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

In a kindred with a familial visceral myopathy, seven patients had operations seeking relief of chronic abdominal pain and other symptoms of intestinal obstruction; one patient had an 80% cystectomy and a Y-V-plasty of the bladder neck for urinary retention. Five patients with megaduodenum had bypass operations; a side-to-side duodenojejunostomy was done in four and a retrocolic gastrojejunostomy in one. Two of these died of postoperative complications, and one developed symptomatic adhesions. Two other patients who had duodenojejunostomy have done well for 6 years and 1 1/2 years respectively. One patient with dilation of the distal jejunum and proximal ileum had relief of intestinal obstructive symptoms from jejunostomy to decompress the destal jejunum. One patient who had a resection of the descending and sigmoid colon for sigmoid volvulus has done well for four years. Three of these seven patients developed peritonitis postoperatively, and two had symptomatic adhesions after operations. Duodenal aspiration from a patient who developed postoperative peritonitis grew E. coli, 10(13) colonies per ml. After review of the results of operations in other families and in our kindred, we favor side-to-side duodenojejunostomy in megaduodenum. Duodenal aspirate must be cultured before operation. Evidence of bacterial overgrowth in the aspirate should prompt appropriate antibiotic treatment to reduce the likelihood of sepsis.
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PMID:Surgical treatment in familial visceral myopathy. 42 61

Volvulus of the jejunum and ileum in three horses was associated with intestinal strangulation in a mesenteric rent. The rent was in the jejunal mesentery at its point of attachment with an anomaly that was classified as a mesodiverticular band. The band also was attached to the dorsolateral surface of the jejunum, thus forming one side of a triangular hernial sac that was completed on the other side by the adjacent jejunal mesentery. Incarceration of a loop of small intestine in the hernial sac preceded rupture of the jejunal mesentery and subsequent intestinal strangulation. Surgical correction was successful in two horses and involved resection of the gangrenous intestine, then jejunocecal anastomosis. The third horse was euthanatized when intestinal rupture and peritonitis were found on exploratory laparotomy. Two mesodiverticular bands attached to the distal jejunum were incidental necropsy findings in a fourth horse.
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PMID:Mesodiverticular bands as a cause of small intestinal strangulation and volvulus in the horse. 52 51

During the 14 yr from 1965 through 1978, 49 infants presented shortly after birth with intestinal obstruction due to impacted meconium. Three of these patients did not have fibrocystic disease. Eight patients were cured by a Gastrografin enema. There were 18 patients who had complications that included associated atresia, volvulus, and/or peritonitis. Various operations were done including resection with either primary anastomosis or enterostomy or varieties of the foregoing. Twenty-three babies had the simple uncomplicated form of meconium ileus. Eleven of these underwent resection and six patients died. Twelve patients were treated by laparotomy, ileotomy through a purse-string suture and prolonged irrigations using acetylcysteine. Of this group only one succumbed. This latter course of management is recommended for patients with simple uncomplicated meconium ileus as it involves no resection, no enterostomy, nor any primary anastomosis.
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PMID:Meconium ileus: laparotomy without resection, anastomosis, or enterostomy. 55 Nov 49

The findings on the radiographs of 14 cases of ileosigmoid knot are presented and analysed. The clinical features and pathology of the condition are briefly described. The key radiological features consist of a dilated loop of pelvic colon, evidence of small intestinal obstruction and retention of faeces in an undistended proximal colon. The dilated loop usually lies in the right side of the abdomen and the limbs taper inferiorly into the right lower quadrant. Medial deviation of the distal descending colon is an inconsistant but highly specific finding. The radiographs readily permit distinction from primary volvulus of the small intestine and from non-obstructive surgical emergencies such as perforated viscus and ruptured ectopic pregnancy. The combination of radiographic findings may however be simulated by volvulus of the right colon, closed loop small intestinal obstruction and by volvulus of the pelvic colon complicated by peritonitis. The differential diagnosis is discussed and the value of sigmoidoscopy, rather than barium enema, emphasised.
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PMID:The radiology of ileosigmoid knot. 63 62

Of 11 infants and children with mesenteric cysts, seven patients were boys and four, girls. Clinical findings included abdominal distention, pain and vomiting in seven patients, while a movable abdominal mass was noted in four. Two patients presented with peritonitis and one patient, in a state of shock. All patients underwent laparotomy-seven as an emergency procedure. Volvulus with perforation and infarction was noted in the two patients uith peritonitis. Excision of the cyst required resection of the small intestine and end-to-end anastomosis in seven patients, while simple enucleation was possible in four. All 11 patients survived, and there have been neither subsequent complications nor recurrences. Early recognition and appropriate resection of these benign, but occasionally life-threatening, malformations is associated with an excellent long term prognosis.
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PMID:Mesenteric cysts in infancy and childhood. 68 68

We have reviewed the records of 48 patients who had colonic volvulus. Volvulus occurred in the sigmoid colon in 27 (56%) and in the right colon in 19 (40%). Volvulus elsewhere in the colon is rare, requiring unusual anatomic circumstances of a long mesentery and a mobile colon. The clinical history is characterized by a long history of bowel dysfunction followed by an episode of acute intestinal obstruction. The patient is often aged and is plagued by mental disorders and a number of degenerative diseases. Distention of the abdomen is the most significant finding, and tenderness may indicate peritonitis due to ischemic changes in the bowel. Three-positional films of the abdomen are most valuable, showing great distention of the colon and air-fluid levels in the bowel with regularity. Barium-enema studies will more accurately reveal the site and nature of obstruction. The barium-enema examination must be done carefully. It is omitted when peritonitis is present. Operative treatment is necessary for volvulus of the right colon. Non-operative reduction is effective for nonstrangulating volvulus of the sigmoid colon as an emergency procedure. Sigmoidoscopic examination and insertion of a long rubber tube will give dramatic relief to a substantial number of patients. Operative intervention is necessary when conservative measures fail. When gangrene is found at operation, exteriorization resection of the colon may be life-saving. Elective resections are recommended for patients who are in otherwise good health in order to prevent recurrences. The mortality rate in this series of 48 cases was 12.5 per cent. Cecal volvulus was present in each of the six patients who died. Sepsis and cardiopulmonary diseases were common in patients who died.
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PMID:Volvulus of the colon. 86 92

Two cases of obstruction of the bypassed small intestine after jejunoileal shunt for obesity are presented. These cases illustrate the possible failure of radiologic visualization of the obstructed bowel since no gas traverses this bowel, as well as two of the possible causes-internal herniation and volvulus. A third cause, intussusception of the blind loop into the colon, has been reported. Obstruction of the bypassed bowel demands surgical intervention and could lead to perforation and peritonitis if untreated. Its prevention involves the closure of all mesenteric defects at the original operation. Surgeons should be aware of the possibility of these conditions in any patient who has had a small-bowel bypass operation.
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PMID:The excluded small-bowel segment. A source of complications after small-bowel bypass. 94 55

The results of treatment for volvulus of the colon during 13 years in a community hospital are analysed, It is concluded that sigmoid volvulus should be treated with proctoscopic examination and insertion of a rectal tube, unless signs of gangreana or peritonitis are present. In patients without accompanying sever diseases, elective resection should be performed later. Repeated tube decompressions should be attempted in patients with recurrence and high operative risk. Unsuccessful tube decompressions or signs of a non-viable colon should be followed by emergence laparotomy and, probably, resection of the sigmoid colon whether gangraena is present or not. Volvulus of the cecum should be treated with operative reduction and pexia or cecostomy, unless gangreana necessitating a hemicolectomy is present.
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PMID:Volvulus of the colon. 118 63

Meconium peritonitis is a chemical peritonitis usually resulting from antenatal bowel rupture. Prenatal ultrasound findings include ascites, intraabdominal masses, bowel dilatation and the development of intraabdominal calcifications [1-5]. The most common bowel disorders which lead to meconium peritonitis in utero are those resulting in bowel obstruction and perforation, such as small bowel atresias, volvulus and meconium ileus [1-5]. Meconium ileus is associated with cystic fibrosis in most cases, although extraluminal abdominal calcifications are usually scarce in cases of cystic fibrosis [1, 6]. Postnatal outcome for infants with meconium peritonitis depends on the etiology for bowel rupture and underlying disease.
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PMID:Fetal meconium peritonitis without sequelae. 152 51

Sigmoid volvulus (SV) is uncommon in the United States. Little has been published in the English literature about the high incidence of SV among rural areas of the Bolivian and Peruvian Andes at 13,000 feet above sea level. A review of 230 cases of SV in a Bolivian hospital is presented. SV accounted for 79 percent of all intestinal obstructions. Nonoperative reduction was attempted in all patients except those with peritonitis. Nonoperative reduction alone was performed in 31 percent of the patients, and 69 percent underwent surgical intervention, 66 percent as an emergency and 3 percent electively. Surgical treatment consisted of sigmoidectomy and primary anastomosis (50 percent), Hartmann's procedure (12 percent), and operative detorsion with sigmoid plication (38 percent). Overall mortality was 13.5 percent. Fifty-seven of the surgically treated patients developed significant complications. The etiology of SV is unclear. High altitude, along with other etiologic factors, may play an important role in SV. To our knowledge, this series represents the highest incidence of SV in bowel obstruction.
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PMID:Sigmoid volvulus in the high altitude of the Andes. Review of 230 cases. 158 56


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