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Query: UMLS:C0021933 (intussusception)
 3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of obstruction of the bypassed small intestine after jejunoileal shunt for obesity are presented. These cases illustrate the possible failure of radiologic visualization of the obstructed bowel since no gas traverses this bowel, as well as two of the possible causes-internal herniation and volvulus. A third cause, intussusception of the blind loop into the colon, has been reported. Obstruction of the bypassed bowel demands surgical intervention and could lead to perforation and peritonitis if untreated. Its prevention involves the closure of all mesenteric defects at the original operation. Surgeons should be aware of the possibility of these conditions in any patient who has had a small-bowel bypass operation.
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PMID:The excluded small-bowel segment. A source of complications after small-bowel bypass. 94 55

This is a review of 261 patients operated for 271 instances of mechanical intestinal obstruction over a 5-year period in a developing country in the tropics. The pattern of intestinal obstruction in Chinese is similar to that in Caucasians, where adhesions account for the largest number of cases. The occurrence in Malays, Indians, Pakistanis and Ceylonese is similar to that in other developing communities where external hernia is commonest while adhesive or tumour obstruction is rare; however, these racial groups do not exhibit the high incidence of intussusception and volvulus found in Africa and India. The operative mortality was 13-9 per cent, which is comparable to that in Western series. The major adverse factors in intestinal obstruction, i.e. extremes of age, associated disease, gangrenous bowel, large bowel obstruction and malignancy, were confirmed. Fluid and electrolyte imbalance was frequent, as in other tropical series, but with intensive preoperative correction it was not an important adverse factor.
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PMID:The pattern of intestinal obstruction in Malaysia. 100 47

Between 1966 und 1975 42 children and 46 adults were operated on Meckel's diverticulum. The diverticulum is explained as one of the possible disturbances during regression of ductus omphaloentericus. The appendicitis-like symptomatology correlates to the involvement of gastric and colonic mucosa as well as heterotopic exo- and endocrine tissue of the pancreas in the wall of the diverticulum. In 34% complications were due to inflammation, perforation, bleeding, intussusception, volvulus, gut-strangulation with ileus, ulcer, neoplasia or lesion by foreign bodies. 4 out of 88 patients died. Preoperative diagnostic fails in 75%, therefore in every case the distal gut should be inspected and every diverticulum should be resected.
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PMID:[Clinical importance of Meckel's diverticulum]. 108 17

Endometriosis causing acute small bowel obstruction is a clinical complex which should be considered in the differential diagnosis of intestinal obstruction. Theories as to etiology and pathogenesis are discussed. The best clue to preoperative diagnosis of the lesion is a careful history with regard to previous episodes of ileus having menstrual periodicity. The lesion itself usually causes obstruction by kinking or volvulus secondary to serosal adhesion formation, and more rarely by stenosis or intussusception. The treatment of total small bowel obstruction secondary to endometriosis is surgical, with resection of the involved bowel and end-to-end anastomosis.
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PMID:Endometriosis causing acute small bowel obstruction: report of a case and review of the literature. 111 57

Mechanical obstruction of the small intestine was induced in 79 rabbits. Ligation and/or fixation of an intestinal loop with sutures was performed in order to produce simple obstruction, strangulation, intussusception and volvulus. The obstructed loop and the adjacent segments of the bowel were examined with microscopic, microangiographic and angiographic methods at fixed time intervals of 6, 12, 24 and 48 hours. Dynamics of arterial changes in the intestinal wall and mesentery were investigated. Angiographic patterns of obstruction in the exteriorized loop of a living animal are described. These findings may be of value in evaluating clinical cases.
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PMID:Angiographic patterns in experimental obstruction of the small bowel. 120 39

Acute hydrops of the gallbladder (AHGB) is a rare paediatric disease being diagnosed with increased frequency due to its association with other illnesses and the availability of ultrasonography. The symptoms and signs of AHGB include abdominal pain, vomiting, abdominal mass and/or tenderness. As these clinical features mimic the more common surgical conditions such as acute appendicitis, intussusception and volvulus, some cases are still diagnosed only at laparotomy. Diagnosis is established by ultrasonography of the abdomen demonstrating normal biliary ducts and a distended gallbladder without calculi or congenital malformation. The aetiology of acute hydrops of the gallbladder is unknown but may be multifactorial. Treatment varies from non-operative management to surgical intervention.
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PMID:Acute hydrops of the gallbladder in childhood. 139 81

Intestinal obstruction is a rare but serious complication of pregnancy with significant maternal and fetal mortality. The reported incidence of intestinal obstruction complicating pregnancy varies widely, from 1 in 66,431 to 1 in 1,500 deliveries. A retrospective review of 66 cases of intestinal obstruction complicating pregnancy and the puerperium, including 2 cases from our institution, revealed that the most common causes of mechanical obstruction were adhesions (58%), volvulus (24%), and intussusception (5%). Seventy-seven percent of the patients with obstruction due to adhesions had undergone previous abdominal or pelvic surgery. Presenting symptoms and signs were similar to those of the nonpregnant patient; abdominal pain was present in 98% of patients, vomiting in 82%, and tenderness to palpation in 71%. In 82% of patients, obstruction was evident on radiographic evaluation. Prompt management of obstruction is essential; the median length of time from admission to laparotomy in the 66 patients was 48 hours. Bowel strangulation requiring resection was present in 23% of patients. Thirty-eight percent of patients completed term pregnancies after operative resolution of obstruction; total maternal mortality was 6%, and total fetal mortality 26%. Thus, both mother and fetus are at risk when intestinal obstruction complicates pregnancy. Clinical suspicion of the presence of obstruction and aggressive intervention are required to decrease the morbidity and mortality of this rare complication of pregnancy.
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PMID:Intestinal obstruction complicating pregnancy. 141 49

Three patients with the acquired immunodeficiency syndrome (AIDS) had complete or incomplete gastrointestinal obstruction resulting from infection with Mycobacterium avium intracellulare. The pathophysiologic mechanisms of the obstruction in the three cases were ileal volvulus due to adhesions from matted infected mesenteric lymph nodes, ileal intussusception due to engorged infected ileal mucosa, and small bowel displacement and compression by massively enlarged infected intraabdominal lymph nodes. These reports extend the clinical manifestations of Mycobacterium avium intracellulare infection in patients with AIDS to include partial and complete gastrointestinal obstruction.
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PMID:Gastrointestinal obstruction due to Mycobacterium avium intracellulare associated with the acquired immunodeficiency syndrome. 144 51

Patients aged 1 month to 12 years admitted with an acute abdominal surgical condition comprising 226 cases with and 206 cases without ascariasis, recorded in the operation theatre registers and in-patients clinical sheets, were studied in relation to morbidity, duration of operation and hospital stay and mortality. Annually, 7.5% of laparotomies were due to complications of ascariasis. Operations for ascariasis accounted for 10.6% of all hospital admissions for an acute abdominal emergency. Also, ascariasis accounted for 26.3% of emergency operations. All operated biliary obstruction cases were due to ascariasis. Moreover, 20.4% of all cases of ascariasis with abdominal complications required operation. The mean ages at operation were higher in Ascaris-induced than in non-Ascaris-induced intestinal obstruction (5.1 vs 3 yr), intussusception (3.5 vs 1.2 yr) and volvulus (4.8 vs 1.7 yr). The durations of operation and hospital stay were longer and case fatality rates higher in Ascaris-induced than in non-Ascaris-induced cases. The importance of this study in relation to the socio-economic benefits of controlling ascariasis is discussed.
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PMID:Role of ascariasis in surgical abdominal emergencies in the Rangoon Children's Hospital, Burma. 169 45

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.
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PMID:Gastroenterological emergencies in the tropics. 176 26


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