Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042961 (volvulus)
4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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".
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PMID:[Chronic abdominal pain in childhood]. 375 Oct 69

The concomitant occurrence of Crohn's disease and small bowel volvulus is rare because of the serosal inflammation in the former disease causes adherence of the bowel to adjacent structures. A 61-year old female patient with ileocolitis developed 30 cm. of recurrent Crohn's disease in the ileum proximal to a previous ileosigmoidostomy. Following several episodes of small bowel obstruction she was found to have a small bowel volvulus which progressed to infarction. The possibility of volvulus should be considered in the differential diagnosis of a patient with granulomatous disease because of the danger of gangrene, perforation and peritonitis. Surgery should not be delayed in Crohn's disease if complete obstruction persists more than 24 hours, particularly if ischemia of the bowel cannot be ruled out.
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PMID:Small bowel volvulus in association with recurrent Crohn's disease. 745 57

In order to examine the presentation and course of Crohn's disease (CD) versus those of ulcerative colitis (UC) in children < or = 10 years of age, a retrospective review of children < or = 10 years old with inflammatory bowel disease singled out 40 patients and compared their findings with those of 38 children with UC. The mean age at onset was 7.5 years for CD, as compared with 5.9 years for UC. A family history of inflammatory bowel disease was present in 13 patients (32%). Abdominal pain (97%), diarrhea (78%), and weight loss (88%) were the major initial complaints, with growth retardation present in 12 (30%) children. At onset, four children had diffuse small-bowel disease, nine had terminal ileal disease, 15 had ileocolitis, and 12 had colitis; at the end of the study two had diffuse small-bowel disease, four had terminal ileal disease, 25 had ileocolitis, and seven had colitis. Extra-intestinal manifestations increased with duration of disease. Although the number of recurrences did not differ greatly between groups, those with ileocolitis and colitis needed longer steroid therapy and more days in hospital than did those with only small-bowel disease. Operation was required in 42.5% of children with CD, as compared with 5% of those with UC, with six CD children (35%) requiring later reoperation for recurrent disease or fistula and abscess. Two children died from causes unrelated to their disease (gastric volvulus, carcinoma of the breast).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Crohn's disease in children 10 years old and younger: comparison with ulcerative colitis. 857 7

Conditions which resulted in colonic preservation such as strangulated hernia, intestinal volvulus, and mesenteric infarction were once the main reasons for a major intestinal resection leading to the short bowel syndrome. Now Crohn's disease is the most common underlying diagnosis; such patients often have a jejunostomy. A measurement of the residual jejunal length from the duodenojejunal flexure makes possible predictions of patient outcome. Patients with a jejunostomy and less than 100 cm jejunum usually need long-term parenteral support, whereas 50 cm or more of jejunum usually suffices for adequate oral nutrition if the colon is preserved. While patients with and without a colon have problems with nutrient absorption, those with a jejunostomy also have problems of water, sodium and magnesium losses. Stomal losses may exceed oral intake and all such patients ('secretors') need parenteral supplements. Fluid and sodium losses can be reduced by octreotide, omeprazole or H2 blockers but not sufficiently to avoid the need for intravenous supplements. Colonic preservation increases the incidence of calcium oxalate renal stones (20%). Patients with and without a colon have a high prevalence of gallstones (40%). Clinically important intestinal adaptation occurs in those with a colon but not in those with a jejunostomy. Many surgical techniques, including small bowel transplantation, have been suggested to improve absorption, but as the quality of life of most patients with a short bowel is good with current treatments, they are not at present recommended.
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PMID:The short bowel syndrome: what's new and old? 844 53

Nausea and vomiting are common problems of pregnancy. Three pregnant women, 27, 25 and 28 years of age, presented with vomiting in the third trimester. The causes appeared to be maternal small bowel volvulus, which was derotated after primary caesarean section, an ileocecal abscess, which was the first manifestation of Crohn's disease, and acute pyelonephritis, treated with cefuroxim. The second and third babies were born spontaneously; no maternal or foetal mortality occurred. Persistent vomiting after the first trimester of pregnancy should be considered an alarm symptom which always requires further investigation.
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PMID:[Vomiting after the first trimester of pregnancy: an alarming symptom]. 964 5

A staging classification is proposed by CT findings in 27 patients with acute abdomen, caused by inflammatory colonic non-parasitic pathology. Of the 17 patients with diverticular disease, 4 were stage A (edema/ischemia on thickness of the abdominal wall), 2 were stage B (partial intramural infarction on the abdominal wall) and 3 were stage C (abscess/peritonitis and obstruction/vascular strangulation). None of the patients in the series were stage D (ischemia/infarction of the colonic wall with dilatation). Of the 4 patients with ulcerative colitis, 3 were stage A and 1 in stage C. Of the 3 patients with Crohn's disease, 2 were stage A and 1 was in stage C. Classified as stage D were 1 pseudomembranous colitis, 1 volvulus and 1 idiopathic megacolon. Clinical severity was in parallel with CT stages that gave better information on the progression of the pathology. Staging by CT in acute abdomen caused by inflammatory colonic non-parasitic pathology could be useful in therapeutics.
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PMID:Acute abdomen caused by inflammatory colonic non-parasitic pathology: staging by CT. 1042 Oct 16

The clinical presentation, management and outcome of patients with small intestinal and large bowel obstruction unrelated to adhesive or primary colonic neoplastic disease is not well described. The aim of this study was to determine the clinical presentation, evaluation, operative management, and outcome in patients with secondary causes of intestinal obstruction. The medical records of 200 patients who underwent an operation for intestinal obstruction from January 1995 through December 1997 were reviewed. Seventy-three patients (37%) had secondary causes of intestinal obstruction, and these records were reviewed in detail. The cohort included 37 men and 36 women with a mean age of 52 +/- 2 years. The etiology of intestinal obstruction was metastatic neoplastic obstruction (19%), colonic volvulus (18%), Crohn's disease (14%), herniae (11%), diverticular disease (7%), and miscellaneous causes (31%). Six patients (8%) had intestinal motor disorders and a misdiagnosis of intestinal obstruction. The clinical presentation of patients with secondary causes of obstruction was similar to typical patients with adhesive small bowel obstruction. Preoperative evaluation included frequent use of CT (42%), but intestinal contrast studies were used in 13 (18%) patients only. Two-thirds of the patients required an intestinal resection, and 50 per cent of the patients with a misdiagnosis had a nontherapeutic celiotomy. Operative mortality and morbidity were 3 per cent and 48 per cent, respectively, and 15 per cent of patients required reoperation. Suspected intestinal obstruction from secondary causes requires rigorous preoperative evaluation with liberal use of intestinal contrast examinations to avoid misdiagnosis, operative complications, and reoperations.
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PMID:Secondary causes of intestinal obstruction: rigorous preoperative evaluation is required. 1091 78

Intestinal failure requiring total parenteral nutrition (TPN) is associated with significant morbidity and mortality. Intestinal transplantation can be a lifesaving option for patients with intestinal failure who develop serious TPN-related complications. The aim of this study was to evaluate survival, surgical technique, and patient care in patients treated with intestinal transplantation. We reviewed data collected from 95 consecutive intestinal transplants performed between December 1994 and November 2000 at the University of Miami. Fifty-four of the patients undergoing intestinal transplantation were children and 41 were adults. The series includes 49 male and 46 female patients. The causes of intestinal failure included mesenteric venous thrombosis (n = 12), necrotizing enterocolitis (n = 11), gastroschisis (n = 11), midgut volvulus (n = 9), desmoid tumor (n = 8), intestinal atresia (n = 6), trauma (n = 5), Hirschsprung's disease (n = 5), Crohn's disease (n = 5), intestinal pseudoobstruction (n = 4), and others (n = 19). The procedures performed included 27 isolated intestine transplants, 28 combined liver and intestine transplants, and 40 multivisceral transplants. Since 1998, we have been using daclizumab (Zenepax) for induction of immunosuppression and zoom videoendoscopy for graft surveillance. We began to use intense cytomegalovirus prophylaxis and systemic drainage of the portal vein. The 1-year patient survival rates for isolated intestinal, liver and intestinal, and multivisceral transplantations were 75%, 40%, and 48%, respectively. Since 1998, the 1-year patient and graft survival rates for isolated intestinal transplants have been 84% and 72%, respectively. The causes of death were as follows: sepsis after rejection (n = 14), respiratory failure (n = 8), sepsis (n = 6), multiple organ failure (n = 4), arterial graft infection (n = 3), aspergillosis (n = 2), post-transplantation lymphoproliferative disease (n = 2), intracranial hemorrhage (n = 2), and fungemia, chronic rejection, graft vs. host disease, necrotizing enterocolitis, pancreatitis, pulmonary embolism, and viral encephalitis (n = 1 case of each). Intestinal transplantation can be a lifesaving alternative for patients with intestinal failure. The prognosis after intestinal transplantation is better when it is performed before the onset of liver failure. Rejection monitoring with zoom videoendoscopy and new immunosuppressive therapy with sirolimus, daclizumab, and campath-1H have contributed to the improvement in patient survival.
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PMID:Ninety-five cases of intestinal transplantation at the University of Miami. 1199 9

Intestinal failure and its most important cause, short-bowel syndrome (SBS), are rare clinical entities leading to a vast complex of symptoms and complications with significant morbidity and mortality. Both conditions occur as the result of a massive reduction in enteral nutrient absorptive capacity. Disease manifestation is based on aetiological and anatomical characteristics such as remaining intestinal length and the presence of a functionally intact colon. Congenital and perinatal conditions, for example, intestinal atresia, necrotizing enterocolitis (NEC) and intestinal volvulus are the most important causes in children. The aetiology in adults is based on diseases inducing loss of intestinal function or loss of intestinal surface area after extensive surgical resections. The most frequent causes are mesenteric infarction, radiation enteritis and Crohn's disease. Knowledge of the epidemiology of intestinal failure and SBS is limited, being mainly based on the extrapolated figures of home parenteral nutrition centres and single-centre studies. At present, the incidence of SBS is estimated to be 2-5 per million.
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PMID:Classification, epidemiology and aetiology. 1464 55

Aim of the study is to analyse physiopathological implications of massive intestinal resection and factors affecting prognosis in patients with short bowel syndrome. Twenty massive intestinal resections were performed. The causes of bowel resection were: intestinal infarction (11 cases), Crohn's disease (5 cases), small bowel volvulus (4 cases). All intestinal resections were more than 50-60% of the intestinal length. In eighteen patients intestinal anastomosis was performed immediately. In all the patients postoperative therapy with parenteral nutrition (PN) was performed. The operative morbidity and thirty-day mortality were respectively 30% (6 cases) and 35% (7 cases). The diarrhea was the dominant symptom. The average weight was 20% lower compared to the initial weight. The length of residual small bowel and type of anastomosis strongly affect survival of patients underwent massive intestinal resections. Parenteral nutrition (PN) has great importance in postoperative treatment. A useful treatment, in severe short bowel syndrome, can be small bowel transplantation.
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PMID:Factors affecting prognosis in patients with short bowel syndrome. 1466 87


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