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Query: UMLS:C0021933 (
intussusception
)
3,822
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The hemolytic-uremic syndrome consists of microangiopathic hemolytic anemia, acute renal failure, and
thrombocytopenia
following a prodromal illness of gastroenteritis or upper respiratory infection. The syndrome can present in dramatic fashion with severe abdominal pain and signs of peritonitis suggesting an acute surgical crisis. In a series of 25 patients, 40% had abdominal pain, 25% had abdominal tenderness, and 20% had peritoneal signs. Clues to diagnosis in the early stages of the acute illness were mild to moderate hypertension, abnormal peripheral blood smear, anemia despite dehydration, and proteinuria. Significant abdominal pain and x-ray evidence of colitis may occur before development of typical laboratory findings, and these were evident in at least one case. Three patients underwent laparotomy for suspected bowel perforation. Colitis without perforation was found in all cases. In the absence of documented perforation, toxic megacolon, or
intussusception
, the decision to perform laparotomy in patients with hemolytic-uremic syndrome who have signs of peritonitis must be individualized. Failure to recognize the underlying renal problem can lead to serious errors in fluid and electrolyte management and delay of appropriate therapy.
...
PMID:Hemolytic-uremic syndrome: a diagnostic and therapeutic dilemma for the surgeon. 73 58
A retrospective study of 76 children with hemolytic uremic syndrome (HUS) who were admitted to the Alberta Children's Hospital in Calgary. Alberta between January 1982 and December 1988 was undertaken to explore the gastrointestinal manifestations of the syndrome. The children (mean age of 4.0 +/- 3.1 years) presented primarily during the summer months with a microangiopathic hemolytic anemia (Hgb 94 +/- 26 g/L),
thrombocytopenia
(platelets 87 +/- 83 X 10(9)/L), and acute renal failure (oligoanuria with a BUN of 26 +/- 15 mmol/L, and a creatinine of 294 +/- 90 mumol/L). Forty-three children required dialysis for 10 +/- 17 days. The duration of hospitalization was 17 +/- 17 days. Four children died of complications attributable to HUS. The following symptoms and gastrointestinal manifestations of HUS were noted: fever (33%), vomiting (80%), abdominal discomfort/tenderness (59%), diarrhea (100%), hemorrhagic colitis (79%), rectal prolapse (13%), colonic stricture (3%), colonic perforation (1%),
intussusception
(1%), indirect hyperbilirubinemia (49%), and elevated hepatocellular enzymes (58%). Of the last 29 children studied, 19 (66%) had elevated levels of amylase and lipase in the presence of acute renal failure, and six (21%) had a marked elevation of lipase (more than four times normal) with additional supportive evidence of pancreatitis. The additional supportive evidence included persistent elevation of lipase after the resolution of acute renal failure in four children, a marked increment in lipase in association with abdominal pain and an abnormal ultrasound of the pancreas after the initiation of oral feeding in a fifth child, and pancreatic exocrine and endocrine necrosis at autopsy in a sixth child.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Gastrointestinal manifestations of hemolytic uremic syndrome: recognition of pancreatitis. 170 51
With the continuing advancement in the treatment of childhood leukemia and the lengthened survival of these patients, an increased incidence of abdominal complications has been observed. A retrospective analysis of 364 patients with leukemia treated at the National Taiwan University Hospital from January 1977 through April 1988 was undertaken. Eleven patients (3.0%) developed abdominal complications during their course of disease, including acute appendicitis,
intussusception
, intestinal perforation, ovarian cyst rupture, etc. All of these patients had abdominal complications during the initial presentation or relapse of leukemia, and 9 (82%) of them had just received chemotherapy. Ten patients (91%) had
thrombocytopenia
and 7 (64%) had leukopenia. Blood cultures were positive in 5 patients (45%), and gram-negative enteric bacilli were isolated in 4 of them. All 5 septicemic patients had leukopenia or neutropenia. The clinical manifestations were nonspecific and were often masked. Most of the complications occurred in the right lower abdominal structures. Of the 7 children treated surgically, 3 had long term survival. Among the 4 patients who did not receive an operation, only 1 survived for more than 4 weeks. The mean length of survival tended to be longer in patients with additional surgical treatment. Prompt diagnosis and early aggressive treatment, under modern supportive facilities, appear to offer a more favorable outcome.
...
PMID:Acute abdomen in childhood leukemia. 197 4
Hemolytic-uremic syndrome (HUS) of childhood is a triad of acute hemolytic anemia,
thrombocytopenia
, and acute renal failure associated with a gastrointestinal prodrome. From 1977 to 1988, 134 patients with HUS were admitted to this institution. All patients presented with abdominal pain and diarrhea, which was virtually always bloody. Seventy-eight patients (60%) required dialysis. Five patients died (4%). One patient died as a result of colon perforation, the other four patients died of other nonsurgical complications of HUS. Three patients underwent exploratory laparotomy. One patient had a hemoperitoneum from mesenteric and transmural bleeding of the entire intraabdominal colon. Another patient had undergone surgery elsewhere for presumed
intussusception
with pancolitis found at exploration. Fourteen days postoperatively, he had a spontaneous perforation of the transverse colon. The third patient presented with pancolitis and perforation of the transverse colon. Despite surgical intervention he died on the sixth postoperative day. One other patient was treated conservatively for pancreatitis, which developed 3 weeks after her presentation with HUS. Complications requiring surgical intervention in HUS are rare, potentially lethal, and usually involve the colon.
...
PMID:Surgical complications of the hemolytic-uremic syndrome. 227 21
A 3-year-old girl is reported on who underwent laparotomy for ileocaecal
intussusception
elsewhere one week following severe gastroenteritis. Immediately after surgery, she developed haemolytic-uraemic syndrome with haemolytic anaemia,
thrombocytopenia
, increase of urea and creatinine and anuria as well as subsequent peritonitis, enterocolitis and sepsis. Following relaparotomy with establishment of ileostomy, peritoneal dialysis for several days was carried out for treatment of the haemolytic-uraemic syndrome. This case demonstrates that the haemolytic-uraemic syndrome can be treated effectively by peritoneal dialysis despite fresh bowel anastomoses, and that simultaneously occurring peritonitis can be managed by intraperitoneal administration of antibiotics via dialysis fluid.
...
PMID:[Peritoneal dialysis in hemolytic-uremic syndrome following ileocecal resection for invagination in postoperative peritonitis]. 275 Mar 44
The hemolytic-uremic syndrome consists of hemolytic anemia, acute renal failure and
thrombocytopenia
. In childhood, some hemolytic-uremic syndrome can take the mask of a pseudo-surgical crisis mimicking
intussusception
or ulcerative colitis. Two cases are reported in children with abdominal pain, rectal bleeding, anomalies on the barium enema and in one case histologic features of ulcerative colitis. In the two cases, the biological disturbance of the hemolytic-uremic syndrome appeared with delay after the onset of the abdominal syndrome making the diagnosis difficult. Typical findings on the barium enema must evoke the hemolytic-uremic syndrome before renal failure: narrowing of the lumen of the colon, "thumbprinting", spasms and ulceration. But sometimes the diagnosis is more complicated because of the possibility of true surgical complications of hemolytic-uremic syndrome.
...
PMID:[Pseudo-surgical aspects of hemolytic-uremic syndrome in childhood (author's transl)]. 724 35
Between January 1983 and December 1992, the medical records of 187 patients (116 boys and 71 girls) with Kawasaki disease (KD) who were admitted to the hospital in the acute phase were retrospectively reviewed. Of these, 175 patients (93.6%) were under 4 years of age. Among the six principal symptoms of KD, the incidence of cervical lymphadenopathy (41.2%) was relatively low. Additionally, we found some unusual features including
intussusception
in a 4-month-old female, transient
thrombocytopenia
in seven children (3.7%) and isolated azotemia in five. KD is a systemic disease of unknown etiology. The diverse associated features make KD puzzling and difficult to diagnose. In caring for children with KD, physicians should be alert to the principal symptoms as well as the unusual associated manifestations.
...
PMID:Unusual manifestations in children with Kawasaki disease. 921 70
Hemolytic uremic syndrome is caused primarily by Shiga toxin-producing Escherichia coli O157:H7. The most common cause of acute renal failure in children, hemolytic uremic syndrome also can occur in adults. Characteristic features of the syndrome are microangiopathic anemia, thrombotic
thrombocytopenia
, and renal failure. Although the presentation of this syndrome is diverse, the classic prodromal illness is bloody diarrhea following ingestion of hamburger meat contaminated with E. coli O157:H7, the most common mode of infection in the United States. Children with hemolytic uremic syndrome generally present with gastroenteritis complaints (e.g., abdominal pain or tenderness, nausea or vomiting, fever, anemia); affected adults may be asymptomatic. Complications from hemolytic uremic syndrome can include
intussusception
, chronic renal failure, and seizures in severe cases. Because an incubation period of approximately one week occurs between the start of diarrhea and the onset of hemolytic uremic syndrome, physicians should maintain a high index of suspicion; early laboratory testing is important to diagnose and manage this syndrome. Obtaining a complete blood count and stool culture and performing Shiga toxin testing are the first of a series of tests that may help diagnose hemolytic uremic syndrome.
...
PMID:Hemolytic uremic syndrome: an emerging health risk. 1700 34
Coinfection with Ehrlichia canis, Babesia canis, Hepatozoon canis, Isospora spp., Giardia spp., and Dipylidium caninum were detected in a 6-week-old dog. The effect of multi-pathogen infection was a fatal combination of gastrointestinal and hematologic abnormalities, including diarrhea, vomiting, anorexia, distended painful abdomen,
intussusception
, severe
thrombocytopenia
, anemia, and hypoproteinemia.
...
PMID:Coinfection with multiple tick-borne and intestinal parasites in a 6-week-old dog. 1761 60
Hemolytic-uremic syndrome (HUS) is the most common cause of acute renal failure in young children. It is classically characterized by the triad of microangiopathic hemolytic anemia,
thrombocytopenia
, and uremia. Further, not only is
intussusception
one of the differential diagnoses of HUS but it may also become a complication during disease progression. We report a case of HUS preceded by
intussusception
in a previously healthy 17-month-old boy. The patient presented at the emergency department with bloody stools that developed the day after reduction of
intussusception
. HUS was diagnosed 4 days after the reduction of
intussusception
. The patient was provided only supportive care and his laboratory test findings were normal at discharge.
...
PMID:A case of hemolytic uremic syndrome preceded by intussusception. 2173 52
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