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

A continent urinary reservoir was constructed from an ileocolonic segment and anastomosed to the urethra in 30 males after radical cystectomy for infiltrating bladder cancer. A small cuff of the prostate was retained for anastomosis with the reservoir and ureteric anastomosis was done from within the reservoir by the "pull through" method. Complete continence was achieved in 29 patients, all of whom had an adequate reservoir capacity exceeding 400 ml; they were able to empty the reservoirs satisfactorily as judged by the residual urine (< 50 ml). Urodynamic study revealed an intra-abdominal pressure < 30 cm of water at rest and at reservoir capacity of 500 ml. Early post-operative complications included urinary leaks in 3 patients, intestinal obstruction in 3 and a faecal fistula in 1. Deterioration of the upper tracts was noted in 5 cases. Twenty-seven patients are alive after a mean follow-up of 36 months.
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PMID:Neobladder after cystectomy: an Indian experience. 834 98

Bezoars are masses of solidified organic or nonbiological material commonly found in the stomach and small bowel. Identification, therapy, and long-term management of patients with bezoars depends on accurate classification and knowledge on the pathophysiology of formation. Four types of bezoars have been described based on their composition: phytobezoars, trichobezoars, lactobezoars, and miscellaneous. Pediatric trichobezoars are associated to emotional disturbed children with aberrant appetite (trichophagia). Hair strands become retained and attached in the folds of the gastric mucosa because the friction surface is insufficient for propulsion by peristalsis. They generally are asymptomatic until enlargement produce pain, compression or intestinal obstruction. Bezoars are diagnosed with conventional radiology and gastroscopy permits identification of its nature. Currently, management of bezoars consists of: dissolution, suction, lavage, mechanical endoscopic fragmentation using pulsating jet of water, fragmentation with extracorporeal shock wave lithotripsy and surgical removal. Treatment should also focus on prevention of recurrence, since elimination of the mass will not alter the conditions contributing to their formation.
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PMID:Trichobezoar in a 11-year old girl: a case report. 888 40

Mouse models of cystic fibrosis that are generated by targeted disruption (knockout) of the cystic fibrosis transmembrane conductance regulator gene, cftr(-/-), typically die shortly after weaning, from intestinal obstruction/rupture caused by an inability to secrete fluid into the bowel lumen. We investigated the use of a commercial osmotic laxative, Colyte, provided continuously in the drinking water, to increase the survival of cftr(-/-) mice. Genotype analysis of 623 offspring surviving at 10 days of age yielded 28.1% cftr(+/+), 59.6% cftr(+/-), and 12.4% cftr(-/-) mice (25% predicted), suggesting that cftr(-/-) mice have a significant perinatal mortality rate. However, of the 77 cftr(-/-) mice alive at 10 days of age, >98% survived weaning and were maintained in apparent health to a minimum of 56 days of age (arbitrary age for experimentation). In intestinal bioelectric studies Colyte-treated drinking water, compared with tap water, had no significant effect on basal short-circuit current, cyclic AMP-stimulated Cl- secretion, Na+-coupled glucose absorption, or electrogenic Na+ absorption across intestinal sections from cftr(+/+ or +/-) mice. Other than a mild dilatation of the distal portion of the colon in the Colyte-treated animals, examination of jejunal and colonic sections revealed no histologic differences between the two treatments. These findings indicate that the chronic use of Colyte osmotic laxative in drinking water is an economical means of greatly increasing the survival of CFTR knockout mice without altering the major electrolyte transport processes or histomorphologic integrity of the intestine.
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PMID:Increased survival of CFTR knockout mice with an oral osmotic laxative. 900 Nov 72

Pseudomyxoma peritonei is a condition characterized by the production of large amounts of mucopolysaccharide by a neoplastic epithelium. Although surgical debulking and removal of the mucinous ascites may be attempted, complete removal of the material is often impossible. Intraperitoneal lavage with 10% dextrose in water (D10W) has been advocated to prevent reaccumulation of the mucus and complications such as bowel obstruction requiring repeat laparotomy. We describe a patient undergoing operation for a large abdominopelvic mass. At laparotomy, a mucinous cystadenocarcinoma of the ovary was found with a great deal of tenacious, mucinous ascites and peritoneal implants. In an effort to more efficiently remove the mucus and prevent subsequent reaccumulation, intraperitoneal irrigation with 10% dextrose in water (D10W) was performed. The patient, who gave no history of prior glucose intolerance, was soon thereafter found to be profoundly hyperglycemic (serum glucose >500 mg/dl). She was treated with insulin and recovered without evident sequelae. Practitioners should be aware of this potentially dangerous complication associated with intraperitoneal dextrose instillation.
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PMID:Acute hyperglycemia following intraperitoneal irrigation with 10% dextrose in a patient with pseudomyxoma peritonei. 915 52

Intussusception is a major cause for intestinal obstruction in children. Its etiology is unclear, but it is often associated with some kind of infection. We have developed a model for intussusception in mice using intraperitoneal (IP) injection of lipopolysaccharide (LPS). The objective of this study was to identify the putative mediators that participate in this LPS-induced intussusception. LPS (12 mg/kg) was injected into adult mice (N = 52) and 6 hr later, 25% of the animals demonstrated intussusception in the small or large intestine. We next tested whether nitric oxide (NO) or various inflammatory mediators contributed to this effect: Indomethacin (10 mg/kg) injected with LPS (12 mg/kg) completely prevented the effect of LPS (N = 20). The tumor necrosis factor (TNF) blocker pentoxifylline (200 mg/kg) significantly reduced the incidence of intussusception to 6.6% (N = 30). The platelet-activating factor (PAF) antagonist BN52021 (10 and 20 mg/kg) reduced the incidence of intussusception to 13.3% in both doses (N = 15 for each dose). Addition of 2% arginine (NO precursor) to the drinking water 36 hr before the injection of LPS increased the incidence of intussusception to 30.7% (N = 32). In mice injected with the NO synthase inhibitor L-NAME (20 mg/kg) only 3.8% developed intussusception (N = 26). Our results indicate that the induction of intussusception by LPS proceeds via parallel pathways involving cytokines, prostaglandins, and NO. Our previous pathological study showed that LPS did not cause any changes that may act as a lead point for the intussusception, suggesting that LPS induced intussusception by altering gut motility. We therefore propose that these mediators combine to induce disturbed gut motility that results in the formation of intussusception.
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PMID:The contribution of inflammatory mediators and nitric oxide to lipopolysaccharide-induced intussusception in mice. 920 71

A population-based prospective epidemiological study was conducted to assess risk factors for equine colic. A stratified sample of 3925 equids in 138 randomly selected equine farms in the state of Michigan was monitored in two 12-month rounds of data collection. Incidence densities were used to describe the rate of development of colic in the study population. Mortality rates, case fatality rates and survival rates were used to describe the severity of colic on the study population. Multivariable logistic regressions with random effects (grouped according to farm) were used to identify risk factors associated with occurrence of colic. A total of 3175 equids from 132 farms from the starting population of 3925 equids in 138 farms was used in the multivariable analysis. There were 77 cases of colic reported during the study period in 62 animals. Of these animals, 54 (87%) had one case, 5 (8%) had two cases, 2 (3%) had three cases, and 1 (2%) had seven cases. Of the cases reported, 49 (64%) were non-specific diagnoses, 13 (17%) impaction/acute intestinal obstruction colics, 7 (9%) spasmodic colics, 4 (5%) sand colics, 2 (3%) gas colics, 1 (1%) verminous mesenteric arteritis, and 1 (1%) enteritis due to ingestion of moldy grain. The annual incidence density of colic in the study was 3.5 cases per 100 equid-years. The surgical treatment risk was 17% (13/77). The overall mortality risk due to colic was 0.5 deaths per 100 equids, and the case fatality risk was 13% (10/77). The case fatality risk for cases treated surgically was 31% (4/13), while the case fatality risk for non-surgical colics was 10% (7/69). Risk factors associated with significantly increased likelihood of developing colic were foaling during the study, deworming during the study, increased age, and participation in showing activities. Geldings and equids provided group drinking water from sources other than tanks, buckets and automatic waterers were significantly associated with reduced risk of colic.
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PMID:Risk factors for colic in the Michigan (USA) equine population. 923 9

On the basis of results of complex treatment of 427 patients with acute small bowel obstruction the authors of the article have established five stages of the clinical course of the disease. The stage of ischemia was diagnosed in 26.9% of the patients, the stage of water-electrolytic disturbances--in 26.2% the peritonitis stage--in 15.9%, the stage of multiple organ insufficiency at the postoperative period--in 8.9%. The stage of chronic intestinal insufficiency at the remote postoperative period was diagnosed in 41.1% of the patients operated upon. The amount of lethal outcomes was found to depend on the stage of the clinical course of the acute small bowel obstruction in which complex treatment had been started.
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PMID:[Differentiated approach to choice of strategy in the treatment of patients with acute obstruction of the small intestine depending on the stage of the clinical course of disease]. 950 81

A 31-year old man presented to the emergency department complaining of abdominal pain which had begun 2 hours earlier. The pain was located mainly around the umbilicus, did not radiate, and was of colicky character, coming and going in 30-minute intervals. The patient had vomited several times and had had the most recent bowel movement on that day. He admitted to having swallowed a water-filled condom about 20 hours earlier. Drug couriers sometimes fill condoms with drugs and swallow them for clandestine transport. The patient manifested signs and symptoms consistent of intestinal obstruction, although ingested foreign objects rarely obstruct the adult intestine. Ultrasonography of the abdomen revealed a fluid-filled foreign body within the small bowel. Due to radiological signs of an ileus and because the patient's symptoms failed to resolve after spasmolytic therapy, the condom was tapped transcutaneously under ultrasonographical guidance. The procedure immediately relieved the patient's symptoms and his further course was uneventful.
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PMID:A fluid-filled condom causing intestinal obstruction: nonsurgical therapy of an ileus by ultrasound-guided transabdominal tapping. 967 37

We report a case of subacute bowel obstruction due to a compression of the rectosigmoid junction by a chronically distended bladder, occurring in a 91-year-old male suffering from a long-standing diabetes mellitus and a prostatic adenoma. Radiographic, water-soluble contrast enema and pelvic CT features are reported.
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PMID:[Subacute intestinal obstruction due to bladder distension]. 979 69

A case is presented of a male patient that presented with intestinal obstruction in the early postoperative period of a transabdominal preperitoneal inguinal repair (TAPP) that was diagnosed and repaired successfully using laparoscopy. Whenever a total extraperitoneal procedure (TEP) cannot be performed, the peritoneal closure of the TAPP should be done water-tight using interrupted stitches of absorbable monofilament sutures.
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PMID:Bowel obstruction in the postoperative period of laparoscopic inguinal hernia repair (TAPP): review of the literature. 987 54


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