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

The aim of the study was analysing of the diagnostic value of different imaging modalities in evaluation patients with bowel obstruction. The material comprises a group of 47 patients with diagnosed acute abdomen. Erect radiography, and radiographs in supine and left lateral patients' positions, US and CT examination were performed in those patients. CT examination was performed in 5 mm--and 10-mm thick axial sections before and after administering the contrast agent. In 6 patients small barium enema was performed. In 5 cases water-soluble contrast was administered orally. In 6 cases on plane radiographs the presence of high small bowel obstruction was found. In 3 cases the level of small bowel obstruction was in the distal ileum. In 12 patients the obstruction of large bowel was seen on plain radiographs. In 3 patients intussusception of sigmoid bowel was found. The mesenteric ischemia was found to be a reason of bowel obstruction in 5 cases. On CT section soft tissue mass with irregular contrast enhancement was found, reflecting ischemic intestinal loops. In 2 patients the gall stone small bowel obstruction was found. In one of them the presence of gas in the biliary tree was seen on CT images. The determining of the level of the obstruction is facilitated on plain radiographs, erect and in supine and left lateral patients' position. In small bowel obstruction, normal or equivocal initial radiographs may result in a delayed diagnosis. As the bowel diameter cannot be assessed the plain radiographic diagnosis is difficult or impossible. If there is persistent diagnostic difficulty, follow-up plain radiographs taken a few hours later will often resolve the problem and, if not, a barium study or CT may be performed. Orally administering of water-soluble contrast agent, diluted barium, barium enema are also helpful in differentiating the character and etiology of obstruction.
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PMID:The diagnostic value of different imaging modalities in evaluation of bowel obstruction. 1614 91

MR enteroclysis (MRE) is an emerging technique for the evaluation of small intestinal diseases. Administration of an iso-osmotic water solution through a nasojejunal catheter can guarantee adequate luminal distention, and in combination with ultrafast sequences, such as single shot TSE, true FISP, HASTE and 3D FLASH, results in excellent anatomic demonstration of the small intestine. MR fluoroscopy can be performed during MRE examination to monitor the filling process and might be useful in studying low-grade stenosis or motility related disorders. MRE is a very promising technique for the detection and characterization of involved small bowel segments in patients with Crohn's disease while its diagnostic performance in disclosing lumen narrowing and extramural manifestations and complications of the disease is outstanding. Initial experience shows that MRE is very efficient in the diagnosis of small bowel tumors and can be used in the evaluation of small bowel obstruction.
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PMID:Magnetic resonance enteroclysis. 1615 38

Water-soluble contrast media (Urografin) cause redistribution of intravascular and extracellular fluid into intestinal lumen due to their hyperosmolarity. As a consequence, these media decrease intestinal wall edema and act as a direct stimulant to intestinal peristalsis. In this prospective study, we aimed to examine objectively the therapeutic role and ability of Urografin in patients with postoperative small bowel obstruction for whom failed to respond to conservative treatment. Three hundred and seventeen patients with postoperative small bowel obstruction due to intraperitoneal adhesions were included prospectively in this study. In the Urografin group, 40 mL Urografin diluted in 40 mL distilled water was administered through the nasogastric tube. No contrast media were administered in the control group, but the patients were decompressed via a nasogastric tube continuously. The number of obstruction episode in 317 patients was 338. In total, 199 patients were in the Urografin group, and 118 patients were in the control group. In the Urografin group, 178 (89.4%) patients responded successfully to the treatment, but 21 (11.6%) patients underwent surgical operation. Intensive intraabdominal adhesions and obstructing fibrous bands were observed and repaired in 15 (71.4%) patients at the operation, while 6 patients underwent segmental small intestine resection in control group, conventional management was successful in only 89 (75.4%) patients, and the remaining 29 (24.6%) patients underwent surgical intervention. In conclusion, it was suggested that in patients with intestinal obstruction due to postoperative intra-abdominal adhesion, water-soluble contrast media such as Urografin may be safely administered via a nasogastric tube or oral route and may decrease the need for surgical operation; furthermore, they may help the physician to operate the patients who needs surgery as early as possible.
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PMID:Comparison of Urografin versus standard therapy in postoperative small bowel obstruction. 1631 52

Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities.
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PMID:Abdominal manifestations of cystic fibrosis in children. 1639 28

Clinical radiology is a key to the management of bowel obstruction. Plain abdominal radiographs combined with history, clinical exam, and laboratory findings are essential for further individualized strategies. If the cause of obstruction is obvious after plain films and there is a need for emergent surgery, no further imaging is required. In all other cases, multislice CT with at least intravenous and rectal contrast is the method of choice due to its broad diagnostic spectrum. If CT is not available, contrast enema is recommended in suspected large bowel obstruction. Oral administration of water-soluble contrast agents has no significant value in the workup of bowel obstruction.
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PMID:[Emergency radiology of bowel obstruction]. 1696 Jul 3

Computed tomography (CT) enteroclysis is a new technique consisting of helical CT of the abdomen and pelvis after administration of water through a nasojejunal tube and intravenous contrast, resulting in adequate distension and visualization of the small bowel wall. The use of this technique is especially recommended in patients with gastrointestinal bleeding of unknown etiology, possible neoplastic processes of the small bowel, partial small bowel obstruction, and inflammatory bowel disease. One-hundred consecutive patients underwent CT enteroclysis (multiple detectors; 8, 16, or 64) over a 1-year period for suspected lesions of the small bowel. Of these, 31 were positive: Crohn's disease (17), tumors (8), partial obstruction (2), radiation enteritis (1), sprue (1), pneumatosis cystoids (1), and dilatation of bowel loops (1). In 28 of the 31 patients, the findings were confirmed by pathology, endoscopy or clinical follow-up.
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PMID:[Advances in radiography of the small intestine: computed tomography enteroclysis]. 1712 46

Chronic pelvic pain (CPP) with or without adhesions and symptoms of intestinal occlusion is a complex but relatively common complaint. The etiology and pathophysiology of CPP and adhesions are unclear, as is their possible relation. However, it is evident that continuous abdominal pain leads to evident suffering and disability. Unfortunately, there is little proof or evidence of success for many of the currently used diagnostic and therapeutic interventions. Laparoscopy is neither the ultimate evaluation nor the panacea for CPP or intra abdominal adhesions. An integral approach to CPP has shown beneficial results. In this multidisciplinary approach dealing with the pain is far more important than finding an organic cause and cure for the pain. Equal and simultaneous attention is paid to psychosocial, sexual and somatic aspects. The treatment of adhesions depends on the extent of symptoms and complaints. Because of the questionable relation between adhesions and pain, and the probability of reformation and de novo adhesion formation after surgery, adhesiolysis should be avoided. Even for patients with signs and symptoms of small bowel obstruction a conservative treatment is often justified. These patients require careful evaluation and management. Frequent reassessment is important to rule out impending strangulation, complete obstruction or perforation. Water soluble contrast can be useful to justify prolongation of conservative treatment and by that postpone unnecessary surgery. Most adhesive small bowel obstructions resolve following conservative treatment. The unsolved questions about etiology, diagnosis, treatment and prevention, and the great individual and community burden of CPP and adhesions clearly show that further research is needed.
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PMID:The difficult patient in gastroenterology: chronic pelvic pain, adhesions, and sub occlusive episodes. 1754 10

Pseudomyxoma peritonei is a condition characterized by the production of a large amount of mucopolysaccharide by a neoplastic epithelium. Although surgical removal of the mucinous ascites may be attempted, complete removal of the material is difficult. Thus, intra-peritoneal lavage with the liquid containing glucose or dextrose has been advocated to prevent reaccumulation of the mucus and complications such as bowel obstruction requiring repeated surgery. We report a case showing transient hyperglycemia following intra-peritoneal irrigation with 5% glucose in a patient with psudomyxoma peritonei. The patient was a 72-year-old woman. Preoperatively, she had hypertension and angina pectoris; but no history of glucose intolerance. Serum glucose was 92 mg x dl(-1). General anesthesia was induced with propofol (100 mg), vecuronium (6 mg), and fentanyl, and maintained with oxygen (33%), nitrous oxide and sevoflurane (1-2%). A mucinous tumor was found with a great deal of mucinous ascites. To remove the mucus and prevent subsequent re-accumulation, intra-peritoneal irrigation with 5% glucose in water was performed. Shortly after this procedure, the patient was found to be hyperglycemic (serum glucose 266 mg x dl(-1)) with normal oxygenation and hemodynamic data. The patient recovered uneventfully and could be extubated soon after surgery. Serum glucose level returned to 154 mg x dl(-1) one hour after surgery. Therefore, we think that this acute hyperglycemic condition, presumable due to intra-peritoneal irrigation, was transient. It is important to be aware of this dangerous complication associated with intra-peritoneal glucose instillation. Glucose monitoring during and after irrigation with glucose or dextrose is recommended.
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PMID:[Transient hyperglycemia following intra-peritoneal irrigation with 5% glucose in a patient with pseudomyxoma peritonei]. 1771 92

The dynamics of intraperitoneal pressure (IPP) in acute small bowel obstruction was investigated in 50 patients with acute small bowel obstruction (ASBO), 25 men and 25 women aged from 16 through 82 years. The measurements were made in a nasogastral probe. Commissural ASBO was found in 24 (48%) patients, obturation--in 6 (12%), invagination--in 3 (6%) patients. Two groups of patients with high IPP (median 124 mm H2O) and low IPP (median 35 mm H2O) were established. The IPP level over 100 mm H2O, measured at admittance, can be considered an indication to operative treatment. Increased IPP makes the lethality risk of the patient higher. In case of non-complicated course of the postoperative period IPP is not higher than 10 mm H2O by the 2nd day. IPP higher than 30 mm H2O points to the development of intraperitoneal complications.
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PMID:[Intraperitoneal pressure in acute small bowel obstruction]. 1805 Jun 37

Adhesive small bowel obstruction is a common cause for admission to general surgical wards in developed countries. Recent advances in diagnosis and management include the use of water soluble contrast agents in the treatment and triage of patients to an operative or conservative course, the use of CT scanning in diagnosis, the use of laparoscopy in treatment and antiadhesion techniques to prevent recurrence.
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PMID:The management of adhesive small bowel obstruction - an update. 1835 64


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