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)

This report describes two cases of intrauterine volvulus without associated intestinal malrotation. Polyhydramnios was present in one neonate; the presentation was very sudden and catastrophic in the other. Neither plain films nor contrast enema indicated the correct preoperative diagnosis in these infants. A "normal" plain film or enema in a suspected case of volvulus may lead to a delay in surgical management resulting in extensive ischemic necrosis of the bowel, often with extremely high mortality. Bile emesis or aspirate in neonates demands a high index of suspicion of intestinal obstruction. Shock, bloody diarrhea, and tense and distended abdomen are ominous, indicating volvulus often with gangrene.
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PMID:Intrauterine volvulus without malrotation. 176 23

The optimal surgical management of neonates with gastroschisis and omphalocele remains controversial. Early attempts at primary closure were limited by respiratory and vena cava compromise and were gradually replaced by skin closure only, staged reduction of implanted prostheses, and escharification of the intact omphalocele. Advances in surgical technique, neonatal intensive care, and mechanical ventilation have made primary closure a viable alternative once again. We wish to report a consecutive series of 73 infants, including 54 with gastroschisis and 19 with omphalocele, over a 16-year period. Fifty gastroschisis patients were closed primarily, with four deaths (8%), and four with staged prostheses, with one death (25%). Sixteen omphaloceles were closed primarily, with three deaths (19%); two closed with a staged prosthesis, and one patient, closed with skin flaps only, died (100%). Overall survival for primary closure was 59/66 (89%) and for staged reduction, 5/7 (43%). In the past 5 years all patients have been closed primarily with no deaths (100% survival). All survivors were alive and well 1 to 15 years postoperatively. Our current operative technique involves vigorous manual stretching of the abdominal cavity, manual emptying of the entire Gl tract, and primary fascial closure, with no gastrostomy. Key points in postoperative management include total paralysis and mechanical ventilation, as the initially tense abdominal wall softens over 1 to 2 days, followed by weaning from the ventilator, and vigorous fluid support. Gl function returns more rapidly after primary closure (average of 3 days) and hospital stay is not prolonged. Other complications (intestinal obstruction, two patients; fistulae, one patient, etc) are much less frequent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Primary fascial closure in infants with gastroschisis and omphalocele: a superior approach. 622 19

A case of cystic duplication of the rectum is presented. This infant was admitted with progressive tenesmus and constipation resulting in intestinal obstruction. Rectal examination revealed a tense, cystic presacral mass. Barium enema confirmed the presence of the cyst. Complete excision resulted in a cure and histologic findings showed it to be a rectal duplication.
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PMID:Cystic duplication of the rectum: a case report. 737 5

Volvulus of the small bowel without predisposing anatomical defects is a rare cause of acute intestinal obstruction in the Western world, and its incidence is decreasing in Europe and America, although it is common in others parts of the world. The causes of primary volvulus of the small bowel and the mechanism of rotation of the entire root of the mesentery remain unexplained. Several anatomical and dietary factors have been implicated. This theory requires strong peristalsis, tense, firm abdominal muscles and feeding pattern of very bulky meals taken at long intervals. In the present case, a large quantity of bulky poorly digested food consumed previously, and strong abdominal muscles are in keeping with the above theory.
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PMID:[Jejuno-ileal volvulus, a rare cause of intestinal obstruction]. 856 95

Pneumatosis cystoides intestinalis is an uncommon condition characterized by gas filled cysts within the bowel wall. We present a case of a 40-year old male who complained of abdominal pain and distension. The clinical diagnosis was intestinal obstruction and intraoperative impression was intestinal lymphangioma. The resected segment of the bowel showed multiple thin walled, tense, air-filled cysts on the serosal surface, which collapsed with a popping sound when pricked. The histologic diagnosis was pneumatosis cystoides intestinalis. Pneumatosis cystoides intestinalis has varied clinical manifestations, course and outcome depending on its benign or fulminant form. There are varying theories regarding its pathogenesis and it is seen in association with a variety of diseases. Hence it should be interpreted with relevance to its entire clinical context, as it may not be a disease in itself but a sequel to other conditions.
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PMID:Pneumatosis cystoides intestinalis: disease or sequel? A case report and review of theories regarding pathogenesis. 1502 95

Duplications of the gastrointestinal tract are rare malformations, most commonly presenting as cystic structures growing within the smooth muscle wall. Very rarely, they are completely detached from the tract. Several theories have been proposed regarding their embryological development, but no single one has been able to account for all of the described variants. The most common type of duplication is related to the small bowel and develops at its mesenteric border, assuming a spherical or tubular shape. Their clinical manifestations vary, depending mainly on their localization and size. Most commonly, they cause subacute abdominal pain and intestinal obstruction in children of less than two years of age. We present a case of an 8.5-year-old girl, investigated for right lower quadrant abdominal pain. On ultrasound scan, a cystic mass indicative of a duplication cyst was discovered and she underwent a laparotomy. A tense cystic spherical mass 2.2 cm in diameter was excised from the terminal ileum, 4 cm from the ileocecal valve. The cyst had the characteristics of a gastrointestinal tract duplication, except from the fact that it was located on the antimesenteric border of the intestine. On the other hand, the lesion did not present the characteristic features of a Meckel's diverticulum. According to our knowledge, this is the first report of an intestinal duplication cyst appearing on the antimesenteric intestinal border.
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PMID:Antimesenteric gastrointestinal tract duplication undergoing non-ulcerative perforation. 3084 12