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 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of spontaneous rupture of colicartery aneurysms are presented, one involving the left colic artery and the other the right colic artery, and the literature on abdominal apoplexy and visceral arterial aneurysms is reviewed. In view of the potential for life-threatening hemorrhage, it is urged that, whenever feasible, visceral arterial aneurysms be resected prophylactically when discovered by angiography or at celiotomy.
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PMID:Spontaneous rupture of colic-artery aneurysms: report of two cases. 108 64

Four males with ectopic ureteral opening are reported herein. Case 1 was a 17 year old who complained of miction pain and macroscopic hematuria. Cystoscopy and radiological examinations showed left ectopic ureteral opening into the seminal vesicle associated with left renal agenesis. The left ureter and seminal vesicle were extirpated. Case 2 was a 21 year old who complained of lower abdominal pain. On physical examination, a child's head sized mass was palpable in the midline of the lower abdomen. Operation was performed under diagnosis of intrapelvic tumor, but the mass was cystic dilatation of left ureter which opened into the seminal vesicle. Case 3 was a 19 year old who complained of right CVA colic pain. On cystoscopy, the right ureteral orifice was absent. During the operation, right ureter was found to open into the posterior urethra. Case 4 was a 57 year old who complained of fever. Plain X-ray on the pelvic cavity showed a 82 X 10 mm calcified shadow. CT revealed a right ectopic ureteral opening into the posterior urethra with a ureteral stone in it. On cystoscopy, the right ureteral orifice was identified and pus discharge was observed to flow out of it. Operative exploration demonstrated that the right ureter was inverted Y duplication; one opened into the posterior urethra and the other into the trigone. Seventy nine males with ectopic ureteral opening and 3 with inverted Y ureteral duplication from the Japanese literature are reviewed briefly.
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PMID:[Ectopic ureteral opening in four males: including a case of inverted Y ureteral duplication]. 409 Nov 41

The authors present 15 cases of patients with pharyngo-oesophageal foreign bodies, of which 6 occurred in subjects with a normal, healthy oesophagus. In two cases the foreign bodies were eliminated spontaneously, one was extracted by endoscopy, two through cervicotomy and one through thoracotomy. The author stress the fact that dental prostheses are very rarely swallowed, and the deglutition of a live fish is mentioned --. In 7 patients the foreign body became struck in an old post-caustic oesophageal stenosis. In one of these patients the foreign body was extracted by thoracotomy, in 3 cases gastrostomy was performed, in 2 cases colo-oesophagoplasty was necessary and in one case the oeso-colic stenosis was recalibrated. The late results were excellent, excepting one case when the patient died a short time after surgery through a cerebral vascular accident. The therapeutic attitude was differentiated in relation with the condition of the oesophagus, the site of the foreign body and the time of hospitalization.
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PMID:[Surgical management of pharyngo-esophageal foreign bodies subsequent to the failure of endoscopic interventions]. 645 63

Gastrointestinal and liver disorders are often observed in high performance athletes, especially those training for the increasingly popular endurance sports including the marathon and the triathlon. The disorders often start with stress before competition or training, followed by dehydration during the event. Insufficient training is an aggravating factor as are certain environmental factors including hot climate, irregular terrain and high altitude. Athletes may also consume non-steroid anti-inflammatory drugs, for example after a minor bone lesion or joint sprain, in an attempt to maintain their highest level of performance. Gastric signs include epigastric pain known to be caused by ischaemic gastritis resulting from decreased splanchnic flow and increased vasoconstriction in the gastric mucosa. Gastrooesophageal reflux results from modifications in sphincter tone and gastric emptying. Drinking hyperosmolar liquids also plays a role. Abdominal pain, diarrhoea, melena and uncommonly ischaemic colitis are the main signs of colic disorders. Mesenteric ischaemia may occur due to lowered splanchnic blood supply (by as much as 80% in some cases). Mechanical trauma is another mechanism; in marathon runners the "caecal slap syndrome" is a repeated microtrauma of the caecum against a hypertrophied muscular wall. Waterborne infectious agents may also lead to colic lesions. Exertion heat stroke is an emergency situation which can cause multiple organ damage and usually occurs after long intense exercise, often, but not always in a hot environment. Uncompensated thermogenesis and excessive loss of water by perspiration leads to central hyperthermia and ischaemic hepatic necrosis. Fatal liver failure has been observed. More or less severe symptoms of gastrointestinal or hepatic disorders are observed in 30% of high performance athletes and the incidence may reach 40% in those who have trained insufficiently. Such disorders lead to reduced performance in 10% of these athletes.
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PMID:[Hepato-digestive disorders in athletic practice]. 802 25

Between 1981 and 1996, several interventional studies proved the efficacy of periconceptional folic acid supplementation in the prevention of neural tube closure defects (NTCD), first in women at risk (with a previous case of NTCD) and also in women of the general population in age to become pregnant. The poor observance of this supplementation led several countries (USA, Canada, Chile...) to decide mandatory folic acid fortification of cereals, which permitted a 30% (USA) to 46% (Canada) reduction in the incidence of NTCD. Moreover, this benefit was accompanied by a diminished incidence of several other malformations and of stroke and coronary accidents in elderly people. However, several papers drew attention to an increased risk of colorectal and breast cancer in relation with high blood folate levels and the use of folic acid supplements. A controlled interventional study showed a higher rate of recurrence of colic adenomas and a higher percentage of advanced adenomas in subjects receiving 1mg/day of folic acid. A recent study demonstrated an abrupt reversal of the downward trend in colorectal cancer 1 year after the beginning of cereal folic acid fortification in the USA and Canada. Two studies also reported impaired cognitive functions in elder persons with defective vitamin B(12) status. Taken in aggregate, these studies question the wisdom of a nationwide, mandatory, folic acid fortification of cereals. As of today, despite their limited preventive efficacy, a safe approach is to keep our current French recommendations and to increase the awareness of all caregivers, so as to improve the observance of these recommendations.
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PMID:[Folic acid and prevention of neural tube closure defects: the question is not solved yet]. 1856 83

Abdominal apoplexy, or the newer term, idiopathic spontaneous intraperitoneal hemorrhage (ISIH), represents a rare cause of non-traumatic intra-abdominal bleeding. As with any acute blood loss, this problem often presents to the Emergency Department (ED) for initial evaluation and resuscitation. The case of a 52-year-old man with abdominal pain and distention due to spontaneous intraperitoneal hemorrhage is presented. This patient developed impending cardiovascular compromise in the ED and was subsequently diagnosed by computed tomography scan as having an intra-abdominal hematoma. Emergent exploratory laparotomy was performed and the patient was found to have spontaneous bleeding from a branch of the middle colic artery that was ligated without complication. The patient recovered well with no recurrent bleeding. The pathophysiology, diagnostic approach, and treatment of ISIH are reviewed.
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PMID:Abdominal apoplexy: a case report and review. 1868 63

A 58-year-old woman presented with a problem with her peripheral vision. Computed tomography scan showed an occipital hemorrhagic stroke. She subsequently suffered gastrointestinal bleeding and at surgery biopsy of a portion of the middle colic artery aneurysm revealed changes consistent with polyarteritis nodosa.
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PMID:Sherlock Holmes in the ER (the case of red and the head). 1917 Dec 14

An online survey was conducted to determine associations between transport management and transport-related injuries and diseases in horses in Australia. The survey was composed of three sections: respondents' demographic information, transport management strategies or procedures (before, during and after transportation) and transport diseases experienced in the previous two year period. Univariate and multivariate modelling was performed exploring associations between variables (respondents' details and transport management strategies) and the following transport-related diseases as outcomes: traumatic injuries, diarrhoea, heat stroke, muscular problems, laminitis, transport pneumonia and colic. The survey generated 797 responses. Traumatic injuries were the most common transport-related problem, with a reported incidence of 45.0%. Younger respondents (<40 years old) caring for large numbers of horses (>30 in a week) were more likely to report transport-related injuries. Injury risk was also linked to the use of protections and tranquilizers prior to transport, and checking horses after the journey. Diarrhoea (20.0%) and heat stroke (10.5%) were reported more by amateur than professional horse carers. Increased risk of heat stroke was linked to the restriction of hay and water prior to transportation. Muscular problems (13.0%) appeared to be exacerbated when horse health was not assessed before journey; whilst the risk of laminitis (2.9%) was around three fold greater when post transport recovery strategies were not applied. Associations were made between transport pneumonia (9.2%) and duration of journey, and with activity (horses involved in racing at greater risk). No associations were seen between the incidence of colic (10.3%) and the variables examined. Study findings should be interpreted with caution as they represent participant perceptions and recall. Nevertheless, results support many current recommendations for safe transportation of horses. They also highlight the need to further investigate many of identified management factors to refine existing policies and practices in equine transportation.
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PMID:A Survey on Transport Management Practices Associated with Injuries and Health Problems in Horses. 2758 89

A colovesical fistula (CVF) is a pathological connection between the colon and the urinary bladder. Although they are uncommon, consequences can severely affect quality of life and mortality. Diverticula are the most common cause of CVF. This case details a patient's CVF diagnosis in the emergency department with unremitting gastrointestinal and urinary symptoms. A 78-year-old male patient with recent hospitalization for stroke and left carotid endarterectomy complicated by urinary retention treated with a Foley catheter presented to the Emergency Department with a chief complaint of hematuria and unremitting diarrhea. Foley exchange resulted in improved urinary retention and diarrhea during hospitalization. One day following hospital discharge, the patient presented again with a blocked Foley catheter and diarrhea. Foley irrigations resulting in near immediate diarrhea and lack of bladder filling on bladder scan portended to a diagnosis of colovesical fistula despite no history diverticula or colon malignancy. An abdominal/pelvic computed tomography scan and cystogram confirmed a colovesical fistula. This case highlights the need for consideration of colovesical fistula in a seemingly simple ED complaint of urinary retention. It is prudent to closely follow bladder scan volumes when flushing a Foley catheter. Given the significant comorbidities such as urosepsis and health care impact of repeat ED visits and hospitalizations, CVF can and should be entertained and rapidly diagnosed in the emergency department. Our case highlights the need for consideration of a vesico-colic fistula despite the absence of initial relevant risk factors.
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PMID:A unique presentation of Colovesical fistula. 3282 88