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

We report the results of 30 antero-posterior rectopexies (APR) for rectal kinetic disorders with descending perineum syndrome. All patients were investigated by digital subtraction defecography and ano-rectal manometry. The associated surgical procedures were: sphincterotomy (n = 13) for outlet obstruction demonstrated by anal manometry or balloon expulsion test: hypertonic sphincter (n = 7), narrow fibrous sphincter (n = 6); 10 cases of prolapsectomy with extended anterior mucosectomy to reduce anterior rectal prolapse; 2 sigmoidectomy for dolichosigmoid. Best results (mean follow-up: 12 months, 3-26) were observed for ano-rectal or pelvic pain and rectal bleeding, which were cured in more than 80% of cases. Faecal incontinence (n = 5) was cured in all cases. Although normalisation of bowel movements and easier defecation were observed in 78% of cases, improvement in the dyschezic syndrome was differently perceived by the patients. Postoperative investigation demonstrated the probable cause of surgical failures (23%): impairment of rectal sensitivity (n = 2), anismus (n = 3), motor constipation (n = 4), with dolichosigmoid (n = 3). Severe perineal deficiency was also noted in 4 cases. Solitary ulcer (n = 6), anterior proctitis (n = 8), were cured within 2 months. Postoperative defecography showed correction of rectal intussusception without impairment of anterior rectal motility during defecation. These results confirm the efficacy of ARP for treatment of rectal intussusception or anterior rectocele. This functional rectopexy avoids the rectal "sling effect" of standard rectopexy which usually increases rectal dysfunction. Nevertheless, ARP alone seems to be insufficient when the associated functional or organic disorders implicated in rectal dysfunction are not also corrected, essentially outlet obstruction and dolichosigmoid.
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PMID:[Anteroposterior rectopexy for disorders of rectal stasis: clinical and radiologic results. Value of digital subtraction rectography. Apropos of 30 cases]. 260 61

Vascular morphogenesis through mechanisms of vasculogenesis, angiogenesis and intussusception is associated primarily with embryonic and fetal development and is down-regulated in the healthy adult. Physiological angiogenesis in the adult is restricted to the female reproductive system where it occurs cyclically in the ovary and the uterus as well as pregnancy-associated in the placenta and in the mammary gland. Of all the different organs, the cyclic corpus luteum of the ovary is the organ site with the strongest physiological angiogenesis. The hormonally regulated cyclic processes in the corpus luteum are characterized by discrete phases of blood vessel growth, vessel maturation and vessel regression. This chapter discusses the morphological changes of the vasculature in the cyclic corpus luteum in relation to the regulating molecular mechanisms. These data establish the dynamic processes in the ovarian corpus luteum as a unique system for studying all steps of the angiogenic cascade, including vessel maturation and vessel regression. Inhibition of angiogenesis impairs the normal ovarian cycle, reflecting that angiogenesis is rate-limiting for ovulation and growth of the corpus luteum and may, thus, be a potential target for therapeutic intervention in the reproductive function.
Baillieres Best Pract Res Clin Obstet Gynaecol 2000 Dec
PMID:Vascular morphogenesis in the ovary. 1114 38

Vascular malformations of the gastrointestinal tract may be diagnosed at any age. They may present with bleeding, anaemia, or if they form a mass lesion, with intussusception. Many lesions remain asymptomatic. In a minority of patients there are well-defined genetic conditions present, such as hereditary haemorrhagic telangiectasia. In others, particularly the angiodysplastic lesions that occur in the caecum in elderly patients, the lesions appear to be degenerative. Vascular malformations may affect any section of the gastrointestinal tract, and in some patients there are vascular anomalies elsewhere, particularly in the skin. Diagnosis is usually based on recognition endoscopically, or at angiography. Symptomatic lesions that are discrete and localized respond well to local treatment with laser or heat coagulation or sclerotherapy. Mass lesions, diffuse lesions and severe bleeding may require surgery.
Best Pract Res Clin Gastroenterol 2001 Feb
PMID:Vascular malformations of the gastrointestinal tract. 1135

Symptomatic involvement of the small bowel by metastasis from an extra-abdominal primary malignancy is rare, most commonly resulting from malignant melanoma and lung cancer; very rarely is small bowel involvement as first metastatic site. The Authors report a case of anaplastic thyroid carcinoma with lung metastasis, brain metastasis and an isolated metastasis to the small bowel leading intestinal obstruction due to small bowel intussusception. The Authors review the international literature about frequency, etiopathogenesis, clinical and diagnostic features and therapy of small bowel metastasis by extra-abdominal malignancies, especially by primary anaplastic thyroid carcinoma. Small bowel metastasis from extra-abdominal malignancies are very unusual, especially from anaplastic thyroid carcinoma, and the etiopathogenesis is still unknown. Clinical findings are typical for abdominal urgency, especially by small bowel obstruction from anaplastic thyroid carcinoma. Computed Tomography has an important role in detecting the type of intestinal obstruction despite it is often unable to diagnose an isolated metastasis. Best therapy is surgical resection, that allows the assessment of metastasis and the definitive staging. The prognosis is poor, despite long-term survival has been occasionally reported for isolated small bowel metastasis
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PMID:[Small bowel intussusception caused by metastasis from anaplastic thyroid carcinoma: case report and literature review]. 1691 Mar 63

Difficult patients with constipation mostly suffer for years, have consulted more than one physician and have had some experience with laxatives. The first step should be sorting out what exactly the patient's problem is. For this purpose technical investigations may be helpful, but the most important measures are a detailed history, symptom analysis and proctological examination. Rarely, an underlying and treatable cause of the constipation can be identified. In disordered defaecation this may be a large rectocele or an intussusception of the rectum amenable to proctosurgery. In most cases, however, some form of laxative treatment will be required. For this purpose, a detailed knowledge of their pharmacology is mandatory. The type of laxative and the schedule of administration often have to be determined on an individual basis over a number of weeks. In some patients, combination treatment with macrogol and a stimulant laxative may be the solution. Psychological features must also be taken into account in difficult patients, in particular if they ask for colectomy. Total colectomy with ileorectal anastomosis is an effective (although not universally successful) treatment of constipation, which is, however, hampered by a high rate of both early and late complications.
Best Pract Res Clin Gastroenterol 2007
PMID:The difficult patient with constipation. 1754 12

Constipation and evacuation difficulty symptoms are common in the general populace. The ROME III criteria define the latter as a subset of the former. Constipation and defaecatory symptoms rarely occur in isolation and can often form part of a global pelvic floor problem, involving bladder voiding difficulties, sexual dysfunction and pain syndromes. While there is often a functional cause for symptoms, there are a number of organic causes particularly in the elderly that should not be missed. Novel physiological and imaging insights are improving our understanding, and potentially treatment, of these symptoms. Conservative therapies focus on a holistic approach in tandem with evolving drug therapies that target intestinal secretion and transit. The role of the biofeedback specialist is continually being re-defined to an all-encompassing one of physiotherapist, behavioural psychologist and moderator for alternative therapies such as rectal irrigation. Sacral neuromodulation for constipation is an emerging minimally invasive surgical option, although the criteria for patient selection are still to be elucidated. Colectomy for functional constipation is associated with a high morbidity, and gut symptoms often persist, suggesting a global GI phenomenon. Surgical correction of rectocele and intussusception for evacuation difficulty will benefit those with anatomical symptoms; for those with predominantly functional features, surgery is best avoided to prevent a vicious cycle of multiple re-operations.
Best Pract Res Clin Gastroenterol 2009
PMID:Constipation and evacuation disorders. 1964 87