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

Metrizamide (Amipaque) has been used to image the bowel of four neonates and one older child with possible bowel obstruction. In each case, barium and hypertonic water-soluble agents, such as Gastrografin and Hypaque, were contraindicated. In each case, the metrizamide study provided unique formation altering the management of the patient. Metrizamide provides a new method of evaluating selected difficult cases of suspected bowel obstruction in the newborn, and in older children it may help to distinguish between postoperative ileus and mechanical obstruction.
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PMID:Metrizamide in neonatal and childhood small bowel obstruction. 698 29

Meconium ileus equivalent is an unusual cause of intestinal obstruction in adults. In this paper we report of our experience with a 29-year-old male with a long-standing history of cystic fibrosis and recurrent abdominal pain. Following barium examination of the stomach and small bowel, the patient developed increasing abdominal pain and evidence of meconium ileus equivalent as the etiology of his small bowel obstruction. The obstruction was relieved by administration of a 20% sodium diatrizoate enema and oral saline cathartics. The clinical and radiographic findings of meconium ileus equivalent are reviewed, as is the use of water-soluble contrast agents in the management of this condition. The role of prior barium study in precipitating this condition is discussed.
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PMID:Meconium ileus equivalent: treatment with Hypaque enema. 738 74

Total and regional plasma water and extracellular fluid volumes were measured in rats after obstruction of the small intestine. The rats lost 12.6 per cent of their initial weight. The volume of the sequestrated fluid in the obstructed intestine corresponded to 91 per cent of the plasma water volume. Intestinal obstruction caused a 19 per cent reduction of the total plasma water volume, while the total extracellular fluid volume was unchanged. Regional extracellular fluid volumes were diminished in the lung, liver and gastric antrum and increased in omental fat. The results indicate regional differences in fluid space responses to obstruction of the small intestine.
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PMID:Effects of intestinal obstruction of plasma water and extracellular fluid volumes in the rat. 746 84

Diarrhea is a distressing symptom that limits the quality of life in terminally ill patients. In these patients, many factors can affect intestinal secretion, absorption, and motility, including drugs, infective agents, antibiotics, chemotherapy, radiotherapy, surgery, malnutrition, neuroendocrine tumors, and mechanical bowel obstruction. Diarrhea can result in water and electrolyte losses. This review discusses the pathophysiology, assessment, and treatment of diarrhea in advanced cancer patients.
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PMID:Diarrhea in terminally ill patients: pathophysiology and treatment. 760 80

A case is described in which inspissated barium was retained in the colon for 16 months before causing large bowel obstruction. To our knowledge this is the first case described in which the time interval between barium ingestion and the onset of symptoms was more than a few weeks. Scybalum formation is due to resorption of water from the barium sulphate, which although less common with modern preparations, still appears to be possible in certain high-risk patients. Prolonged retention of barium should be avoided by increased awareness of the problem, encouraging patients to eat and drink normally after the examination, encouraging mobility and administration of lactulose in high risk patients.
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PMID:Case report: colonic obstruction following small bowel barium study. 771 88

The use of barium contrast study is considered accurate and safe in suspected intestinal obstruction. However, the use of barium in 2 patients with small-bowel obstruction converted their partial obstruction into a complete one. This complication has been previously mentioned but not documented. The use of water-soluble agents may be safer.
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PMID:Barium contrast study converts partial small-bowel obstruction into a complete one. Report of 2 cases. 812 20

The pathophysiological significance of fetal echogenic gut (FEG) is unknown. Our aim was prospectively to evaluate FEG in infants with intrauterine growth retardation (IUGR) and absent umbilical artery end diastolic flow velocities. Over a 15 month period, nine infants with FEG met these criteria. Nine infants who, on antenatal assessment, had demonstrated IURG and absent umbilical artery end diastolic flow velocities, but no evidence of FEG, were selected as case-controls. Gastrointestinal function was then prospectively evaluated in both groups after delivery. All liveborn infants received nasogastric feeds of breast milk by 8 days of age. All in the FEG group developed marked abdominal distension, large, bile stained, nasogastric aspirates, and constipation requiring rectal washouts. This led to a discontinuation of enteral feeds on one or more occasions. Two patients in the FEG group required water soluble contrast enemas in order to relieve intestinal obstruction. In the control group, 3/9 patients had abdominal distension, but no rectal washouts were given and enteral feeds were not interrupted. The median (range) time to tolerate full enteral feeds was 15 (7-32) days in the FEG group, compared with 4 (1-8) days in the control group. In the FEG group 5/6 patients required parenteral nutrition for 5-27 days. In the control group one patient required parenteral nutrition over a period of four days only. No child had necrotising enterocolitis or cystic fibrosis. When FEG is observed in the fetus with IUGR, problems with enteral feeding should be anticipated.
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PMID:Fetal echogenic gut: a marker of intrauterine gut ischaemia? 828 55

Lipomas occur through the intestinal tract, from the hypopharynx to the rectum, the colon having the highest incidence, where lipomata are the commonest benign neoplasm after adenomata. Nevertheless they are uncommon. CASE REPORT. 1) A 68-year-old man presented as an emergency with abdominal pain associated with bowel obstruction. He had a 2 to 3 month history of intermittent right-sided abdominal pain, constipation spontaneously resolved. At laparotomy there was a mass of the transverse colon, next hepatic flexure. A right hemicolectomy was performed. The patient made an uneventful recovery. Histologic examination showed a lipoma of the submucosal plane. 2) A 65-year-old man presented as an emergency with lower abdominal pain associated with a prolapsed rectal polyp. He had 1 month history of passing fresh blood per rectum. Ap ast colonoscopy revealed a large polypoid lesion in the descending colon. Transanal examination revealed a polypoid lesion with a maximum diameter of 4 cm, acting as an intussuseptum. Transanal polypectomy was performed. At laparotomy there was an intussuseptum of the descending colon into the rectum: a left hemicolectomy was performed. Histology showed the polyp to be a submucosal lipoma. DISCUSSION. Lipomas are the most common benign nonepithelial tumors of the colon. Lipomata of the large bowel are reported as incidental findings in 0.3-0.5% of cases in large series of autopsies. In the wall of the intestine most lie in the submucosal plane, less frequently they are found in the subserosal plane. The commonest site for symptomatic solitary large bowel lipoma is the ascending colon, including the caecum, followed by the transverse colon, including both hepatic and splenic flexure, descending colon, sigmoid colon and rectum. The peak incidence for lipomata of the large bowel is in fifth-sixth decade. Colonic lipomas are generally asymptomatic but occasionally patients may have intermittent crampy abdominal pain secondary to intussusception of a pedunculated lipoma or with intermittent fresh rectal bleeding. On barium enema lipomas appear circular, ovoid, well demarcated, and smooth. A barium enema showing a relatively radiolucent mass, caused by the radiolucency of fat, is suggestive of a lipoma. The water enema, with water as the contrast agent, accentuates the difference in density between a lipoma and surrounding tissues. Another characteristic feature of lipomas on barium enema is said to be their fluctuation in size and shape during the study: "squeeze sign". Lipomas of the large bowel can be seen, however, by colonoscopy. On computerized tomography scan the lipoma has a uniform appearance and density. In expert hands pedunculated and sessile lesions can be removed endoscopically, but often large bowel lipomata are treated on the basis of a presumptive malignant diagnosis with exploratory laparotomy. CONCLUSION. Colonic lipomas, although unusual, continue to present difficulties in the preoperative differentiation between malignant and benign colonic neoplasm. Two cases of colonic lipomas are reported.
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PMID:[Intestinal occlusion due to a colonic lipoma. Apropos 2 cases]. 829 Jan 48

The diagnosis of intestinal obstruction is established or suspected on clinical grounds, and it is usually confirmed with plain abdominal radiography. Because of significant limitations in the clinical and initial radiographic evaluations, antegrade or retrograde contrast-enhancement (barium, water-soluble media) studies are being additionally requested for about 20-30% of patients [1-6]. In the past few years, the steady advances in technology, technique, and interpretation have increased the value of CT in diagnosing and evaluating intestinal obstruction [7-10]. Although the precise role and contribution of CT are still being investigated and remain controversial, its significant clinical impact is already generally accepted. For patients thought to have mechanical intestinal obstruction who have confusing clinical and conventional radiographic findings, CT is currently used as a complementary imaging study, in direct competition with the more traditional gastrointestinal contrast-enhanced examinations generally used. The potential contribution of CT and its role, advantages, and limitations in the diagnosis and evaluation of intestinal obstruction are explored.
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PMID:George W. Holmes Lecture. CT of small-bowel obstruction. 831 Sep 6

The physiopathology of intestinal obstruction consists of increased intestinal peristaltis, distension by gas and fluids, contraction of the extracellular fluid volumes (plasma and interstitial sectors) and bacterial proliferation. To this must be added, in obstruction by strangulation, the passage of bacteria and bacterial products into the general circulation and the peritoneal cavity through an ischaemic or necrotic intestinal wall. Metabolic disorders consist of water, sodium and potassium deficits and acid-base disturbances. Water and electrolyte replacement should take into account the deficits that existed at the beginning of treatment, the additional losses expected during treatment and the needs for daily maintenance of water and electrolyte balance. The therapeutic procedure is simple provided it is systematized.
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PMID:[Physiopathology and principles of intensive care in intestinal obstructions]. 834 42


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