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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The influence of several diseases and conditions upon the prevalence of pulmonary embolism in autopsies performed over the July 1, 1964 to June 30, 1974 period at the University of Michigan Medical Center (Ann Arbor, Michigan) were analyzed. The prevalence of pulmonary was 12.3% in the 4600 necropsies in this sample. Patients with pulmonary fat emboli or tumor emboli and patients thought to have thrombosis of the pulmonary artery were not designated as having pulmonary thromboembolism. The patients were categorized with regard to heart disease on the basis of both clinical and necropsy findings. The major factors contributing to an increase in risk of development of pulmonary embolism include heart disease, certain types of cancer, obesity, acute paraplegia and accidental and operative trauma. Other risk factors which could not be assessed in this study include a prior history of venous thromboembolism, pregnancy and the puerperium, use of oral contraceptives, ulcerative colitis and Crohn's disease. Age plays a major role in the prevalence of pulmonary embolism. A portion of the effect of age is related to the age distribution of other diseases contributing to an increased risk, yet advanced age alone may have an independent influence. The risk factors defined should be used in a selective program designed to increase the rate of detection of deep venous thrombosis before pulmonary embolism occurs. Alternatively, patients at increased risk should be treated with prophylactic low dosage heparin during hospitalization.
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PMID:Risk factors in pulmonary embolism. 95 58

A group of 212 patients operated upon for Crohn's disease were studied and the early postoperative complications with related problems were assessed. The morbidity was 28.3 per cent, 60 patients had at least one complication, mainly of septic nature. The mortality was 3.3 per cent (7 patients), sepsis and deep vein thrombosis with pulmonary embolism were the most common causes of death. Postoperative complications were significantly higher (39.7%) (p less than 0.001) in patients with a pre-operative nutritional deficit and in those who had urgent surgery (44.4%) (p less than 0.001). Among patients with pre-operative sepsis, the morbidity was also higher (34.6%), but was not significant. Peri-anastomotic complications (dehiscence, abscess, fistula, bleeding) were apparently more frequent (45.4%) in patients with histological residual Crohn's disease at macroscopically free resection margins although this contrasts with previous series. A proper pre-operative diagnostic approach, adequate peri-operative protein-caloric repletion, antibiotic therapy, prevention of thromboembolism and elective surgery, are still the primary tools in reducing the morbidity and mortality after surgery for Crohn's disease.
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PMID:Early complications after surgery for Crohn's disease. 221 4

Pulmonary embolism in childhood is a rare but under-diagnosed condition. We report four children aged 5 to 13 years presenting with pulmonary emboli, their primary diagnoses being craniopharyngioma, asthma, Crohn's Disease and Reye's syndrome. The diagnosis was supported by technetium micro aggregate lung perfusion scans in three of the children and in the fourth, the only child to die, by autopsy. Three of the children had markedly elevated plasma osmolalities, one as a result of his diabetes insipidus and two following hyperosmolar treatment for cerebral oedema. The child who died was found to have a femoral vein thrombosis but the sites of origin of emboli in the other children were not defined.
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PMID:Pulmonary thromboembolism in children. 379 57

Low anterior resection for carcinoma in the mid- and lower third of the rectum has been performed with autosuture technique, using the EEA autosuture stapling instrument in 38 patients, 26 with carcinoma, 10 with diverticulitis, and 2 with Crohn's disease. In 16 patients the anastomotic line was 4-6 cm above the anal verge, and in 22 patients 7-12 cm above the anal verge. Thirty-two patients (80%) had an uneventful postoperative course. Four patients had complications: one, with leakage from a very low-seated anastomosis, was treated with an abdominoperineal resection; 2 had temporary transversostomy performed due to minor anastomotic leakage; and 1 patient developed a fistula, which closed spontaneously. Two patients died, 1 from pulmonary embolism, 1 from cerebral thrombosis. The EEA stapling instrument seems safe, and approximately 42% of the patients in this material would formerly have been subjected to abdominoperineal resection and permanent colostomy.
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PMID:Sphincter-saving resection of the rectum using the EEA autostapler. 675 32

In a series of 161 patients treated surgically for Crohn's disease, 7 patients were seen with a psoas abscess as a complication of the bowel disease. Drainage only was not sufficient to check the rapid downhill course in these patients. Resection of the underlying bowel disease was performed in all patients. There was one death from pulmonary embolism and 3 patients required drainage on more than one occasion.
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PMID:Psoas abscess in Crohn's disease. 712 38

We traced 1,000 patients with Crohn's disease hospitalized at Lenox Hill Hospital in New York City during 1972-1987 to identify those who died, the events preceding death, and their relationship to Crohn's disease. We considered any management early in the disease that might have influenced outcome. We introduce the term "virulent" Crohn's disease to describe those patients with most or all of the following: young age at onset, multiple surgical procedures, short bowel/malabsorption, chronic steroid therapy, narcotic addiction, and sepsis. Twenty-five patients (2.6%) had died. Major events preceding 18 deaths related to Crohn's disease were virulent Crohn's disease (six), gastrointestinal neoplasms (six), complications in the elderly (five), and complications of drug therapy (one). Those seven deaths probably unrelated to Crohn's disease were attributed to extraintestinal neoplasms (four) and myocardial infarction (three). Death was related to Crohn's disease or its treatment in 72% and perhaps in all. Ten of the 25 died at age 46 or younger (mean 36 years, range 25-46 years). Twenty-two (88%) who died had undergone surgery for Crohn's disease (mean 3.3 procedures) including eight who died postoperatively (six elderly), attributable to sepsis in seven and pulmonary embolism in one. The events preceding death suggest that early aggressive nonoperative therapy for severe Crohn's disease warrants a careful controlled evaluation.
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PMID:Death from Crohn's disease. Lessons from a personal experience. 788 72

Thromboembolic complications during the course of inflammatory bowel disease are infrequent but are mainly found in young patients and are associated with a high morbimortality. The etiopathogenesis of these complications has been widely debated and the existence of coagulation alterations and fibrinolysis have been suggested. Nonetheless, the mechanism must be complex since not only do not all the patients with these alterations present this complication but neither do all the patients with thromboembolism have recognized coagulation disorders. The most common clinical presentation is deep vein thrombosis with pulmonary embolism with arterial thrombosis being rare. Five patients with Crohn's disease and two with ulcerative colitis who presented a total of new thromboembolic episodes, six arterial (1 in primitive iliac artery, 1 in common femoral artery, 1 in humeral-axillary artery, 2 in internal carotid and 1 in superior mesenteric artery) and three of venous localization (1 in brachyocephalic-subclavian trunk, 1 axillary and 1 iliac-femoral/pulmonary thromboembolism) are reported. An updated review of the etiopathogenesis, presentation, treatment and prophylaxis of the thromboembolic complications of inflammatory bowel disease is presented.
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PMID:[Thromboembolic complications in inflammatory bowel disease]. 928 Jun 11

Azathioprine is a drug commonly used for the treatment of inflammatory bowel disease, organ transplantation and various autoimmune diseases. Hepatotoxicity is a rare, but important complication of this drug. The cases reported to date can be grouped into three syndromes: hypersensitivity; idiosyncratic cholestatic reaction; and presumed endothelial cell injury with resultant raised portal pressures, venoocclusive disease or peliosis hepatis. The components of azathioprine, 6-mercaptopurine and the imidazole group, may play different roles in the pathogenesis of hepatotoxicity. The strong association with male sex, and perhaps with human leukocyte antigen type, suggests a genetic predisposition of unknown type. Many of the symptoms of hepatotoxicity, such as nausea, abdominal pain and diarrhea, can be nonspecific and can be confused with a flare-up of inflammatory bowel disease. As well, the subtype resulting in portal hypertension can occur without biochemical abnormalities. A 63-year-old man with Crohn's disease who is presented developed the rare idiosyncratic form of azathioprine hepatotoxicity, but also had a severe disabling steroid myopathy, peripheral neuropathy, resultant deep venous thrombosis and pulmonary embolism related to immobility, and a nosocomial pneumonia. His jaundice and liver enzyme levels improved markedly on withdrawal of the drug, returning to almost normal in five weeks. Treating inflammatory bowel disease effectively while trying to limit iatrogenic disease is a continuous struggle. Understanding the risks of treatment is the first important step. There must be a low threshold for obtaining liver function tests, especially in men, and alertness to the need to discontinue the drug or perform a liver biopsy should patients on azathioprine develop liver biochemical abnormalities, unexplained hepatomegaly or signs of portal hypertension.
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PMID:Cholestatic hepatocellular injury with azathioprine: a case report and review of the mechanisms of hepatotoxicity. 981 67

Elevated levels of anti-cardiolipin antibodies are associated with an increased risk for venous and arterial thrombosis. In patients with inflammatory bowel disease thrombosis is a well known complication. We determined the prevalence of elevated anti-cardiolipin antibodies in 136 patients with inflammatory bowel disease compared with 136 healthy controls and analyzed thromboembolic complications in patients with increased anti-cardiolipin antibody levels. Anti-cardiolipin antibody titers were significantly elevated in patients with Crohn's disease (5.7 units/ml) and ulcerative colitis (5.3 units/ml) compared to the control group (2.5 units/ml). We found no correlation between disease activity and anti-cardiolipin antibody levels. Seven patients had deep venous thrombosis in their history, in three of them this was complicated by pulmonary embolism. In only two of the seven patients with deep venous thrombosis were anti-cardiolipin antibody levels increased. In conclusion, anti-cardiolipin antibody titers were significantly increased in patients with inflammatory bowel disease. Elevated anti-cardiolipin antibody levels appear to play no role in the pathogenesis of thromboembolic events in patients with inflammatory bowel disease.
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PMID:Anti-cardiolipin antibodies in patients with inflammatory bowel disease. 1021 48

Intermittent fever has a wide variety of causes such as infectious, cancers, or inflammatory disease. Intermittent fever is sometimes a diagnostic challenge when fever appears as the first and isolated sign of the disease. Adult onset Still disease and juvenile chronic arthritis are mainly the most common cause of intermittent inflammatory fever. Some frequent diseases gives intermittent fever in few cases like ankylosing spondylitis, pulmonary embolism, sarcoidosis or Crohn's disease. Some rare inflammatory disease gives typical intermittent fever like genetic periodic fever. Other rare diseases give sometimes intermittent fever like vasculitis, polychondritis, Castleman disease, etc. Drug fever and factitious fever are other classical causes of intermittent fever. Diagnosis of inflammatory intermittent fever is frequently based on the clinical course but some biological tests and computerized tomographic scans are worthwhile tools. Follow-up of undiagnosed cases is needed.
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PMID:[Symptomatic intermittent fever of inflammatory diseases]. 1191 60


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