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

Several hemodynamic abnormalities in the patient with cirrhosis comprise a unique distributive circulatory disturbance that causes intractable ascites and that is, in turn, worsened by the resulting ascites. Ascites is promptly alleviated by drainage of the ascitic fluid into the intravascular compartment. The circulatory abnormalities improve in part because of elimination of the ascites, and also because of a compensatory hypervolemia. The consequences of the latter, especially in the immediate postoperative period, are increased likelihood of pulmonary edema and of gastrointestinal bleeding from heightened portal vein pressure. Postoperative coagulopathy is also a significant problem. Careful selection of patients for the procedure, close postoperative observation and vigorous use of diuretics and other agents will usually enable these complications to be obviated or successfully treated. Increases in body muscle and fat masses and serum albumin concentrations indicate nutritional improvement. Despite evidence of benefits from the procedure, these patients continue to die from the complications that threaten other cirrhotics: effects of return to alcoholism, gastrointestinal hemorrhage, recurrent infections and intestinal obstruction. Thus, it is not yet clear that the benefits include prolongation of life.
Med Clin North Am 1979 May
PMID:Treatment of intractable ascites in patients with alcoholic cirrhosis by peritoneovenous shunting (LeVeen). 44 38

The clinical features of the multiple mucosal neuromas (MMN) syndrome permit the recognition of these patients and their potential development of the associated medullary thyroid carcinoma (MTC). The distinctive physical appearance caused by the mucosal neuromas, the Marfanoid habitus and, occasionally, the positive family history aid in establishing the diagnosis. Neurogangliomas are frequently present in the gastrointestinal tract of these patients who may have megacolon, constipation and diarrhea. The third instance of the MMN syndrome is reported in the newborn as intestinal obstruction. It is suggested that the syndrome be considered in the differential diagnosis of Hirschsprung's disease and bowel obstruction in the neonate. Serum calcitonin measurements following stimulation by calcium or pentagastrin infusion reliably detect incipient MTC and may be used to select those MMN patients requiring thyroid surgery. Recognition of patients with the MMN syndrome and subsequent calcitonin screening and early surgical intervention will significantly reduce the chance of their developing terminal MTC. All MMN patients with mucosal neuromas or intestinal neurogangliomas should have such evaluations at least yearly. Relatives who are at risk for inheriting this dominant disease should be similarly evaluated, regardless of their normal appearance.
Ann Clin Lab Sci
PMID:Medullary carcinoma of the thyroid in the multiple mucosal neuromas syndrome. 53 32

Hirschsprung's disease is one of the more common causes of childhood bowel obstruction. The disease can cause enterocolitis which, untreated, may result in considerable mortality. We describe our evaluation of two infants who suffered from intractable diarrhea of infancy secondary to Hirschsprung's disease. We found that mucosal damage to the small bowel and disaccharidase deficiency are among the most important mechanisms producing this complications. Therefore, management of enterocolitis including parenteral alimentation should proceed as soon as the complication is observed.
J Clin Gastroenterol 1979 Sep
PMID:Small intestinal changes in enterocolitis complicating Hirschsprung's disease. 55

Tuberculosis continues to be a major health problem in India. Our experience of 102 cases of gastrointestinal tract tuberculosis is presented. Eighty-one of these patients experienced obstructive symptoms, 62 had radiographic evidence of intestinal obstruction, and four had bowel perforation. Lymphadenopathy was present in 16 patients and pulmonary tuberculosis in 28. The commonest sites of bowel involvement were ileo-caecal, ileum and ascending colon. Duodenal lesions were seen in three cases and in another three there was isolated appendicular involvement. Right hemicolectomy was necessary in 55 of the 74 patients who had surgical exploration. Histopathological reports were available in 88 subjects. The various radiographic manifestations of tuberculosis of the bowel are discussed. Radiologically and sometimes even on histopathology, differentiation of ileo-caecal tuberculosis from Crohn's ileo-colitis may prove impossible.
Clin Radiol 1978 Mar
PMID:Gastrointestinal tract tuberculosis: a study of 102 cases including 55 hemicolectomies. 63 58

The findings on the radiographs of 14 cases of ileosigmoid knot are presented and analysed. The clinical features and pathology of the condition are briefly described. The key radiological features consist of a dilated loop of pelvic colon, evidence of small intestinal obstruction and retention of faeces in an undistended proximal colon. The dilated loop usually lies in the right side of the abdomen and the limbs taper inferiorly into the right lower quadrant. Medial deviation of the distal descending colon is an inconsistant but highly specific finding. The radiographs readily permit distinction from primary volvulus of the small intestine and from non-obstructive surgical emergencies such as perforated viscus and ruptured ectopic pregnancy. The combination of radiographic findings may however be simulated by volvulus of the right colon, closed loop small intestinal obstruction and by volvulus of the pelvic colon complicated by peritonitis. The differential diagnosis is discussed and the value of sigmoidoscopy, rather than barium enema, emphasised.
Clin Radiol 1978 Mar
PMID:The radiology of ileosigmoid knot. 63 62

Gastrointestinal metastases secondary to bronchogenic carcinoma are relatively uncommon and most are found incidentally at autopsy examination in patients with advanced or widely disseminated lung cancer. Occasionally gastrointestinal metastases occurr relatively early in the course of the disease and give rise to a variety of clinical symptoms and radiological abnormalities. Recognition of these abnormalities is important in order that appropriate palliative therapy may be undertaken. The clinical. radiological and pathological findings in 12 patients with symptomatic gastrointestinal metastases secondary to bronchogenic carcinoma were reviewed. Clinical symptoms varied according to the site of metastatic involvement and included dysphagia, epigastric pain, nausea, vomiting, gastrointestinal bleeding, anaemia and signs of intestinal obstruction or perforation. The sites of metastatic involvement were: oesphagogastric junction (2 cases); stomach (2 cases); duodenum (1 case): jejunum (3 cases); ileum (2 cases), colon (2 cases). The radiological findings are discussed and illustrated.
Clin Radiol 1978 Mar
PMID:Symptomatic gastrointestinal metastases secondary to bronchogenic carcinoma. 63 63

Five hundred patients with the isomorphic pattern of the isoenzymes of serum lactate dehydrogenase (LDH) were surveyed. The isomorphic pattern of LDH isoenzymes is defined as a significant increase of total LDH with normal or low percentage of individual fractions, but with the LDH1:2 ratio less than unity. Diagnoses were, in descending order of frequency, cardiorespiratory diseases, malignancy, fracture, diseases of the central nervous system, infection/inflammation, hepatic cirrhosis and/or alcoholism, trauma without fracture, infectious mononucleosis, hypothyroidism, uremia, necrosis, pseudomononucleosis, viremia and intestinal obstruction. Incidence of increased serum activity in individuals without evidence of disease or drug explanation was 3 percent. Low PaO2 was observed in 88 percent of the 67 patients in whom it was measured.
Ann Clin Lab Sci
PMID:Clinical significance of the isomorphic pattern of the isoenzymes of serum lactate dehydrogenase. 90 Aug 65

The presence of multiple intestinal air-fluid levels and the distention of jejunum and colon are common and expected sequelae of small bowel bypass procedures for morbid obesity. The radiologist must be familiar with these findings in order to avoid the misdiagnosis of bowel obstruction.
Radiol Clin North Am 1976 Dec
PMID:Radiographic changes after small bowel bypass for morbid obesity. 100 90

Though endometriosis is a frequent finding in females, it rarely causes obstruction of the small bowel. However, 11 patients with such obstruction were seen at the Mayo Clinic in the years 1950 through 1970. Their ages ranged from 27 years to 51. A portion of involved bowel had to be resected in every case, but most of the lesions were single. Generally the obstructions were subacute and did not produce surgical emergencies. But because the symptoms were neither specific nor acute, the diagnosis seldom was established prior to laparotomy and the majority of the resections were performed without bowel preparation. Nevertheless, morbidity was minor in most cases and there was no mortality. Small-bowel obstruction has not recurred. Endometriosis of the small bowel tends to be limited to the serosa and the muscular coats, not penetrating the mucosa; and obstruction is due to fibrosis and kinking of the bowel. The obstructed segment usually must be resected. If pelvic endometriosis is minimal, no further surgery is necessary. But if the pelvic lesions are extensive, or if multiple sites in the small and large intestines are involved, then more radical resection and bilateral oophorectomy are indicated.
Mayo Clin Proc 1975 May
PMID:Small-bowel obstruction secondary to endometriosis. 112 91

The significance of pica and geophagia as a public health problem is well known. The objective radiographic diagnosis of geophagia depends on the abnormal opacification of the bowel as an immediate manifestitation of the condition. The chance of detectability of geophagia is highest in the colon and can be improved by using low penetration films, particularly for smaller amounts of ingested clay. Other radiologic changes frequently associated with the prolonged practice of geophagic are an atonic pattern of the colon, secondary radiographic changes due to iron-deficiency anemia and bone-age retardation. The occurrences of intestinal obstruction due to pica in the presence of preexisting bowel stricture is demonstrated.
Am J Clin Nutr 1975 Oct
PMID:Radiological changes in pica. 118 Feb 44


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