Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021933 (intussusception)
 3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with intussusception who have necrotic bowel requiring bowel resection or who are at major risk of perforation from attempted hydrostatic reduction may be better managed without barium reduction. Ideally, the clinician would like to identify such patients at presentation. Two groups of patients, representing the extreme ends of the intussusception treatment spectrum were investigated in order to highlight the clinical features of patients in whom an attempted barium reduction is not justified. A group of 200 patients who had successful and safe hydrostatic reduction was compared with 104 patients who ultimately required bowel resection. Four features were found to be indicators of an increased likelihood of resection: age 3 months or less, or greater than 2 years, duration of symptoms greater than 24 h, presence of small bowel obstruction on plain radiology, and clinical assessment of dehydration greater than 5%. The validity of these features as prognostic indicators was assessed by applying them to all patients who had attempted barium reduction to see how they predicted patient outcome. In isolation, each feature was found to be compatible with a safe and successful hydrostatic reduction. The rate of resection was increased in patients with multiple adverse features and in these patients the enema technique may require modification. Patients with three or four adverse features had an unacceptably high incidence of gangrenous bowel requiring resection and a low likelihood of successful hydrostatic reduction. It is believed that attempts at reduction are not appropriate in these patients.
 ...
PMID:Intussusception: clinical prediction of outcome of barium reduction. 325 Apr 27

Intussusception is the commonest cause of intestinal obstruction in childhood in Trinidad. A review of 94 consecutive cases seen at the General Hospital, Port-of-Spain, over a 12-year period (1974-1985) indicates that there had been a very rapid increase in incidence of intussusception in the last 4 years. The majority were under 1 year of age (87%) and there was a predominance in the Negro child (62%). Male to female ratio was 1.2:1. A high misdiagnosis rate (55%) lead to inappropriate treatment and delay in surgical intervention. This resulted in a high case fatality (6.4%) and complication rate. In order to minimize morbidity and mortality from intussusception steps must be taken to ensure earlier diagnosis and treatment.
 ...
PMID:Intussusception in infancy and childhood. 326 14

A case is reported in which a surgical gastrostomy tube migrated into the duodenum and eroded through the jejunal wall into an adjacent loop of jejunum. This resulted in an entero-enteric fistula, small bowel obstruction and intussusception. Since the number of gastrostomy tubes being placed endoscopically and surgically is increasing, gastroenterologists and surgeons should be alerted to these and other potential complications.
 ...
PMID:Prolapse of gastrostomy tube resulting in entero-enteric fistula and intussusception. 328 33

Jejunal leiomyoblastoma was first described in 1960, and since then many reviews were made because its histological particularity, biological behavior, and rarity. Gastric localization is most common, and only 6 jejunal cases were described. A case of a 48 years old man with tumoral mass localized only on a proximal jejunum loop was operated because of intestinal obstruction due to intussusception of a jejunal leiomyoblastoma. Although the presence of some malignant criteria like lymphnodes and peripancreatic tissue metastasis after one year of follow-up, no sign of disease was present.
 ...
PMID:[Leiomyoblastoma. Apropos of a case of jejunal localization]. 333 26

After 3 days of intestinal obstruction, a proximal jejunojejunal intussusception was resected during surgery in an adult Holstein cow. A transmural adenocarcinoma was found at the proximal margin of the intussusception. The cow recovered well from surgery and produced milk and embryos to expectation. During the seventh month after surgery, the cow developed pneumonia and, therefore, was euthanatized. Disseminated abdominal and thoracic neoplasia was observed at necropsy.
 ...
PMID:Jejunojejunal intussusception associated with a transmural adenocarcinoma in an aged cow. 335 Jul 45

Intussusception is an uncommon condition, but it is the most frequent cause of bowel obstruction in infants and children aged 3 months to 5 years. If undiagnosed, it can result in bowel necrosis, perforation, and even death. Four cardinal signs and symptoms (abdominal pain, rectal bleeding, vomiting, and abdominal mass) are described in patients with intussusception, but these manifestations are not always present and their absence may lead to misdiagnosis. Lethargy might be considered a fifth cardinal symptom. As demonstrated in this case, lethargy may be a significant presenting feature in an infant with no history of abdominal pain, and in association with the other cardinal symptoms, it may be an early indication of a significant illness such as intussusception. Awareness of this association may result in an earlier diagnosis and an improved outcome in patients with intussusception.
 ...
PMID:Intussusception. A case that suggests a new cardinal symptom--lethargy. 337 51

In a 55-year-old woman with intestinal obstruction and intussusception, an excised segment of distal ileum was shown by light and electron microscopy and immunohistologically to contain an inflammatory fibroid polyp. This rare, usually solid lesion of the gastrointestinal canal should be included in differential diagnosis of small-bowel obstruction and intussusception.
 ...
PMID:Inflammatory fibroid polyp of the ileum. Case report. 337 95

Twenty-seven children with major sickle hemoglobinopathies underwent elective cholecystectomy for cholelithiasis. All were managed with a preoperative transfusion regimen to achieve a hemoglobin concentration of 11-14 g/dl with greater than 65% hemoglobin A. Intraoperative cholangiography revealed common bile duct stones in five patients, although only one case was diagnosed by preoperative ultrasonographic examination. Twenty-four children underwent incidental appendectomy by total intussusception. There were no vaso-occlusive events nor any other perioperative morbidity or mortality. Four months after cholecystectomy, one boy had a small bowel obstruction requiring surgical re-exploration. No patients had transfusion-acquired infection, although one boy had erythrocyte allosensitization to Lewis A antigen. This preoperative transfusion regimen and careful perioperative management permits safe elective cholecystectomy in children with sickle cell disease.
 ...
PMID:Elective cholecystectomy in children with sickle hemoglobinopathies. Successful outcome using a preoperative transfusion regimen. 338 43

Duplications of the alimentary tract are unusual congenital anomalies that frequently present a diagnostic as well as therapeutic challenge to the surgeon. Because these lesions occur so infrequently, they are often not suspected until encountered intraoperatively. Due to the complicated anatomy and common blood supply shared between the duplication and associated native bowel, appropriate management requires a familiarity with the anatomy and clinical characteristics of this entity. To better define the range of patient characteristics, clinical presentation, and preferred therapy, 20 enteric duplications were reviewed in 17 patients treated at the Children's Hospital Medical Center from 1956 to 1986. Ages of patients ranged from 1 day to 11 years; 60% were less than 2 years of age at initial presentation. Seven duplications in six patients involved alimentary tract structures of foregut derivation (esophagus, stomach, and Parts I and II of duodenum), with a predominance of girls (4 of 6). Most of these patients (67%) presented with moderate to severe acute respiratory distress and a mass present on chest radiograph. In 67% of the patients, the correct diagnosis was established before operation. None required emergency operative intervention. By contrast, 13 duplications in 11 patients were of midgut or hindgut derivation (Parts III and IV of the duodenum, jejunum, ileum, and colon). In this group of patients, 62% of the duplications involved the cecum, 23% involved the ileum, and 16%, the jejunum. Seventy-eight per cent of the patients were boys. The most common symptoms were nausea and vomiting, and the most common sign was a palpable abdominal mass. Emergency operative intervention was required of eight of 11 patients with duplications involving the small bowel and colon. Three patients presented with an intussusception, four with signs and symptoms consistent with acute appendicitis, one with a small bowel obstruction, and two with gastrointestinal hemorrhage due to the presence of ectopic gastric mucosa within the duplication. It was found that two important points must be considered in regard to the management of enteric duplications: (1) the common blood supply shared between the duplication and native bowel must be carefully protected to avoid undue sacrifice of normal bowel, and (2) the presence of heterotopic gastric mucosa in 35% of patients negates internal drainage.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Duplications of the alimentary tract. Clinical characteristics, preferred treatment, and associated malformations. 340 Oct 62

Of 217 children with vitelline duct anomalies, 85 (40%) had symptomatic lesions (mean age, 2.4 years). Forty-eight patients presented with rectal bleeding; 28, with intestinal obstruction; five, with abdominal pain; and four, with bilious umbilical drainage. An asymptomatic Meckel's diverticulum was discovered incidentally at laparotomy in 132 children. Surgical therapy included bowel resection in nine patients with volvulus, four with intussusception, seven with bleeding, three with vitelline cysts, and one with a perforation. Diverticulectomy was performed in 189 cases, and excision of a patent vitelline duct was accomplished in four neonates with umbilical drainage. Ectopic gastric mucosa was present in all 48 patients with bleeding and in four of five with inflammation but in only two asymptomatic specimens. More than one third of the cases were symptomatic and presented in younger patients. This suggests that elective resection of asymptomatic vitelline remnants in early childhood is reasonable at the time of laparotomy for other conditions.
 ...
PMID:Vitelline duct anomalies. Experience with 217 childhood cases. 349 50


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>