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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although many surgeons still perform the definitive terminal colostomy using the initial technique--pararectal incision, transperitoneal tract, secondarily retouched excess--this procedure complicates uselessly the surgical technique leading frequently to complications. These drawbacks might be avoided by using transrectal extraperitoneal extemporaneously matured colostomy that simplifies the surgical technique and prevents both precocious complications (peritonitis, occlusions, parietal abscess, necessity of a second "retouch" surgery) and also tardy complications (stomal prolapse, parastomal eventration).
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PMID:[The technical details of the definitive terminal colostomy]. 253 35

Diaphragmal injuries are rare but serious. They are caused by traffic accidents, murder or suicide, fall from height, crush or blast injuries. Mechanisms of diaphragmal rupture may be various: sudden intraabdominal pressure increase, transferred strike force from pelvis (like "contra coup"), direct pressure on one or both hemitoracices, injuries piercing or sclopetar. Negative intraabdominal pressure is convenient for prolapse of abdominal organs into pleural cavity. Ruptures were more often of tendinous than muscular part of diaphragm, and they were more often on left side. Diaphragmal injuries can be: open--percutaneous (thoracoabdominal) and closed--subcutaneous. There are three types of thoracoabdominal injuries: thoracoabdominal, abdominothoracal and thoraco-retroperitoneal. Open diaphragm injuries are followed by shock, hemorrhages, cardiopulmonary disfunction, haematothoracic, peritonitis and other lesions. Closed diaphragmal injuries can be manifested clinically or latent. In the first stage of treatment there is a conservative approach (solving the shock) and in the second stage surgical approach. More often thoracotomy is better than laparotomy and the place of incision depends on localisation of injuries and clinical signs. During last 10 years we surgically treated 19 diaphragmal injuries with mortality rate of 15.9% (3). Most frequent causes of injuries were traffic accidents or sclopetar injury, and the predominant compression. Diaphragmal lesions were a part of thoracoabdominal injuries and politraumas with high mortality rate. The frequency of injuries of other abdominal organs was the following: spleen, lungs, liver, stomach, bowel, kidney, bladder, retroperitoneal blood vessels, legs, arms and pelvis. The treatment of diaphragmal injuries requires multidisciplinary, experienced surgery team with well equipped anaesthesiology and reanimation unit.
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PMID:[Injuries of the diaphragm]. 261 72

In 144 pull-through-operations performed for anorectal-atresia, following complications were observed: pneumonia 11%, sepsis 8.3%, peritonitis 5%, bowel obstruction 5%, osteomyelitis 1%, retraction of the pulled-through colon 4%, anal stenosis 16%, secondary megacolon 9%, fistula relapse 8%, mucosal prolapse 4%. Recto-urethral, recto-vesical- and recto-vaginal fistula relapses are managed by interposition of the gracile muscle. Anal stenoses and secondary megacolon are prevented by a sufficiently long postoperative bougienage.
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PMID:[Therapy of postoperative complications following abdominoperineal or abdominosacroperineal pull-through surgery in anal atresia]. 343 Dec 99

A new inherited neuromuscular disease was identified in 4 patients (1 male, 3 females), offspring of consanguineous marriages, belonging to the same kindred. The proband was a 24-year-old female with history of ptosis and ophthalmoplegia since childhood and progressive intestinal pseudo-obstruction for the last 4 years of her life. A sural nerve biopsy showed axonal and demyelinating neuropathy. Muscle biopsies of pectoral and gastrocnemius revealed myopathic alterations with marked variation in muscle fiber size, atrophy of both fiber types and normal mitochondria. An upper gastrointestinal study showed barium in the stomach after 8 h and jejunal diverticula. Tests for absorption of fat, protein, carbohydrate, folic acid and vitamin B12 were normal. Serum levels of vitamin A and lipoproteins were also normal. The patient underwent partial gastrectomy and gastrojejunostomy. Postoperatively, she developed severe pancreatitis, sepsis, peritonitis and expired. Tissue samples from the proband and from her brother, revealed normal mucosa, but degeneration of smooth muscle of the stomach and small intestine. The myenteric plexus and vagus nerves were normal. The biochemical studies of contractile proteins (myosin, actin, tropomyosin) in the fresh and cultured smooth muscle cells of the proband obtained at the time of gastrectomy showed a 50-75% decrease in the synthesis of different contractile proteins. Turnover of contractile proteins and synthesis and turnover of collagen showed normal values. The reduction in synthesis of contractile proteins may account for the weak peristalsis and be a factor in the pathogenesis of the intestinal pseudo-obstruction.
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PMID:Inherited ophthalmoplegia with intestinal pseudo-obstruction. 668 98

We performed the Mikulicz procedure in 46 pediatric patients. Thirty-five were high-risk patients, 20 of whom had necrotizing enterocolitis. High risk was defined by the presence of peritonitis, intestinal perforation, poorly demarcated intestinal gangrene, or severe associated systemic illness. The remaining 11 patients had the procedure performed for technical reasons, most commonly a discrepancy in the size of the proximal distal limb ratio greater than 4:1. The procedure consisted of intestinal resection with double-barreled enterostomy, crushing of the spur between stomas, and subsequent lateral closure of the enterostomy. The mortality rate of 30% was due to the underlying disease and in no instance was death caused by a complication of the procedure. Complications (13%) were stricture or prolapse of the stoma and wound infection. Subsequent enterostomy closure in 32 patients had no mortality rate and a 3% complication rate. Because the risk of fatal anastomotic leak and peritonitis is very low, we prefer the Mikulicz procedure to all other intestinal anastomotic techniques for high-risk pediatric patients.
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PMID:A reappraisal of the Mikulicz enterostomy in infants and children. 705 4

94 maternal deaths and 1546 fetal and neonatal deaths were registered among 28,706 births at the CHU Averroes in Casablanca between 1978-80. 45% of women who deliver at the clinic are very poor and only 10% are relatively well off. Obstetrical antecedents were noted in 27% of the fetal deaths. 70% of the maternal deaths occurred in women aged 20-34. 32 maternal deaths occurred among 16,232 women with 1-2 children, 30 among 6514 women with 3-5 children, and 32 among 5960 women with 6-14 children. 11,027 of the 28,706 were primaparas. Perinatal mortality was 4.46% among primaparas, 8.24% among grand multiparas, and 4.1% among secondiparas. In 58 of the 94 cases of maternal mortality the woman was hospitalized after attempting delivery at home or in a village clinic. Among women with 1 or 2 children, hemorrhage was the cause of death in 8 cases, infection in 7 cases, eclampsia in 3 cases, thromboembolism in 2 cases, uterine inversion in 2 cases, pulmonary tuberculosis in 1 case, embolism in 5 cases, and other causes 1 case each. Among women with 3-5 children hemorrhage was the cause of death in 10 cases, septicemia in 3 cases, uterine rupture in 3 cases, eclampsia in 3 cases, uterine inversion in 2 cases, viral hepatitis in 2 cases, emboli in 2 cases, and other reasons 1 case each. Among grand multiparas hemorrhage was the cause of death in 11 cases, uterine rupture in 12 cases, peritonitis in 2 cases, eclampsia in 2 cases, emboli in 2 cases, and other causes 1 case each. 19 of the maternal deaths were judged to have been avoidable with better management. Prematurity and birth weight of 1000-2500 g associated or not with other pathology were found in 714 of 1546 perinatal deaths. Of 390 cases of death in utero with retention and maceration, 68 were caused by reno-vascular syndromes, 76 by maternal infections, 33 by maternal syphilis, 26 by fetal malformation, 18 by maternal diabetes, 10 by Rh incompatability, and 159 by indeterminate causes. In 795 cases of intrapartum mortality without maceration, 114 were caused by retroplacental hematomas, 61 by placenta previa, 74 by uterine rupture, 119 by prolapse of the cord, 51 by fetal malformation, 45 by dystochia, 53 by twin pregnancies, 104 by fetal distress, 44 by obstetrical trauma, 55 by prematurity, and 75 by undetermined causes. In 361 cases of early neonatal mortality, 88 were caused by renovascular syndromes, 24 by diabetes, 13 by Rh incompatibility, 34 by placenta previa, 94 by prematurity, 28 by fetal malformation, 35 by fetal infections, 31 by fetal distress, and 14 by obstetrical trauma. The rates of maternal and perinatal mortality are very high compared to those of European countries.
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PMID:[Maternal mortality and perinatal mortality]. 720 85

In recent 11 years, 5 cases of severe high voltage electrical burn with intestinal perforations were successfully treated. They showed obvious whole layer necrosis of abdominal wall, exudation, intestinal prolapse and peritonitis. On the basis of antishock therapy and protection of renal function, acute laparotomy was done early. Resection of the small intestine with necrosis and perforation and end-to-end anastomosis were done in 4 cases (5 regions). Colon resection and colostomy were done in 2 cases, and immediate end-to-end anastomosis in 2 cases. Bowel segment with external fistulae was left in 1 case (2 regions). If the abdominal wall defect could not be sutured directly, skin grafting on the residual tissue and omentum may be temporarily effective. And myocutaneous pedicle flap should be repaired secondarily. After operation, parenteral nutrition and anti-infection are important for patient recovery. No complication occurred in this group.
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PMID:[Intestinal perforation caused by severe electrical burn: report of 5 cases]. 803 90

In order to identify possible underlying ganglion-cell disorders, specimens have been taken in neonates and infants with intestinal obstruction treated between January 1988 and June 1992. NID was confirmed in 3 patients with intestinal malformation, 2 patients with neonatal intestinal obstruction, 3 patients with meconium peritonitis, 1 patient with persistent constipation after Duhamel's pull-through for Hirschsprung's disease and 1 patient with rectal stricture after conservative treatment for necrotising enterocolitis. Additionally, NID was found in 1 patient with recurrent prolapse of an ileostomy. Associated Hirschsprung's disease has been ruled out by additional rectal suction biopsies in patients where specimens have been collected at laparotomy first. Development of NID in previous normal bowel, the association of NID with intestinal malformations as well as the clinical heterogeneity of patients with NID of the present series suggest that NID is a reaction of the neural intestinal system caused by congenital obstructive factors or inflammatory diseases.
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PMID:Is neuronal intestinal dysplasia (NID) a primary disease or a secondary phenomenon? 821 74

During the period 1982-91, 52 patients were treated for rectal prolapse. We present the results for 25 treated with Delorme's operation and 14 with rectopexy, all of whom were observed for more than 12 months after operation. Four patients who had internal prolapse were treated with rectopexy. Eight (15%) of 52 patients had postoperative complications, including six in the Delorme group and two in the rectopexy group. A 75 year-old woman operated with rectopexy died from peritonitis. Eight patients (32%) developed recurrent prolapse after Delorme's operation. Five of these were successfully reoperated. No patients in the rectopexy group had a recurrent prolapse. Incontinence and bleeding were reduced in both groups. Despite a relatively high rate of recurrence, we consider Delorme's operation to be a good alternative, also for old debilitated patients, and to involve a minimal risk of serious complications. If recurrence occurs, reoperation can be carried out with good results.
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PMID:[Rectal prolapse. Experiences with rectopexy and Delorme's operation]. 826 91

In the years 1972-1995 41 patients suffering from prolapse of the rectum were operated according to the Moore method. The method is based on the observations which suggest that the cause of prolapse is intestinal intussusception which can be prevented by translocating the anus under the pubic joint. The observation time is from 1 to 23 years. Two patients were reoperated; one-as a result of a recurrence of rectal prolapse and one due to a post-operative adhesive ileus. One patient died as result of peritonitis following an overlooked microperforation in the rectal wall. In the case of the remaining patients, the treatment was fully successful. Regular defecation cycle as well as incontination of stool and flatus returned and the anal sphincters almost fully regained their tension in comparison to the pre-operative state. Early and distant results of surgery of prolapse of the rectum are satisfactory.
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PMID:Surgical treatment of prolapse of the rectum--evaluation of distant results. 902 May 65


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