Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dietary habits in the civilised countries of the West with foods low in bulk and cellulose are blamed as causes of the increase in colon diverticulosis and the complicating diverticulitis in recent times. Of all sections of the colon, the sigmoid is most frequently involved, older patients above the 5th decade being principally affected. While uncomplicated diverticulosis of the colon usually remains symptomless, complicated diverticulitis often shows very uncharacteristic symptoms. For prophylaxis and the treatment of slight complaints, conservative treatment with administration of bulky foods (bran etc.) is indicated. Threatening hemorrhages and perforative peritonitis demand emergency operations. In closed abscess formation, internal or external fistulae and incipient scarring stenosis with imminent ileus, resection of the affected part of the intestine is indicated.
 ...
PMID:[Colon diverticulosis and complicating diverticulitis (author's transl)]. 12 78

A recent review of the surgical management of diverticular disease of the colon included 73 patients. One-stage resections were accomplished in 67%, primarily in patients operated on electively for recurrent diverticulitis or fistula, and in the group of patients with cecal diverticulitis operated on for presumed appendicitis. Single-stage resection with ileorectal anastomosis is also preferred in patients with massive diverticular bleeding. For patients with large abscesses or diffuse peritonitis a two-stage procedure which removes the site of disease in the initial operation is recommended. There were no deaths and a lower incidence of complications in the group of patients who had elective operations for recurrent diverticulitis and fistula.
 ...
PMID:Diverticular disease of the colon: surgical management at a military hospital. 30 57

32 patients suffering from diverticulitis of the sigmoid colon underwent resection with end-to-end-anastomosis. In 24 cases the operation was performed electively as a one step procedure, the rest of the patients were operated on by two or three steps. One patient with ileus and peritonitis came to death. 28 from 31 surviving patients live without trouble. Resection of the inflammatory part of intestine is recommended instead of permanent colostomy.
 ...
PMID:[Surgical treatment of divertikulitis of the sigmoid colon (author's transl)]. 55 21

Diverticular disease is very common among elderly members of "Western, civilized" communities. The aetiopathogenesis is unknown, but may be related to diet and raised intracolonic pressure. Patients with diverticulosis are usually asymptomatic, but those with diverticulitis (which implies inflammation) often present with pain, pyrexia and changes in bowel habit. Careful differential diagnosis is necessary to permit appropriate treatment (medical or surgical), and to detect and treat potentially dangerous complications (abscess, peritonitis, haemorrhage, stenosis, fistula).
 ...
PMID:The diagnosis and management of diverticular disease. 69 22

Out of a total of 2727 operations of the large bowel because of tumors and inflammatory disease, performed over a 14-year period, 897 were one-stage resections of the colon and rectum without relaxing colostomy. Standard preoperative preparation of the bowel consists of a balanced diet, laxatives, and enema supplemented by 9 g Neomycin and 1.8 g Achromycin, within a 2-day period. Disturbances in wound healing occurred in 12.5%, seroma included. Anastomotic insufficiency occurred in 4%, and fatal fecal peritonitis due to tumors in 1.3% and due to diverticulitis in 1.2%. Total mortality was about 5.7%. Postoperative hospitalization after resections because of tumors was 15 days and because of diverticulitis, 19 days.
 ...
PMID:[Preoperative preparation in colorectal surgery: antibiotics (author's transl)]. 73 67

Nonspecific immunosuppression of transplant patients frequently leads to complications which might be circumvented by inducing donor-specific immune unresponsiveness. Such specific immunosuppression has been produced experimentally, with use of donor antigen and antilymphocyte serum (ALS) for active enhancement. A case is presented in which the recipient of a cadaveric renal allograft (zero antigen match, cross-match negative) was given ALS (first 14 days after operation) and 11 X 10(9) donor bone marrow cells (twenty-fifth postoperative day) along with conventional doses of prednisone and Imuran in an attempt to produce donor-specific immune unresponsiveness. There were no rejection episodes, and serum creatinine remained less than 1.0 mg. per 100 ml. By the second month after transplantation there was no evidence for the persistence of donor erythrocytes or white cells. The conventional immunosuppressive agents were tapered and renal function was normal 8 months after transplantation, when the patient developed fatal peritonitis secondary to perforated sigmoid diverticulitis. At autopsy the renal allograft showed only minimal evidence of rejection. The present case illustrates an attempt to use ALS and donor bone marrow cells for active enhancement of a human cadaveric renal allograft. The infusion of stored donor marrow cells after transplantation is a particularly applicable technique for human cadaveric organ transplantation. The rejection-free course of this patient suggests that attempts to produce active enhancement clinically deserve further trial.
 ...
PMID:Possible active enhancement of a human cadaver renal allograft with antilymphocyte serum (ALS) and donor bone marrow: case report of an initial attempt. 76 19

The danger with diverticulitis is that the disease may progress to life threatening complications. The development of diverticulitis leads from local infiltration and fibrosclerosis to final perforation. Nonresected diverticulitis favors the development of diverticulosis proximal to the affected bowel. Conservative therapy seems to be of little use in avoiding the progression of recurring diverticulitis. Signs of irreversible diverticulitis are repeated attacks, signs of local peritonitis, fixed deformation of the wall and stenosis, revelaed by barium enema. One-stage resection was performed in 101 patients for uncomplicated diverticulitis. There was one death (myocardial infarction).
 ...
PMID:[Early resection in diverticulitis (author's transl)]. 79 93

Thirty instances of perforating diverticulitis seen at the University of Alabama Hospital were retrospectively reviewed. The correct diagnosis was assumed prior to operation in only 12. A palpable mass located in the lower part of the abdomen was found in 15 patients. All of the patients had a pericolic type of perforation. Seven patients, five with symptoms highly suggestive of a diverticular disease of the colon, were operated upon for suspected gynecologic problems. It appears that the patients in this group could have been treated more appropriately if the diagnosis of a perforating diverticulitis had been considered preoperatively. It is important to determine whether or not the perforation is pericolic, intramesenteric or free, with spreading peritonitis, since the advocated treatment is different for each type of perforation observed.
 ...
PMID:The surgical management of diverticular disease of the colon complicated by perforation. 83 Dec 94

Sigmoid diverticulitis with free perforation or perforation through the mesentery results in generalized peritonitis. Emergency surgical treatment is mandatory, but the most efficacious procedure has not been clearly established. Ten consecutive patients were treated by removal of the perforated sigmoid colon, temporary end colostomy and peritoneal toilet. All but one patient survived the initial procedure, and there were only four minor complications. The preoperative diagnosis was correct in 8 of the 10 patients. Analysis of the preoperative clinical findings revealed that a decision in favor of immediate operation was not difficult. The predominant clinical manifestations were severe abdominal pain and tenderness, fever, and elevation of the white blood cell count. The most reliable diagnostic finding was localization of the area of maximum tenderness to the left lower quadrant and suprapubic areas. While it is not applicable for all the pathologic manifestations of diverticulitis, sigmoid colectomy, temporary end colostomy and peritoneal toilet is efficacious therapy in perforative diverticulitis with free communication between the colonic lumen and the peritoneal cavity.
 ...
PMID:Diverticulitis with perforation into the peritoneal cavity. 83 38

A retrospective study was carried out of all patients admitted to the hospital with either local or free perforating diverticulitis. Fifty-one patients had perforating diverticulitis of the sigmoid colon with local abscess formation, while 26 patients had free perforation with generalized peritonitis. Of the 67 patients who had a defunctioning colostomy, 18 died, while of ten patients who had either resection or exteriorization of the perforated segment, one died. Thus, exteriorization or resection as the primary surgical procedure for perforating diverticulitis is the procedure of choice, since it leads to a low operative mortality because of removal of the septic focus, preventing continuing intraperitoneal soilage.
 ...
PMID:Management of perforating diverticulitis of the colon. 83 62


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