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

A retrospective review was undertaken to determine factors important in predicting functional results following the ileal reservoir and ileoanal anastomosis procedure. One hundred seventy-nine patients underwent ileal reservoir and ileoanal anastomosis at the University of Toronto between December 1981 and January 1987. One hundred sixty-three patients had ulcerative colitis, 11 had familial adenomatous polyposis, and five had Crohn's disease. A J-reservoir was constructed in 72 patients and an S-reservoir in 107 patients. Functional results were assessed in 102 patients who had their loop ileostomies closed for more than one year. The most significant technical complications were anal anastomotic leaks (10 percent), reservoir anastomotic leaks (3.9 percent), anal anastomotic stricture (7.8 percent), late fistula-inano (2.8 percent), small-bowel obstruction (19 percent), and loop ileostomy complications (23 percent). Overweight males and patients with operative blood loss greater than 1000 cc developed anal stricture more frequently (P less than .005). Patients who had a stapled J-reservoir had a higher rate of reservoir leak. The average number of bowel movements reported by patients for 24 hours was 6.2 +/- 3.1. Only ten (9.8 percent) patients had to intubate their reservoir to empty it. Urgency was experienced by 24 patients and soilage at night by 23 (22.5 percent) and during the day by 18 (17.6 percent). Seven patients (6.8 percent) were incontinent during the night and only one during the day. Pouchitis was reported in 16 patients (15.7 percent). Patients with anal anastomotic stricture had more urgency and pouchitis, and had to intubate their reservoir more frequently (P less than .05). No other factors analyzed affected technical or functional results.
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PMID:The ileal reservoir and ileoanal anastomosis procedure. Factors affecting technical and functional outcome. 336 21

This editorial consists of summaries of the discussions on incidence, pathogenesis, prognosis and patient follow-up, and transcripts of the discussions on detection and treatment of endometrial carcinoma, from a symposium held in Carefree, Arizona. 75% of the cancers occur in postmenopausal women; average age is 52 years, but is decreasing. Endometrial carcinoma rose from 20.3 to 46.3% of all uterine cancers in Cleveland University Hospitals from 1941-1970. Older patients are often diabetic, overweight, nulliparous, with anovulatory or familial history; young women frequently resemble mild Stein-Levinthal syndrome. Clinically, 20% of patients are assymptomatic, others may have softer or larger uterus, larger ovaries, irregular postmenopausal bleeding, or lengthy onset of menopause. The Gravlee jet wash is indicated for high risk patients and those about to take estrogen. Endometrial carcinoma first affects epithelium, then endometrial stroma, then upper myometrium, lower myometrium, then other organs, perhaps via lymphatics, vagina, tubes, but ascites is uncommon. Generally, U.S. physicians use intrauterine radium followed by surgery, British use surgery first, and Swedish use radiation only. Cases must be treated individually, e.g. surgery only for minimal cancer, radium and surgery for more serious cases, and preoperative external radiation also for advanced disease. Although radiation lessens chance of implantation during surgical trauma, insertion of intrauterine radium enhances spread of tumor cells. Injectable progestins sometimes control metastatic disease, although they require 8 weeks to act. Progestins may help those with late recurrence, squamous metaplasia, or who are under 50 years of age. Estrogens are rarely effective. Prognois for terminal patients often includes subjective improvement, bowel obstruction, lung complications, hemorrhage. Radiation side effects and menopausal symptoms are often problems for cured patients. In young cured patients the endometrium should be suppressed with progestins or oral contraceptives.
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PMID:Endometrial cancer: rising incidence, detection and treatment. 469 33

In recent years, a growing number of severely obese adolescents and their families have sought out surgical treatment because behavioral or medical therapies were not successful. A number of reports have suggested that bariatric surgery for this patient group is safe and can provide durable weight loss. However, most of these reports have been retrospective studies with short-term outcomes, and more long-term, prospective studies are needed to optimize care for these patients. Evaluation of the severely obese patient for surgery involves multiple factors, including the overall maturity of the patient; joint discussions with the patient and his or her family; a complete medical evaluation; evaluation by a child psychologist or psychiatrist; and a minimum of 6 months of private, interdisciplinary, multifaceted lifestyle preparation. Surgical options are restricted to severely overweight adolescents without endocrine disorders who have achieved puberty and have failed more conservative therapies. The Roux-en-Y gastric bypass is the most commonly performed procedure in adolescents, but the laparoscopic adjustable gastric band procedure is growing in popularity. Postoperatively, patients are evaluated 2 weeks after surgery and then every 1 to 2 months for the first postoperative year; every 2 months to 6 months in the second year, depending on the individual case; and then annually for life. A careful diet plan backed by continuing family support is essential. Short- and long-term complications are similar to those seen in adults, and include bowel obstruction, bleeding, blood clots, nausea, gallstones, hernia, and vitamin and iron deficiencies.
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PMID:Bariatric surgery for the severely obese adolescent. 1908 45

The article made a comparative assessment of traumatic injury of open hand-assisted laparoscopic anterior resection of the rectum in lateral and spinal positions. The presented technique of hand-assisted laparoscopic colon and rectal surgery is simple. There are advantages in case of obesity presence (IMT more than 30 kg/m2), in significant shortening of the mesocolon and mesentery, high fixation of splenic flexure and intimate fixation of the spleen, in case of bad preparation of the bowels in partial intestinal obstruction or in case of emergency operation, big cancer size, expressed perifocal inflammation. A comparative analysis of dynamics of hormone stress content and metabolism (cortisol, adrenaline, thyrothrophic hormone) showed their expressed increase in blood during operation after traditional surgery. Less stressed reaction was noted after hand-assisted surgery, especially in overweight patients. An application of low invasive method allowed reduction of hemorrhage, pain syndrome, terms of patient's activation and restoration of intestinal motility after operation.
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PMID:[Comparative research of traumatic injury of open hand-assisted laparoscopic anterior resection of the rectum]. 2596 96

Optimal nutrition care is important in the management of cystic fibrosis (CF). This paper summarises the '2017 Nutrition Guidelines for Cystic Fibrosis in Australia and New Zealand (NZ)'. CF dietitians formulated 68 practice questions which were used to guide a systematic literature search and review of the evidence for nutrition in CF. Identified papers underwent quality and evidence assessment using the American Dietetic Association quality criteria checklist and the National Health and Medical Research Council of Australia (NHMRC) rankings. Evidence statements, graded recommendations and practice points were developed covering core nutrition topics (assessment and nutrition interventions including oral, enteral and micronutrient supplementation); nutrition-related co-morbidities (including pancreatic insufficiency, CF-related diabetes, bone health and distal intestinal obstruction syndrome); and key new topic areas (genetic modulator therapies, overweight/obesity and complementary therapies). This paper showcases highlights from the guidelines, focussing on new topic areas and geographic and climate considerations for vitamin D, salt and hydration.
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PMID:Highlights from the nutrition guidelines for cystic fibrosis in Australia and New Zealand. 3117 4

Background: Patient preparation for routine abdominal ultrasound, such as fasting for 8 hours and having a light meal the night before the examination, is a common practice employed to avoid digestive motility and gases, which are considered the main causes of artifacts and image quality degradation. Importance of this study: Patient preparation before abdominal ultrasound plays a major role to ensure better visualization of internal organs and pathologies by minimizing artifacts, but because abdominal gases are still present in many patients and in large amounts, causing artifacts, it is important to search for new, safe, efficient, reliable and cost-effective methods to improve patient preparation by eliminating excessive abdominal gases. Material and method: This was a prospective study involving a randomly selected sample of 52 adult patients, both men and women, of different age groups. The participants met the inclusion criteria and had no history of previous or current abdominal surgery. Pediatric patients, pregnant women, patients with a history of abdominal surgery, bedridden patients, and patients with bowel obstruction were excluded. Routine abdominal ultrasound was performed after usual patient preparation involving fasting for 8 hours. Subsequently, the same patients were asked to come again after 48 hours for re-scanning and were instructed to follow the same routine preparation and to take one capsule of activated charcoal 8 hours before re-scanning. The results of both scans were compared by focusing on the pancreas as the reference. Result: Significant improvement by 57.2% was noticed in overweight, obese and extremely obese patients. The improvement noted in underweight patients and in patients with normal weight was 39.05%. The improvement in males reached 66.9% while in females: 49.9%. The overall improvement in pancreas visualization was 63%. Conclusion: Our preliminary study concluded that activated charcoal can be used to reduce gastrointestinal gases efficiently, providing an inexpensive, safe and easy-to-use method to improve visualization in routine abdominal ultrasound scans in adults.
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PMID:Effect of adding a capsule with activated charcoal to abdominal ultrasound preparation on image quality. 3232 Jan 65