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)

An 85-year-old man with a clinical and x-ray picture consistent with a large bowel obstruction had a large left inguinal hernia with an incarcerated loop of sigmoid colon containing a small annular constricting colon carcinoma. Colonic obstruction due to inguinal hernia alone is so rare that a thorough evaluation should be done preoperatively in any patient believed to have colonic obstruction due to inguinal hernia.
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PMID:Complete colonic obstruction caused by a sigmoid colon cancer incarcerated in an inguinal hernia sac. 192 37

In the past 30 years 338 patients with colorectal carcinoma were admitted for acute intestinal obstruction which accounted for 17.17% of 1969 surgically treated colorectal carcinomas. Of these, right colon carcinoma was found in 116 cases, left colon carcinoma in 177, and rectal carcinoma in 45. Sixty nine one-stage resections of the tumor out of 148 emergent operations were carried out including all 29 right colon carcinomas, 20 out 34 left colon carcinomas, and 4 out of 6 rectal carcinomas. In patients undergoing one-stage resections, the overall operative mortality was 3.77%, morbidity happened in one case suffering from anastomotic leakage, and the five year survival rate was 43.4% compared with no operative mortality, and five year survival of only 18.75% in delayed resection group. Our data showed that the mortality of one stage resection of left colon carcinomas complicated with acute obstruction was acceptable and the five year survival rate was slightly higher than that in delayed resection. In terms of whole series, the five year survival rate in one stage resection group was significantly higher than that in delayed resection group. The authors, therefore, favour one stage resection of the tumor in cases of acute intestinal obstruction.
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PMID:[Surgical treatment of acute intestinal obstruction caused by large bowel carcinoma]. 259 34

This report describes a case of wound infection associated with Vibrio parahaemolyticus. The patient had ingested steamed crabs 7 days before admission for surgical treatment of intestinal obstruction due to colon carcinoma. The Vibrio sp. was isolated from postoperative wound drainage as well as from stool. Recovery was uneventful.
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PMID:Postoperative wound infection associated with Vibrio parahaemolyticus in a patient without exposure to seawater. 338 32

A case of obstruction of the appendix simulating colon carcinoma is presented. The cause of the patient's symptoms and radiographic findings was found at colonoscopy to be a toothpick embedded in the appendix. The toothpick was extracted colonoscopically. Cases of intestinal obstruction by toothpicks reported in the literature are reviewed.
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PMID:Appendiceal obstruction by a toothpick removed at colonoscopy. 377 65

We have described a patient with intestinal obstruction caused by schistosomiasis but closely resembling colon carcinoma. The cause, demography, pathologic characteristics, and clinical management of the disease caused by Schistosoma mansoni are reviewed.
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PMID:Intestinal obstruction due to schistosomiasis. 397 2

A woman suffering more than ten years with Crohn disease, makes one day a small intestinal obstruction. She undergoes a laparotomy in which a resection of 30 cm terminal ileum is done. Surprisingly the anatomo-pathologic diagnosis is adenocarcinoma between the Crohn's inflammatory lesions. Weedom and Greenstein have proven that Crohn disease and colon carcinoma are related in their follow-ups. But to find such a relationship between Crohn and carcinoma of the small intestine tumours is very small: +/- 0,3/100.000 in a year and so the cases in literature too. We have found 38 cases with enough information. This people with Crohn and carcinoma of the small intestine have an age of 43 years and more than 10 years Crohn symptoms before tumour was found. The tumours are localized in more than 70% in the ileum; 85% are adenocarcinoma. Such differences in localization, age and anatomopathology between Crohn's patients and a normal population let us presume that malign degeneration in Crohn disease is more than accidentally. A casual connection can't be given. For therapeutic use a resection is to prefer because many dysplasias are found in bypass segments.
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PMID:[Malignant degeneration of the intestine in Crohn's disease]. 665 16

During the last 4 years (11/93-11/97) 330 patients with acute bowel obstruction were treated and analysed retrospectively. 80% of the obstructions (n = 265) were in the small bowel and 20% (n = 65) in the large bowel localized. Adhesions were the main cause in 65.7% (n = 174) of all small bowel obstructions, and one third (35.1%, n = 61) of these patients were treated conservatively. In the large bowel, however, 37% were caused by obstructing colon carcinoma mainly localized in the rectosigmoid region. Mechanical bowel obstruction remains to be one of the most common emergencies in general surgery. A successful treatment is based on a rapid and correct diagnosis followed by an immediate surgical intervention if indicated. There are no reliable clinical, laboratory or radiological signs of bowel strangulation available. Preoperative diagnostic examinations should confirm bowel obstruction, determine its localization and origin and exclude other pathologies. Furthermore, it should help in selecting a patient subgroup with small bowel obstruction due to adhesions, which might be treated conservatively. Preoperative diagnostic procedures include case history, clinical examination, basic laboratory tests and a plain abdominal x-ray. In patients with suspected small bowel obstruction due to adhesions without any signs of strangulation a contrast medium follow-through study may be indicated. If the contrast medium fails to pass into the colon within 5 hours, a surgical exploration is recommended. In large bowel obstruction a contrast medium enema, a computed tomography or a colonoscopy are valuable diagnostic tools.
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PMID:[Modern diagnostic strategy in ileus]. 1006 41

While the liver and lung are primary targets for distant metastasis from colorectal carcinoma, metastasis in other distant sites is rarely found. We report herein an unusual case of metastasis to the skeletal muscle of the right forearm from an adenocarcinoma of the transverse colon. A 60-year-old man was originally admitted to our hospital for surgical treatment of an intestinal obstruction caused by a transverse colon carcinoma. Transverse colon resection along with lymph node dissection was performed and no evidence of distant metastatic foci was found. Angiography-enhanced computed tomography scanning done 14 months after the first operation revealed multiple hepatic metastases which were resected. A metastasis was subsequently detected in the right extensor carpi ulnaris muscle 2 years after the primary resection, and a major part of the right extensor carpi ulnaris and the extensor digiti minimi muscle were resected, warranting a sufficient margin of 5 cm of normal tissue from the tumor. Reattachment of the residual muscles into the ulna was performed. Metastases to bone and/or soft tissues from colorectal carcinomas are extremely rare and to our knowledge, only eight other cases have been reported in the world literature. This low incidence may be related to the anatomical characteristics and/or the biochemical environment of the skeletal muscle, but it is also possible that the true incidence is underestimated. Recent improvements in interventional radiological procedures may facilitate a diagnosis of skeletal muscle metastasis being made more frequently.
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PMID:Metastasis to the forearm skeletal muscle from an adenocarcinoma of the colon: report of a case. 1119 47

Colonic metastasis of the bronchogenic carcinoma is quite rare. Here we document an extremely rare presentation of the lung cancer that presented with acute abdomen and was diagnosed as intestinal obstruction due to colon carcinoma initially. He underwent an urgent operation and the obliterating mass in the colon was resected and reported as "colon metastasis from epidermoid carcinoma probably of the lung". Afterwards bronchoscopy revealed an endobronchial lesion in the right lower lobe that was diagnosed as poorly differentiated squamous cell lung carcinoma. In this case, colon metastasis was diagnosed before the diagnosis of the primary disease.
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PMID:A case of bronchogenic carcinoma presenting with acute abdomen. 1625 89

CASE 1: A 64-year-old, otherwise healthy woman was referred to the surgery clinic for a presumed umbilical hernia. On physical examination, a cutaneous nodule was noted on the umbilical region and the patient was referred to the dermatology clinic. The patient was reexamined and an erythematous nodule was observed in the umbilicus measuring 2.5 cm in diameter. The patient denied pain, change in bowel habits, or weight loss. There were no other abdominal masses, no sign of ascites, and no regional lymphadenopathy. A skin biopsy from the nodule showed mucinous adenocarcinoma. Immunohistochemical staining was positive for carcinoembryonic antigen, and negative for cytokeratin (CK)7 and CK20. These results were consistent with a Sister Mary Joseph's nodule and led to the diagnosis of an occult colon carcinoma. The patient had no risk factors for colorectal carcinoma. The patient underwent surgery in another hospital, and died 3 months after the initial diagnosis of Sister Mary Joseph's nodule. CASE 2: A 73-year-old woman was referred to the dermatology clinic for evaluation of a painful, ulcerated, 3-cm lesion in the umbilicus (Figure 1). She was otherwise asymptomatic. A skin biopsy showed neoplastic glandular cells infiltrating among collagen bundles (Figure 2). Stainings for mucin and for CK7 were positive, while staining for CK20 was negative. An abdominopelvic CT scan demonstrated a 3.5-cm space-occupying lesion in the liver. Results of gastroscopy, colonoscopy, chest computed tomographic (CT) scan, and mammography were normal. Serum levels of the tumor-associated protein CA125 were elevated to 164 units, while those of CA 19-9 and carcinoembryonic antigen were within normal range. A gynecologic examination and a transvaginal ultrasound were normal. The patient had no personal or family history of any malignancy or any risk factors for developing a carcinoma. The patient was scheduled for a palliative resection of the umbilical nodule, combined with a laparoscopic inspection in search of the undetected primary tumor. She refused surgery and was lost to follow-up. She died 4 months after the initial diagnosis of umbilical metastasis. CASE 3: A 51-year-old man was aware of a silent mass in his umbilicus for 2 years without seeking medical advice. Following 2 weeks of increasing pain in this area, he was referred to the emergency room for a suspected incarcerated umbilical hernia. Surgery revealed a mass attached to the fascia and peritoneal fat. The mass was removed and diagnosed as a poorly differentiated adenocarcinoma, staining positively for carcinoembryonic antigen, and negatively for CK20, CK7, prostate-specific antigen, and prostatic acid phosphatase. Both gastroscopy and colonoscopy failed to detect the primary tumor. An abdominopelvic CT scan was normal, but a CT scan of the chest disclosed a nodule measuring 2.5 x 1.5 cm in the lower lobe of the right lung. On bronchoscopy, it was found to be an invasive adenocarcinoma, consistent with a primary tumor of the lung. The patient was a heavy smoker (45 pack-years). The patient received 4 cycles of combined chemotherapy with carboplatine and gemcitabine, with no improvement. A month later, the patient complained of abdominal pain. Following demonstration of intra-abdominal spread of disease by CT scan, a second line chemotherapy was instituted with paclitaxel. A month later the patient's condition deteriorated and he complained of cough, sweating, and pain along the right leg. A bone scan revealed bone metastases in the right femur and left tibia. Two weeks later he was admitted to the hospital with intestinal obstruction and underwent laparotomy. He had massive intra-abdominal spread of cancer and ascites. Only a palliative colostomy was performed. The patient died 3 weeks later, 9 months after the diagnosis of adenocarcinoma of the lung. The clinical data on the three patients are summarized in Table I.
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PMID:Sister Mary Joseph's nodule as a presenting sign of internal malignancy. 1695 43


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