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

In cases of an acute abdomen, bowel obstruction cannot always be excluded. In this case the administration of oral water soluble contrast media (Visotrast) is helpful. On the basis of their experience with 189 patients who underwent gastrointestinal x-ray examination with Visotrast (157 spontaneous mechanical obstruction, 32 postoperative ileus) the authors recommend this diagnostic procedure in difficult situations.
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PMID:[Results of 189 Visotrast studies in the differential diagnosis of acute intestinal obstruction]. 401 35

Reviewed was a series of 47 obstetric, gynecologic, and general surgical patients with apparent postoperative ileus who had received an oral administration of water-soluble radiocontrast material. Forty of these patients were found to have an ileus, and seven to have a mechanical small bowel obstruction. In the 40 patients with ileus, prompt resolution of the ileus was obtained, no complications were noted, and the method provided rapid differentiation between ileus and obstruction. This modality of therapy offers an excellent alternative both therapeutically and diagnostically to the traditional treatment of ileus with intravenous fluid, nasogastric suction, and gastrointestinal rest.
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PMID:Water-soluble radiocontrast material in the treatment of postoperative ileus. 401 38

The effects of small-bowel obstruction on the regional distribution of blood flow and water content were studied in a new chronic dog model. Nonstrangulative obstruction was induced 40 cm proximal to the canine ileocolic valve. Blood flow was measured with 15-micron microspheres and hemodynamic and respiratory values were recorded before (experimental phase I) and five days after (experimental phase II) the induction of the obstruction. Two separate control groups of dogs were studied: baseline controls and sham-operative groups (phases I and II). Hemodynamic and respiratory values were stable in both phases in all groups. A comparison of sham phase-II data with the experimental phase-II data in the 120-cm segment of bowel proximal to the site of obstruction showed an 85% increase in blood flow (range, 49% to 106%); for the 280 cm of bowel proximal to the site of obstruction, there was a 6% increase in water content (range, 5% to 9%), and a 39% decrease in dry bowel weight (range, 34% to 46%). These findings help illustrate the pathophysiologic characteristics of microvascular changes in bowel obstruction, which are likely to have particular clinical significance for patients with cardiopulmonary diseases.
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PMID:Regional blood flow and water content of the obstructed small intestine. 401 84

Bowel obstruction by adhesion and tumor is the most common cause of mechanical ileus. The major alteration of obstructed bowels is distention. Microcirculation is hampered by raising the intraluminar pressure to 30 mm Hg. The high losses of water and electrolytes are not only due to lower resorption but also to secretion of liquid caused by enterotoxin. Therefore, perioperative antibiotics are necessary in addition to other therapeutic steps like decompression, parenteral nutrition and early operative intervention.
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PMID:[Pathophysiology and morbidity of mechanical ileus]. 405 66

Plain abdominal roentgenograms are usually adequate for the treatment of patients with small-bowel obstruction. There is a select group of patients who may benefit from a more precise diagnosis or by nonoperative therapy for whom contrast roentgenograms may be helpful. Contrast roentgenograms were performed in 68 (21%) of 327 patients who had nondiagnostic abdominal films, atypical histories or findings, or those in whom nonoperative resolution would be highly desirable. Sixty-eight percent of 48 contrast tracers gave useful information, whereas 75% of 24 contrast enemas were helpful. Contrast material passed through a site of obstruction in 34 patients, yet 13 (38%) still required an operation. Contrast material did not pass in 16 patients and only one avoided a surgical procedure. No difference was noted between barium sulfate or water-soluble contrast material or how it was administered.
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PMID:Roentgenographic contrast studies in acute small-bowel obstruction. 649 37

We have performed a prospective study on 117 patients in order to assess the value of a single contrast water soluble enema in acute large bowel obstruction. In 99 cases where the plain films suggested a diagnosis of mechanical obstruction, the Diodone enema confirmed its presence in 52, and relocated its site in 11. There was free flow of contrast to the caecum in the remaining 35, 11 of whom were shown to have idiopathic pseudo-obstruction. The plain films suggested a diagnosis of pseudo-obstruction in 18 patients. The Diodone enema confirmed this diagnosis in 15, but revealed an unsuspected mechanical obstruction in two. The examination failed in two cases. We conclude that the water soluble single contrast enema is of value in the management of large bowel obstruction. It will confirm the diagnosis of mechanical obstruction and prevent unnecessary surgery in patients with pseudo-obstruction.
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PMID:Does a water soluble contrast enema assist in the management of acute large bowel obstruction: a prospective study of 117 cases. 654 97

This report reviews the clinical and radiographic features of 40 patients who underwent visceral esophageal substitution with colon for benign or malignant lesions of the esophagus. The incidence and radiographic identification of complications are discussed. All patients were routinely examined with barium esophagrams on postoperative day 10. If an anastomotic leak was suspected clinically before this time, studies were performed using water-soluble iodinated contrast material. Follow-up barium esophagrams were obtained 1-96 months after operation (average, 60 months) in 24 patients. Eight patients (21%) demonstrated asymptomatic "jejunization" of the colonic mucosa with no attributable clinical manifestations; this finding resolved in 1-3 months, without sequelae, and has not been reported before. The spectrum of ischemic changes in the colonic segment included mucosal edema, spasm, ulceration, loss of haustration, and frank necrosis. Radiographically detectable early postoperative complications included anastomotic leak in six (three pharyngocolic, three cervical esophagocolic) and aspiration of barium into the tracheobronchial tree due to incoordinated swallowing in eight. Late postoperative complications included anastomotic narrowing (12) malfunctioning of the colon due to impaired emptying (five), recurrent aspiration pneumonia (three), small bowel obstruction (three), transhiatal herniation of small bowel through the diaphragmatic hiatus (one), and reflux into the retained bypassed esophagus (one).
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PMID:Colonic interposition: radiographic evaluation. 660 25

Metrizamide is the first water-soluble radiographic contrast agent which, because it is nonionic, can be used in isotonic solution and gives good visualization of the desired body structure. Its only major disadvantage is that it is very expensive. Metrizamide can be used to study the neonatal bowel in clinical situations where all the other existing contrast agents are contraindicated. The results of 55 metrizamide studies of the bowel in infants are reviewed. In necrotizing enterocolitis metrizamide aids in confirming or rejecting the diagnosis, identifying patients for surgery, and in evaluating the response to surgery. Metrizamide can identify the etiology in unusual cases of bowel obstruction. Metrizamide correctly identified a thoracic origin of free peritoneal air in four cases and a bowel origin in two cases. It identified bowel perforation in two patients in the absence of pneumoperitoneum. In six patients, the metrizamide study identified the cause for a gasless abdomen. It is concluded that metrizamide has a valuable role to play in evaluating a variety of neonatal bowel disorders.
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PMID:A new look at the neonatal bowel-contrast studies with metrizamide (Amipaque). 662 87

Mechanical occlusions were created in the intestines of four germ-free dogs. At the time of the operation, a control loop of mid-intestine was perfused in vivo and then excised for examinations in vitro, which included the determination of the equilibrium uptake of phenylalanine and of beta-methyl-glucoside, the influx kinetics of phenylalanine and morphometric analysis of the mucosa by microdissection and stereological techniques. Seven days after establishment of the occlusion the abdomen was reopened, and loops above and below the occlusion were perfused, and then excised for the same tests in vitro. Unlike occluded loops of conventional dogs, the intestine of the germ-free animal above the occlusion does not secrete water and electrolytes into the lumen. Its transport properties in vitro do not differ from those of the control loop, and the morphometric analyses reveal only slight changes in villus structure. The loop below the obstruction undergoes marked atrophy, as has been observed in conventional dogs. The results suggest that the copious secretion that occurs above an intestinal obstruction in normal animals is due to the presence of an abundant bacterial population in the obstruction fluid.
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PMID:Intestinal obstruction in germ-free dogs. 679 45

Short chain fatty acid (SCFA) and enteric bacteria in enteric fluid of 26 patients with non-strangulated intestinal obstruction were investigated. Sixteen to 905 mg/L of SCFA was detected in all the samples and acetic, propionic and lactic acid were prominent in the fraction. Concentration of SCFA reached a peak around the time of operation and then gradually decreased, in most cases. It also gradually decreased with clinical improvement in conservatively treated cases. Cultures of these enteric samples revealed 10(4-11)/ml of SCFA producing bacteria. SCFA may be one factor related to inhibition of water and electrolytes absorption and lead to distention of the bowel.
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PMID:Short chain fatty acid in intestinal obstruction. 688 65


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