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Target Concepts:
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Query: UMLS:C0021933 (
intussusception
)
3,822
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and
intussusception
) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and
intussusception
. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently. Chronic liver disease and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic
liver abscess
, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific pancreatitis can present as an acute abdominal emergency.
...
PMID:Gastroenterological emergencies in the tropics. 176 26
Point-of-care ultrasound is fast becoming a routine diagnostic tool in the pediatric emergency department, including in resource-limited settings. We describe a case where a patient was initially diagnosed with
intussusception
and admitted to a hospital. While serving as a patient model for a point-of-care ultrasound course, he was found to have a
liver abscess
. We discuss the manner in which the ultrasound study for ileocolic
intussusception
is performed and potential mimickers of ileocolic
intussusception
.
...
PMID:Circular right upper quadrant mass, not intussusception. 2593 46
Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Although ascariasis is a chronic disease, it can present as acute abdomen rarely. The wandering nature of Ascaris in and out of the bowel causes various abdominal complications such as intestinal obstruction, perforation, biliary ascariasis, pancreatic ascariasis,
liver abscess
, appendicitis, and Meckel's diverticulitis. Intestinal obstruction is the most common complication seen in children and is usually due to mechanical bowel obstruction, volvulus or
intussusception
. Mechanical obstruction by a bolus of worms is the most common cause of bowel obstruction. Perforation of bowel is rarely reported and it usually occurs in the diseased segment of bowel or following trauma. Perforation of an ileal volvulus secondary to ascariasis has been reported rarely. We present a 4-year-old boy who presented to the emergency room with features of bowel perforation and sepsis, after unsuccessful management for intestinal obstruction in another hospital. On laparotomy, the small bowel was teaming with Ascaris worms. Ileum showed a volvulus with closed loop obstruction and perforation. Peritoneal lavage with resection and ileostomy was done, which was closed at a later date. Anti-helminthic agents were started postoperatively and the boy recovered uneventfully.
...
PMID:Ascaridial Volvulus: An Uncommon Cause of Ileal Perforation. 3004 14