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

Elemental enteral alimentation (EEA) is an alternative to parenteral nutrition in patients with a functioning gastrointestinal tract and increased caloric requirements or in whom regular oral feeding is impossible or impractical. EEA is given by nasogastric, jejunostomy, or gastrostomy tube. It is useful in cases of short-gut syndrome, pancreatic disease, partial intestinal obstruction, colitis, neuropsychiatric cachexia, trauma, fistula, vascular insult, and renal and liver disease, as well as in patients being prepared for surgery or requiring hyperalimentation after surgery or abdominal irradiation. Strict attention must be paid to fluid and electrolyte status and to blood and urine glucose levels in patients receiving EEA. With use of a nasogastric tube, infection of the middle ear is a possible but uncommon complication.
Postgrad Med 1978 Sep
PMID:Meeting exceptional nutritional needs. 2. Elemental enteral alimentation. 10 Jul 74

Skin tests (ST) in 1332 patients are associated with increased morbidity from sepsis. Patients with normal skin tests had a 7% major sepsis rate and 2% mortality rate. Thirty-six per cent of anergic (A) patients and 21% of relatively anergic (RA) patients died; 52% of A patients and 34% of RA patients had sepsis. These data include all patients studied and represent their worst skin test. Two studies were done. The first was a retrospective evaluation of effect of surgery upon 49 anergic patients with biliary tract disease, colon cancer, bowel obstruction, hypovolemia and visceral abscesses. The patients did not receive total parenteral nutrition (TPN). The data show that surgery without TPN can reverse the anergic state and did so in 84% of patients reported. The second study was a prospective, double-blind, randomized trial of the effect of levamisole on skin tests, neutrophil chemotaxis (CTX), sepsis and mortality iin 39 preoperative anergic patients. Major sepsis was significantly increased in placebo group (p less than 0.05). Mortality, minor sepsis, restoration of skin tests and chemotaxis were somewhat better in levamisole patients but not statistically so. These studies show that in addition to TPN, surgery and immunorestorative drugs are viable approaches to the management of selected anergic patients.
Ann Surg 1979 Sep
PMID:Therapeutic approaches to anergy in surgical patients. Surgery and levamisole. 11 27

Perforations of the uterus are of 2 types: 1) the IUD is completely in the peritoneal cavity; or 2) the IUD is partly in the peritoneal cavity, partly embedded in the uterine wall. The incidence of uterine perforation is 0.6, 0.6, 1.6 and 5.0/1000 for the loop, spiral, steel ring, and bows respectively; the type of applicator used may influence the rate. Devices similar to the Grafenberg ring and the Birnberg bow are associated with intestinal obstruction and predispose to bowel herniation. There is a virtual absence of endometrial reactions in the polythelene spirals and loops, which are pliable and unlikely to penetrate the intact uterine wall due to muscle contraction alone. Most perforations occur at the time of insertion; insertion during the early postpartum period or during the period of lactational amenorrhoea, or in the case of an undiagnosed pregnant uterus or an acutely anteflexed or retroflexed uterus can be the cause. Other factors are 1) the manner of insertion; 2) the consistency of the uterine wall and its position; and 3) the type of device and introducer used. Thorough knowledge of gynecological anatomy is required to avoid defective placements. The hypothesis of erosion of the uterine wall was based on misdiagnosis due to the use of plain films in cases of incomplete perforation; perforation is best diagnosed by hysterography. Although polyethylene devices are said to be free of irritation or adhesions inside the peritoneal cavity, laparotomy is probably the best treatment for all cases and particularly where the IUD is in an anterior position.
J Indian Med Assoc 1976 Sep 16
PMID:Translocation of intrauterine contraceptive device. 14 10

Sclerosing peritonitis developed in a 43-year-old man with angina pectoris who had been receiving the beta-adrenergic receptor antagonist, propranolol. The patient had abdominal and back pain, weight loss, a midabdominal fullness, ascites, and evidence of partial small bowel obstruction. At surgery, the small bowel was distended and encased by dense fibrous tissue. Infectious and neoplastic causes of fibrosing peritoneal inflammation were excluded. The patient described in this report illustrates several features commonly experienced by individuals who developed sclerosing peritonitis associated with beta-adrenergic receptor blockade therapy. To my knowledge, the development of ascites and considerable ascitic fluid leukocytosis have not been described previously with this disorder.
Arch Intern Med 1978 Sep
PMID:Sclerosing peritonitis and propranolol. 15 Aug 26

During a two-year period, major operations were performed on 874 males and 649 females at the first-aid section of a major hospital. Acute appendicitis was the most common intraoperative diagnosis (45.63%), followed by intestinal obstruction (21%), gastroduodenal perforation (6.83%), abdominal injury (5.98%), angiosurgical emergency situations (5.19%, including amputation for gangrene), gynaecological emergency situations (3.74%), acute cholecystitis (3.35%), haematemesis (1.44%), acute pancreatitis (1.31%), and various other diseases. Further surgery as a result of complications was required in 2.63%. Mortality (1 year only) was 7.42%. The results achieved and the tactical criteria employed are discussed.
Minerva Chir 1978 Sep 15
PMID:[Epidemiological study of emergency surgical pathology in the first aid department of a large hospital]. 30 23

There is a high incidence of primary colonic intussusceptions in infants and children in Africa. The case histories of 37 patients are reviewed. Of the varieties described, the caecocolic intussusception (16 patients) presents as an intestinal upset, often mild, with symptoms of colic and vomiting. In many of these patients there is known to be an intestinal infestation with Ascaris lumbricoides. This often leads to a delay in establishing the correct diagnosis. Colocolic intussusception (13 patients) gives rise to more acute abdominal symptoms. On clinical assessment, signs of intestinal obstruction are found and there is usually an intra-abdominal mass which can be palpated in the left colon. Further confirmatory evidence of intussusception is the finding of occult blood in stools. There is an unusually high incidence of sigmoid intussusceptions in infants (8 patients). The diagnosis of this form of intussusception is often delayed owing to inadequate clinical assessment of prolapsed bowel at the anal orifice. The length of the prolapsed bowel, the curved nature of the prolapse and the possible demonstration of a sulcus between the prolapsed bowel and the anal canal wall, aid in diagnosis.
S Afr Med J 1978 Sep 23
PMID:Colonic intussusceptions in children. 36 78

We report on an 89-year-old female admitted with signs of intestinal obstruction in whom three independent adenocarcinomas of the proximal jejunum were found. Multiple foci of pyloric gland metaplasia, glandular hyperplasia and dysplasia, carcinoma-in-situ, and several varieties of adenocarcinoma were identified on microscopic examination of 14 cm of excised jejunum. Multifocal adenocarcinoma of the small intestine is extremely rare. We are not aware of any case harboring the complex changes described herein.
Cancer 1979 Sep
PMID:Multifocal adenocarcinoma of the jejunum. 38 70

A case of generalized amyloidosis associated with cyclic neutropenia is presented. A 24-yr-old female with cyclic neutropenia died from intestinal obstruction caused by necrosis and perforation of the small intestine. Post-mortem examination revealed generalized amyloidosis involving almost all organs. Amyloid deposits were prominent, especially in the alimentary tract, kidneys, spleen, and small blood vessels. As has been suggested in gray collie dogs with congenital cyclic neutropenia known to develop secondary amyloidosis in adulthood, an increase of antigenic stimulation during the intermittent bouts of acute infections may be one of the factors responsible for the development of secondary amyloidosis in this case. Although the association of amyloidosis and cyclic neutropenia in man has rarely been described, it is probable that amyloidosis is not a rare complication of human cyclic neutropenia, considering that patients with this hematologic disorder are chronically exposed to excessive antigenic stimulation.
Blood 1979 Sep
PMID:A case of generalized amyloidosis associated with cyclic neutropenia. 46 32

A retrospective study of 174 patients with small intestine cutaneous fistulas was carried out. Cause, location of fistula, amount of output, presence of inflammation, intestinal obstruction, presence of malnutrition and anemia are associated wih an increased mortality. The results of various modes of treatment indicate that intestinal resection with primary anastomosis, carried out six weeks or later after the onset of the fistula, was associated with the lowest mortality and the highest success rate.
Surg Gynecol Obstet 1979 Sep
PMID:Small intestine cutaneous fistulas. 47 91

An unusual late complication of side-to-side intestinal anastomosis, chronic small-bowel obstruction with massive proximal ileal dilation despite a widely patent anastomosis, occurred in a patient. The classic blind loop syndrome was not present. Several potential mechanisms are suggested, including regional absence of normal peristalsis on a mechanical basis and bacterial overgrowth. This report adds support to the concept that side-to-side intestinal anastomosis should be avoided whenever possible.
Arch Surg 1979 Sep
PMID:Chronic pseudo-obstruction secondary to side-to-side intestinal anastomosis. 48 41


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