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

An 8-year-old sexually intact male llama was euthanatized because of obstruction of the penile portion of the urethra and rupture of the urinary bladder. Clinical signs of obstruction included anorexia, lethargy, teeth grinding, straining to defecate, inability to urinate, and tense abdomen. Laboratory findings included anemia, leukocytosis with left shift, high serum urea nitrogen, creatinine, and phosphorus concentrations, and low serum chloride concentration. Necropsy revealed ruptured urinary bladder and acute fibrinous peritonitis. A firm, gray, nonmineralized urethral plug occluded the penile portion of the urethra for a distance of 14 cm in the midpenile region, distal to the sigmoid flexure of the penis. The urinary bladder mucosa and the urethra had microscopic evidence of chronic inflammation. Escherichia coli, Klebsiella sp, and alpha-streptococci were isolated from the urethral plug.
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PMID:Urethral obstruction in a male llama. 259 47

A stepwise development of the technique for the urine derivation into the artificial rectal urinary bladder was followed up. The cutting of the superior rectal artery and the vein which permitted one to form a rectal urinary bladder at the superampullar portion of the rectum turned to be the basic point of the technique development. A beneficial effect was achieved due to the extra-abdominal location of the rectal stump and the performance of ureterorectal anastomosis that minimized the hazards of urinary peritonitis development; the ligature of the superior rectal artery and vein decreased the resorption of the urine; lower mobilization and cutting of the rectum reduced surgery-related traumatism and enabled the surgeon to preserve the part of the sigmoid colon for its descending into the perineum. Based on the comparative evaluation of three modifications of the aforementioned technique, the authors made a conclusion that the derivation of the urine into an artificial rectal urinary bladder minimized the hazards of urinary peritonitis development and the occurrence of ascending pyelonephritis. X-ray and radionuclide investigations revealed recovery of the anatomical and functional status of the upper urinary tract in 75 per cent of the patients during 3-4 mos. The authors revealed insignificant changes in the values of nitrogen-excretory function of the kidney, glomerular filtration and tubular reabsorption in the immediate postsurgery period. Later on, these values approached those documented before the operation.
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PMID:[Rectocystoplasty in supravesical urinary diversion]. 261 42

A veterinarian dealing with critical and trauma patients must be proficient with techniques for tracheostomy, thoracostomy tube placement for chest drainage, diagnostic peritoneal lavage, and autotransfusion. The utilization of these techniques may be life-saving in the critical patient. A tracheostomy is indicated in any patient with upper airway obstruction that cannot be managed with supplemental oxygen and/or orotracheal intubation. A tracheostomy tube with an inner cannula is preferred. Tracheostomy tubes should be cleaned at 3- to 4-h intervals, and methods should be employed to decrease thick tracheal secretions and to remove them from the trachea. A patient with a tracheostomy tube should be monitored continuously. A thoracostomy tube is indicated in any patient with large and/or continuous accumulation of air, blood, fluid, or chyle in the pleural space. The thoracostomy tube should be at least the same size as the patient's main stem bronchus. The thoracostomy tube is placed aseptically at the seventh intercostal space at the junction of the upper one third and lower two thirds of the lateral chest wall. Fluid or air may be removed from the chest intermittently with a three-way stopcock attached to the thoracostomy tube and a 60-ml syringe. If continuous drainage is needed, a continuous underwater seal and suction system should be used. Diagnostic abdominal paracentesis and peritoneal lavage are useful techniques in the determination of abdominal trauma, hollow viscus rupture, peritonitis, hepatic trauma, and urinary system trauma. When a multiholed catheter and lavage are used, the accuracy of detecting abdominal trauma is 95 per cent. When only needle paracentesis is used, the accuracy drops to 47 per cent. Abdominal lavage fluid can be analyzed for bacteria, whole blood, white blood cells, free bilirubin, creatinine, blood urea nitrogen, amylase, alkaline phosphatase, and alanine aminotransferase. Large volumes of whole blood recovered from abdominal or thoracic paracentesis can be reinfused into the patient if needed, providing it is not contaminated or markedly hemolyzed. The blood should be collected aseptically into blood bottles or bags. If the bleeding is ongoing or the blood only a few hours old, anticoagulants should be used. If the hemorrhage is several hours old, then clotting and defibrination has already occurred and the blood can be collected into "dry" bags or bottles. Before use, abdominal blood should be analyzed for urine, bile or fecal contamination. Blood collected from the thoracic cavity is much less likely to be contaminated. Autotransfused blood is administered through a standard blood administration set.
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PMID:Critical care surgical techniques. 268 82

"Two-route chemotherapy" (TRC) using cis-diamminedichloroplatinum(II) (DDP) and its antidote, sodium thiosulfate (STS), combined with the angiotensin II (AT-II)-induced hypertension method was evaluated for its efficacy against peritoneally disseminated tumors in rats. A bolus i.p. injection of DDP (15 mg/kg) was given 1 min after the initiation of an AT-II (16.5 micrograms/kg) i.v. infusion lasting 11 min. Immediately after the termination of the AT-II infusion, 1,580 mg/kg STS was injected i.v. over a further 5 min. This modified TRC significantly improved the antitumor effect, evaluated by survival (increase in life span, 273%), compared with that achieved with other treatments, as follows: 15 mg/kg DDP i.p. and the concomitant i.v. infusion of 1,580 mg/kg STS (conventional TRC), 153% increase in life span; 5 mg/kg DDP i.p. with or without AT-II i.v. (167% and 107% increases in life span, respectively). As an index of nephrotoxicity, blood urea nitrogen (BUN) levels seen after modified TRC (21.1 mg/dl) were as low as those observed after conventional TRC (19.1 mg/dl), despite the postadministration of STS, and were much lower than those seen after DDP alone or DDP plus AT-II (35.6 and 35.7 mg/dl, respectively). Further evaluation of the effectiveness of modified TRC using various doses of DDP gave similar results. The feasibility of the administration of STS 10 min after DDP treatment was explained by the significant inhibition of DDP delivery to the kidney during the AT-II-induced hypertension. Thus, TRC combined with AT-II has a superior therapeutic effect against peritonitis carcinomatosa induced in rats.
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PMID:"Two-route chemotherapy" using cis-diamminedichloroplatinum(II) and its antidote, sodium thiosulfate, combined with angiotensin II is effective against peritoneally disseminated cancer in rats. 273 7

Changes in osmolarity, blood and urine levels of medium-size molecules (MSM), osmolarity and MSM index, free water clearance (FWC) and alterations in traditional clinical and biochemical parameters typical of acute renal failure (creatinine, urea nitrogen, K+, Na+, diuresis) have been compared in 27 patients with peritonitis complicated in 17 cases by acute renal failure (ARF). In patients with developing ARF disturbances in osmotic condition, osmotic clearance, FWC, MSM level precede an increase in creatinine and urea nitrogen level and diuresis decrease. Dynamic studies of FWC and MSM blood and urine levels allow of early ARF diagnosis in patients with peritonitis. Progressive growth of plasma osmolarity and FWC with a parallel decrease in MSM index below 1 is a criterion indicative of functional renal failure turning into organic one.
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PMID:[Early diagnosis of acute renal insufficiency in patients with peritonitis]. 274 92

The effect of overfeeding on survival from peritoneal infection as well as changes in protein metabolism was evaluated. Rats were randomly divided into two groups and given for 6 days different quantities of a liquid diet containing 18% of the energy supplied as protein and 82% as carbohydrate and lipid via an implanted gastric tube. The control group received 301 +/- 4 kcal/kg/day which was equivalent to their mean voluntary intake and the overfeeding group received 528 +/- 8 kcal/kg/day (P less than 0.001). Following 6 days of enteral feeding, all rats received a jugular vein cannulation and cecal ligation with enterotomies. The overfeeding group showed a significantly (P less than 0.05) higher mortality rate to experimental peritonitis, a 24% lower leucine incorporation into whole body protein (P less than 0.05), and a 28% lower fractional synthetic rate of serum albumin (P less than 0.05). Although overfeeding in the rat increased body weight gain and was associated with significantly (P less than 0.001) greater nitrogen balance before infection, it can be concluded that such diets increase mortality to peritonitis and reduce whole body protein and serum albumin synthesis in response to such infections.
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PMID:Complications associated with the overfeeding of infected animals. 308 Jun 40

This study examined the effects of total parenteral nutrition (TPN) enriched with branched-chain amino acids (BCAAs) on metabolite levels of carbohydrate and protein metabolism in septic rats. Results also were obtained for standard amino acid hyperalimentation (conventional TPN). Septic peritonitis was induced in rats by cecal ligation and puncture. Two different experimental models were tested. In one, the two kinds of TPN were administered to the operated rats during the progress of sepsis (the septic phase). In the other, TPN was started immediately after surgical removal of the focal cecum (the recovery phase). The conventional and BCAA-enriched TPN solutions were isocaloric and isonitrogenous except that the percentage of BCAAs in the total amino acids by weight was 35.8% in BCAA-enriched TPN and 20.9% in conventional TPN. On the fifth postoperative day, TPN was discontinued, the animals were killed, and samples of arterial blood, liver, and rectus abdominis muscle were taken. BCAA-enriched TPN had a significant effect on nitrogen balance and survival rate in the septic phase model, and on muscle adenine nucleotide content in both models. Other metabolites showed similar changes in the two TPN groups. These results indicate that BCAA supplement in TPN improves nitrogen balance and peripheral cellular energy status and is thus clinically beneficial in preventive therapy for increased catabolism.
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PMID:Effect of total parenteral nutrition enriched in branched-chain amino acids on metabolite levels in septic rats. 313 10

Several factors contribute to impaired nutritional status in patients undergoing CAPD. The protein loss into the dialysate varies between 5-15 g per day; during peritonitis protein loss increases by 50-100%. The loss of free amino acids during CAPD is of the same magnitude as under hemodialysis. The observed plasma amino acid abnormalities in CAPD patients probably reflect metabolic derangements in uremia, rather than depletion due to dialysate amino acid loss. Sustained hyperinsulinemia in CAPD patients also may contribute to reduced plasma amino acid concentrations. A further factor contributing to nutritional problems in CAPD is a decreased protein intake. Dietary protein intake should exceed 1.2 g/kg/day during long-term CAPD treatment to maintain nitrogen equilibrium. Total energy intake may exceed 35 kcal/kg/day.
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PMID:Protein and amino acid metabolism in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). 314 Oct 94

Under study were parameters of protein metabolism and state of nitrogen balance in 83 patients with peritonitis, in 29 of them (with diffuse peritonitis) partial parenteral nutrition was performed. It reduced the degree of protein catabolism, facilitated elimination of metabolic disorders. Reinforcement of the ration of the caloric-nitrogen nutrition in order to completely fill up the energetic and plastic expenditures of the organism at the early postoperative period will entail danger of superflous transfusion load.
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PMID:[Status of nitrogen balance and parenteral feeding in peritonitis]. 314 29

We report a case of spontaneous intraperitoneal rupture of the bladder. A 54-year-old woman was admitted to our hospital with the chief complaints of severe lower abdominal pain, dysuria and macroscopic hematuria in October, 1985. In 1969, she had had a radical hysterectomy and postoperative irradiation for cancer of the uterus. Two years later she had undergone additional irradiation. On physical examination, the abdomen was tender with guarding and signs of peritonitis. Laboratory data revealed a blood urea nitrogen of 32.8 mg/dl and all electrolytes were normal. Excretory urogram showed normal upper urinary tract but irregularity of the bladder dome. Cystoscopy revealed acute inflammation of the bladder mucosa. Consequently, we made a presumptive diagnosis of radiation cystitis and she was treated with antibiotics and drip infusion. Within a week her general condition was improved and she had discharged. In June, 1986 she was admitted again with the same chief complaints as at her first admission. Cystoscopic findings showed a hole on the postero-superior wall and retrograde cystogram revealed an intraperitoneal rupture of the bladder. At exploration a necrotic bladder wall was resected and closed in 3 layers. The post operative course was uneventful.
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PMID:[Intraperitoneal spontaneous rupture of the bladder subsequent to irradiation of the uterus: a case report]. 323 25


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