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

The possibility that the composition of amniotic fluid is significantly altered with fetal intestinal obstruction was examined in 15 normal, 15 sham operated and 15 ewes in which jejuno-ileal atresia was created by devascularizing a 15 cm intestinal segment in the fetus at 90--100 days gestation. Samples of amniotic fluid for osmolality, urea N, creatinine, electrolytes, amylase, lipase, bilirubin, and proteins were obtained at 100 days gestation and at C-section performed 5 days prior to the anticipated date of delivery. One sham operated and four operated fetuses aborted prior to term for an 83% overall fetal survival rate. All surviving operated animals had total intestinal obstruction with the classical appearance of jejuno-ileal atresia. The volume of amniotic fluid at term varied from gelatinous material to as much as 1.0 liter of clear yellow to dark orange fluid. Amniotic fluid composition in term animals was not significantly different from those at 100 days gestation when the creatinine was below 15 mg%. However, sodium and chloride were significantly elevated in all groups at term when the creatinine was above 15 mg%. The osmolality and urea N in the latter group was not significantly different from animals at 100 days gestation. The amylase, lipase, total proteins, albumin, total and direct, and bilirubin in control animals at term was not significantly different from sham operated and experimental subjects. This study suggests that routine amniocentesis in the "high risk" patient would not be diagnostic of fetal intestinal obstruction.
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PMID:Composition of amniotic fluid with experimental jejuno-ileal atresia. 87 26

This article examines the effects of experimental prenatal intestinal obstruction on the growth and blood composition of chick embryos. Intestinal atresia (IA) was produced by bipolar bowel electrocoagulation in fertile eggs on the 14th day of incubation. The chicks killed on the 19th day were measured, weighed, and blood-sampled. Twenty-three control, 10 sham-operated, and 11 IA chicks were studied. Animals with IA were severely undernourished by weight (43.4 +/- 4.7 v 70.3 +/- 7.6% of egg weight, P < .001) and length (15.3 +/- 1.1 v 18.1 +/- 0.9 mm tibial length, P < .001) in comparison with sham-operated ones. Their hematocrit was slightly lower, and total protein increased. Prealbumin was absent in their sera and albumin, alpha and beta globulins were significantly decreased, whereas gamma-globulin was greatly increased. Sodium, potassium chloride, urea, and glucose remained within normal limits. The lack of placenta in the avian embryo precludes any supply of nutrients by this route and the ingestion of amniotic fluid, which is protein-rich after the 13th day of incubation, when the opening of the seroamniotic connection allows albumen to be mixed with it, becomes the main source of nutrients until hatching. Obstruction of the main incoming avenue by IA induces severe malnutrition in this model which relies on this route to a greater extent than the human fetus. In spite of the obvious biological differences between the avian embryo and the human fetus, the present evidence supports the hypothesis that prenatal interruption of the amniotic fluid transit contributes to fetal undergrowth in IA.
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PMID:The nutrition of the fetus with intestinal atresia: studies in the chick embryo model. 140 14

Mesenteric vascular occlusion and intestinal obstruction are difficult-to-diagnose medical emergencies. We evaluated a large panel of biochemical markers as diagnostic and prognostic indicators in a rat model of intestinal infarction and partial, complete, and strangulated intestinal obstruction. After intestinal infarction and obstruction, laboratory data are distinctly abnormal. Serum urea nitrogen dramatically increased in all groups, but most rapidly in the groups with infarction and strangulated obstruction. Inorganic phosphorus proved to be a sensitive indicator of infarction, but less so for any form of obstruction. While all members in the infarct group demonstrated significant increases in the aminotransferases, creatine kinase, and alkaline phosphatase, such increases in the groups with obstruction were less pronounced. Serum maltase assays revealed decreasing activities in all members of the groups with complete and strangulated obstruction, but in only 17% of the rats with partial obstruction. Serum maltase activity increased from abnormally low values after surgery to abnormally high values in the six animals that recovered from partial intestinal obstruction. The proportion of hexosaminidase A (of total beta-N-acetylhexosaminidase, EC 3.2.1.30) was generally abnormal in rats with complete and strangulated obstruction.
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PMID:Acute intestinal infarction or obstruction: search for better laboratory tests in an animal model. 296 10

Patients with concomitant ovarian cancer and bowel obstruction were studied in an effort to find objective prognostic factors predictive of patient outcome. A total of 62 patients were followed from 31 to 354 weeks, and a total of 20 variables were considered in the analyses. At the end of the study 49 patients were dead of their disease, and 13 were alive (six disease free and seven with persistent disease). Survival probabilities of the sample were 79% at 6 weeks, 48% at 20 weeks, and 24% at 104 weeks. Univariate analyses revealed no significant difference in the survival times of medically versus surgically treated patients; age greater than 60 years at diagnosis of cancer, presence of ascites, low serum albumin levels, elevated blood urea nitrogen levels, elevated alkaline phosphatase levels, lack of previous radiotherapy (p less than 0.002 for all), advanced tumor stage, normal/ileus x-ray results, and a short diagnosis to obstruction interval (p less than 0.04 for all) resulted in lower survival probabilities.
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PMID:Bowel obstruction in patients with ovarian cancer: a search for prognostic factors. 334 1

Preoperative risk calculation in children with bowel obstruction allows early therapeutic measures to improve prognosis. In a retrospective study the preoperative status was evaluated in 310 newborns and 127 children beyond the newborn period who had to be operated for bowel obstruction. Preoperative parameters were: age, birth weight (newborns), weight, body temperature, red and white blood count, electrolytes, urea-nitrogen, total serum protein, pH, PO2, PCO2 and base excess. These parameters were compared in surviving children and children who died postoperatively. In newborns a statistically significant difference between both groups was found for birth weight, rectal temperature, pH and total serum protein, whereas in children beyond the newborn age the same was true for age, weight and total serum protein. Besides well balanced electrolytes and good management of artificial respiration, total serum protein and in newborns additionally blood-pH and rectal temperature must be normalized preoperatively to reduce the risk in children with bowel obstruction.
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PMID:[Preoperative risk evaluation in juvenile ileus]. 652 47

Congenital duodenal webs are rare lesions, usually detected during early infancy because of signs of high intestinal obstruction. The occasional patient escapes both symptoms and detection until adolescence or adulthood. This report concerns two cases of congenital duodenal web at different ages and with different clinical manifestations. Case 1, a six-month-old male, was admitted because of abdominal distention and vomiting. Case 2, a 13-year-old boy, was referred here for further evaluation of recurring seizure attacks, elevated blood urea nitrogen and creatinine and hyponatremia. Duodenotomy and excision of the web performed for both patients. Complete amelioration of all symptoms was then observed at Outpatient Clinic follow-up for one year.
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PMID:Congenital duodenal web in late infancy and childhood: a report of two cases. 803 46

This paper examines the effects of experimental prenatal intestinal obstruction on the growth and blood composition of chick embryos. Intestinal atresia (IA) was produced by bipolar bowel electrocoagulation in fertile eggs on the 14th day of incubation. The chicks sacrificed on the 19th day were measured, weighed and blood-sampled. Twenty-three control, 10 sham-operated and 11 IA chicks were studied. Animals with IA were severely undernourished by weight (43.4 +/- 4.7 vs 70.3 +/- 7.6% of egg weight, p < 0.001) and length (15.3 +/- 1.1 vs 18.1 +/- 9 mm. tibial length, p < 0.001) in comparison with sham-operated ones. Their haematocrit was slightly lower, and total protein increased. Pre-albumin was absent in their sera and albumin, alpha and beta globulins were significantly decreased whereas gamma-globulin was greatly increased. Sodium, potassium chloride, urea and glucose remained within normal limits. The lack of placenta in the avian embryo precludes any supply of nutrients by this route and the ingestion of amniotic fluid, which is protein-rich after the 13th day of incubation, when the opening of the sero-amniotic connection allows albumen to be mixed with it, becomes the main source of nutrients until hatching. Obstruction of the main incoming avenue by IA induces severe malnutrition in this model which relies on this route to a greater extent than the human foetus. In spite of the obvious biological differences between the avian embryo and the human foetus, the present evidence supports the hypothesis that prenatal interruption of the amniotic fluid transit contributes to foetal undergrowth in IA.
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PMID:[Fetal nutrition in intestinal atresia. Studies on the chick embryo]. 821 10

AIMS: This prospective controlled trial was undertaken to resolve the controversy over whether intestinal obstruction due to postoperative adhesions should be managed by immediate operation or by conservative care. METHODS: A randomized prospective controlled study was undertaken of all private and public sector patients admitted under the care of one surgeon with intestinal obstruction due to postoperative adhesions over a 15-year period. The patients were randomly allocated either to immediate operation or conservative care with nasogastric aspiration and intravenous fluids. Patients managed conservatively who had not settled after 5 days were operated on. The data were analysed by Student's t test and Fisher's exact test. RESULTS: There were 127 patients. The two groups were statistically identical regarding age, number of previous operations and time since last operation, and heart rate, blood pressure, haemoglobin concentration, white count and urea level on admission. Sixty-three patients were treated conservatively; 22 failed to settle and were operated on, of whom 11 required a bowel resection. There were two postoperative deaths. In 64 patients treated immediately by operation, the incidence of bowel resection was not significantly reduced (22 per cent; P > 0.05) but there were four postoperative deaths. There was no significant difference in the length of stay. CONCLUSIONS: Conservative management of postoperative adhesional intestinal obstruction is safe and 65 per cent settle. In those who fail to settle there is no significantly increased risk of bowel strangulation. There is no way of identifying those who will not settle from the history or initial investigations on admission.
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PMID:Operative versus conservative management of adhesional intestinal obstruction 1071 51

Hirschsprung disease (HSCR) is a congenital disorder characterised by intestinal obstruction due to an absence of intramural ganglia along variable lengths of the intestine. RET is the major gene involved in HSCR. Mutations in the GDNF gene, and encoding one of the RET ligands, either alone or in combination with RET mutations, can also cause HSCR, as can mutations in four other genes (EDN3, EDNRB, ECE1, and SOX10). The rare mutations in the latter four genes, however, are more or less restricted to HSCR associated with specific phenotypes. We have developed a novel comprehensive mutation detection system to analyse all but three amplicons of the RET and GDNF genes, based on denaturing gradient gel electrophoresis. We make use of two urea-formamide gradients on top of each other, allowing mutation detection over a broad range of melting temperatures. For the three remaining (GC-rich) PCR fragments we use a combination of DGGE and constant denaturing gel electrophoresis (CDGE). These two dual gel systems substantially facilitate mutation scanning of RET and GDNF, and may also serve as a model to develop mutation detection systems for other disease genes. In a screening of 95 HSCR patients, RET mutations were found in nine out of 17 familial cases (53%), all containing long segment HSCR. In 11 of 78 sporadic cases (14%), none had long segment HSCR. Only one GDNF mutation was found, in a sporadic case.
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PMID:RET and GDNF gene scanning in Hirschsprung patients using two dual denaturing gel systems. 1079 Feb 3

Volvulus of the small bowel is not so frequent as is volvulus of the colon. A delayed diagnosis and surgical treatment result in high rate bowel infarction which can lead to perforation and stercoral peritonitis. If perforation does not take place, the infarcted bowel has to be resected causing multiple complications and mortality. The small bowel volvulus is caused by mesenteric lipoma in about 5% of cases. We present a 77-year-old man operated on for intestinal obstruction. The patient was admitted in a serious condition with a five-day history of abdominal pain and vomiting. On admission he vomited a small bowel content (miserere), he was dehydrated and with high blood urea and creatinine values. Plain X-ray showed a number of air fluid levels in the small bowel. At operation a small bowel volvulus caused by mesenteric lipoma (18 x 11 x 10 cm in diameter) with bowel infarction but without free perforation and peritonitis, was found. The tumour was removed together with 10 cm of resected bowel with end-to-end anastomosis. The recovery was uneventful. The patient is still symptom free.
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PMID:[Mesenteric lipoma causing volvulus of the small intestine]. 1108 23


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