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

A case of ileal atresia consequent to intrauterine intussusception is reported. The baby presented with features of neonatal intestinal obstruction but signs of peritonitis were absent. The intussusception was discovered on gross examination of distal atretic ileal segment. The case was managed successfully by resection and end to back anastomosis. This case is reported to highlight intrauterine intussusception as one of the causes of ileal atresia.
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PMID:Intrauterine intussusception--a cause for ileal atresia. 1121 89

The purpose of the present study was to investigate the acid-base status and the concentration of organic acids in horses with colic caused by various disorders. Blood samples were collected from 50 horses with colic and from 20 controls. No intravenous fluids had been given prior to sample collection. Identified causes of colic included gastric ulceration, small intestinal volvulus, cecal intussusception, cecal rupture, colonic impaction, left dorsal colon displacement, right dorsal colon displacement, colonic volvulus, colitis, peritonitis, and uterine torsion. Thirty-seven horses recovered from treatment of colic, 8 horses were euthanized, and 5 died. Most cases were not in severe metabolic acidosis. In previous studies, most horses presented for diagnosis and treatment of colic were in metabolic acidosis and in shock.
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PMID:Determination of the acid-base status in 50 horses admitted with colic between December 1998 and May 1999. 1156 69

The vast majority of symptomatic intussusceptions in children arise in the ileum and are either ileocolic or ileoileocolic. The clinical diagnosis of these "idiopathic" intussusceptions may be difficult to make. Failure to make a prompt diagnosis and initiate appropriate treatment may lead to bowel ischemia, perforation, peritonitis, shock and even death. The clinician, therefore, may have to rely on imaging procedures to diagnose or exclude the presence of intussusception promptly and accurately. The imaging diagnosis of intussusception can be made with sonography or plain abdominal radiographs or by contrast (including air) enema examinations of the colon. This article highlights the current concepts and some controversial issues related to the imaging diagnosis of intussusception.
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PMID:Intussusception. Part 1: a review of diagnostic approaches. 1255 62

postoperatively Seventeen females presenting rectal intussusception with a combined outlet obstruction underwent laparoscopic resection of the rectum (n = 4) or rectum and sigma (n = 13). Mean age was 61.5 +/- 9.7 years, mean duration of surgery took 117 +/- 30.4 minutes, realimentation started 3.5 +/- 1.3 days postoperatively and the mean stay in hospital lasted 11.8 +/- 2.9 days. In all patients an ano-rectal pressure-measurement and EMG were carried out. There was a significant lower resting-pressure of the anal sphincter in comparison to a normal collective of healthy patients with 67.8 +/- 21.6 cm H2O (p < 0.006). Postoperatively one severe complication with a generalized peritonitis and a resulting ARDS occurred. No perioperative mortality had to be remarked. Our results show that laparoscopic resection in patients with a rectal intussusception and outlet obstruction is safe. Wether rectal intussusception apart of rectal prolapse is an entity of its own, has to been shown in further investigations.
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PMID:[Rectal prolapse--laparoscopic resection and results]. 1269 25

OBJECTIVE: To investigate the frequency, predisposing factors, clinical presentation, and outcome of abdominal compartment syndrome (ACS) in critically ill pediatric patients. DESIGN: A prospective study over a 5-yr period. SETTING: Pediatric intensive care unit of a tertiary care, university hospital. PATIENTS: All patients admitted to the pediatric intensive care unit were screened for the presence of ACS and were treated with a uniform protocol. ACS was defined as abdominal distention with intra-abdominal pressure (IAP) > 15 mm Hg, accompanied by at least two of the following: oliguria or anuria; respiratory decompensation; hypotension or shock; metabolic acidosis. MEASUREMENTS AND MAIN RESULTS: Of 1762 patients admitted over 5 yrs, ten patients (0.6%) had a total of 15 episodes of ACS. Of 406 trauma cases, three had ACS (0.7%). Three of the ten patients had primary abdominal conditions (mesenteric vein thrombosis, intussusception, enterocolitis), three had abdominal surgery (trauma, Kasai operation, esophageal perforation and peritonitis), three had primary central nervous system involvement, and one had meningococcemia. At laparotomy, bowel ischemia or necrosis was found in four episodes of ACS (27%). Mean IAP at diagnosis of ACS was 23.9 +/- 3.8 (range 17-31) mm Hg. Physiologic parameters were compared during 4 hrs before the development of ACS, during ACS, and after abdominal decompression. Mean arterial pressure, Pao(2), Pao(2)/Fio(2) ratio, and urinary output decreased significantly, whereas Paco(2), peak inspiratory pressures, positive end-expiratory pressures, and base deficit increased significantly after the development of ACS. After decompressive laparotomy, the condition of the patients improved promptly and these variables returned to pre-ACS values. Overall mortality rate in this group was 60%. CONCLUSIONS: Although relatively infrequent compared with adults, ACS occurs in critically ill children. Timely decompression of the abdomen results in uniform improvement, but overall mortality is still high. In contrast with adults, children with ACS have diverse primary diagnoses, with a significant number of primary extra-abdominal-mainly central nervous system-conditions. Ischemia and reperfusion injury appear to be the major mechanisms for development of ACS in children. Clinical presentation is similar to adults, but children may develop ACS at a lower IAP (as low as 16 mm Hg).
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PMID:Abdominal compartment syndrome in children. 1279 89

A case of complete intussusception induced by appendiceal carcinoma is reported. The patient was a 49-year-old man complaining of rectal bleeding. Barium enema and colonoscopy revealed a cecal polyp; it was interpreted as an inverted appendix with a tumor. Computed tomography showed an invaginated appendix into the cecal cavity. During surgery, the appendix was found to be inverted completely into the cecum; ileocecal resection with regional lymph node dissection was performed. Microscopic examination revealed well-differentiated adenocarcinoma in tubular adenoma. Diagnosis of intussusception with carcinoma of the appendix is often difficult because appendiceal carcinoma with intussusception of the appendix is a rare condition. Although this condition can be diagnosed by radiographic imaging or colonoscopy, computed tomography has also been useful. The clinical manifestation of appendiceal intussusception with primary appendiceal tumor resembles a large cecal polyp, but its treatment differs greatly. Failure to recognize this condition may result in unexpected complications such as consequent peritonitis in case of endoscopic removal.
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PMID:Complete appendiceal intussusception induced by primary appendiceal adenocarcinoma in tubular adenoma: a case report. 1452 63

Intussusception represents the most common abdominal emergency in infancy. The classical clinical triad, consisting of abdominal colics, red jelly stools and a palpable mass, is only present in approximately 50% of cases, 20% of patients are symptom free at clinical presentation. Primary imaging modality of choice is ultrasound scanning, which enables the diagnosis or exclusion of an intussusception at a sensitivity of 98-100%, specificity of 88% and a negative predictive value of 100%. In emergency cases, additional plain films are necessary to detect potential intestinal perforation, to identify intestinal obstruction or other diseases mimicking the clinical presentation. Once the diagnosis of an intussusception is established, non-surgical reduction (NSR) is used. A surgical approach is chosen in patients with signs of perforation, shock or peritonitis. Depending on the choice of guiding imaging technique, different contrast media are used for NSR. Barium suspension or air with fluoroscopic guidance, or saline only or mixed with water-soluble contrast under sonographic guidance, has to be used. Regardless of the used contrast medium, NSR is an effective technique, being successfully employed in more than 90% of cases.
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PMID:Management of intussusception. 1475 70

When presentation is delayed, intussusceptions may be difficult to reduce using standard enema regimens. Our endeavour to minimize the need for surgery in an environment where failed reductions are common has led to the development of an aggressive, non-operative method of reducing intussusceptions. One hundred and six patients with intussusception were reviewed with the aim of evaluating a new method of reducing intussusceptions suited to our Third World environment. In our cohort, delayed presentation was common, with 32% of patients presenting more than 48 h after the onset of the intussusception. On clinical grounds alone, 41% of patients required a primary laparotomy. Standard barium and air reductions for intussusception were rarely successful under these conditions i.e. 13% and 22%, respectively. By using an air enema under general anaesthesia in the operating theatre, the reduction rate has improved to 53%. This approach is suggested as a last attempt at reducing an intussusception prior to laparotomy following failed standard enema reduction, and as the first line of management in the attempted reduction in the patient with delayed presentation without symptoms of peritonitis.
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PMID:Minimizing surgery in complicated intussusceptions in the Third World. 1506 60

Intrauterine intussusception, an uncommon cause of bowel obstruction, has rarely been detected by prenatal ultrasonography. We report two cases of intrauterine intussusception after gestation, which presented as isolated fetal ascites at 30 weeks of gestation by ultrasonography. In case 1, on the follow-up ultrasonography at 32 weeks of gestation, the previously observed ascites had disappeared, whereas the echogenicity of the bowel was increased without any sign of dilation, suggesting the presence of meconium peritonitis. The fetus was delivered at 39 weeks. In case 2, however, the amount of fetal ascites became increased, and the fetus was delivered at 34 weeks of gestation. After delivery, both infants were surgically explored with resection of the ileum with end-to-end anastomosis because of intrauterine intussusception and ileal atresia. From the experience of these cases, we suggest that the ultrasonographic finding of isolated or transient fetal ascites might contribute to the early diagnosis and management of intrauterine intussusception.
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PMID:Intrauterine intussusception presenting as fetal ascites at prenatal ultrasonography. 1516 24

Intussusceptions originating in the jejunum are rare. We report a 20-year-old woman who had a chronic jejuno-jejunal intussusception due to an inflammatory fibroid polyp manifesting in the post-partum period as peritonitis. Resection-anastomosis of the intussuscepted segment was done. She is well one year later.
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PMID:Inflammatory fibroid polyp of jejunum causing jejuno-jejunal intussusception. 1559 9


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