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

In this study the attention was focused on the possible application of the new low-osmolar water-soluble contrast media in already existing routines for radiologic diagnostic work-up and management of the abdominal emergencies of simple intestinal obstruction and ischemia: Iohexol was a good, or better, alternative to sodium diatrizoate regarding taste acceptance and patient reactions: Seventy-five per cent of patients characterized the taste of iohexol as good or neutral, while 52% gave sodium diatrizoate similar scores. The scores were also consistently in favor of iohexol as compared with sodium diatrizoate for the other chosen criteria; nausea, vomiting and diarrhea, but a larger number of patients may be needed for conclusive evaluation. Water-soluble media may have therapeutic effects on intestinal obstruction when preceded by conventional gastric suction using a short gastric tube: Twenty-three of 25 patients with subtotal small bowel obstruction due to peritoneal adhesions improved following the ingestion of either iohexol or sodium diatrizoate. Hyperosmolar contrast media might stimulate peristalsis and dilute the bowel contents, hence, easing the passage through a subtotally obstructed bowel. In rats, a direct relationship was found between contrast medium osmolality and the degree of intestinal distension, fluid influx to the bowel lumen and the speed of contrast medium progression. The water-soluble, low-osmolar contrast media seem promising as diagnostic aids in examination of the gastrointestinal tract: The low-osmolar contrast media gave better intestinal details on films than both barium sulphate and sodium diatrizoate in rats with intestinal obstruction or ischemia when high volumes of radiopaques were employed. Also in patients iohexol retained its radiographic density in the small bowel better than sodium diatrizoate. The diagnostic efficacy of the water-soluble radiographic media varied directly with their osmolality and the resulting fluid influx to bowel lumen. Hyperosmolality stimulated contrast medium progression and bowel distension, and reduced the radiographic density of the contrast media and the alignment to the bowel wall. Water-soluble contrast media may aid the diagnosis of bowel ischemia and the evaluation of the degree of ischemic injury: No bladder opacification, following absorption of water-soluble contrast media from the simply obstructed bowel, was observed in the majority of the animals and was only faintly present in 8%. Distinct radiographic opacification of the urinary bladder in rats with intestinal ischemia was demonstrated as early as 1-2 hours after the administration of contrast medium.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Water-soluble contrast media in obstructed in ischemic small intestine. A clinical and experimental study. 264 49

Meconium ileus equivalent (MIE) can be defined as a clinical manifestation in cystic fibrosis (CF) patients caused by acute intestinal obstruction by putty-like faecal material in the cecum or terminal ileum. A broader definition includes a more chronic condition in CF patients with abdominal pain and a coecal mass which may eventually pass spontaneously. The condition occurs only in CF patients with exocrine pancreatic insufficiency (EPI). It has not been seen in other CF patients nor in non-CF patients with EPI. The frequency of these symptoms has been reported as 2.4%-25%. Pathophysiologically, MIE is probably caused by a combination of EPI, increased intestinal transit time, and abnormal intestinal mucus. The treatment should primarily be non-operative. Specific treatment with N-acetylcysteine, administrated orally and/or as an enema is recommended. Enemas with the water soluble contrast medium, meglucamine diatrizoate (Gastrografin), provide an alternative form for treatment and can also serve diagnostic purposes. It is important that the physician is familiar with this disease entity and the appropriate treatment with the above mentioned drugs. Non-operative treatment is often effective, and dangerous complications following surgery can thus be avoided.
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PMID:[Meconium ileus equivalent]. 291 55

Feeding animals large quantities of dry hydrophilic fiber sources, such as psyllium husk or guar gum, may lead to intestinal obstruction or to other mechanical effects unrelated to the normal function of these materials in human diets. Such fiber sources should be hydrated prior to feeding, rather than being incorporated into dry diets as is. The water-holding capacity of psyllium hydrophilic mucilloid, for example, is greater than or equal to 40 g/g, compared to 2-3 g/g of wheat bran. Consumption of the psyllium product dry would be much more likely to produce intestinal dehydration than would consumption of dry bran. Because of possible untoward effects of high levels of these materials, it may also be more appropriate to feed such fiber sources in quantities approximating that of their potential human dietary consumption, rather than very high quantities that would be unlikely to be attained in human diets.
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PMID:Warning: feeding animals hydrophilic fiber sources in dry diets. 300 90

The local effects and radiographic efficacy of 4 water-soluble contrast media, barium and saline were evaluated in 86 anaesthetized rats with the distal ileum ligated. The rats were observed for 8 hours after instillation of 3 ml of the test substance via orogastric tube. Radiographs were taken after 1, 4 and 8 hours of observation. After 8 hours the intestines were weighed and biopsied for light microscopy, and blood and urine were sampled for testing. Sodium diatrizoate caused increased fluid influx to the bowel lumen and, like barium, provided poorer radiographic images as compared with iohexol, ioxaglate or iodixanol. Barium showed slower progression through the small bowel than the other agents, while sodium diatrizoate was the most rapidly progressing contrast medium and caused the greatest distension. Correlation to osmolality was obvious. No significant morphologic effects on the small bowel mucosa were seen in any of the groups. Low-osmolar, water-soluble contrast media may have prospects for clinical use in patients with suspected small bowel obstruction.
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PMID:Water-soluble contrast media compared with barium in enteric follow-through. Local effects and radiographic efficacy in rats with simple obstruction of the small bowel. 316 85

Twenty horses with small intestinal obstructions requiring surgery were evaluated prospectively. Ten horses lived (group 1) and 10 died (group 2). Eight of the horses in group 1 had simple obstruction and 7 of the horses in group 2 had strangulation obstruction. There was a significant difference (P less than 0.001) between the mean intraluminal hydrostatic pressure in horses of groups 1 and 2 (6.3 cm H2O and 15 cm H2O, respectively). The mean peritoneal fluid protein concentration in horses of groups 1 and 2 (2.8 mg/dl and 5.4 mg/dl, respectively) also differed significantly between groups (P less than 0.01). Histologic evaluation of the intestinal specimens from horses of group 1 (n = 3) and group 2 (n = 6) revealed more severe mucosal lesions in group 2. The measured values that were not significantly different between the 2 groups included PCV, total serum protein content, WBC count, anion gap, and duration of colic before admission. It was concluded that peritoneal fluid protein concentration and intraluminal hydrostatic pressure in small intestinal obstruction may be used as adjuncts to diagnosis and as prognostic indicators.
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PMID:Factors for prognostic use in equine obstructive small intestinal disease. 377 38

One hundred thirteen patients presented with gastrointestinal complications due to persimmon phytobezoars during a 3 year period. One hundred three patients had a history of persimmon ingestion. One hundred five patients had undergone previous gastric operation for duodenal ulcer, one patient underwent highly selective vagotomy, and seven patients had not undergone previous operation. An elevated temperature, leukocytosis, and decreased bowel sounds were typical early clinical manifestations of small bowel obstruction by persimmon phytobezoars. In 13 patients, gastric bezoars were found, in 20 patients, gastric and intestinal bezoars, and in 80 patients, intestinal bezoars. One hundred patients were treated surgically. In 14 of the 20 patients with concomitant gastric and intestinal phytobezoars, extraction of the bezoars was achieved by gastrotomy. Of the remaining six patients, it was achieved by intraoperative milking of the gastric bezoar into the small bowel in two patients and by conservative treatment in four patients. Of the 100 patients who presented with small bowel obstruction, 60 were treated by milking of the bezoar into the large bowel, 34 by enterotomy, and 6 by conservative therapy with intravenous fluids, gastric suction, and a water-soluble contrast meal. Small bowel resection of a gangrenous segment was necessary in two patients. Two patients died after operation because of sepsis and respiratory complications. Eleven of the 13 patients in whom postoperative wound infection developed underwent gastrotomy or enterotomy. We conclude that the treatment of choice of intestinal obstruction due to persimmon phytobezoars is milking of the bezoar into the large bowel without enterotomy. Preoperative or operative endoscopy should be performed in patients presenting with complications of gastrointestinal phytobezoars. Patients who have undergone gastric operation should be warned against the risk of persimmon ingestion.
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PMID:Surgical aspects of gastrointestinal persimmon phytobezoar treatment. 377 32

Over the last 11 years, 22 neonates were treated with water-soluble contrast enemas to relieve the obstruction of meconium ileus. Fifteen babies had a gestational age of at least 36 weeks, and 16 weighed more than 2,500 g. All presented with clinical findings of a bowel obstruction, confirmed by roentgenograms, and each eventually had high sweat chloride levels. Each neonate had from 1 to 4 water-soluble contrast enemas administered slowly by syringe over 15 to 30 minutes. Eight enemas were successful in relieving the obstruction, four newborns requiring only one enema. Fourteen were unsuccessful, three having more than one enema. Seven of these 14 had intraabdominal pathology that would have required surgery. In five babies the bowel was perforated by the enema, the colon in three, and terminal ileum in two. These perforations were all immediately recognized during the course of the enema and operated on forthwith; a stoma was made in four cases. Only one of these five babies would have required an operation because of a volvulus. There were no fluid or electrolyte disturbances caused by the contrast material, and none of the babies with perforations died. Although this enema technique was successful in one third of cases, and despite the fact that perforations ensued in one quarter of cases, the procedure still seems warranted if the following precautions are taken: establishment of proper temperature, fluid, and electrolyte balance; the radiologist is not rushed, is extremely gentle, willing to repeat the study until no further progress is evident; the surgeon is available for an immediate laparotomy should a perforation occur.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bowel perforation with nonoperative treatment of meconium ileus. 382 12

Endotoxin has been measured in the blood and peritoneal fluid from 28 patients with diffuse peritonitis after intestinal perforation, intestinal obstruction or mesenteric infarction. Phenol-Water-Extraction for plasma preparation has been used. Endotoxin in correlated with the clinical state in these patients.
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PMID:[Endotoxin in diffuse suppurative peritonitis]. 391 54

The effects of elevated intraluminal hydrostatic pressure on the active absorption of the amino acid selenium 75 L-methionine has been analyzed in the normal and obstructed small intestine. An intestinal loop of defined position and length was included in a recircling perfusion system from which the elimination rate of the radiolabeled amino acid was measured. Preset pressure levels within the system were maintained by a servo-controlled unit, which added or subtracted volume to keep the pressure constant. The rate of amino acid elimination increased when the nonobstructed loop was subjected to a pressure of 10 cm H2O but decreased when exposed to 20cm H2O. Using a loop of intestine subjected to 48 hours of obstruction, amino acid elimination was greatly retarded compared with that of the nonobstructed loop. By increasing the intraluminal pressure to 10 and 20 cm H2O, the elimination rate increased, equalling that of the nonobstructed gut. The results suggest that intestinal obstruction per se decreases active absorption secondary to impaired intestinal viability. Moderately increased intraluminal pressure adds a driving force to L-methionine absorption, the mechanism of which is obscure.
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PMID:Effects of intraluminal hydrostatic pressure on L-methionine absorption in the obstructed small intestine of the rat. 395 59

Experiments were designed to study the effect of duration of small bowel obstruction (SBO) on rate of recovery of fasting and nonfasting GI myoelectric activity (MEA) in 10 dogs. Two weeks after implantation of a gastric cannula and bipolar silver electrodes in the antrum, duodenum, proximal and midjejunum, terminal ileum, right and left colon, complete SBO was created in the distal ileum. Duration of SBO was 24 hr in group I (five dogs) and 48 hr in group 2 (five dogs). MEA was recorded on 5 consecutive postop days after creating SBO. Water (500 cc) was given via cannula 90 min after release of SBO and on subsequent days after 90 min of fasting MEA recording. Control data were pooled from MEA recordings obtained on 10th and 12th days after electrode implant, each dog serving as its own control. On the day of SBO release there were no significant differences in MEA between groups 1 and 2. Twenty-four hours after SBO release, group 2 fasting and nonfasting jejunal and ileal MEA was significantly decreased vs group 1 and control levels. These significantly decreased jejunal and ileal MEA levels persisted for 48 hr after SBO release. After water by cannula, group 2 antral MEA was significantly less than group 1 and control levels and remained at these low levels for 72 hr after SBO release. Colonic MEA in group 1 and group 2 was not significantly decreased vs control levels. These data suggest that the colon does not play a regulatory role in ileus caused by SBO. These results also imply that prolonged ileus can be avoided by early operation for mechanical SBO.
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PMID:Gastrointestinal myoelectric activity in mechanical intestinal obstruction. 399 Feb 79


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