Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The rationale of "crash induction" in patients with full stomach is reviewed. The technique does not precipitate regurgitation in normal patients having competent cardia, provided respiratory obstruction and IPPV are avoided during induction. On the other hand, in patients with incompetent cardia such as intestinal obstruction or hiatus hernia, excessive material may accumulate in the lower oesophagus. The accumulation will be suddenly released with the cricopharyngeal relaxation subsequent to "crash induction". The stomach and oesophagus should be adequately decompressed pre-operatively, and precautionary measures such as backward cricoid pressure must be taken during induction.
 ...
PMID:"Crash induction" in patients with full stomach. 52 72

Bile acid concentration was measured in amniotic fluid obtained for standard indications from 11 healthy pregnant women without polyhydramnios (28 to 42 weeks of gestation) and from 9 patients with polyhydramnios (28 to 38 weeks of gestation). Two of the latter women delivered infants with intestinal obstruction distal to the papilla of Vater, a condition that causes regurgitation of bile into the amniotic fluid. In the women without polyhydramios, the total bile acid concentration ranged from 1.4 to 2.4 micronmol/liter. In the seven patients with polyhydramnios not associated with fetal intestinal obstruction, the bile acid concentration in amniotic fluid was not significantly different (0.9 to 1.9 micronmol/liter). By contrast, the bile acid concentration in amniotic fluid specimens from the two patients with polyhydramnios who gave birth to children with intestinal obstruction was considerably elevated (30.3 to 83.1 micronmol/liter). These findings suggest that determination of bile acid concentration in amniotic fluid permits prenatal diagnosis of intestinal obstruction distal to the papilla of Vater.
 ...
PMID:Determination of bile acid concentration in human amniotic fluid for prenatal diagnosis of intestinal obstruction. 85 34

The pre- and intra-operative care of patients with acute intestinal obstruction is reviewed. The most important pre-operative problems are hypovolaemia, sepsis, electrolyte and acid-base imbalances. The evaulation and treatment of these disorders are discussed. The importance of preventing regurgitation and inhalation of stomach contents is emphasised and the methods which are used are described. The safest techniques of induction and maintenance of anaesthesia as well as muscle relaxation and intra-operative fluid therapy are indicated.
 ...
PMID:[Anesthesia for patients with intestinal obstruction]. 115 44

Pylorostenosis is still the most frequently encountered type of congenital intestinal obstruction. A severe course of the disease with a fatal outcome is observed today. Successful treatment is linked in many respects with adequate feeding of the patient. The authors examined and performed operations on 90 children. According to the type of feeding they were divided into 3 groups. Group 1 consisted of patients given the generally accepted oral diet in portions, group 2 was made up of infants fed according to a "forced" schedule (the physiological requirements were supplied by the natural way by the 3rd-4th postoperative day), and group 3 received enteral feeding through a tube. The tube was introduced by means of an endoscope before or during the operation. It was found that in feeding through a tube children with pylorostenosis could be given 2-3 times more milk before the operation and in the first days after it. Regurgitation and the phenomena of esophagitis and jaundice are arrested in this case. The gain in weight is 3 times that in children of group 1. The authors consider this type of feeding to be justified in gravely ill patients. The "forced" schedule is used in an uncomplicated course of the disease. Feeding of infants with pylorostenosis by the generally accepted method was found to be unsatisfactory and the authors rejected it.
 ...
PMID:[Comparative evaluation of various methods for feeding children with pyloric stenosis]. 194 93

Investigation into the severity of hemolytic disease due to Rh isoimmunization may be complicated by concurrent amniotic fluid contamination with bile. We have presented a case in which a prenatal sonogram showed evidence of fetal intestinal obstruction, which was subsequently confirmed postpartum by exploratory laparotomy. Since intrauterine regurgitation of bile occurs with intestinal obstruction distal to the papilla of Vater, percutaneous umbilical blood sampling is necessary to discern the presence and severity of hemolytic disease as indicated by an abnormal spectrophotometric absorption pattern.
 ...
PMID:Fetal intestinal obstruction: necessity for percutaneous umbilical blood sampling to assess the severity of Rh sensitization. 210 70

In a double-blind, placebo-controlled, crossover trial, we investigated the effects of the prokinetic drug cisapride in patients with cystic fibrosis and chronic recurrent distal intestinal obstruction syndrome (DIOS). After a baseline period, 17 patients (12.9 to 34.9 years; 12 boys) received, in random order, cisapride (7.5 to 10 mg) and placebo three times daily by mouth, each for 6 months. Gastrointestinal symptoms (flatulence, abdominal pain, fullness, abdominal distension, nausea, anorexia, heartburn, diarrhea, vomiting and regurgitation) were scored three times monthly and physical examinations assessed. At baseline and at each 6-month period, assessment included food intake for 7 days, 3-day stool collection, pulmonary function tests, and abdominal radiographs. During cisapride therapy compared with placebo, there were significant reductions in flatulence (p less than 0.005), fullness, and nausea (p less than 0.05). Patients with the worst symptom scores benefited most from cisapride. With cisapride, 12 patients felt better and three worse (p less than 0.05); physicians judged 11 patients improved and two worse (p less than 0.05). No side effects were noted. There were no significant differences between cisapride and placebo periods in nutritional status, x-ray scores, pulmonary function, food intake (fat, protein, calories), stool size and consistency, and fecal losses of fat, bile acids, chymotrypsin, and calories. For acute episodes of DIOS, intestinal lavage was needed 6 times in 4 patients during treatment with cisapride, and 11 times in 6 patients receiving placebo. In comparison with unselected patients with cystic fibrosis and pancreatic insufficiency who were receiving enzyme supplements and who had no distal intestinal obstruction, fecal fat losses (percentage of intake) were almost twice as high in the study group with DIOS (31.2 +/- 20.6% vs 16.2 +/- 17.6%; p less than 0.01). We conclude that in the dosage used, long-term treatment with cisapride appears to improve chronic abdominal symptoms in patients with cystic fibrosis and DIOS, but fails to abolish the need for intestinal lavage. Cisapride treatment had no effect on digestion and nutritional status of cystic fibrosis patients with pancreatic insufficiency.
 ...
PMID:Effects of cisapride in patients with cystic fibrosis and distal intestinal obstruction syndrome. 223 Dec 17

In a 6.5 year period starting January 1982, 121 patients (74 male, 47 female; 1.6:1) with complicated gastroesophageal reflux referred to Alberta Children's Hospital, University of Calgary, required a Nissen fundoplication at a mean age of 35.5 months (range 3 weeks to 18 years). The median age of onset of symptoms was less than 1 month. Symptoms and indications for surgery included regurgitation (88%), failure to thrive (52%), reflux-associated pulmonary symptoms and aspiration (48%), biopsy evidence of esophagitis (35%) with heartburn (17%), dysphagia (18%), hematemesis (17%), anemia (13%), and hypoproteinemia (22%). Sixty-four percent of the patients had a syndrome or chromosomal abnormality, respiratory disease, or neuromuscular disorder. The barium contrast upper-gastrointestinal radiographic series, performed in all patients, identified structural [gastric outlet obstruction (2%), esophageal stricture (11%), erosive esophagitis (9%)], and functional abnormalities [gastroesophageal reflux (90%), barium aspiration (8%), esophageal hypoperistalsis (30%), delayed gastric emptying (4%)]. Barium contrast upper gastrointestinal radiographic series identified gastroesophageal reflux with a sensitivity of 90% (compared to history), was 50% sensitive and 92% specific for erosive esophagitis (compared to biopsy), was 59% sensitive and 74% specific for esophageal dysmotility (compared to esophageal manometry), and there was a significant (p less than 0.01) association between barium aspiration and prior evidence of aspiration pneumonitis. Esophageal manometry demonstrated a significantly (p less than 0.001) lower esophageal sphincter pressure in patients compared with controls, but no significant correlation with failure to thrive, aspiration pneumonia, biopsy evidence of esophagitis, or parameters of the 24-hour esophageal pH study. Twenty-four hour pH monitoring showed significantly (p less than 0.05) more reflux episodes than in asymptomatic controls and there was significant (p less than 0.05) correlation between the percentage of time pH was less than 4 and the presence of hypoalbuminemia, and biopsy-proven erosive esophagitis or Barrett's esophagus. Endoscopic appearance was 91% sensitive and 60% specific for esophagitis when compared to biopsy. Nissen fundoplication was completely effective at resolving gastroesophageal reflux in 83%, and associated with marked improvement in 15%. No patient died as a result of fundoplication. Major complications included: recurrence of symptoms requiring reoperation (2%), subsequent mechanical bowel obstruction (8%), wound infection or pneumonia (12%).
 ...
PMID:Investigation and outcome of 121 infants and children requiring Nissen fundoplication for the management of gastroesophageal reflux. 227 17

Laparoscopy is reviewed in this keynote lecture of the 1st annual meeting of the American Association of Gynecological Laparoscopists in Las Vegas, Nevada, November 1972. The pneumoperitoneum may produce pressure on the inferior vena cava and stomach and cause splinting of the diaphragm leading to impaired ventilation, reduction in venous return to the heart, and possible regurgitation of stomach contents. Absorption of carbon dioxide may cause a rise of partial pressure of carbon dioxide with associated cardiac arrhythmias. All of these problems are controlled or prevented by a general anesthetic with intubation by a cuff tube, good muscle relaxation, and controlled ventilation by a respirator. Laparoscopy may be used to determine intact ectopic pregnancy and study female sterility, early endometriosis, acute salpingitis, chronic pelvic inflammatory disease, small uterine or other masses, and primary and secondary amenorrhea. Surgical uses include puncture and/or aspiration of ovarian cysts or tubo-ovarian cysts, removal of foreign bodies, resection of adhesions, tubal sterilization, and ventrosuspension of uterus. Contraindications include difficulty in establishing an adequate pneumoperitoneum; acute peritonitis, ileus, or intestinal obstruction; and inadvisability of penumoperitoneum or Trendelenburg position. Laparoscopy can diagnose the extent and nature of pelvic and abdominal cancer and evaluate treatment. Reported complications with laparoscopy include puncture of vessels, perforation of intra-abdominal viscus, parietal or omental emphysema, cardiorespiratory embarrassment, and effects of high-pressure gas injections. A woman infertile due to absent or useless oviducts but with a healthy uterus and at least 1 healthy functioning ovary could seemingly be assisted through recovery of oocytes via laparoscopy, fertilization and cleavage of the ovum in vitro, and finally embryo transfer into her uterus. The first 2 steps have already been accomplished for women.
 ...
PMID:Gynecological laparoscopy. 426 3

The rationale of "crash induction" in patients with full stomach is reviewed. The technique does not precipitate regurgitation in normal patients having competent cardia, provided respiratory obstruction and IPPV are avoided during induction. On the other hand, in patients with incompetent cardia such as intestinal obstruction or hiatus hernia, excessive material may accumulate in the lower esophagus. The accumulation will be suddenly released with the cricopharyngeal relaxation subsequent to "crash induction". The stomach and esophagus should be adequately decompressed pre-operatively, and precautionary measures such as backward cricoid pressure must be taken during induction.
 ...
PMID:"Crash induction" in patients with full stomach. 718 1

The authors examined and treated 52 newborn babies and infants with Hirschsprung's disease. The total form was encountered in 25%, the subtotal in 23.1%, the rectosigmoid in 36.5%, the rectal in 9.6%, and the supraanal in 5.8% of cases. The clinical picture was characterized by retention of meconium (94.2%), regurgitation or vomiting (75%), abdominal distention (100%). Irrigography with calculation of the rectosigmoid ratio was conducted in 35 children, histochemical examination in 46, and histological examination in 38 children. Twenty-four (68.5%) children had the third phase of disturbed proportion of the intestinal bacteria with clinical manifestations of enterocolitis. Emergency decompression of the intestine for low acute intestinal obstruction was carried out in 27 newborn babies. Twenty children were subjected to radical surgery in the first 2-4 months of life. The choice of the operative method was guided by the form of the disease and the length of the aganglionic zone.
 ...
PMID:[Hirschsprung's disease in newborns]. 799 Mar 12


1 2 Next >>