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Query: UMLS:C0042961 (
volvulus
)
4,305
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Gastrointestinal disease in middle Africa is changing. The traditional patterns were high frequencies of parasitic and infectious diseases and sigmoid
volvulus
, and low incidences of colonic polyps, carcinoma of the colon,
appendicitis
, diverticulosis, ulcerative colitis and Crohn's disease. The current disease patterns are compared with those for gastrointestinal disease in developed countries and etiological factors are discussed.
...
PMID:Epidemiology of chronic intestinal disease in middle Africa. 44 97
Eighty-eight patients with perforations of the gastrointestinal tract in infancy and childhood, excluding those caused by
appendicitis
, are presented. Fifty-five patients were four weeks of age or younger. Fourteen of the perforations occurred during the first year of life and 19 occurred between one and 15 years of age. The locations of perforations by order of frequency were the ileum, rectosigmoid, stomach and duodenum. The causes in order of frequency were necrotizing enterocolitis, ulcers, unknown causes, Hirschsprung's disease, atresia of the small intestine,
volvulus
, trauma, gastroschisis and ventriculoperitoneal shunts for hydrocephalus. A high index of suspicion, aided by roentgenograms, is essential for an early diagnosis. The over-all mortality was 49 of 88 patients. No reduction in mortality was observed in the last ten years, despite improved surgical techniques and better antimicrobial agents. Early recognition and rapid transport of the child to a pediatric intensive care unit with better supportive measures plus antimicrobial agents effective against both anaerobic and aerobis bacteria should reduce this high mortality.
...
PMID:Perforation of the gastrointestinal tract in infancy and childhood. 65 71
Between 1966 und 1975 42 children and 46 adults were operated on Meckel's diverticulum. The diverticulum is explained as one of the possible disturbances during regression of ductus omphaloentericus. The
appendicitis
-like symptomatology correlates to the involvement of gastric and colonic mucosa as well as heterotopic exo- and endocrine tissue of the pancreas in the wall of the diverticulum. In 34% complications were due to inflammation, perforation, bleeding, intussusception,
volvulus
, gut-strangulation with ileus, ulcer, neoplasia or lesion by foreign bodies. 4 out of 88 patients died. Preoperative diagnostic fails in 75%, therefore in every case the distal gut should be inspected and every diverticulum should be resected.
...
PMID:[Clinical importance of Meckel's diverticulum]. 108 17
Fifty-one children under the age of 10 years admitted to a general hospital in Trinidad had a confirmed diagnosis of malrotation of the intestines. This was the primary diagnosis in 20 cases. Analysis of the records of these 20 revealed that one-half were less than 1 month of age at first presentation. Vomiting was a universal complaint, and nearly two-thirds were malnourished. Disturbed bowel habit, anorexia and abdominal pain were also reported. In 30% (six of 20) there were signs of dehydration; an equal number had features of intestinal obstruction. Radiological investigation provided the diagnosis in all but one child, who underwent surgical exploration with a provisional diagnosis of
appendicitis
. Although a
volvulus
was found in 35% of cases, no resections were necessary. A high rate of morbidity and a mortality rate of 15% highlight the problems involved in the surgical care of young infants.
...
PMID:Intestinal malrotation in Trinidad. 140 41
During the last decade neonatal surgical results have improved considerably. Except for infants born with serious congenital heart disease, diaphragmatic hernia or exomphalos, postoperative mortality rates for infants with single anomalies have fallen to the region of 10%. This dramatic success story has been marred by a corresponding increase in the number of individuals with several anomalies entering late childhood with severe chronic handicaps. During the remainder of this century much effort will be expended in devising programmes of investigation which will attempt to predict which individuals will have a poor long-term prognosis. Such programmes will necessitate very close liaison between obstetricians, radiologists, neonatologists, local paediatricians, paediatric surgeons, general practitioners and parents. Very urgent surgery is necessary for the best results in infants with gastroschisis, intestinal
volvulus
and irreducible inguinal hernia, but for most other conditions there have been recent trends away from very urgent surgery to operation during daylight hours within the ensuing 24 h. Surgery within a few hours of presentation is necessary for intussusception and for early acute appendicitis, but perforated
appendicitis
should be treated by aggressive fluid replacement and intravenous antibiotics and surgery should be contemplated only in the rare cases of continued deterioration.
...
PMID:Paediatric emergencies. 176 28
Meckel's diverticulum occurs in 2% of the population and may present at any age. Its management, when found incidentally at laparotomy, remains controversial, particularly in the pediatric population. From 1970 to 1989, a Meckel's diverticulum was discovered in 164 children at laparotomy. There were 120 boys and 44 girls with a mean age of 5.2 years (range, 0 to 18 years). Forty-seven cases were asymptomatic, representing an incidental finding at laparotomy, 25 were resected, and ectopic gastric mucosa was present in 7 specimens (28%). Three postoperative deaths (6%) that were not related to the resection and 2 complications (4%) (postoperative leak and wound infection) occurred in this group. Of the 117 symptomatic patients, 49 (42%) presented with bowel obstruction, 45 (38%) had rectal bleeding, 16 (14%) had diverticulitis, and 7 (6%) had umbilical pathology.
Volvulus
(20) and intussusception (19) were the most common causes of obstruction. Predisposing factors for bowel obstruction were fibrous bands to umbilicus or mesentery (37%) and ectopic mucosa (35%). Severe painless rectal bleeding occurred in 45 patients, 30 of whom (67%) required blood transfusion. A nuclear medicine Meckel scan was positive in 32 of 37 patients (85%). Contrast studies were not diagnostic; colonoscopy and gastroscopy ruled out other causes of bleeding. Patients with diverticulitis (16) presented with acute abdominal pain compatible with
appendicitis
. In the symptomatic group, ectopic mucosa was present in 61% of the resected specimens. Gastric (88%), pancreatic (7%), and gastric with pancreatic (3%) were the most common ectopic tissue. Postoperative morbidity and mortality for symptomatic patients was 8.5% and 0%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Meckel's diverticulum in children: a 20-year review. 181 59
The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of
volvulus
of the small intestine, a stress ulcer, gangrenous
appendicitis
, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Acute abdomen as a postoperative complication]. 182 40
Acute abdominal pain in the patient receiving oral anticoagulants poses a difficult diagnostic and therapeutic challenge. We describe two cases of peritonitis requiring laparotomy in anticoagulated patients, and review 49 similar case reports from the world literature. These patients were usually explored for signs of bowel obstruction. At operation, the intestine often appeared infarcted, but pathologic examination commonly revealed intramural hematomata. In contrast, we present microscopic evidence of hemorrhagic cecal infarction complicating oral anticoagulation therapy in one patient. Intramural intestinal hemorrhage is the most common cause of acute abdominal pain in the anticoagulated patient who undergoes laparotomy. In addition to intramural hemorrhage, 14 per cent of patients had coexistent
volvulus
,
appendicitis
, intestinal wall disruption or intestinal infarction. We conclude that anticoagulated patients with suspected intramural intestinal hemorrhage may have severe intraabdominal pathology requiring operation. Therefore, operation is mandatory for patients who fail to improve after a short course of expectant management.
...
PMID:Management of the acute abdomen complicating oral anticoagulation therapy. 222 4
The authors describe the case-history of a
volvulus
of the appendix which developed as a result of an inborn defect in the appendiceal mesenteriolume. The surgical finding did not suggest primary
appendicitis
but rather strangulation of the aboral part of the appendix.
...
PMID:[Volvulus of the appendix]. 260 71
Recurrent abdominal pain in childhood can be caused structurally, functionally, metabolically or psychosomatically. In the neonatal period there occur malformations, in infancy chronic inflammations of bowel as well as obstructions due to adhesions following laparotomies or chronic intussusceptions or
volvulus
. In pre-school and school-age symptoms of
appendicitis
, lymphadenitis, Crohn's disease or Colitis ulcerosa occur. But every 8th to 9th child of school-age suffers from functional abdominal pain without structural origin, probably caused by an "irritable colon".
...
PMID:[Chronic abdominal pain in childhood]. 375 Oct 69
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