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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The alterations in diagnosis and therapy of intussusception in infants is described in 155 cases from 1978-1989. The primary diagnostic procedure is the abdominal sonography. It is followed to 1988 the attempt of hydrostatic reduction by barium enema and now the pneumatic reduction. The rate of success with conservative treatment was finally over 80%. Primary operative treatment is only necessary in the rare cases with signs of perforation of intestine or of peritonitis.
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PMID:[Changes in the diagnosis and therapy of invagination]. 227 Jul 30

A retrospective study of sixty consecutive cases of proven intussusception with attempt at contrast enema reduction was performed to evaluate currently proposed contraindications to such reduction. When patient age, duration of symptoms, presence of small bowel obstruction and presence of a dissection sign were considered alone, none of the findings indicated irreducibility. Our overall reduction rate was 72% with a complication rate of 3%. This is similar to previously reported series and we concur with more recent publications that the only contraindications to non-surgical reduction of intussusception are free intraperitoneal air, peritonitis or evidence of infarcted bowel. Only when we encountered a combination of symptoms being present for greater than 48 hours and the presence of both small bowel obstruction and a dissection sign was reduction likely to be unsuccessful. However, the presence of a prognostic indicator occurring alone should not be considered a contraindication.
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PMID:Significance of age, duration, obstruction and the dissection sign in intussusception. 239 63

To provide guidelines for the choice of treatment of intussusception, 10 factors that are known to be related to the outcome of treatment were studied in a series of 146 children with intussusception. The length of history, vomiting, rectal bleeding, small bowel obstruction, ileoileocolic intussusception, and the presence of a leading point were all significantly related to failure of hydrostatic reduction. Only 'rectal bleeding' and 'duration of symptoms of more than 48 hours' contributed significantly to the prediction of failure of hydrostatic reduction by logistic regression analysis. We believe that as well as the generally accepted contraindications--signs of peritonitis or bowel perforation--the presence of rectal bleeding when symptoms have lasted more than 48 hours is a contraindication to hydrostatic reduction.
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PMID:Intussusception: factors related to treatment. 240 Feb 24

From February 1981 to December 1988, 30 children with Abdominal Malignant Non Hodgkin's Lymphoma (NHL) have been followed and treated in the Department of Pediatric Surgery of Saint Vincent de Paul's Hospital. The place of surgery in the Diagnosis, Evolution and Treatment of NHL is defined. In the diagnostic Stage, Surgery should be a fortuitous event, as in some cases of acute Intestinal Intussusception, or Appendicectomy, where lymphoma is an unexpected discovery. In all other cases, a cytologic study of ascites and/or pleural effusion that should be searched, can give a quick and reliable Diagnosis. Exceptionally, a complication of chemotherapy, as a peritonitis, with or without intestinal perforation, require an intervention. Most often in cases of already diagnosed and treated NHL, an abdominal residual mass have to be removed surgically and submitted to careful pathologic examination, to determine further treatment. If in some cases, initial Diagnosis is an unexpected discovery, the treatment of NHL is essentially medical. Surgery takes place in the Remission Evaluation after conventional chemotherapy.
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PMID:[The surgeon facing malignant non-Hodgkin's lymphoma of the abdomen in children]. 261 66

103 patients with intestinal gangrene were treated over a ten-year period in Ile-Ife, Nigeria. The various causes of the intestinal gangrene were herniae (63%), intussusception (20%), adhesions (12%), volvulus (3%) and mesenteric vascular occlusion (2%). The presence of pre-operative shock, purulent and faeculent peritonitis, intra-peritoneal perforation of bowel and involvement of long bowel segments in the gangrene process; constitutes the important prognostic factors. The presence of a pre-operative febrile response also influences the course of the disease while the age and sex of the patient, the duration of symptoms and the portion of bowel involved showed no relationship with the ultimate outcome. It is recommended that the patients with the ominous prognostic factors constitute a high risk group and should be given intensive care to ensure survival.
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PMID:Prognostic factors in intestinal gangrene. 271 52

Two cases of colo-recto-anal intussusception are reported, both in old women and with a tumour at the apex of the intussusception. Primary resection of the sigmoid colon with terminal sigmoidostomy was successful in one case. Resection with anastomosis in the other case was followed by anastomotic leakage with peritonitis, requiring revisional closure of the rectum and terminal sigmoidostomy.
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PMID:Colo-recto-anal intussusception. Case report. 274 29

A 3-year-old girl is reported on who underwent laparotomy for ileocaecal intussusception elsewhere one week following severe gastroenteritis. Immediately after surgery, she developed haemolytic-uraemic syndrome with haemolytic anaemia, thrombocytopenia, increase of urea and creatinine and anuria as well as subsequent peritonitis, enterocolitis and sepsis. Following relaparotomy with establishment of ileostomy, peritoneal dialysis for several days was carried out for treatment of the haemolytic-uraemic syndrome. This case demonstrates that the haemolytic-uraemic syndrome can be treated effectively by peritoneal dialysis despite fresh bowel anastomoses, and that simultaneously occurring peritonitis can be managed by intraperitoneal administration of antibiotics via dialysis fluid.
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PMID:[Peritoneal dialysis in hemolytic-uremic syndrome following ileocecal resection for invagination in postoperative peritonitis]. 275 Mar 44

Alimentary tract duplications are unusual anomalies that may require surgical intervention in the neonate, infant, and occasionally in the older child. The clinical presentation of patients with alimentary tract duplications includes bleeding, abdominal pain, intussusception, and respiratory distress, or it may be an incidental finding on either abdominal examination or chest x-ray. A review of 96 patients with 101 duplications seen over the last 37 years is reported herein. Twenty-one duplications were confined to the thorax; three were thoracoabdominal, and 77 were abdominal. Seventy-four patients presented as infants less than 2 years of age, and 22 patients were older. Ectopic gastric mucosa was found in 21 duplications, and pancreatic tissue was found in five. Seventy-five duplications were cystic and 26 were tubular. Ultrasonography, computed tomography (CT), and myelography are helpful diagnostic tools. Ninety-four of the 96 patients underwent surgical management for their duplications. One duplication was found at necropsy, and one patient was asymptomatic and did not undergo operation. A single death occurred in a 2-day-old infant who had intrauterine volvulus and meconium peritonitis. Management was based on the age and condition of the patient, the location of the lesion, whether it was cystic or tubular and communicating with the true intestinal lumen, and whether it involved one or more anatomic locations. Generally, total excision was preferred, but staged approaches were sometimes necessary.
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PMID:Surgical management of alimentary tract duplications. 291 61

The use of ultrasound techniques has brought about considerable changes in the diagnosis and therapy of intussusception in the past few years. (1) Whenever intussusception is suspected ultrasound examination of the abdomen is the diagnostic procedure of choice; a diagnosis of intussusception can be made or excluded with an adequate degree of accuracy. (2) Ultrasound monitoring is also good for the follow-up of cecal edema after reduction of intussusception, making it possible to check that there are no pathological lead points and that complete restoration of function has been achieved. (3) There are only three absolute contraindications for attempting an enema: peritonitis, shock, and perforation. (4) Whenever there are relative contraindications for administration of an enema, e.g., long duration of symptoms, complete small-bowel obstruction, it is of the utmost importance to inform the pediatrician and the surgeon and to discuss with them the potential benefits and risks involved in an attempt at hydrostatic reduction.
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PMID:[Invagination. The present status of diagnostic imaging and therapy]. 305 22

This study concerns a homogenous series of 163 cases of intussusceptions in children, seen in the Visceral Pediatric Surgical Unit of Montpellier from 1974 to 1985. The authors differentiate and compare two periods with regard to the year 1980: the first one (P1 = 64 cases) during which, surgery was always the rule;the current one (P2 = 99 cases) where non operative treatment is the modality of choice under precise conditions. Synthetic analysis and comparison of the different therapeutic groups which have been distinguished in every period lead to the following data. 14% of intussusceptions are directly operated whatever the period or the modality of management probably because this group represents the absolute contra-indications of a barium enema--It concerns children with a long duration of the disease, obstructive or peritonitis signs and late diagnosis--Laparotomy is mandatory and finds a high percentage of leading points and ileo-ileal forms. Intestinal resection was necessary in 59.5% of cases. Because of this and a poor general condition, morbidity was high and Hospital stay was long. 56.4% of intussusceptions are operated after failure of barium enema reduction. This hydrostatic irreducibility is probably explained by the prevalence of ileo-colic forms (53.3%) in this group. A shorter duration of the disease (less than 2 days in 43.1%) and a strong majority of idiopathic intussusception (90.5%) are surely responsible of a high percentage (80%) of successful manual reduction without the need of a resection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute intestinal invagination in infants and children, critical evaluation of the diagnostic and therapeutic strategy. Apropos of a series of 163 cases]. 332 59


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