptoms of bowel obstruction, the patient underwent surgery revealing a high-risk gastrointestinal stromal tumor (GIST) of the terminal ileum within an area of Crohn's ileitis. Whereas the association of chronic inflammatory bowel disease (IBD) and gastrointestinal adenocarcinoma is well known, other primary intestinal tumors are rare in these patients, particularly at the time of onset of clinical symptoms. This is the 3rd patient reported in the literature with a sarcoma complicating IBD, and in fact, the first description of the coincidence of Crohn's disease and GIST. Though the present case is likely to be a mere coincidence of two pathologically distinct entities (without any potential causal relationship), it should remind one of the possibility of small bowel 'Crohn's carcinoma' in patients with a sudden change in symptomatology as well as in those in whom intestinal obstruction fails to resolve with adequate therapy.
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PMID:Coincidence of Crohn's disease and a high-risk gastrointestinal stromal tumor of the terminal ileum. 1039 32

We describe a patient who presented with autoimmune hemolytic anemia and small bowel obstruction secondary to a malignant stromal tumor (leiomyosarcoma) of the jejunum, 25 years postchemotherapy and radiation treatment for stage IIA Hodgkin's disease. The patient was treated with corticosteroid therapy and surgical resection of the jejunal tumor. We conclude that autoimmune hemolytic anemia may be an unusual presentation for postirradiation sarcoma.
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PMID:Autoimmune hemolytic anemia associated with postirradiation malignant stromal tumor (leiomyosarcoma) of the jejunum. 1114 67


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