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)

Ileostomy function was studied in 12 patients with an established ileostomy following proctocolectomy, in 6 of whom minimal amounts (less than 9 cm) and in 6 significant amounts (30-120 cm, mean 60 cm) of terminal ileum had been removed. Patients who had undergone significant ileal resection had daily faecal volumes considerably greater than those with minimal ileal resection (1202 +/- 284 ml versus 401 +/- 92 ml, P less than 0.001), and also greater daily outputs of sodium (146 +/- 53 mEq versus 43 +/- 12 mEq) and potassium (12.7 +/- 9.0 mEq versus 4.0 +/- 0.99 mEq). The percentage water content of the ileostomy fluid was greater in patients who had had the ileum resected (93.1 +/- 1.8% versus 89.8 +/- 2.5%). In addition, the sodium/potassium ratio in the urine in patients with a properly acting ileostomy after ileal resection was low. It is concluded that when recurrent inflammatory bowel disease, partial small bowel obstruction and intraperitoneal sepsis have been excluded there remains a number of patients whose high ileostomy output is due entirely to the amount of ileum resected. The management of patients with a high output ileostomy with codeine phosphate, Lomotil and oral administration of sodium chloride tablets is discussed.
 ...
PMID:Cause and management of high volume output salt-depleting ileostomy. 117 16

Intestinal obstruction is often diagnosed prenatally by ultrasound, providing an opportunity for prenatal counseling, genetic investigation, and planned delivery at a perinatal center. We describe a patient with typical features of fetal bowel obstruction, who was found at birth to have congenital chloride diarrhea. A 25-year-old white woman had marked polyhydramnios; multiple dilated, fluid-filled loops of intestine were seen in the fetal abdomen on prenatal ultrasound. However, postnatally, there was no evidence of bowel obstruction. The infant girl passed large amounts of watery stools, but tolerated feeds well. A rectal biopsy showed normal ganglion cells. On the fourth day of life her serum sodium and chloride were markedly decreased, and stool chloride levels were diagnostic of congenital chloride diarrhea. She was placed on sodium chloride and potassium chloride supplements, and her serum electrolytes normalized. Congenital chloride diarrhea is a rare, inherited condition caused by an abnormality of intestinal electrolyte transport. This case illustrates that it may present prenatally with a picture similar to that seen with intestinal obstruction.
 ...
PMID:False diagnosis of intestinal obstruction in a fetus with congenital chloride diarrhea. 181 57

Associated with the intoxication of intestinal obstruction there exists a definite impairment of the excretory function of the kidneys. The degree of functional depression corresponds roughly with the intensity of the clinical intoxication. The decrease in the urea ratio and in the capacity of the kidneys to excrete sodium chloride is more marked than is the percentage decrease of phenolsulfonephthalein elimination. The great increase in the non-protein nitrogen of the blood usually observed in acute intestinal obstruction, which has hitherto been explained as being due entirely to an increased rate of protein catabolism, is due in part to retention of the products released from the injured cell protein. It is probable that the impaired renal function is due to direct action of the toxic substances upon the renal epithelium. The actual demonstration of this renal injury is perhaps the strongest evidence so far obtained to prove the presence of an actual toxic substance in the blood during intestinal obstruction. This obscure disability of the kidneys during the height of the intoxication of acute ileus should always be considered in the clinical management of this condition. It may also serve as a guide to indicate the degree of intoxication.
 ...
PMID:I. RENAL FUNCTION INFLUENCED BY INTESTINAL OBSTRUCTION. 1986 27

The injection of the toxic proteose obtained from the contents of the obstructed small intestine causes a definite impairment of the eliminative function of the kidneys as shown by a decreased capacity to excrete urea, sodium chloride, and phenolsulfonephthalein. This involvement of the renal function is similar to that shown by the preceding report (1) to accompany the intoxication of intestinal obstruction. The observed depression of function is readily demonstrable even when large amounts of fluid and urea, dye, or salt are injected directly into the blood stream. There is in all probability a temporary injury of the kidney cells, since the most important extrarenal factors have been largely eliminated in the above experiments. There is no appreciable impairment of the renal function following the injection of a number of other proteose preparations from a variety of sources. This study affords new evidence in favor of the view that the function of an organ can be profoundly disturbed for a time without any demonstrable anatomical lesions. The repair of this type of injury promptly follows the disappearance of the intoxication and is functionally and anatomically perfect.
 ...
PMID:II. RENAL FUNCTION INFLUENCED BY PROTEOSE INTOXICATION. 1986 28

Experiments to determine the effect of furnishing an ample supply of sodium chloride on the toxemia of pyloric and intestinal obstruction are reported. A fall in chlorides is the first and seemingly most significant change to take place in the blood after pyloric and intestinal obstruction. The chloride is apparently utilized by the body as a protective measure against the primary toxic substance. Two dogs with pyloric obstruction were given 50 cc. of 10 per cent NaCl subcutaneously daily. One lived 3 days, the other 4. The blood showed little change, except a marked terminal rise in chlorides. Animals given a like amount of distilled water or 25 per cent glucose showed the changes typical of untreated animals. The obstruction of the pylorus was released in six dogs 48 to 72 hours after the initial operation. Two died within 24 hours after the second operation with a high non-protein nitrogen in the blood. Two survived but showed a high level of non-protein nitrogen in the blood and a high nitrogen excretion in the urine, low blood chlorides, and a marked alkalosis. One dog in such a state died on the 13th day from peritonitis, arising in a wound infection. The other showed a marked fall in non-protein nitrogen in the blood following the administration of 10 gm. of sodium chloride by mouth, but died following the intravenous injection of 25 per cent sodium chloride. Two animals were given 50 cc. of 10 per cent NaCl subcutaneously, at the time of the second operation. The blood rapidly returned to normal and complete recovery followed. Two dogs with the duodenum obstructed by section and inversion of the cut ends were treated with 10 per cent sodium chloride after the obstruction had existed for 48 hours and the characteristic blood changes had developed. The non-protein nitrogen returned to normal within 48 hours after treatment was begun. One dog died following a lateral anastomosis for relief of the obstruction. A second operation was not attempted in the other animal. Two dogs in which the duodenum was obstructed by section and inversion of the cut ends were given 500 cc. of 0.85 per cent NaCl subcutaneously on the day of operation and each day thereafter until death. One dog lived 21 days, the other 28. Both dogs showed a marked alkalosis, but never any rise in the non-protein nitrogen of the blood. The animals at autopsy showed intussusception of the ileum with extensive ulceration. In one there was a perforation and terminal peritonitis. The operation wounds healed normally. Three dogs with section of the duodenum were given 500 cc. of distilled water every day. One died in 24 hours, one in 48 hours, and the third in 72 hours. Autopsy showed no cause for death other than toxemia. One dog with section of the duodenum was given 500 cc. of 2 per cent glucose every day. The blood showed a rapid rise in non-protein nitrogen and carbon dioxide-combining power, and a fall in chlorides. The animal died 72 hours after operation. Three dogs with section of the duodenum were given 500 cc. of 1 per cent sodium bicarbonate every day. One dog died in 72 hours, one lived 7 days, and the third lived 9 days. All developed a high non-protein nitrogen in the blood and two showed marked clinical symptoms of an alkalosis. These results demonstrate that solutions of sodium chloride have a marked effect in preventing and controlling the toxemia of pyloric and intestinal obstruction as shown in clinical symptoms and in chemical changes in the blood. Dogs given an abundant supply of distilled water died more quickly than untreated control animals. Solutions of glucose have no specific value, and sodium bicarbonate solutions prolong life only a short while. Good therapeutic results have been obtained with very concentrated sodium chloride solutions, and with dry sodium chloride given by mouth. It seems evident that sodium chloride has a specific action in preventing and possibly in controlling the changes produced by the toxic body. Sodium chloride is a valuable therapeutic agent in pyloric and high intestinal obstruction.
 ...
PMID:THE EFFECT OF SODIUM CHLORIDE ON THE CHEMICAL CHANGES IN THE BLOOD OF THE DOG AFTER PYLORIC AND INTESTINAL OBSTRUCTION. 1986 71

The chemical changes in the blood of dogs treated with various inorganic salts after obstruction of the duodenum are reported. Two dogs treated with sodium chloride survived approximately six times as long as the average untreated animal, one living 22 days, the other 24 days. Ammonium chloride was found to produce an acidosis. The administration of potassium chloride, calcium chloride, and magnesium chloride did not prevent the usual rise in non-protein nitrogen and fall in chlorides, and the fatal outcome. Iodides seemingly hasten the toxic process. Sodium bromide appears to have an inhibitory action upon it, but much less than that of sodium chloride. Sodium sulfate, magnesium sulfate, sodium citrate, monosodium phosphate, and disodium phosphate failed to alter the course of the intoxication. Atropine and pilocarpine were without therapeutic value in preventing the changes characteristic of intestinal obstruction.
 ...
PMID:THE EFFECT OF INORGANIC SALTS ON THE CHEMICAL CHANGES IN THE BLOOD OF THE DOG AFTER OBSTRUCTION OF THE DUODENUM. 1986 47