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

A 9-year-old pregnant Standardbred broodmare was evaluated for signs of mild abdominal pain, failure to defecate, and mild abdominal distention. Rectal examination revealed the leading edge of a small colon intussusception, and peritoneal fluid analysis indicated suppurative peritonitis. Surgical management, including reduction of the intussusception and small colon resection with end-to-end anastomosis, resulted in successful outcome (1-year follow-up evaluation). Postoperative complications including dehiscence of the ventral midline surgical incision and simple obstruction at the anastomosis site necessitated a second surgical procedure. Small colon intussusception is an uncommon cause of signs of abdominal pain and is similar to type-IV rectal prolapse.
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PMID:Small colon intussusception in a broodmare. 335 76

The gastrointestinal (GI) tract is a common site for malignant melanoma. Diagnosis of lesions in the GI tract is usually delayed until complications occur, such as obstruction, bleeding, or perforation of the GI tract. Of 348 patients with malignant melanoma treated during a 10-year period, 11 had GI involvement either in a metastatic form or as a primary melanoma. Three of these patients were treated surgically for metastatic lesions in the small bowel causing intussusception, two for peritonitis secondary to perforation of the small bowel, and one for massive bleeding from metastatic melanoma in the stomach. Another patient had a primary melanoma in the esophagus and underwent esophagectomy. Three patients had primary melanomas of the anal canal and one of the rectum. Three of them underwent abdominoperineal resections, and two had bilateral groin dissection in addition. Six of the patients are alive 6 months to 4 years following diagnosis. The remaining five died of metastatic melanoma from 6 months to 4 years post-surgery.
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PMID:Surgical approach to malignant melanoma in the gastrointestinal tract. 362 57

In recent years patients with cystic fibrosis (CF) have experienced longterm survival and have demonstrated a number of intra-abdominal complications. This report evaluates the intra-abdominal complications seen in 69 of 189 children with cystic fibrosis from 1972 to 1983. Forty-one patients were boys and twenty-eight girls. Complications occurred in 36 neonates, with meconium ileus (MI) noted in 33 and giant cystic meconium peritonitis (GCMP) in 3. Meconium ileus equivalent occurred in seven older children presenting with bowel obstruction. In addition, rectal prolapse occurred in 12, inguinal hernia in 10, intussusception in 3, cholelithiasis in 3, GE reflux in 4, stress ulcer in 1 and appendicitis in 1. Three infants with GCMP survived resection and enterostomy. Infants with MI were divided into simple (15) or complicated (18) cases. Nonoperative therapy using gastrografin enema was successful in three of eight with simple MI. Operative enterotomy and irrigation was successful in three cases while resection and enterostomy was done in nine. MI was complicated by atresia, volvulus and/or perforation in 18 cases requiring resection and anastomosis or enterostomy. Survival for MI was 86% compared to 36% in 25 MI patients treated in the previous two decades. Meconium ileus equivalent was successfully managed using gastrografin enema in five of seven children. Only 3 of 12 children with rectal prolapse required repair. Two cases of intussusception were reduced while one required resection. Three of 10 children had hernia recurrence due to chronic pulmonary problems.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intra-abdominal complications of cystic fibrosis. 404 71

Gallbladder disease in children today is being diagnosed increasingly because of better awareness of its existence and of improved diagnostic capability. A case is presented to describe an unusual pathologic variant termed "acute hydrops" of the gallbladder. This entity occurs specifically in children and is characterized by an acute illness with massive distention of the gallbladder in the absence of stones, bacteria, or congenital malformations. Differential diagnoses include appendiceal abscess, intussusception, volvulus, peritonitis, and pyelonephritis. Routine and contrast radiographic techniques may be combined with abdominal ultrasound to aid in the preoperative diagnosis. The etiology of hydrops is not known, but bile stasis and mesenteric lymphadenitis seem to be important factors. Treatment has varied from supportive observation to operative aspiration or cholecystectomy.
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PMID:Hydrops of the gallbladder in children. 685 91

Abdominal pain, vomiting, and obstipation often occur in children and young adults with cystic fibrosis (CF). The common causes include meconium ileus equivalent, intussusception, and adhesions from previous surgery. One of our patients with CF who had meconium peritonitis as a neonate presented with duodenal obstruction during childhood. This was caused by colonic polyps arising in the hepatic flexure and eroding through the colonic and duodenal walls into the duodenum. She was treated with total parenteral nutrition, right colectomy, gastric diversion, and a controlled duodenal fistula that healed uneventfully. She has remained well 1 year after discharge from the hospital. To our knowledge, a similar case has not been reported previously.
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PMID:Colonic polyps and coloduodenal fistula: unusual complications in patient with cystic fibrosis. 724 43

The appearance of gastrointestinal wall thickening of various entities is demonstrated on magnetic resonance imaging (MRI). The entities include benign gastric ulcer, gastric carcinoma, pancreatic carcinoma with direct invasion of stomach, duodenal leiomyoma, radiation enteritis, peritonitis, colonic carcinoma, recurrent carcinoma at the gastrojejunal anastomosis with direct extension to the transverse colon, colocolic intussusception, sigmoid diverticulitis with pericolonic abscess and fistula into the urinary bladder, and lymphoma of the stomach, duodenum, small bowel, and colon. Air was introduced antegradedly or retrogradedly into the alimentary tract to act as a contrast agent. When the bowel was distended by air, the normal bowel wall was barely visible or even invisible. Abnormal focal or segmental wall thickening was outlined between the intraluminal air and extraluminal fat. In some instances, the thickenings were better demonstrated on coronal or sagittal sections. The proper muscular layer of the bowel has a low-signal intensity and was delineated between the thickened mucosa-submucosa and extramural fat. Interruption of this low-intensity zone might represent tumor invasion through the muscular layer.
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PMID:MRI manifestations of gastrointestinal wall thickening. 795 Aug 12

The operative rate in intussusception has been significantly reduced by (1) expansion of the indications for attempted enema reduction of intussusception to include all children except those with peritonitis or septicaemia and (2) use of the gas (oxygen) enema rather than barium. This prospective study looked at the value of performing a delayed repeat gas enema in children in whom only partial reduction was achieved during the first enema, and who remained clinically stable. Twenty-one patients (of 156 with proven intussusception) had a repeat delayed gas enema, 30 minutes or more after the first attempt at reduction. This was successful in over 50%, reducing the number of patients requiring surgery at our institution by 24% and saving approximately five children a year from surgery.
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PMID:Intussusception: a repeat delayed gas enema increases the nonoperative reduction rate. 803 62

Acute appendicitis is the first cause of emergency surgery in children. Actually, emergency abdominal sonography has evolved in differential diagnosis of acute appendicitis in children to differentiate it from other causes of acute abdomen as mesenteric lymphoadenitis, acute right pyelonephritis, acute diverticulitis in Meckel's diverticulum, intestinal intussusception, regional enterits, primary peritonitis, anaphylactoid purpura of Henoch-Schonlein. The aim of this study is the evaluation of the usefulness of abdominal sonography in diagnosing acute appendicitis in our current series of pediatric patients. We have operated 102 patients afflicted by appendicitis admitted to the pediatric department of Ospedale San Raffaele, Milano in a period of 5 years and operated on for appendectomy. In the last 2 years 36 patients were evaluated with abdominal sonography. This diagnostic tool showed in 34 (94.4%) a liquid effusion, sometimes thick of the right iliac fossa. In 2 patients the appendix had thickened layers, was edematous and the lumen was clearly filled with debris. Abdominal sonography has given a clear cut picture of the acute inflammatory process of the appendix. None of these patients has suffered from septic or obstructive complications. Mean duration of hospital stay was 6.35 days (3-15 days). Differential diagnosis of acute appendicitis can be extremely variable, from simple, paradigmatic situations to the most intriguing ones. This concept is well emphasized by William Silen when he says that "differential diagnosis of acute appendicits is an encyclopedic compendium of every abdominal disease that causes pain" in the 11th edition of Harrison's Principles of Internal Medicine.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current diagnostic-therapeutic trends in treatment of pediatric appendicitis]. 803 58

A criterion for successful hydrostatic reduction of intussusception is reflux into the terminal ileum. In our practice, absence of reflux into the terminal ileum is not an indication for laparotomy if the radiographic appearances suggest edema of the ileocecal valve. The aim of this study was to validate our approach. We reviewed the case notes of patients with a diagnosis of intussusception (n = 107; age 11.74 +/- 1.48 months; mean +/- SEM) treated from 1987 to 1991. Eleven required primary laparotomy for peritonitis. Ninety-six patients who had a contrast enema were studied. Edema of the ileocecal valve was defined as a persistent filling defect in the cecum after apparently complete hydrostatic reduction, without reflux of contrast into the distal small bowel. In 59 patients hydrostatic reduction was successful: 11 (18.6%) had edema of the ileocecal valve and no reflux contrast into the terminal ileum (group B). All improved clinically after the enema and needed no further treatment. In 37 patients hydrostatic reduction of the intussusception was unsuccessful and an operation was performed: 26 (70.3%) required manual reduction of the intussusception (group C) and 11 (29.7%) underwent bowel resection (group D). None of the patients with edema of ileocecal valve required further treatment or developed recurrent intussusception. In none of the patients who had an operation was the intussusception found to have been reduced by the contrast enema. There were no deaths.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Indications for laparotomy after hydrostatic reduction for intussusception. 830 83

Diagnosis and management of intussusception remain controversial. The authors discuss the evolution of changes and advances in practice and procedures. They advocate sonographic diagnosis and air enema reduction; the abdominal radiograph is reserved for children with clinical evidence of peritonitis and suspected perforation, if clinical findings are unusual, or if the sonographic examination is equivocal.
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PMID:Intussusception. Issues and controversies related to diagnosis and reduction. 867 7


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