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

Thirteen (13) patients with proven diverticulitis are presented with the aim of demonstrating the current evaluation and management. Radiological evaluation were obtained with plain abdominal x-rays and computed tomography (CT) in all cases, abdominal ultrasonography (US) in 8 cases and contrast enema in 5 patients. Radiological percutaneous abscess drainage (PAD) were performed in 5 cases, two of which preceded surgery. A clinical suspicion of diverticulitis was made in only 3 of the 13 cases. CT provided the diagnosis in all cases and helped in directing the appropriate management. Ultrasound was also useful but to a lesser extent. CT or US guided PAD reduced the surgical operation to a single stage procedure instead of the former 2- to 3-stage surgical management. Plain abdominal x-ray were only useful for the diagnosis in intestinal obstruction and vesical fistula. Contrast enema provided supporting information when necessary. CT clearly diagnosed both suspected and totally unsuspected cases of diverticulitis and provides guidance for the appropriate management. When CT is unavailable US with accurate colonic imaging and abscesses identification can also be useful in diagnosing and guiding drainage. Plain abdominal x-rays are less helpful but mandatory since the presentation is usually that of acute abdomen. Water soluble contrast enema also provides supportive features when necessary. In areas where diverticular disease is uncommon, diverticulitis should be suspected in cases with left iliac fossa or pelvic pain with mass and tenderness.
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PMID:Radiological diagnosis and management of diverticulitis. 992 Oct 96

To give objective assessmed of endotoxicosis, the authors for the first time have studied blood myoglobin as a marker of tissue hypoxy in 84 patients with acute obstruction of the small bowel. A strong correlation between serum myoglobin level and clinical manifestations of endotoxicosis was established. It enables the authors to recommend the study of myoglobin values in patients for quick and objective evaluation of endotoxicosis. As a result of comparative analysis of the pronouncement of clinical and roentgenological symptoms as well as changes in laboratory findings and among them--myoglobin level in 427 patients with acute intestinal obstruction, the authors demonstrate 5 stages of clinical course of the disease. Th stage of ischemia was in 48.9% patients. In 22% of them manifestations of obstruction were eliminated by conservative means, 26.9% of patients of this stage were operated. The stage of water-electrolyte balance disturbances was detected in 26.2% of patients. The stage of peritonitis was detected in 15.9% of patients. The stage of multiorganic insufficiency was revealed in 8.9% of patients. All of these patients were operated. The stage of rehabilitation took from 2 months to 3 years after the operation. Conservative symptomatic treatment was used in all these patients. It was established that maximal informativevalue of myoglobin study was achieved in patients at the stages of water-electrolyte balance disturbances, in peritonitis and polyorganic insufficiency. The results of the examinations allows evaluation of the stage of endotoxicosis, prediction of the course of the disease and assessment of the effectiveness of detoxication therapy.
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PMID:[Serum myoglobin as an indicator of endotoxicosis in acute intestinal obstruction]. 1023 10

The aim of our study was to determine whether Urografin has the potential to offer surgeons a way of differentiating complete from partial small bowel obstruction and whether partial small bowel obstruction can be treated nonoperatively. Altogether 116 patients who had postoperative small bowel obstructions without any toxic signs underwent Urografin studies. Urografin (40 ml) mixed with 40 ml of distilled water was administrated either orally or via nasogastric tube to each patient. Serial plain abdominal radiographs were taken 2, 4, and 8 hours later. A total of 74 patients (63.8%) whose contrast medium reached the colon within the first 8 hours were considered to have partial obstruction and were successfully treated with intravenous hydration and nasogastric decompression. The remaining 42 patients (36.2%) in whom the contrast medium failed to reach the colon within the first 8 hours were regarded as having complete obstruction, and 34 of those patients (81.0%) underwent surgery; 8 (19.0%) received conservative treatment. Adhesion bands with complete bowel obstruction were observed in all 34 patients (100.0%) during laparotomy. Regardless of the presence of an air-fluid level on a plain abdominal radiograph or abdominal pain, a liquid diet followed by a soft diet could be given to those patients whose Urografin emptied into the colon. All the patients with partial bowel obstruction were treated successfully with nonoperative methods. The presence of Urografin in the colon within 8 hours of ingestion as an indicator for nonoperative treatment had a sensitivity of 90.2%, a specificity of 100%, and an accuracy of 93. 1%. Urografin, a safe and reliable water-soluble contrast medium, can be used to differentiate partial intestinal obstruction from complete intestinal obstruction. Early oral intake was found to be a major advantage of Urografin use in this study, and the potential of Urografin use to shorten the period of conservative treatment for postoperative small bowel obstruction needs further investigation.
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PMID:Oral urografin in postoperative small bowel obstruction. 1051 46

A high frequency of constipation was observed in calves with an average body weight of 150 kg. Eleven out of 200 animals died, at necropsy intestinal obstruction was identified due to agglomeration of stone like particles, identified as shell fragments of palm kernels. The calves were fed 3 kg maize silage, 1.5 kg of a commercial mixed feed, 0.5 kg soya meal, and 50 g of a mineral supplement. Hay was offered ad libitum, all animals had free access to drinking water. The composition of the mixed diet was estimated by microscopy and was completely different from the label as provided by the manufacturer. A palm kernel product with high amounts of stone shells was identified in a concentration of 25% of the mixed feed, confirming the findings in the necropsied calves. The pathogenesis of the obstruction seemed to be influenced by a concurrent infectious disease, which might have had negative effects on the gastro-intestinal motility.
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PMID:[Animal nutrition in veterinary medicine--an actual case: high incidence of constipation in calf rearing]. 1054 30

Small bowel obstruction is a significant surgical problem and is commonly caused by postoperative adhesions. Patients suffering from this condition are often difficult to assess and require careful evaluation and management. Articles regarding the diagnosis, evaluation and management of small bowel obstruction have been identified from the Ovid, Embase and Silver Platter electronic databases and then reviewed by the authors. Particular emphasis has been placed on randomised controlled trials or large prospective series. Anecdotal reports or those containing small numbers have been largely excluded, but where they have been included it has been made clear in the text. The management of small bowel obstruction is predominantly the management of obstruction due to postoperative adhesions. The selective use of radiological techniques, such as water soluble contrast and CT studies, often help to characterise the nature of the obstruction and may even help with its resolution. Techniques involving the use of laparoscopy and barrier membranes may reduce morbidity but there is a need to evaluate these strategies further with prospective clinical trials.
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PMID:A review of the management of small bowel obstruction. Members of the Surgical and Clinical Adhesions Research Study (SCAR). 1221 38

For the initial management of total colon aganglionosis (TCA), an ileostomy is usually created at the distal end of the ganglionic bowel, which is associated with profuse diarrhea resulting in a water and electrolyte imbalance as well as malnutrition during the ileostomy period. An ileostomy at the aganglionic ileum several centimeters toward the anal side of the transition for TCA is thus expected to cause bowel retention without any bowel obstruction and to facilitate water reabsorption in the small bowel. We performed this procedure in 2 babies with TCA. The length of the aganglionic ileum was 50 cm and 10 cm, respectively. The ileostomies were made 5 cm distal to the transition at 1 month and 1 day after birth, respectively. Oral feedings were well tolerated, resulting in adequate weight gain and the stools were semisolid during the ileostomy periods. Definitive operations using the Duhamel procedure with a right colon patch graft without the creation of a new ileostomy were successfully performed at 7 and 3 months of age, respectively. The postoperative courses were satisfactory. An ileostomy at the aganglionic ileum appears to be the method of choice as initial management for patients with TCA.
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PMID:An ileostomy at the aganglionic ileum for total colon aganglionosis. 1077 Feb 51

Many dangerous surgical complications like intestinal obstruction, acute appendicitis with perforation, ileal perforation in a typhoid patient, Meckel's diverticulitis, disruption of post operative intestinal anastomosis, volvulus, and intussusception are known to occur due to ascariasis, with considerable morbidity and mortality. In this retrospective study of 250 cases of gastrointestinal ascariasis admitted in paediatric surgical wards of Govt. Medical College, Jabalpur (MP), the authors analysed the results of conservative (especially the use of hypertonic saline enema-given just like an ordinary soap water enema but substituting freshly made hypertonic saline in place of soap water) and surgical treatment. The success rate of conservative treatment was 95.6%. Hypertonic saline passes through the incompetent ileo-caecal valve (present in 80% of children) and irritates the worm bolus commonly situated in the terminal ileum, causing it to disintegrate. It also helps to increase the intestinal motility and passage of worms into the colon. The use of hypertonic saline enema is safe and effective in the conservative treatment of gastrointestinal ascariasis. Authors feel that it is the most grossly under utilized part of conservative treatment and deserves to be known and used on wider scale.
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PMID:Hypertonic saline enema in gastrointestinal ascariasis. 1079 28

Roundworm infestation, one of the most common helminthic diseases worldwide, is caused by Ascaris lumbricoides, one of the largest parasites that infests the human bowel. A lumbricoides is virtually universal at some stage of childhood in semitropical and tropical regions. This study describes our experience with the ultrasonographic appearance of intestinal ascariasis in 84 patients, 2.5 to 42 years of age, examined over 2 years beginning October 1997. The patients' conditions ranged from acute intestinal obstruction to no clinical features pertaining to obstruction. Ultrasonographic examination was performed with an Echocee power Doppler real-time unit with a variable-frequency 3.7-MHz convex, 7.5-MHz linear probe. In longitudinal section the Ascaris worm presented as a linear intraluminal mass with 3 or 4 linear echogenic interfaces; in the cross section, it was round, sometimes appearing as a "target" sign. Some worms also showed serpentine movements. Sonographic examination of the patients in the left lateral decubitus position after ingestion of water improved detection and visualization of the worms in some cases. It is concluded that A lumbricoides in the small bowel has a sonographic appearance that can be recognized by the wary observer.
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PMID:Ultrasonographic appearance of Ascaris lumbricoides in the small bowel. 1127 May 32

Colonic Pseudo-obstruction is a poorly understood syndrome. It was first described by Ogilvie in 1948 and is characterized by signs of large bowel obstruction with a non-mechanical etiology. The suggested cause of this pathophysiology is an imbalance in the autonomic nerve supply to the colon. The syndrome affects mainly old, bedridden patients, usually hospitalised for non-colonic causes. The actual incidence of this syndrome is unknown, mainly due to the fact that spontaneous recovery may occur. When massive abdominal distention is apparent, diagnosis and treatment are usually problematic and other causes of obstruction must be ruled out. It is usually managed by water soluble contrast administered orally or rectally, or by colonic decompression. In extreme cases surgical treatment is required with significant morbidity and mortality. Pharmacologic management with parasympathomimetic drugs has been suggested recently. We describe the successful treatment of a patient with neostigmine and review the current literature.
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PMID:[Acute colonic pseudo-obstruction]. 1154 65

The aim of this study was to prospectively define the role of multiplanar spiral CT enterography with a new negative oral contrast material for noninvasive assessment of the small bowel in patients with Crohn's disease. Thirty patients with established Crohn's disease prospectively underwent spiral CT enterography at 45-60 min after distension of the small bowel with 1400 ml of a negative oral contrast material (Mucofalk water enema). Spiral CT scans were obtained 50 s after administration of intravenous contrast material with the following parameters: 5-mm collimation; 7.5-mm/s table feed; and 3-mm reconstruction interval. The adequacy of bowel opacification, luminal distension, and the contribution of two-dimensional multiplanar reformatted imaging were assessed by two observers. Spiral CT imaging findings were compared with results of enteroclysis as well as endoscopic and histological findings in all patients. Spiral CT enterography with Mucofalk water enema was well tolerated in 29 of 30 patients. Findings on spiral CT enterography were comparable with those of barium studies in 25 of 30 patients, superior to those on barium studies in 4 patients, and inferior in 1 patient ( p<0.05). The addition of multiplanar reformatted images to axial spiral CT scans significantly improved observers' confidence in image interpretation ( p<0.05) but did not reveal additional abnormalities. Multiplanar spiral CT enterography with Mucofalk excellently provides information in patients with Crohn's disease. This technique accurately depicts the level of small bowel obstruction and the extent of inflammatory small bowel disease and its extraluminal complications.
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PMID:Multiplanar spiral CT enterography in patients with Crohn's disease using a negative oral contrast material: initial results of a noninvasive imaging approach. 1219 78


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