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)

Colonic lipomas are uncommon, benign, submucosal adipose tumors that are usually asymptomatic. Large lipomas can cause symptoms such as constipation, abdominal pain, rectal bleeding and intussusception. We report the case of a 60-year-old man with a history of lower abdominal pain and pseudoobstructive symptoms. Colonoscopy revealed a large polypoid sessile lesion in the sigma. We used a standardized technique of polypectomy, preceded by submucosal injection of dilute 5 ml polygelin with epinephrine 1:10,000 solution, to fully resect large colonic lipomas. The lipoma size was 3.5 cm. No bleeding or perforation developed. Histology showed the polyp to be a submucosul lipoma. On follow-up, there was no residual lesion. Colonic lipomas larger than 2 cm can be safely and efficaciously removed using electrosurgical snare polypectomy technique. The technique of submucosal injection before resection and using an electrocautery snare appears to be safe and reduces the risk of perforation reported in the literature.
 ...
PMID:Endoscopic Resection of a Large Colonic Lipoma: Case Report and Review of Literature. 2110 20

Chronic constipation is a symptom complex caused by a wide variety of diseases. Primary causes of constipation, including enterocele, rectocele, rectum prolapse and intussusception, involve changes of the bowel which either delay or prevent the passage of bowel content. This condition has been termed "obstructed defaecation syndrome" (ODS).This article is based on clinical experience and a review of selected literature. The complexity of chronic constipation warrants interdisciplinary work-up and treatment. The diagnostic work-up includes taking a focus on the history of patient's complaints. This can be objectified using a standardized scoring system, e. g. Longo score. Gynaecological examinations must be performed on all female patients. Intraluminal abnormalities are best excluded by colonoscopy and rectoscopy. An abnormal score in combination with negative findings on endoscopy and gynaecologic examinations warrant a radiological assessment with a defaecogramm in symptomatic patients. Treatment is usually medical, involving changes in life style, bowel habits and the use of laxatives. Biofeedback has been shown to be effective in some patients. Surgery is indicated for selected patient who do not improve after medical treatment. A range of surgical procedures have been shown to be effective in the treatment of chronic constipation. The minimal invasive double stapled trans anal rectum resection (STARR procedure) has been proven effective in treating rectocele and rectum prolapse in selected patients. The advantages of the STARR procedure include: short hospital stay, reduced postoperative pain and an early return to work. We consider this procedure as safe and effective when performed by a well trained surgeon in selected patients.
 ...
PMID:[Surgical options in the treatment of the obstructed defaecation syndrome]. 2141 77

A 66-year-old woman presented with 3-month history of progressive constipation and occasional bright red per-rectal bleeding. An urgent flexible sigmoidoscopy (FS) showed an abnormal lesion within the anal canal and biopsy showed tubulovillous adenoma with low-grade dysplasia. She mentioned "no" response to a preparatory enema given before FS. The patient presented 4 days after FS with absolute constipation and passing a "jelly-like" substance since the procedure. A large soft tissue lump with "currant jelly" mucus discharge was noted on per-rectal examination. An abdominal x ray was suggestive of distal large bowel obstruction and a water-soluble contrast enema suggested sigmoidorectal intussusception. The intussusception was irreducible with rigid sigmoidocopy and therefore the patient underwent sigmoid resection and Hartmann's procedure, which showed a distal sigmoid polyp as a lead point for the intussusception. Retrospectively looking into the case, the intussusception was present during FS, but was scoped-around and therefore lesion was considered to be in the anal canal.
 ...
PMID:"Scoping-around" a sigmoidorectal intussusception: a pitfall of flexible sigmoidoscopy. 2168 98

Intussusception secondary to Primary Non-Hodgkin lymphoma presenting colo-colic variety is a very rare clinical entity and sometimes causing diagnostic dilemma due to non-specific, varied & wide spectrum presentation. In this study, a 9 years female child presented with recurrent, intermittent, colicky abdominal pain with occasional bilious vomiting, along with a left illiac fossa swelling & occasional per rectal bleeding and constipation for 3 months was clinically diagnosed as a case of recurrent obstructing intussusception. At laparotomy, a colo-colic intussusception with prolapsed intussusception was marked & finally on histopathology, she was diagnosed as a case of colo-colic variety of intussusception due to primary Non-Hodgkin lymphoma- a pathological lead point in mid transverse colon. After uneventful recovery of post operative period she was treated with combination chemotherapy accordingly & follow up was given up to 5 years. She had been found alright without any recurrence or organ involvement. The study focused on the avoidance of unusual delay in diagnosis as well as in proper management of rare variants of intussusception.
 ...
PMID:Non-Hodgkin's lymphoma is a pathological lead point causing large gut (colo-colic varity) intussusception. 2256 80

Obstructed defecation syndrome (ODS) is one of the most widespread clinical problems which frequently affects middle-aged females. There is a new surgical technique called stapled transanal rectal resection (STARR) that makes it possible to remove the anorectal mucosa circumferential and reinforce the anterior anorectal junction wall with the use of a circular stapler. This surgical technique developed by Antonio Longo was proposed as an effective alternative for the treatment of ODS. In this study we present our preliminary results with the STARR operation for the treatment of ODS. For this purpose, 40 consecutive female patients with ODS due to rectal intussusception (RI) and/or rectocele (RE) were recruited in this prospective clinical study, from May 2008 to October 2010. No major operative or postoperative complications were recorded, and after 12-month follow-up, significant improvement in the ODS score system was observed, and the symptoms of constipation improved in 90% of patients; 20% of patients judged their final clinical outcome as excellent, 55% as good, and 15% as moderate, with only 10% having poor results. After analyzing our results we can conclude that STARR is an effective and safe procedure for the treatment of obstructed defecation syndrome due to rectal intussusception and/or rectocele and can be performed safely without major morbidity.
 ...
PMID:Stapled transanal rectal resection for the surgical treatment of obstructed defecation syndrome associated with rectocele and rectal intussusception. 2257 84

Intussusception in neonatal age is very rare. A 12-day-old child was referred from peripheral hospital with history of intolerance to feed, absolute constipation, abdominal distension and significant bilious aspirate. Per-rectal examination revealed necrotic haemorrhagic fluid. The patient was treated on the lines of necrotising enterocolitis in the referring hospital. On further investigation and exploration, the patient turned out to be ileo-colic intussusception which is exceedingly less common in premature neonates. Hence, other causes of intestinal obstruction should also be considered along with vigilant clinical outlook in neonates.
 ...
PMID:Ileo-colic intussusception in premature neonate. 2266 73

Background and Aims. The optimal treatment of patients with internal rectal intussusception (IRI) is unresolved. The aim was to study the short- and long-term outcome of resection rectopexy in these patients. Methods. An observational and mainly prospective study of 48 patients (44 women) with IRI who had ligament-preserving suture rectopexy by laparoscopic (n = 25) or open (n = 23) technique. Outcome measures were morbidity, scores for constipation and anal incontinence, patients' report, and health-related quality of life (HRQoL). Results. From preoperatively to a median of 6 months and 76 months postoperatively, constipation scores were reduced from a mean of (95% CI) 13.20 (11.41 to 15.00) to 6.91 (5.29 to 8.54) and 6.35 (4.94 to 7.76) (P < 0.0001). The number of constipated patients was reduced from 35 to eleven and eight, respectively, and none became constipated. Nine of ten symptoms of constipation improved. Corresponding scores for anal incontinence were 4.7 (2.4-7.0), 4.0 (2.4-5.7), and 4.1 (2.3-5.8), respectively. HRQoL at long-term followup compared to the general Norwegian population was reduced in four out of eight dimensions concerning physical factors. The patient-reported outcome at short- and long-term followup was improved by 85.4% and 75.0%, respectively. Conclusions. Resection rectopexy for IRI improved the outcome. HRQoL was reduced compared with the general population.
 ...
PMID:Long-term outcome after resection rectopexy for internal rectal intussusception. 2334 11

The authors present epidemiology etiology pathophysiology management, and treatment of constipation including proper qualification for surgery. Constipations can be divided into more common - primary and less frequent - secondary The latter may occur due to organic lesions of the large bowel, in the course of metabolic and endocrine disorders, or neurological and psychiatric diseases. Constipation may also be a side effect of multiple medications. In turn, primary constipation is either a slower movement of contents within the large bowel or twice as likely pelvic floor dysfunction with the inability to adequately evacuate the contents from the rectum. Symptoms such as infrequent defecation and decreased urge to defecate indicate rather colonic inertia whereas prolong straining even in case of loose stools, and feeling of incomplete evacuation are typical of obstructed defecation. Digital rectal examination reveals common anorectal defects presenting with constipation such as tumors, anal fissures and strictures, and rectocele, or less frequent changes such as rectal intussusception and enterocele. Proctologic examination should include the assessment of the anal sphincter tone and the pelvic floor movement. Barium enema or colonoscopy are necessary to confirm or exclude colorectal organic lesions, mostly in patients with alarm features. More accurate differentiation between slow transit constipation and obstructed defecation is possible with tests such as colonic transit time, defecography and anorectal manometry Treatment of constipation, irrespective of the cause, is initiated with lifestyle modification which includes exercise, increased water intake and a high-fiber diet. Pharmacologic treatment is started with osmotic agents followed by stimulant laxatives. In turn, biofeedback therapy is a method of choice for the treatment of defecation disorders. There is a small group of patients with intractable slow-transit constipation and descending perineum syndrome who require surgery Surgical treatment is also indicated in patients with symptomatic rectocele, and advanced rectal intussusception. Enterocele can be corrected during perineopexy performed for the descending perineum.
 ...
PMID:[Practical approach to constipation in adults]. 2337 94

Chronic constipation is caused by disordered colonic motility, impaired rectal evacuation (dyschezia) or a combination of the two. It is important to distinguish the predominant mechanism of constipation in order to choose the optimal therapy (laxatives or prokinetics versus pelvic floor retraining or surgery). The contribution of dyschezia to constipation can usually be identified by a digital rectal examination, but should, in our opinion, be confirmed by anal manometry, transrectal ultrasonography or defecography. These diagnostic methods provide additional information on the severity of the rectal outlet obstruction, the contribution of rectal hyposensitivity and the presence of potentially correctable anomalies such as a rectocele, enterocele or rectoanal intussusception. We conclude that clinical anorectal examination and functional studies are both necessary and complementary to each other in the evaluation and management of patients with chronic constipation who do not respond to standard laxative treatment.
 ...
PMID:[Chronic constipation and rectal functional investigations]. 2342 16

Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.
 ...
PMID:Emergency management of acute abdomen in children. 2345 44


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