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

A 67-year-old white man presented with bloody diarrhea and passed a 22-cm long segment of full-thickness sigmoid colon following a barium enema. He had advanced peripheral and cerebral vascular disease and had undergone pelvic irradiation for a bladder cancer five years previously. He recovered uneventfully from the bowel sloughage. This was apparently due to an intussusception of the sigmoid colon followed by the formation of adhesions between the edges of the adjacent viable bowel.
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PMID:Intussusception of sigmoid colon in an adult. Spontaneous expulsion of sequestered bowel and restoration of bowel continuity. 73 21

Nonischemic intussusception is defined as a variant of acute intussusception exhibiting less acute symptoms of abdominal pain, vomiting, and diarrhea in the older child, longer duration of symptoms (usually 4-14 days), signs of imcomplete bowel obstruction, and absence of intestinal ischemia. Over a 10 yr period (1964-1973) 20 children with this disease were treated without mortality or recurrence at three children's hospitals in Chicago, Illinois. The higher incidence of diarrhea, the lower incidence of a palpable abdominal mass, and the lower incidence of blood per rectum in nonischemic intussusception predispose to diagnostic errors and delays in treatment. Despite the longer duration of symptoms, this variant of intussusception can be treated initially with a careful attempt at barium hydrostatic reduction. If this fails, easy operative manual reduction is the rule.
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PMID:Nonischemic intussusception. 89 56

Initial examination and therapy, and the avoidance of maltreatment are emphasized. Gastric decompression is of prime importance, after which no compound should be administered via stomach tube. Where large amounts of high starch grains are fed, primary acute gastric dilatation must be differentiated from that secondary to small bowel dilatation, by immediate gastric intubation and irrigation of the cardia with lidocaine. If cessation of pain and improvement of peristalsis and general attitude follow, the former state may be assumed. If pain persists and peristalsis does not improve markedly, one should assume small bowel displacement. Rectal examination is helpful in initial evaluation: impactions, inguinal herniation and ileocaecal intussusception may be diagnosed and small bowel displacement suspected. Palpation of one or more distended loops of bowel in the ventral middle third of the abdomen indicates small bowel displacement or ileus and flaccid distension. Distinction by rectal palpation alone is difficult. Palpation of the gas-distended apex of the caecum in the middle third of the abdomen is virtually pathognomonic for 180 degrees rotation of the large bowel. Abdominal paracentesis yielding true sanguineous effusion indicates a necrotizing segment of the bowel. If negative, such a segment is absent, or there is an infarcted segment, not yet damaged to the point of leaching whole blood, or the necrotizing segment is outside the peritoneal cavity, i.e., in the thorax, intussuscepted into the caecum, or herniated into the inguinal canal. Recurrent colics frequently may be due to verminous arteritis but the relationship to diet should be investigated. Recurrent colics after grain ingestion with occult blood in the faeces may be due to ulcers; such cases respond well to grain withdrawal. The advantages and disadvantages of phenothiazine-derived tranquillizers are discussed. They are contra-indicated if there is any evidence of circulating volume insufficiency but are benefical in many instances through improved peripheral perfusion of organs provided circulating volume is adequate, i.e., early in acute abdominal disease prior to development of circulatory insufficiency. They should not be administered if immediate surgery is contemplated because of hypotensive effects. The administration of oral antibiotics (Neomycin) early in the course of the disease is encouraged. This is contra-indicated if the horse is already toxic, when it should receive parenteral antibiotics, preferably chloromycetin. Tetracyclines may predispose to the later development of salmonella diarrhoea. Absolute analgesia should be provided; our preference is the magnesium sulphate-chloral hydrate solutions. Administration of mineral oil is desirable in initiation of peristalsis, depression of Gram-negative overgrowth and softening of impactioning obstructions but nothing should be administered per os if the stomach has required decompression.
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PMID:Monitoring and evaluating the physiological changes in the horse with acute abdominal disease. 117 34

A subacute oral toxicity study of 6-amidino-2-naphthyl 4-[(4,5-dihydro-1H-imidazol-2-yl) amino] benzoate dimethanesulfonate (FUT-187), a new protease-inhibiting agent, was carried out in beagle dogs of both sexes. FUT-187 was administered to dogs at daily oral doses of 15, 50 and 150 mg/kg. Dogs in 150 mg/kg group were given twice a day in a.m. and p.m.. The results were as follows: 1. Changes of physical sign attributed to FUT-187, consisted of vomiting, diarrhea, salivation, decrease of locomotor activity, sedation and hyperemia of eye mucosa. These changes expect vomiting vanished within about 2 hours after treatment. One male given 150 mg/kg died on day 19 and two females given 150 mg/kg were sacrificed on day 55 and 67 due to deterioration of systemic conditions. 2. Body weight gain was suppressed in males given 150 mg/kg and females given 50 mg/kg or more. 3. In hematological examinations, some changes suggesting anemia or inflammation were observed in a few animals received 50 mg/kg or more 4. In serum biochemical examinations, dogs given 50 mg/kg or more had decrease of albumin, total protein, A/G ratio and total cholesterol, increase of GPT activity. In liver function test, decrease of function was observed in a few animals in 150 mg/kg group. These changes diminished by the end of recovery period. 5. In autopsy findings, ulcer formation and desquamation of mucosa in the digestive tract were observed in dead or sacrificed animals and survived animals given more than 50 mg/kg. In sacrificed animals, liver was yellow in color and intussusception was seen. 6. Plasma levels of intact FUT-187 and metabolites on the day 37 or 83 were higher than that on the first day of administration. 7. In histopathological examinations, ulcer formation, desquamation, degeneration and/or atrophy of mucosa in the digestive tract were observed in the animals from 50 mg/kg and 150 mg/kg groups. In addition, fatty deposition in hepatocytes was observed in one dead animal and two sacrificed animals.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 13-week subacute oral toxicity study of 6-amidino-2-naphthyl 4-[(4,5-dihydro-1H-imidazol-2-yl) amino] benzoate dimethanesulfonate (FUT-187) in dogs. 129 28

The classical presentation of intussusception consisting of severe abdominal pain, bloody stool, and a palpable abdominal mass leads to the correct diagnosis in majority of the patients. However, an atypical presentation often results in a delayed diagnosis as is commonly seen in nonischemic intussusception. The nonischemic intussusception is a distinct clinical entity that is characterized by a long history of less severe symptoms commonly noticed in older children. The incidence of diarrhea in this group is higher than in the acute variety of intussusception. This variant of intussusception requires a high degree of suspicion for the diagnosis in atypical clinical presentation. The present study summarises our experience treating 31 such cases of nonischemic intussusception during a period of 25 years from 1966 to July 1990.
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PMID:Nonischemic intussusception in childhood. 147 5

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)
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PMID:Gastrointestinal manifestations of hemolytic uremic syndrome: recognition of pancreatitis. 170 51

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

An 86-year-old man was admitted to hospital because of transitory cramp-like abdominal pain of 6 days' duration. Immediately preceding admission he had suffered a short episode of vomiting and diarrhoea. There was no history of previous abdominal operation. On examination there were signs of incomplete mechanical ileus. Ultrasonography revealed an abnormal cockade with triple ring phenomenon at the ileocaecal junction and the "duck-beak phenomenon" as signs of enterocolic intussusception. Immediate laparotomy demonstrated a submucous lipoma of the terminal ileus as its cause.--If there is clinical suspicion of intussusception, even in the presence of atypical abdominal symptoms, ultrasonography is the procedure of choice to provide rapid diagnosis. In adults treatment is always surgical.
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PMID:[Ileocolic invagination in adults. The sonographic characteristics]. 189 53

Intussusception occurs most commonly in the first five years of life and is classically associated with intense intermittent abdominal pain, vomiting, bloody mucoid diarrhea, and a palpable abdominal mass. These cardinal findings are frequently not present, however, particularly outside the usual age range. The emergency physician must therefore be vigilant in considering intussusception as a potential cause for intestinal obstruction in all patients, if ischemic complications are to be avoided. We present three cases of "unusual" intussusception, and provide a review of this entity and a guide to its consideration and work-up in the emergency department.
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PMID:Unusual cases of intussusception. 194 Feb 39

The records of 22 children (sex rate boy/girl 1.75, mean age 2 7/12 year) treated for intussusception in Randers Central Hospital during the period 1975-1989 were reviewed. In 27% of the cases this diagnosis was made before admission, gastroenteritis being the most frequent differential diagnosis (18%). The mean duration of symptoms before admission was 24 hours. No significant correlation between low age and late diagnosis was found. Symptoms were vomiting (100%), abdominal colic (95%), palpable abdominal tumour (73%), diarrhoea with blood and mucus (63%) and low-grade fever (64%). Treatment by barium enema had a low success-rate (29%); the best results were recorded in children with symptoms for less than 24 hours. The mean duration of the hospital stay was 3.5 days in children treated by barium reduction and 8.5 days in children treated surgically. Early diagnosis seems to increase the success-rate of non-operative treatment. Absence of the classical triad of paroxysmal pain, abdominal mass and red currant jelly stool (found in 41% of the cases) does not exclude the possibility of intussusception.
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PMID:[Intussusception in children]. 204 44


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