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

The mechanism of bowel obstruction in colorectal cancer is likely to involve interactions between tumour cells, host fibroblasts and the extracellular matrix. The role of fibroblast-mediated matrix reorganisation in malignant structures of the large bowel was examined in an in vitro collagen matrix model in which tumour cells and fibroblasts were cultured under serum-free conditions. Colon cancer cells secreted a factor(s) which enhanced the ability of colon fibroblasts to contrast a collagen matrix without an associated mitogenic response by the fibroblasts. Within uncontracted collagen gels marked elongation of fibroblast cell processes was observed in the presence of the tumour-derived factor(s). We propose that matrix reorganisation by host fibroblasts in the wall of the human colon is responsible, at least in part, for malignant large bowel obstruction.
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PMID:The role of colon fibroblasts in malignant large bowel obstruction--an experimental in vitro model. 222 73

The clinical presentation of an abdominal aortic aneurysm can be misleading. The typical triad of abdominal pain, pulsate mass, and hypotension may be absent. Delay in diagnosis is associated with a high mortality. Described in the article is a case of a ruptured abdominal aneurysm presenting as a large bowel obstruction. When found at surgery, the aneurysm had ruptured and was sealed by overlying colonic mesentery, along with retroperitoneal fascia. Elderly male patients who are smokers are believed to be at higher risk for atypical presentations from ruptured abdominal aortic aneurysms. This is thought to result from a generalized defect in collagen combined with diffuse atherosclerotic vascular disease. The diagnosis requires maintenance of a high clinical suspicion, in particular for those patients with higher risk factors.
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PMID:Ruptured abdominal aortic aneurysm presenting as an obstruction of the left colon. 235 97

Five cases of giant inflammatory polyps associated with idiopathic inflammatory bowel disease are reported. Polyps produced intestinal obstruction in three cases; consequently, surgery was performed. In a further two cases, intestinal bleeding was improved by endoscopic polypectomy. Electron microscopy showed fibroblasts, myofibroblasts, mast cells, lymphocytes, collagen fibers, capillaries, and venules. Remnants of the original mucosal epithelial cells, smooth muscle cells, and hypertrophic autonomous nerve plexuses were noted. Nerve fibers were interwoven with the matrix of the polyps. Mast cells were closely linked with vessels, nerves, and collagen fibers. They may have an important role in the excessive granulation, angiogenesis, and fibrotic process in giant inflammatory polyps.
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PMID:Giant inflammatory polyps associated with idiopathic inflammatory bowel disease. An ultrastructural study of five cases. 239 Sep 14

Twenty-six children aged from 1 day to 15 years (18 boys and 8 girls) with visceral neuropathies are analyzed. Clinical symptomatology is dominated by abdominal distension, attacks of occlusion, abdominal pain, and malnutrition. Intestine bacterial overgrowth is frequent. From aspiration biopsies, surgical rectal biopsies, and, in some cases, ileal or ileocolic biopsies, histopathological studies revealed two patterns. One group had abnormalities of the myenteric plexus identified by conventional light microscopic studies, with two patterns: [myenteric plexus hyperplasia (9 patients), characterized by large ganglionic nodes, penetration into the mucosal zone, and altered argyrophilic neurons]. Clinically this pattern was observed in four patients with multiple endocrine neoplasia syndrome with risk of medullary thyroid carcinoma. The second pattern observed was characterized by glial cell hyperplasia (15 patients). Ganglion cells are present but are small and sparse, often infiltrated by collagen tissue; Schwann nerve fibers are hypertrophic. Eleven patients presented with neonatal intestinal obstruction. The second group is characterized by normal conventional light microscopic examination, but silver stains revealed important abnormalities of argyrophobic cells (one case) or argyrophilic cells (one case). In the two groups, most of the patients needed intestinal derivation and prolonged nutritional support with total parenteral nutrition.
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PMID:Visceral neuropathies responsible for chronic intestinal pseudo-obstruction syndrome in pediatric practice: analysis of 26 cases. 239 57

The haemostatic effect of two new materials has been compared with surgical gauze and oxidized cellulose using a standardized liver laceration in New Zealand White rabbits. Following excision of a 3 cm2 disc of tissue from the liver, 42 rabbits were randomized to the use of gauze swabs (n = 6), oxidized cellulose (Surgicel) (n = 12), porcine collagen (Medistat) (n = 12) or calcium alginate (Kaltostat) (n = 12) to control the resulting haemorrhage. Blood loss and time to haemostasis were accurately recorded. The absorbable materials were left in situ and animals killed between 2 weeks and 6 months later to examine speed of absorption and resulting adhesions. Calcium alginate stopped bleeding in less than 3 min in all animals compared with a mean (+/- s.e.m.) of 5.7 +/- 0.75 min for porcine collagen, 12.5 +/- 0.9 min for oxidized cellulose and greater than 15 min with gauze (P less than 0.001). Oxidized cellulose and calcium alginate reabsorbed within 3 months leaving a fibrous scar, but a vigorous foreign body reaction was seen with porcine collagen which caused intestinal obstruction in 5 out of 12 animals within 3 months.
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PMID:Comparison of absorbable materials for surgical haemostasis. 321 44

The collagen content and the relative amount of collagen types were quantitated in control intestine as well as in both inflamed and strictured intestine resected from patients with Crohn's disease. The major collagen type in control intestine was type I (68%), followed by types III (20%) and V (12%). In strictured intestine both collagen content and the relative amount of type V collagen were significantly increased compared with control intestine. Histologic studies demonstrated that in strictured specimens there was a striking proliferation of smooth muscle cells of the muscularis mucosae associated with an accumulation of collagen in the submucosa. The thickness of the muscularis propria was also increased. Immunohistochemical studies demonstrated small amounts of type V collagen in the submucosa of control bowel. In contrast, large amounts of type V collagen were seen in the fibrotic, expanded submucosa of strictured bowel, particularly in the areas where smooth muscle cells of the muscularis mucosae had proliferated. Intestinal strictures in Crohn's disease are therefore characterized by an accumulation of collagen, a proliferation of smooth muscle cells, and an increase in type V collagen, a collagen type produced in relatively large amounts by smooth muscle cells. These changes appear to result in both a loss of the normal compliance of the intestine and a thickening of the intestine wall, resulting ultimately in the intestinal obstruction so frequently seen in patients with Crohn's disease.
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PMID:Collagen content and types in the intestinal strictures of Crohn's disease. 333 5

Avitene, microfibrillar collagen hemostat, is an absorbable topical hemostatic agent prepared from purified bovine corium collagen. A case is reported of a 58-year-old man who, one month after sigmoid colectomy for volvulus in which Avitene as used to control bleeding from a splenic capsular tear, developed symptoms of intestinal obstruction. On exploratory laparotomy, the transverse and descending colon had numerous 0.1 to 2.0 cm nodules, adherent to the serosa of the bowel and mesentery, with kinking and partial obstruction of the splenic flexure. Light microscopically, the nodules were found to be composed of chronic inflammatory and granulomatous reaction with numerous deposits of eosinophilic fibrillar material consistent with Avitene. Electron microscopic examination of the lesions and of Avitene confirmed the nature of this material. The practical and pathobiological implications of utilization of Avitene as a hemostatic agent are discussed.
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PMID:Avitene granulomas of colonic serosa. 374 Jul 98

The response of mouse jejunum at intervals up to 1 year after single 'priming' doses of X-rays has been assessed by crypt survival after retreatment with single doses of X-rays and morphometric analysis of changes in the intestinal submucosa. The first 'priming' dose was given as a single dose to the whole abdomen. To assess crypt survival, groups of mice were retreated to the whole body with a range of test doses 2, 6 or 12 months later, while other groups of mice were given only the priming doses. These data were compared to crypt survival in mice not previously irradiated. The crypt dose-survival curves in mice re-irradiated at all three intervals after priming irradiation were displaced to higher doses in pre-treated than in non-pre-treated mice and were characterized by higher D0 values. Misonidazole given before the test exposure reversed this effect so that the dose survival curve for crypts in pre-treated mice were superimposed on that for mice not previously irradiated, suggesting that the increase in isoeffect dose and the change in the D0 in previously exposed mice was due to crypt hypoxia. Quantification of the area of the submucosa showed that its area was increased at all three times after the priming doses and was a result of collagen deposition and oedema. Thus, the hypoxia in the crypts was probably secondary to these changes. Deaths began at 6-7 months after priming irradiation and were due to intestinal obstruction and stenosis. Thus, as in other tissues, two phases of injury can be assayed in the intestine of experimental animals.
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PMID:Late effects of irradiation in mouse jejunum. 633 87

Six patients with intestinal obstruction secondary to benign adhesions so dense and vascular that the operating surgeon could not free them, were placed on a home total parenteral nutrition program. Four patients had enterocutaneous fistulas, and two had their bowels divided and stomas created to divert intestinal contents from distal enterotomies made during the attempt to free the intestine. The enterocutaneous fistulas closed in four patients within 2 weeks to 5 months and the obstructions spontaneously resolved in 2 to 3.5 months. At reoperation on the two patients whose intestinal tracts were purposely divided, the previously matted bowels with dense adhesions were easily freed. We believe complete gastrointestinal rest allows adhesions to mature into long avascular collagen fibers in the absence of a persistent inflammatory reaction that accompanies partial or total small bowel obstruction. We recommend that patients receive 3 months of home total parenteral nutrition before a second operation for persistent obstruction after recent enterolysis should be considered. Spontaneous resolution should occur, but if not, reoperation can be performed safely after the 3 month interval.
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PMID:Spontaneous resolution of intestinal obstruction while receiving home parenteral nutrition. 641 20

A retrospective study of 412 consecutive hospital admissions of patients with collagen vascular disease yielded 63 patients who were admitted for abdominal complaints. Of these 63 patients, 11 died during their admission of primary intra-abdominal pathology or a complication thereof. A significantly higher incidence of abdominal complications occurred in black women (P less than 0.01). Peritoneal signs invariably were lacking in patients who eventually died. Radiographic documentation of small bowel obstruction or gastroduodenal ulceration in these patients was particularly ominous. Rapid radiologic evaluation and early surgical intervention including diagnostic peritoneal lavage should decrease the mortality rate for these difficult patients.
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PMID:Abdominal complications of collagen vascular disease. 684 56


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