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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preventive intestinal intubation for ileus prophylaxis in cases of diffuse peritonitis and extended adhesion ileus had often been discredited for the technically demanding and thus time-consuming technique involved. Yet, tube-related complications in the context of tube insertion or removal can be minimised by the experienced surgeon who stringently observes a number of precautions and provided that the indication had been accurate. Fifty-three intestinal intubations on 49 patients were accompanied by three iatrogenic perforations intraoperatively and by four instances of postoperative fistulation of the small intestine which, however, were all properly controlled by suturing or conservative action. Ileus recurred in three patients because of too early tube removal and due to progressive peritonitis against the background of inadequately cured primary disease and due to peritoneal mesothelioma in one case. Periods of intestinal intubation ranged from six to 14 days. Postoperative lethality was relatively high (30.6 per cent) and had been exclusively caused by progressive sepsis or cardiopulmonary insufficiency. It amounted to 50 per cent of all cases of diffuse peritonitis and only to 4.7 per cent of patients with recurrent adhesion ileus.
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PMID:[Internal intubation of the small intestine for preventing ileus in peritonitis and recurrent adhesions]. 368 70

The results of this prospective clinical study have demonstrated a low rate of false-positive abdominal sonographic findings in patients undergoing routine studies the seventh day after abdominal surgical procedures. It is concluded that any intraperitoneal fluid collection detected by ultrasound examination in a patient postoperatively demonstrating signs and symptoms of abdominal sepsis (fever, leukocytosis, pain, tenderness, persistent ileus, excessive drainage, wound changes and so on), should be considered as the source, as abdominal fluid collections do not persist as a "normal" part of the healing process one week after extensive biliary tract or colonic operations. Sonography is a highly specific procedure for the detection of abdominal abscesses after the seventh postoperative day. The type of procedure, type of incision, type of closure, presence of drains, history of prior intraperitoneal surgical procedures and operative blood loss did not affect the accuracy of the test. Postoperative ultrasonography is a specific, sensitive and accurate test and is widely applicable to almost all groups of patients.
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PMID:The reliability of the results of ultrasound detection of fluid collections in the early postceliotomy period. 392 80

A case of asymmetrical thoraco-omphalo-ischiopagus tripus will be reported. Anal atresia, ruptured omphalocele with lesion of the small intestine made an artificial anus necessary. Recurrent adhesion ileus made three further operations necessary. After precise preliminary examinations we separated these twins at the age of 21/2 years. After 7 and 9 months both children had to be reoperated because of fistula of the small intestine. Twin R. died at the age of 3 years and 8 months in consequence of a candida sepsis. Twin P. now lives with his parents.
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PMID:[Separation of an asymmetric xipho-omphalo-ischiopagus tripus]. 399 Apr 73

The prevalence, presentation, and outcome of bacteremia due to Shigella and other gram-negative bacteria were determined by review of records of 2,018 inpatients with shigellosis who had their blood cultured in a Bangladeshi hospital in 1976-1983. Shigella bacteremia occurred in 82 (4.1%) patients; other bacteremia occurred in 102 (5.1%) patients. Patients with shigella sepsis more frequently (P less than .02) manifested severe dehydration, abdominal tenderness or ileus, agitation or lethargy, and leukocytosis than did nonbacteremic controls; they developed more frequently (P less than .05) renal failure (26%), leukemoid reaction (22%), thrombocytopenia (20%), and hemolytic-uremic syndrome (6%). The prevalence of all bacteremia was highest in the first year of life. Protein-energy malnutrition was a strong risk factor for shigella sepsis (P less than .01). The fatality rate in shigella bacteremia (21%) was higher (P less than .005) than in nonbacteremic shigellosis (10%) but lower (P less than .001) than in other bacteremia (51%). At highest risk of death from shigella bacteremia (P less than .01) were patients less than one year old, non-breast-fed, malnourished, and afebrile.
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PMID:Shigella septicemia: prevalence, presentation, risk factors, and outcome. 404 31

A new device for assessment of delayed cutaneous hypersensitivity using seven standardized antigens (Multitest CMI) was compared to conventional intradermal testing with two recall antigens in 83 patients referred for nutritional support. Sixteen patients (19.3%) were anergic to Multitest CMI while four (4.8%) were anergic to conventional testing. Patients anergic to Multitest CMI had a higher complication (intraabdominal abscess, prolonged ileus, sepsis, pneumonia) than those who were immunocompetent by this test suggesting a group at greater risk. This interpretation is consistent with an increased specificity of Multitest CMI over conventional testing in the identification of clinically important anergy.
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PMID:A new device for delayed hypersensitivity skin testing. 405 35

Thirty-nine cadaveric renal allografts were performed in 28 children under 6 years of age. Common primary renal diseases were glomerulonephritis, dysplasia/hypoplasia, and reflux/obstructive nephropathy. After a mean follow-up of 40 months of patients with surviving grafts, 19 patients had functioning grafts, 3 had returned to dialysis, and 6 had died. These children required an extraordinary amount of care postoperatively because of anorexia, diarrhea, and ileus. Their psychomotor and physical development was retarded prior to transplant; this reversed dramatically after transplant, but catch-up growth occurred in only 4 patients. Many patients were noticeably more active and distractible for 1 to 2 years post-transplant. Major causes of graft failure were primary nonfunction of 5 donor kidneys (4 from donors under 1 year old) and renal vessel thrombosis in 5 recipients (3 with native kidneys in place who received kidneys from donors over 10 years old). Other causes were recurrence of hemolytic uremic syndrome and Wilms tumor, rejection, and sepsis. Kidneys from donors under 1 year old proved unsatisfactory, and large donor kidneys in small children tended to thrombose, especially when native kidneys with high urine output were left in situ.
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PMID:Cadaveric renal transplants in children under 6 years of age. 636 47

Enteral feeding has many advantages over total parenteral nutrition (TPN) in the early postoperative period. The risk of sepsis is small, the nutrients are cheap and metabolic problems are rare. In the period April 1980 to January 1983, needle catheter jejunostomy (NCJ) was applied in 210 patients after surgery of the oesophagus, stomach, duodenum, liver or pancreas. All but 14 of these patients were fed by NCJ for a certain period postoperatively, NCJ feeding being initiated within 48 hours after the operation in 63% of the cases. In 14 patients, it was decided not to use NCJ feeding because of counter-indications observed postoperatively. The mean duration of the feeding by NCJ was 17 days (range two to 84 days). The complications observed were intraperitoneal leakage in four patients (1.9%), ileus in seven patients (3.3%) and diarrhoea in 54 patients (25.7%). The total number of feeding days was 2,906. This form of feeding resulted in savings of Dfl. 115,00 per patient per day compared with TPN, for a 12,600 Joule intake. NCJ feeding is a relatively safe, economical procedure that can be applied as a matter of routine after abdominal surgery.
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PMID:Needle catheter jejunostomy (NCJ) for early postoperative feeding: experience in 210 patients. 641 77

In the past 10 years, the diagnosis of pseudoobstruction lasting more than two months was confirmed in 10 infants after sepsis, meconium ileus, and Hirschsprung's disease were excluded, and surgery or autopsy failed to demonstrate a site of mechanical intestinal obstruction. Four infants had undergone prior operation for another anomaly: gastroschisis (2) and ileal atresia (2). Five of the remaining infants also had megacystis. The lack of coordinated intestinal motility was best appreciated by radiocontrast small bowel studies, which showed degrees of aperistalsis or segmentation. Rectal manometric studies were not helpful. Histology of the intestine was normal in seven, while a gross deficiency of nerve fibres was noted in one patient and a myopathy of smooth muscle in another. A variety of drugs used to stimulate peristalsis were ineffective. Seven patients had 25 operations, often to exclude mechanical causes of obstruction. The mainstay of treatment was TPN and intestinal decompression. Six children survived; their ages ranged between 8 months and 9 years (median age, 16 months). There has been improvement in intestinal peristalsis in five children, three of whom now tolerate a regular diet and two of whom are on TPN and are currently increasing oral intake. Four infants died, two from sepsis, two from TPN-related hepatic failure. In contrast to previous reports, we conclude that intestinal pseudoobstruction may be self-limited in some neonates, including those with megacystis. Therapy should consist of long-term nutritional support and treatment of other anomalies that may be present.
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PMID:Neonatal intestinal pseudoobstruction. 644 Sep 67

Pseudo-obstruction of the colon is a problem of bowel motility that predominantly involves the large intestine and that can mimic the clinical and radiographic features of mechanical obstruction of the colon. It must not be confused with the much more common and less dangerous complication of post-operative ileus. Although it is most often seen in elderly patients who are confined to bed, it can occur in younger patients. Cecal dilation can develop rapidly to dangerous proportions, and recognition by thorough physical examination and early abdominal radiographs is essential if operative intervention is to be avoided. Nasogastric suction, intravenous fluids, and frequent turning of the patient are often successful if begun early, but are unlikely to be of benefit once cecal dilation approaches fourteen centimeters on plain radiographs. In these advanced cases, tube cecostomy or colostomy may be the only way to avoid necrosis of the bowel wall, perforation, and sepsis.
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PMID:Pseudo-obstruction of the colon. A postoperative complication in orthopaedic patients. 682 84

Sixteen patients underwent a modification of the Sugiura procedure for bleeding esophageal varices, involving (a) esophageal transection, (b) splenectomy, (c) selective vagotomy, and (d) pyloroplasty. Five patients died, and the remaining 11 had barium studies of the esophagus and stomach which were compared with the preoperative appearance. Esophageal varices disappeared in 7 patients and persisted in 1. No recurrent bleeding or encephalopathy was seen: however, there were a large number of complications, including pleural effusion, ascites, ileus, pneumonia, and renal failure. Hepatic failure, respiratory failure, and sepsis secondary to gastrointestinal leakage also occurred and were fatal in all cases. As the Sugiura procedure is increasingly being employed in the United States, radiologists should be familiar with the spectrum of postoperative radiographic findings in the esophagus and stomach.
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PMID:Radiographic findings in the esophagus following the Sugiura procedure. 697 61


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