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

Brunner's Gland Hamartoma (BGH) is a benign tumor of the duodenum that can lead to gastrointestinal bleeding and intestinal obstruction. Endoscopic resection has seldom been reported. We describe the case of a duodenal obstruction caused by a large BGH (6 cm x 4 cm). We report a 57-year-old woman hospitalized for tarry stools, weight loss and anorexia. Endoscopy revealed a large BGH (6 cm x 4 cm). Endoscopic ultrasound (EUS) revealed a submucosal duodenal tumor. In this paper, we report a case of large hyperplasia of BGH, successfully treated by endoscopic technique.
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PMID:Endoscopic resection of a large Brunner's gland hamartoma. 1834 72

Acute abdominal pain can represent a spectrum of conditions from benign and self-limited disease to surgical emergencies. Evaluating abdominal pain requires an approach that relies on the likelihood of disease, patient history, physical examination, laboratory tests, and imaging studies. The location of pain is a useful starting point and will guide further evaluation. For example, right lower quadrant pain strongly suggests appendicitis. Certain elements of the history and physical examination are helpful (e.g., constipation and abdominal distension strongly suggest bowel obstruction), whereas others are of little value (e.g., anorexia has little predictive value for appendicitis). The American College of Radiology has recommended different imaging studies for assessing abdominal pain based on pain location. Ultrasonography is recommended to assess right upper quadrant pain, and computed tomography is recommended for right and left lower quadrant pain. It is also important to consider special populations such as women, who are at risk of genitourinary disease, which may cause abdominal pain; and the elderly, who may present with atypical symptoms of a disease.
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PMID:Evaluation of acute abdominal pain in adults. 1844 63

The importance of constipation lies in its frequency, even among the healthy. The incidence of constipation in oncological patients is 70-80% in the final stage, 40-50% in advanced disease, and 90% in patients with aggressive cancer. This disorder is not only uncomfortable for the patient but also causes complications. Prolonged constipation can cause abdominal pain and even increase the pain caused by the tumor and stronger pain relief can be required when the constipation is unresolved. Among the complications that can occur are intestinal obstruction, diarrhea by spillage, urinary dysfunction, anorexia, nausea and vomiting, restlessness, malaise, and confusion. When analyzing this problem, we aim to unify criteria and nursing interventions, emphasize the importance of prevention, and solve the problem. Health education of both the patient and the main caregiver aid control of this disorder after discharge. The patient will be able to identify the appearance of constipation, its causes and symptoms and will be familiar with the treatment and when and where to go to review it.
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PMID:[Nursing cares in constipation of the oncology patient]. 1844 48

A case of intestinal tuberculosis affecting the jejunum (with perforations) and the colon is presented. The objective is to highlight the challenges medical practitioners face in making a timely diagnosis of intestinal tuberculosis. It also aims to raise awareness that chronic diarrhoea and weight loss are common symptoms of colonic tuberculosis. A 26 year old university student was admitted with a three month history of diarrhoea anorexia and weight loss having been seen and treated for typhoid in several hospitals without improvement. Colonoscopy and biopsy was non conclusive. He later developed subacute intestinal obstruction that did not respond to conservative treatment. Explorative laparotomy revealed jejunal perforations with localised absesses, peritoneal adhesions with caseous nodules and mesenteric Iymphadenopathy. Histology of resected specimens was positive for mycobacterium tuberculosis.
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PMID:Diagnostic challenges of intestinal tuberculosis in a patient with chronic diarrhoea: case report. 1855 55

The objective of this study was to assess antiemetic efficacy of granisetron in inoperable intestinal obstruction caused by advanced cancer. The study was open, prospective, and multi-centered. We assessed 24 patients (mean age: 61.3 years; 10 males, 14 females) with intestinal obstruction who were refractory to previous antiemetics. Obstruction involved the upper intestine in six patients, the lower intestine in three, and was at multiple levels in 15. Daily treatment included intravenous granisetron (3mg) and dexamethasone (8 mg); nasogastric drainage was not allowed. Subcutaneous haloperidol was available as rescue therapy. A numeric scale was used to evaluate nausea, pain, asthenia, and anorexia at baseline visit and every 24 hours up to the completion of four days of treatment (final visit). Treatment failure was defined as nausea >4 on the numeric scale, vomiting 2/day or more, and rescue therapy with haloperidol at 5mg/day or more. Of the 24 patients, 23 were evaluable for efficacy. Evaluation pre- vs. post-treatment indicated a significant decrease in the severity of nausea (score 6.9 vs. 0.8; P<0.001), number of episodes of vomiting (5.3 vs. 1.0; P<0.001), and abdominal pain (score 4.4 vs. 1.2; P<0.001). Nausea and vomiting control was achieved in 86.9% of patients. Although there was a trend toward greater efficacy in the lower and multiple levels of obstruction, the differences were not statistically significant owing, probably, to small sample size. We conclude that granisetron may be highly efficacious in the control of emesis resulting from intestinal obstruction caused by metastatic cancer, and can be used effectively in patients refractory to other antiemetics.
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PMID:Efficacy of granisetron in the antiemetic control of nonsurgical intestinal obstruction in advanced cancer: a phase II clinical trial. 1878 38

Fecal impactions occur in both sexes at any age but are particularly concentrated in children, in the institutionalized or impaired elderly, and in patients with certain psychiatric disorders or medical conditions that predispose to obstipation. The clinical consequences may be disabling and occasionally life threatening. Clinical manifestations include fecal incontinence, abdominal distention and pain, anorexia, weight loss, intestinal obstruction, and stercoral ulceration with bleeding or colonic perforation. Diagnosis begins with recognition of possible fecal impaction and confirmation by digital examination or abdominal radiography. Management consists of disimpaction, colon evacuation, and a maintenance bowel program to prevent recurrent impactions.
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PMID:Management and prevention of fecal impaction. 1879 26

A 30-year-old lady presented with a 6-month history of recurrent partial intestinal obstruction associated with intermittent fever, anorexia and weight loss. Barium meal follow-through and colonoscopic evaluation suggested ulceration of the ileum and caecum with small bowel obstruction. Histology of the lesions showed marked acute and chronic inflammation consistent with ulceration and granulation tissue. Abdominal CT revealed circumferential thickening of the ascending colon, caecum and terminal ileum with extraluminal air pockets. Surgical exploration revealed a large conglomerate mass involving the terminal ileum, caecum and ascending colon. Histopathology of the resected specimen revealed perforated appendix with nonspecific ulceration of the surrounding bowel. She recovered completely after surgery and did not suffer from gastrointestinal symptoms in the 14 months of follow-up.
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PMID:Perforated appendicitis presenting with ileo-caecal ulceration and mechanical intestinal obstruction. 1897 73

In patients with repeated intestinal obstructions after open abdominal surgery, aerophagia associated with disturbances in gastrointestinal passage causes the accumulation of large amounts of air, resulting in chronic symptoms including abdominal pain and distention and consequently malnutrition. We successfully used percutaneous endoscopic gastrostomy (PEG) for long-term gastric decompression in 2 cases with aerophagia. The first case was a 69-year-old Japanese man admitted for repeated intestinal obstruction after an appendectomy. After the last surgery for intestinal obstruction, the patient experienced repeated abdominal distention and anorexia, resulting in weight loss and malnutrition. The second case was a 79-year-old man complaining of abdominal pain and distention. He had a history of resection of the lower pharynx and larynx owing to total laryngectomy and had received a permanent tracheostomy. He then underwent surgery for intestinal obstruction. Because the patients' abdominal symptoms were unresponsive to administration of a peristalsis stimulant and a laxative, we performed PEG to deflate the gastrointestinal tract. An abdominal x-ray taken after the PEG placement showed the elimination of the gas and a remarkable improvement in the gastric dilatation, and the abdominal symptoms soon disappeared. These cases highlight the clinical importance and usefulness of PEG for gastric decompression in patients with aerophagia associated with repeated intestinal obstruction.
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PMID:Percutaneous endoscopic gastrostomy for gastric decompression after repeated intestinal obstruction after open abdominal surgery. 1909 70

An adult domestic shorthair (DSH) cat was presented with acute vomiting, anorexia, lethargy, and dyspnea. The cat's clinical status worsened over 24 hours with conservative medical management. An exploratory celiotomy was performed. Acute intestinal obstruction resulting from infection with Taenia (T.) taeniaeformis was diagnosed. Surgical removal of the cestodes via multiple enterotomies resolved the obstruction. This paper reports, for the first time, small intestinal obstruction caused by T. taeniaeformis infection in a cat.
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PMID:Intestinal obstruction caused by Taenia taeniaeformis infection in a cat. 1925 22

Fatal colonic obstructions were diagnosed in three captive, adult, reticulated giraffe (Giraffa camelopardalis reticulata). Clinical presentations varied, but all cases displayed decreased activity, anorexia, and considerably decreased fecal production, consistent with intestinal obstruction. Case 1 was diagnosed at necropsy with a phytobezoar obstructing the spiral colon. Case 2 was diagnosed at necropsy with a fecal impaction of the colon. Case 3 was diagnosed during surgery with colonic ileus. Cases 2 and 3 underwent surgical intervention but were markedly compromised by the time of surgery and died during surgery or 24 hr postoperatively. Gastrointestinal obstruction, requiring aggressive supportive care and early surgical intervention, should be considered in giraffe in which anorexia and substantially decreased fecal production are observed. Abdominal exploratory surgery will likely be necessary for diagnosis and treatment. Based on a small number of cases, gastrointestinal obstruction has a poor prognosis in giraffe.
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PMID:Colonic obstruction in three captive reticulated giraffe (Giraffa camelopardalis reticulata). 1936 59


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