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

This case report presents an unusual case of primary IUD-associated ovarian actinomycosis, which spread to the sigmoid causing intestinal obstruction. A 43-year-old gravida 3, para 2, had her 1st IUD from 1978-80 (Gyne-T) and her 2nd IUD from 1980 to October 1983 (Multiload). Right lower abdominal pain led to hospitalization in May 1983. A tender nodular mass was palpated in the left pelvic area. Laboratory results confirmed the presence of inflammation. Rapid improvement followed a course of laxatives and cephalosporin antibiotics, and the patient was discharged with the diagnosis of acute sigmoid diverticulitis. 2 months later, a double contrast examination of the large intestine was done and showed severe narrowing of the sigmoid colon over a distance of 12 cm and occasional sharp recesses. Colonoscopy showed a spastic stricture of the sigmoid with massive edema of the otherwise intact mucosa at 18 cm. Computer tomography of the abdomen showed a large, focally cystic infiltrative mass in the pelvis with congestion and displacement of both ureters as well as bilateral hydronephrosis, predominantly on the right side. The descending colon was congested. The patient was readmitted to hospital with the tentative diagnosis of ovarian cancer when her general condition deteriorated. She complained again of abdominal pain in the right lower quadrant and alternating diarrhea and constipation. Pyrexia and the hematological findings suggested sepsis. The pelvis contained a predominantly leftsided nodular mass and a brown fetid discharge was coming through the cervix. The IUD was removed and treatment with ampicillin and clindamycin was started with rapid improvement in the patient's condition. Obstruction with extreme distention of the colon required emergency laparotomy. An inflammatory mass was found in the pelvis consisting of a right-sided ovarian tumor, bilateral hydrosalpinges, and a tightly encased sigmoid colon. The dilated caecum had a large necrotic area in its wall which necessitated caecostomy and double-current sigmoidostomy after subtotal hysterectomy and bilateral salpingo-oophorectomy. The patient made a good recovery. As recently as the 1950s, primary pelvic actinomycosis was a rarity. In the last 4 years alone, 20% of all reported cases of actinomycosis involved the female genital tract. The percentage of cases found among IUD users has been continuously increasing and in the last 2 years all published cases were IUD users. The presence of actinomyces in vaginal smears always is indicative of the presence of a foreign body, most commonly and IUD.
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PMID:IUD-associated ovarian actinomycosis causing bowel obstruction. 374 Sep 65

The blind pouch syndrome is associated with a spectrum of diseases affecting the gastrointestinal tract that includes: malabsorption, ulceration, bleeding, and perforation. The clinical signs and symptoms of anemia, weight loss, abdominal pain, vomiting, and intermittent intestinal obstruction can be found. Occasionally, constipation or more often diarrhea is an important manifestation. A case report of this entity with related radiological and pathological findings secondary to a side-to-side anastomosis is presented and discussed.
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PMID:Blind pouch syndrome: a case report. 405 Jul 62

The presentation of intussusception in children in Zaria, Nigeria has been studied with the aim of identifying any features that may differentiate it from that which obtains in temperate countries. Our data reveal no difference in age of peak incidence, sex ratio, absence of preceding upper respiratory infection or lack of significant seasonal variation. However, there is an unusually high incidence (41%) of caecocolic intussusception. It is believed that this may account for other observed features, such as the low occurrence of constipation and other evidence of intestinal obstruction, and the relatively high incidence of "painless" intussusception and sub-acute or chronic intussusception. Twenty-nine per cent of the patients had only one or two of the usual diagnostic features of the disease and this contributed to delayed diagnosis. In all but two patients the condition was idiopathic and there was no evidence to implicate bacterial enteritis or parasitic infestation in the aetiology of the disease.
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PMID:Tropical paediatric intussusception--is it a different disease entity? 618 75

A 12-yr-old girl was admitted for evaluation of a 5-wk history of increasing abdominal pain. She also reported a history of constipation since birth requiring chronic laxative use. Occasional bouts of abdominal distention and vomiting resulted in dehydration necessitating hospitalization. Two previous laparotomies had identified an apparent obstructing angulation of the ascending colon. Rectal biopsy specimens obtained on this admission failed to reveal any ganglion cells. Sequential biopsy specimens of the entire colon obtained at laparotomy also failed to reveal any ganglion cells. Ganglion cells were found in the distal ileum. A total colectomy was performed. Three previously reported cases of total colonic aganglionosis initially diagnosed in older patients are reviewed. Similarities included nonspecific radiographic findings, a history of constipation since birth, and initial laparotomies revealing spurious causes of bowel obstruction.
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PMID:Total colonic aganglionosis initially diagnosed in an adolescent. 648 1

Systemic scleroderma involves the gastro-intestinal tract in over 50 p. 100 of cases, the commonest target organs being the oesophagus, the small intestine, the colon and the stomach in that order. The G-I symptoms of this collagenosis are all related to disorder of motility secondary to disturbances of innervation and then to atrophy of the smooth muscle and fibrous infiltration. Oesophageal involvement results in gastro-oesophageal reflux and/or dysphagia due to the lack of tonicity of the lower oesophageal sphincter and a reduction of peristalsis. Disease of the small intestine may cause pseudo-intestinal obstruction or a secondary malabsorption syndrome due to abnormal intraluminal bacterial flora. Colonic involvement causes severe constipation with formation of faecoliths. Finally, scleroderma may be complicated by an acute abdominal syndrome: occlusion due to diffuse reduction in small intestinal motility, peritonitis due to perforation of the small intestine, ileo-colonic infarction, gastro-intestinal haemorrhage complicating telangiectasia. Treatment is purely symptomatic: classical remedies for gastro-oesophageal reflux and its complications, and antibiotics for malabsorption syndromes.
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PMID:[Digestive localizations of scleroderma]. 652 55

A variety of intestinal complications, including constipation, abdominal pain, palpable cecal masses, intestinal obstruction, intussusception, and volvulus, have been observed beyond the neonatal period in patients with cystic fibrosis (CF). In a retrospective chart review of 63 patients with CF, we found evidence of one or more of these complications in 26 patients (41.3%). The incidence of intestinal complications was not related to overall disease severity, pulmonary exacerbations, history of meconium ileus at birth, or dose or type of pancreatic enzyme replacement. There was no change in the incidence of intestinal complications after patients switched to a pH-sensitive enteric-coated microsphere enzyme preparation.
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PMID:Incidence of distal intestinal obstruction syndrome in cystic fibrosis. 655 1

An esophageal pressure transducer with three strain gauges was used in the anal canal to study the rectosphincteric reflex (RSR) in five infants and children with intestinal obstruction, 142 children age one day to 18 years with moderate to severe constipation and in 18 healthy control children 4 to 12 years of age. The RSR was present in the four newborns with intestinal obstruction in 133 of the constipated children, and in all healthy controls. The mean (+/- SD) minimal volume of air in the rectal balloon required to produce RSR greater than or equal to 5 mm Hg (RSRT) was 9 mL (+/- 2) for infants 0 to 2 years, 14 mL (+/- 4) for children 2 to 4 years, 15 mL (+/- 6) for children 4 to 12 years, and 14 mL (+/- 6) for children 12 to 18 years of age. The RSRT for control children was 13 mL (+/- 4). The volume of air used in rectal balloon distension correlated with the amplitude of the RSR for control (r = 0.7131) and constipated children (r = 0.6289). The amplitudes of the RSR for the controls were significantly higher than the amplitudes for constipated children for rectal distension volumes between 60 and 15 cc (p less than 0.01). The 10 children with absent RSR had Hirschsprung's disease confirmed at surgery. Measurements of RSR could be used to separate patients with chronic constipation from patients with Hirschsprung's disease.
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PMID:Anorectal manometry: experience with strain gauge pressure transducers for the diagnosis of Hirschsprung's disease. 664 2

Two primary school age children having severe pica for sand, presented with severe constipation caused by sandy faecal impaction, simulating intestinal obstruction. Digital disimpaction and enema relieved the symptoms.
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PMID:Sandy faecal impaction caused by severe pica. 667 Jan 25

Over a period of 30 years a total of 27 patients have been subjected to partial or complete colectomy and anastomosis for constipation. Patients fall into four groups: (i) functional constipation; (ii) adult megacolon; (iii) megasigmoid and (iv) persistent Hirschsprung's disease. The first two groups comprised 17 patients with resistant constipation, with or without megacolon or dolichocolon. Seven (41%) of these patients subsequently required operation for acute small-bowel obstruction due to adhesions. In two patients a permanent ileostomy was necessary for persistent rectal inertia after colectomy. The functional results in these first two groups were good. The third and fourth groups had similar presenting features; five had megasigmoid, and in these resection of the sigmoid colon gave good results. The remaining five patients with proven Hirschsprung's disease responded well to a pull-through resection (4) and to colectomy and anastomosis (1).
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PMID:Surgery for constipation. 694 May 41

Ten cases of intestinal obstruction caused by antacid impactions in renal transplant and hemodialysis patients were added to 16 reports in the literature. In six instances, operative intervention was necessary because of failure of vigorous medical therapy. Three patients who died had perforation of the colon at sites of stercoral ulceration due to firm antacid impactions. Aggressive medical and surgical management of constipation and fecal impaction is recommended. The outlook is grim once colonic perforation has occurred.
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PMID:Management of antacid impactions in hemodialysis and renal transplant patients. 698 82


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