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)

In the great majority of patients treated with radiation, only transitory injury to the bowel occurs, but in five percent of patients, permanent damage to the small bowel or rectum is seen. Symptoms of radiation enteropathy may begin four to six months after the treatment is completed or may not present until several years later. Most often, the patient presents with abdominal pain, diarrhea, hematochezia, and signs of malnutrition. Others may present, initially, with intestinal obstruction, perforation, or fistulization. It is important to differentiate this clinical syndrome from recurrent cancer by appropriate radiological studies and biopsies.This paper presents four patients who were treated with radiation for invasive carcinoma of the cervix and subsequently developed radiation enteritis. All were treated surgically and are surviving.
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PMID:Surgical management of radiation enteritis. 44 53

To assess the efficacy of operative and nonoperative therapy of small bowel obstruction (SBO) in patients with a previous diagnosis of cancer, a review of 54 cases was carried out. The 32 men and 22 women had a mean age of 58 years. At presentation with SBO, 26 patients (48%) had known recurrent cancer. Forty patients were initially treated nonoperatively; 11 (28%) had resolution of their SBO after a mean of 7 days of nasogastric suction. Five of 11 patients developed recurrent SBO prior to death. Thirty-seven patients underwent laparotomy, 14 on the day of admission and 23 after failure of nasogastric suction. Twenty-five of 37 (68%) had obstruction due to recurrent carcinoma. Small bowel obstruction due to recurrent cancer occurred earlier (21 +/- 5 months) than SBO from benign causes (61 +/- 18 months; p < 0.01). Mean survival for patients with malignant obstruction (5 +/- 1 month) was significantly shorter than for those with benign obstruction (50 +/- 10 months; p < 0.001). The 30-day and in-hospital mortality rates for the 25 surgically treated patients with malignant SBO were 24% and 28%, respectively; in 9 of 25 (36%), the obstruction failed to fully resolve. The only factor predictive of in-hospital mortality was obstruction secondary to cancer (p < 0.05). The median posthospital survival for surgically treated patients with malignant SBO was only 2.5 months. We conclude that: (1) patients should be given an initial trial of nonoperative therapy; (2) patients with no known recurrence or a long interval to the development of SBO should be aggressively treated with early surgery if nonoperative treatment fails; and (3) for patients with known abdominal recurrence in whom nonoperative therapy fails, the results of surgical palliation are grim. Innovative approaches are needed to maximize palliation while also limiting morbidity and mortality.
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PMID:Small bowel obstruction in patients with a prior history of cancer. 172 26

A retrospective study was undertaken to evaluate the operative management of patients with chronic radiation enteropathy. Thirty-eight affected patients from 1974 to 1986 were reviewed. Patients with recurrent cancer responsible for symptoms were excluded. Seventy-one percent of patients presented with bowel obstruction. Twenty-one patients were treated with bowel resection, while 17 were treated with a bypass procedure or diverting ostomy alone. Overall morbidity was 45%, and postoperative mortality was 16%. Patients in the bypass group were significantly older than those in the resection group (70.3 vs. 55.5 years, P = .024), suggesting that age may have been a determinant of the procedure performed. In our study there was no difference in outcome based on preexisting vascular disease, tumor site, type of procedure performed, or radiation dose. We conclude that resection is the procedure of choice in cases of chronic radiation enteritis requiring surgery except in cases with dense adhesions when enteroenterostomal bypass is a viable alternative.
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PMID:Chronic radiation enteritis: a community hospital experience. 275 42

Thirty-three healthy women (group 1), 20 patients with a history of ovarian carcinoma but no manifest disease at the time of the study (group 2), and 45 patients with surgically demonstrable ovarian cancer (group 3) were studied to establish guidelines for the use of the ovarian cancer antigen Ca 125 in monitoring the course of ovarian carcinoma. Ninety-nine percent of all Ca 125 titers of patients in groups 1 and 2 were less than or equal to 25 U/mL. By contrast, 96% of patients with manifest ovarian cancer had Ca 125 levels greater than 25 U/mL. Ca 125 values rising from the normal range to greater than 25 U/mL predicted recurrent disease in all of ten patients, provided benign causes (four cases) for titer elevations such as bowel obstruction could be ruled out. Seven of ten patients with recurrent cancer had elevated antigen levels two to five months before the diagnosis could be made clinically. In patients with Ca 125 values greater than 25 U/mL, titer changes of greater than or equal to 50% compared with reference values predicted tumor response or progression in 41 of 43 patients (95%) with antigen positive tumors. Antigen levels less than or equal to 25 U/mL did not exclude the presence of tumor at second look operation in six of 13 patients (46%). It is concluded that the Ca 125 is useful for the detection of persistent and recurrent disease, and for the evaluation of treatment responses.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of Ca 125 as tumor marker in ovarian carcinoma. 300 52

Thirteen patients with rapidly advancing recurrent epithelial ovarian cancers, in whom chemotherapy and, in some cases, radiation therapy failed, were treated with the estrogen antagonist tamoxifen. The presence of cytosol estrogen receptors, which have recently been identified in ovarian cancer specimens, was determined in the tumor from each patient prior to tamoxifen treatment. No complete responses were observed. One patient had a partial response and 4 patients had prolonged stabilization of disease. All patients with stabilized disease had estrogen receptor levels that were borderline or high. Eight patients demonstrated no response to oral tamoxifen therapy, but 5 of these had partial small bowel obstruction secondary to advanced recurrent cancer. As tamoxifen in this preliminary study may have stabilized rapidly advancing recurrent ovarian cancer in combination with cytotoxic chemotherapy should be considered.
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PMID:Tamoxifen therapy for advanced ovarian cancer. 707 Jul 29

The objective of this study was to evaluate short and long term results of management of recurrent intraabdominal malignancy causing intestinal obstruction using surgery and intraperitoneal chemotherapy and determine the clinical features that suggest favorable outcome. Forty two consecutive patients who were treated by cytoreductive surgery with or without intraperitoneal chemotherapy were retrospectively analyzed. There were 20 patients with primary tumors of appendix, 13 with cancer of colon or rectum, and 9 patients with cancer of other origins. All 42 patients were explored and extensively evaluated intraoperatively. Surgery included bowel resections and peritonectomy procedures. In 30 patients early postoperative intraperitoneal chemotherapy was administered. The overall morbidity was 55% while mortality was 7.14%. The projected three year survival for this group of patients was 32.7%. Among the most significant clinical features that reflect favorable prognosis were low histologic grade of malignancy, recurrence 2 and more years after primary surgery, and cancer that could be completely surgically excised. As a result of treatment patients' performance status improved in 47.6% of cases. An aggressive reoperative approach may be considered for palliation of selected patients with recurrent cancer causing intestinal obstruction.
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PMID:Recurrent intraabdominal cancer with intestinal obstruction. 853 Feb 31

An estimated 2,500 women were diagnosed with and 1,500 died from ovarian cancer in Canada in 2002. Up to 42% of patients in the palliative phase develop a malignant bowel obstruction. Options for management include medical therapy, surgery, and/or a percutaneous endoscopic gastrostomy (PEG) tube. The objective of this quality improvement study was to: 1) examine if successful palliation was achieved using a PEG tube, and 2) identify opportunities to improve the quality of nursing care provided. A retrospective review of 24 patient records revealed that 75% did not have nausea/vomiting by time of discharge; 92% resumed a clear fluid diet; 83% were discharged from the acute care setting; and 70% did not require re-admission. A PEG tube may effectively palliate women with non-operable bowel obstruction in advanced/recurrent cancer of the ovary. Opportunities for improving care are presented.
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PMID:Managing bowel obstruction in ovarian cancer using a percutaneous endoscopic gastrostomy (PEG) tube. 1469 64

The current study was designed to analyze safety of the bedside hyperthermic intra-pleural or intra-peritoneal chemotherapy (HIPEC) from September 2007 to July 2015. Total of 5,759 times of bedside HIPEC in 985 cases of malignant pleural or peritoneal carcinomatosis were analyzed. Of them, 1,510 times was given to 315 cases of malignant pleural effusion, while 4,249 times was performed in 402 patients with malignant ascites and 268 patients without ascites (total 670 patients for peritoneal carcinomatosis). In average, patients with pleural effusion was given 5 times bedside HIPEC and stayed in the hospital for 6.7 days; while patients with peritoneal carcinomatosis was given 6 times of HIPEC and stayed in the hospital for 6.5 days. Overall HIPEC-associated mortality was zero. Overall HIPEC-associated incidence of side effect in the intra-pleural HIPEC was 2.0%. Specifically, 0.6% was pneumothorax, 0.3% was cytotoxic agent-induced pleural inflammation, 0.5% was pain at puncture location, and 0.3% was failure of HIPEC procedure. Overall HIPEC-associated incidence of side effect in the intra-peritoneal HIPEC was 2.4%, i.e., failure of HIPEC procedure in 1.3%, pain at puncture location was 0.5%, cytotoxic agent-induced peritoneal inflammation was 0.1%, intestinal obstruction was 0.1% and intestinal perforation was 0.07%. These findings indicated that bedside HIPEC applied in the current study is safe to be performed by a Physician or Oncologist under local anesthesia at a patient's bedside. The procedure is easy to perform and well-tolerated by the patients with late stage cancer or post-surgery recurrent cancer.
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PMID:Retrospective analysis on the safety of 5,759 times of bedside hyperthermic intra-peritoneal or intra-pleural chemotherapy (HIPEC). 2691 43