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

The hydrodynamic influence of different rectal tube sizes, contrast media, and heights of the fluid column on hydrostatic reduction of intussusception was analyzed in vitro. Enemas were performed in dead rabbits to compare the filling speed of bowel with a liquid and a gaseous contrast medium. For hydrostatic reduction, tubing and rectal tube with a large caliber and a low viscosity contrast medium achieved a higher filling speed of colon and are expected to provide a higher force of reduction on the intussusceptum. A rectal tube with a large caliber can be more useful than an increase of the column height. Filling bowel with carbon dioxide was approximately 7 times faster than with meglumine sodium diatrizoate. Theoretical considerations allow the hypothesis that a gaseous medium provides a faster and steadier reduction than a liquid.
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PMID:Comparative examination of various rectal tubes and contrast media for the reduction of intussusceptions. 190 75

Pneumatic reduction using air has recently become popular for the initial non-surgical management of intussusception. Since carbon dioxide (CO2) is rapidly absorbed from body surfaces, it should theoretically result in less cramping and distension following reduction. We reviewed our recent experience with the pneumatic reduction of intussusception using CO2 in 26 children. In 22 of these the intussusception was reduced (85%). There was one performation with CO2; the patient did not suffer any postoperative complications. Five additional children who had been treated unsuccessfully with barium had intussusception subsequently reduced with CO2. Following CO2 reduction, most children were fed within hours, and there were no instances of significant abdominal distension or cramping. We conclude that pneumatic reduction of intussusception using CO2 is safe and effective, and has the theoretical advantage of more rapid absorption from the gastrointestinal tract than air.
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PMID:Pneumatic reduction of intussusception using carbon dioxide. 780 Apr 57

The nonoperative treatment of intussusception is done by fluoroscopy, however, false-positive and negative images may lead to unnecessary operations. The aim of this study was to evaluate the feasibility of laparoscopy in pneumatic reduction. Surgical ileoileocolic intussusception was performed in 27 dogs. Sixteen dogs were observed for 3 days (group A), and 11 were observed for 5 days (group B). Laparoscopy was performed in the intussuscepted dogs during pneumatic reduction. Under general anesthesia, a 10-mm trocar was inserted supraumblically in the midline, and the laparoscope was introduced. The intussuscepted bowel was observed on the video monitor. A 5-mm trocar was inserted in the right upper quadrant. The mesentery of the terminal ileum was manipulated using grasping forceps to assist reduction. CO2 was insufflated into the rectum using a Foley catheter, and the reduction was observed on the video monitor. The success rate was 94% (mean reduction time, 2.5 minutes +/- 1.0) for group A and 100% (mean reduction time, 3.7 minutes +/- 0.8) for group B. Bowel perforation was observed in one dog, and recurrence of intussusception in another. The authors claim that observing the bowel on the video monitor may help in the differential diagnosis and reduction of difficult cases such as ileoileocolic and delayed intussusceptions. Therefore, unnecessary open surgery may be prevented.
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PMID:Laparoscopic-assisted pneumatic reduction of intussusception. 926 59

Experiments to determine the effect of furnishing an ample supply of sodium chloride on the toxemia of pyloric and intestinal obstruction are reported. A fall in chlorides is the first and seemingly most significant change to take place in the blood after pyloric and intestinal obstruction. The chloride is apparently utilized by the body as a protective measure against the primary toxic substance. Two dogs with pyloric obstruction were given 50 cc. of 10 per cent NaCl subcutaneously daily. One lived 3 days, the other 4. The blood showed little change, except a marked terminal rise in chlorides. Animals given a like amount of distilled water or 25 per cent glucose showed the changes typical of untreated animals. The obstruction of the pylorus was released in six dogs 48 to 72 hours after the initial operation. Two died within 24 hours after the second operation with a high non-protein nitrogen in the blood. Two survived but showed a high level of non-protein nitrogen in the blood and a high nitrogen excretion in the urine, low blood chlorides, and a marked alkalosis. One dog in such a state died on the 13th day from peritonitis, arising in a wound infection. The other showed a marked fall in non-protein nitrogen in the blood following the administration of 10 gm. of sodium chloride by mouth, but died following the intravenous injection of 25 per cent sodium chloride. Two animals were given 50 cc. of 10 per cent NaCl subcutaneously, at the time of the second operation. The blood rapidly returned to normal and complete recovery followed. Two dogs with the duodenum obstructed by section and inversion of the cut ends were treated with 10 per cent sodium chloride after the obstruction had existed for 48 hours and the characteristic blood changes had developed. The non-protein nitrogen returned to normal within 48 hours after treatment was begun. One dog died following a lateral anastomosis for relief of the obstruction. A second operation was not attempted in the other animal. Two dogs in which the duodenum was obstructed by section and inversion of the cut ends were given 500 cc. of 0.85 per cent NaCl subcutaneously on the day of operation and each day thereafter until death. One dog lived 21 days, the other 28. Both dogs showed a marked alkalosis, but never any rise in the non-protein nitrogen of the blood. The animals at autopsy showed intussusception of the ileum with extensive ulceration. In one there was a perforation and terminal peritonitis. The operation wounds healed normally. Three dogs with section of the duodenum were given 500 cc. of distilled water every day. One died in 24 hours, one in 48 hours, and the third in 72 hours. Autopsy showed no cause for death other than toxemia. One dog with section of the duodenum was given 500 cc. of 2 per cent glucose every day. The blood showed a rapid rise in non-protein nitrogen and carbon dioxide-combining power, and a fall in chlorides. The animal died 72 hours after operation. Three dogs with section of the duodenum were given 500 cc. of 1 per cent sodium bicarbonate every day. One dog died in 72 hours, one lived 7 days, and the third lived 9 days. All developed a high non-protein nitrogen in the blood and two showed marked clinical symptoms of an alkalosis. These results demonstrate that solutions of sodium chloride have a marked effect in preventing and controlling the toxemia of pyloric and intestinal obstruction as shown in clinical symptoms and in chemical changes in the blood. Dogs given an abundant supply of distilled water died more quickly than untreated control animals. Solutions of glucose have no specific value, and sodium bicarbonate solutions prolong life only a short while. Good therapeutic results have been obtained with very concentrated sodium chloride solutions, and with dry sodium chloride given by mouth. It seems evident that sodium chloride has a specific action in preventing and possibly in controlling the changes produced by the toxic body. Sodium chloride is a valuable therapeutic agent in pyloric and high intestinal obstruction.
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PMID:THE EFFECT OF SODIUM CHLORIDE ON THE CHEMICAL CHANGES IN THE BLOOD OF THE DOG AFTER PYLORIC AND INTESTINAL OBSTRUCTION. 1986 71

Adult intussusception of the bowel is a rare clinical entity, and its management remains debated. The timing of treatment is not yet standardised, and no guidelines exist. We report a case of an 83-year-old woman presenting to the emergency department of our hospital with a history of increasing abdominal pain in the right iliac fossa. A contrast-enhanced computed tomography scan showed the presence of a large ileocolic intussusception with evidence of the terminal ileus invaginated within the right colon and the ileocolic vessels dragged and trapped into the intussusception. A colonoscopy confirmed the ileocolic invagination with a large right colonic lesion as leading point, and a partial pneumatic (carbon dioxide) and hydrostatic reduction was achieved. Subsequent laparoscopic right colectomy was performed according to oncological principles. A totally minimally invasive approach of this rare condition has been achieved but the literature lacks about the correct management of this entity.
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PMID:Ileocolic invagination in adults: A totally minimally invasive endoscopic and laparoscopic staged approach. 3077 93