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)

A 66-year-old man presented with dyspnea and a transient ischemic attack. Echocardiography revealed a right ventricular mass and patent foramen ovale. During surgery the mass was found to be a malignant nerve sheath tumour. Several weeks later, the patient developed small bowel obstruction, and laparotomy disclosed multiple metastases involving the small and large bowel. The paper describes the clinical course and management of this patient and reviews the pertinent literature.
Can J Cardiol 1996 Sep
PMID:Right ventricular nerve sheath tumour and patent foramen ovale presenting with transient ischemic attack. 884 30

Gastrointestinally active agents such as cholesterol absorption inhibitors (CAIs) (eg, ezetimibe) and bile acid sequestrants (BAS) (the resins cholestyramine and colestipol, or colesevelam, a nonabsorbable polymer) offer important options for lipid-lowering therapy. Ezetimibe is a novel CAI that inhibits the absorption of dietary and biliary cholesterol without affecting the absorption of triglycerides or fat-soluble vitamins. In clinical trials, there has been no evidence of increased rates of myopathy or rhabdomyolysis associated with ezetimibe, whether in use as monotherapy or in a combination with statin therapy, although there exist case reports of possible ezetimibe-associated myopathy. Ezetimibe alone does not appear to increase liver transaminase levels significantly, but the coadministration of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) with ezetimibe marginally increases this risk. However, reported increases in liver enzymes have not been associated with clinically meaningful symptoms and often return to baseline levels after the discontinuation of therapy or with continued treatment. To date, no cases of liver failure, liver transplantation, or death have been reported. BAS have been used clinically since the 1960s for lowering low-density lipoprotein cholesterol. Because they are not absorbed from the gastrointestinal tract into the blood, these agents do not contact most body organs and are therefore systemically safe. However, case reports and pharmacokinetic data disclose 3 kinds of adverse effects: (1) the decreased absorption of concomitant medications and sometimes of certain vitamins; (2) the physicochemical alteration of intestinal contents leading to constipation and, very rarely, intestinal obstruction; and (3) modest increases in plasma triglyceride levels due to the alteration of hepatic lipid metabolism. The newest BAS, colesevelam, has greater specificity for bile acids compared with the older agents cholestyramine and colestipol, eliminating most drug interactions and reducing the tendency for constipation. Overall, CAIs and BAS have excellent systemic safety profiles when used alone or in combination with other lipid-lowering drugs.
Am J Cardiol 2007 Mar 19
PMID:Safety considerations with gastrointestinally active lipid-lowering drugs. 1736 79

Angiotensin converting enzyme inhibitors are one of the most commonly prescribed medications and angioedema of upper aerogastric tracts is a well recognized complication. Isolated visceral angioedema with the use of angiotensin converting enzyme inhibitors is rare and is relatively under diagnosed. The visceral angioedema should be considered in patients taking angiotensin converting enzyme inhibitors who develop gastrointestinal complaints. We report a case of subacute intestinal obstruction from the use of benazepril, which was promptly resolved after withdrawing benazepril.
Int J Cardiol 2007 May 31
PMID:Benazepril induced isolated visceral angioedema: a rare and under diagnosed adverse effect of angiotensin converting enzyme inhibitors. 1739 88

Isolated levocardia (ILC) is a developmental abnormality involving an abnormal abdominal situs with a normal cardiac situs. This abnormality is especially rare when it is associated with a normal cardiac anatomy. The prenatal diagnoses of seven cases were reported in the English literature. This report presents two cases referred to the authors' echocardiography laboratory for maternal diabetes mellitus in case 1 and suspected dextrocardia in case 2. In both cases, ILC with a structurally normal heart was diagnosed prenatally. The child in the first case was found to have a normal inferior vena cava (IVC) prenatally. Postnatally, he was found to have intestinal malrotation with duodenal obstruction and multiple splenules. Interruption of the IVC was shown by abdominal ultrasound. The child in the second case was found to have an interrupted IVC with azygos continuation prenatally. Postnatally, intestinal malrotation with no evidence of intestinal obstruction or asplenia was detected. Neither of the cases had reported cardiac arrhythmias. Early diagnosis is crucial in these cases due to the high incidence of associated anomalies and potential life-threatening conditions. Management of patients with ILC is dictated by the associated anomalies. Long-term follow-up assessment is recommended for these patients to monitor the development of rhythm abnormalities.
Pediatr Cardiol 2013 Apr
PMID:Prenatal diagnosis of isolated levocardia and a structurally normal heart: two case reports and a review of the literature. 2261 2

Anorexia nervosa (AN) is a complex psychiatric disorder that can have devastating cardiovascular complications. Its lesser-known association with pericardial effusion has been recently described in the literature. We present the case of a 45 year-old female who presented with a recurrent small bowel obstruction requiring lysis of adhesions and who was found to have a large pericardial effusion that progressed to cardiac tamponade necessitating surgical intervention. The patient had a body mass index of 14.8 kg/m2 (i.e. 71% of ideal body weight) and a long-standing history of food aversion, extreme exercise habits, and weight obsession consistent with AN. To the best of our knowledge, this is the first case of AN-associated cardiac tamponade in the United States, and the first requiring surgical intervention. In conclusion, with this and current data regarding AN-associated pericardial effusions, we recommend a low threshold for performing pre-operative echocardiography for those in whom AN is suspected.
Cardiol J 2012
PMID:Cardiac tamponade in association with anorexia nervosa: a case report and review of the literature. 2322 28

The authors describe a case of Kawasaki disease who presented fever, coronary artery aneurysm, and ischaemic intestinal obstruction requiring stage resections. A review of literature of such association is performed. Atypical Kawasaki disease is more complex to diagnose and in combination of persistent fever with no definite cause and surgical abdominal pain, Kawasaki disease should be considered in the differential diagnosis.
Cardiol Young 2014 Jun
PMID:Intestinal ischaemia as a severe presentation of Kawasaki disease leading to short-bowel syndrome. 2396 48

ST segment elevation on EKG remains among the most important presentations of acute myocardial infarction. Due to the urgency of intervention for this finding, other clinical scenarios causing ST elevations on EKG may sometimes go unaddressed and can lead to fatal complications. We present a case of an 86-year-old male presenting with small bowel obstruction leading to EKG findings of ST segment elevation in the absence of critical coronary obstruction. The EKG finding resolved after the improvement of small bowel obstruction reflecting the reversible cause of the changes.
Case Rep Cardiol 2015
PMID:Small Bowel Obstruction Masquerading as Acute ST Elevation Myocardial Infarction. 2658 91