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

With a rise in the incidence of severe injuries, we are seeing increasing numbers of patients with colonic entrapment occurring at the sites of diaphragmatic injuries. The initial injury might have occurred recently or it might have occurred as long as 25 years before. Blunt trauma, stabbings, and infection accounted for the initial trauma in our patients. Acute symptoms implicate the cardiorespiratory system as a result of interference with respiration and the filling and function of the heart. Acute or chronic gastrointestinal symptoms may suggest intestinal obstruction or functional bowel disorders. The proper diagnosis of colonic entrapment depends upon a high index of suspicion and proper studies. Chest x-rays, fluoroscopy, barium-enema examinations and contrast studies of the upper gastrointestinal tract are essential. Acute cardiorespiratory enbarrassment necessitates prompt surgical intervention. When subdiaphragmatic injuries are suspected, an abdominal incision is necessary. In long-standing cases where the abdominal viscera are intact, the thoracic approach is preferable. At times, the combined thoraco-abdominal incision may be preferable. Diaphragmatic injuries resulting in colonic entrapment occurred most often in the left hemidiaphragm, which is relatively unprotected. In seven of our eight patients, the left diaphragm was the site of herniation. The liver on the right side serves to protect this area from herniation. Only the largest defects permit displacement of the liver into the right chest. Only one of our patients had such a defect. Patients with long-standing cardiac or gastrointestinal symptoms suggestive of colonic entrapment should have a THOROUGH MEDICAL evaluation before any operative treatment is advised. We have reviewed the cases of eight patients in whom infection, stabbings and blunt trauma resulted in diaphragmatic herniations with subsequent colonic entrapment. The splenic flexure of the colon protruded through the defect in three of our eight patients. The transverse colon was located above the diaphragm in five.
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PMID:Entrapment of the colon following diaphragmatic injuries: report of eight cases. 112 60

The authors report 84 cases of post-operative intestinal obstruction and demonstrate the value of straight XRays and barium meal in the diagnosis of the variety of early post-operative obstruction and the indications for operation. In 74 cases out of 82, a precise diagnosis of the mechanical or paralytic nature of the obstruction was made and the operation always carried out under best possible conditions.
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PMID:[Early postoperative intestinal obstructions. Contribution of radiography to diagnosis of the type and to the indication for reoperation (experience in 84 cases)]. 117 56

Fourteen gastrointestinal phytobezoars are presented. There have not been previous reports in Africans. Eleven were gastric and mimicked wither peptic ulceration or carcinoma of the stomach. The classical barium meal appearance of a mobile filing defect was present in the majority but a confident diagnois of carcinoma of the stomach was made in two cases in whom fiberoptic endoscopy established the correct diagnoisis. The bezoars were composed of vegatable material from either a tuber or rhizome. Three ileal bezoars presented with acute intestinal obstruction; two were probably the result of incompletely masticated maize porridge.
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PMID:Gastrointestinal phytobezoars in Africans. 121 87

Three types of involvement of the rectum and recto-sigmoid by carcinoma of the prostate are reviewed through an analysis of eight cases. A fourth type with subserosal metastatic implant of the proximal sigmoid may occasionally be encountered. The roentgenographic findings are not pathognomonic, but are characteristic of extrinsic involvement of the bowel wall. When clinical symptoms are predominantly related to the bowel, carcinoma of the prostate is usually advanced. All patients presented with bone metastases, uretero-hydronephorsis, lack of function of one kidney, or both bone metastases and urinary tract obstruction. Rectoscopy and biopsy are helpful. However, biopsy specimens often show non-diagnostic features in secondary malignancy. Correct diagnosis is important, since there is a difference in treatment of primary carcinoma and of secondary involvement of the rectum by prostatic carcinoma. A diagnostic challenge exists if the patient is evaluated by barium enema examination for primary bowel symptoms, in particular, large bowel obstruction. At this time intravenous pyelography and bone survey for metastases may not be available to suggest the correct diagnosis. More widespread use of barium enema examinations in the evaluation of advanced carcinoma of the prostate is suggested, since the type of rectal disease shown on barium enema study was not clinically suspected in five of eight patients. The prognosis is usually unfavorable because of advanced carcinoma. Survival often does not exceed several months to one year. However, one of our patients is still well after three years of hormonal therapy.
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PMID:Rectal and sigmoid involvement secondary to carcinoma of the prostate. 123 60

Children whose intussusception is caused by a specific pathologic lesion are harder to diagnose and have a higher morbidity than those with the idiopathic variety. We have collected and analyzed 31 such cases found in a series of over 500 intussusceptions. The average age of these children was greater than is usually found in most cases, and the duration of the signs and symptoms was also longer than is usually seen. Almost 50% presented with a picture of advanced small bowel obstruction. Fewer barium enemas were done (50%) and none was successful in reducing the intussusception. There was a higher number of ileo-ideal intussusceptions in this group. The commonest leading points were Meckel's diverticula, polyps, and duplications. All patients with leading points required operation; three-fourths had a bowel resection performed. This study of 569 cases suggests that older children with intussusception and children with recurrent intussusception do not necessarily have leading points causing their intussusceptions.
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PMID:Leading points in childhood intussusception. 126 59

Hirschsprung's disease or aganglionic megacolon is an anomaly caused by the absence of ganglion cells in the myenteric plexus of the distal colon. It produces intestinal obstruction or lethal enterocolitis in the neonatal period and constipation of varying degree in the older child. The diagnosis can be made by history alone and confirmed by physical findings, barium enema, motility studies, and rectal biopsy. Colostomy may be a life saving measure in the newborn, to be followed by a definitive pull-through procedure before the age of 1 year. Operative correction consists of various techniques all of which aim for excision of the aganglionic segment with preservation of the internal anal sphincter. The major pitfall of these procedures is a too perfectly preserved sphincter which remains spastic and still produces obstruction. Some damage to this muscle must be accomplished either during the procedure or postoperatively by bouginage in order to obtain a satisfactory result.
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PMID:Hirschsprung's disease. 126

Intussusception is one of the leading causes of bowel obstruction in early infancy and childhood. From 1984-1989, 67 patients under 2 years of age with intussusception were diagnosed and treated in our institution. There were 48 boys and 19 girls ranging in age from 2 months to 2 years with a mean of 7.4 months. Presenting symptoms and signs included abdominal pain (96%), vomiting (93%), rectal bleeding (60%) and a palpable mass (67%). Symptoms and signs were present for less than 24 hours in about 80% of cases. Most of the intussusceptions were of the ileocolic type (75%). The overall success rate of hydrostatic barium enema reduction was 49%. The highest rate of reduction by enema was among patients between 9 and 16 months of age (83%). The success rate of barium enema reduction was negligible after 24 hours of cardinal symptoms. Five children underwent surgical exploration without contrast studies because of delayed presentation and signs of an acute abdomen. A pathological lead point was found in only four cases, the commonest being Meckel's diverticulum. The average length of hospitalization was 2.57 days after barium enema reduction and 7.55 days after surgical reduction. There were no deaths. There was no case of perforation during enema reduction. Three children had recurrence within 3 months of initial presentation. The best outcome is associated with early diagnosis and barium enema reduction, or selected surgical intervention when indicated.
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PMID:Intussusception in children under 2 years of age in the State of Qatar : analysis of 67 cases. 137 79

Intussusception is a common cause of intestinal obstruction in infants. Use of a barium enema affords both diagnostic confirmation and a chance for nonsurgical reduction of the intussusception. While failed hydrostatic reduction is an indication for surgical intervention, delayed complications of hydrostatic reduction have not been described. We present a case of ischemic stricture and perforation developing after the successful reduction of an intussusception.
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PMID:Ischemic stricture and perforation. An unusual complication after successful barium reduction of an intussusception. 141 95

Repeated or prolonged organic obstruction of the small intestine in the neonatal period can lead to severe refeeding problems, despite a transient ostomy. These problems are thought to result from a postobstructive enteropathy (POE) of the apparently normal small intestine segment above the obstruction. Ten infants with a POE, characterized by limited oral caloric and carbohydrate intakes and increased ostomy effluent, were compared with 8 controls with an enterostomy and a normal postoperative refeeding pattern. There was no statistical difference in the histomorphometric appearance of the mucosa or its digestive or absorptive capacity (brush-border hydrolases, glucose transport) between the two groups. The effluent and duodenal floras of the two groups were similar. However, all POE patients showed significant abnormal peristalsis characterized by barium and carmin transit times. This suggests that repeated or prolonged obstruction in the neonatal period could lead to a POE, caused by chronic motricity abnormalities of the small intestine above the obstruction. Although this POE is more frequent after small bowel atresia, it may also occur with other conditions causing prenatal and postnatal intestinal obstruction.
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PMID:Postobstructive enteropathy in infants with transient enterostomy: its consequences on the upper small intestinal functions. 147 4

The single-contrast barium enema examination remains useful for patients with acute diseases such as bowel obstruction, diverticulitis, appendicitis, and fistulas. It is also the procedure of choice for those patients who are too elderly, debilitated, or ill to cooperate with the maneuvers necessary for a double-contrast examination. The double-contrast technique is more sensitive than the single-contrast technique for detection of polyps, early inflammatory bowel disease, and lesions of the rectum. In the older population, there has been an increase in the incidence of colonic polyps and carcinomas in the right side of the colon. This emphasizes the need to examine the entire colon in these patients. The double-contrast barium enema is a safe, accurate, and cost-effective tool for accomplishing this. It is also recommended as the initial procedure in the examination of patients with positive results on fecal occult blood testing.
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PMID:The role of barium enema in detecting colorectal disease. A radiologist's perspective. 151 57


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