Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This elderly male with a long history of alcohol abuse presented with an acute pleural trauma and hemopneumothorax, which may have served as the precipitating medical illness for cecal volvulus. He subsequently developed bacterial peritonitis as a complication of his bowel obstruction. It is probable that his pleural cavity was seeded hematogenously via a bacteremia from his peritonitis, thus accounting for the empyema with species typical of bowel flora. Cecal bascule is a type of cecal volvulus that causes intestinal obstruction. Diagnosis is difficult, but a delay in recognition may result in intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined based on physical examination or laboratory findings. Plain films of the abdomen may be helpful, and barium enema has been advocated by some authors. However, laparotomy is often necessary for definitive diagnosis and therapy. While cecal volvulus has not been reported to occur frequently in the elderly, the relatively common occurrence of anatomic predisposition in addition to the widespread use of respirators and the increasing age and number of medical illnesses of our population make it possible that cecal volvulus will be seen with increasing frequency in the future.
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PMID:Cecal bascule: an overlooked diagnosis in the elderly. 172 51

Mesenteric vein thrombosis is a rare disorder which can develop rapidly with intestinal infarction or subacutely with abdominal pain due to intestinal ischemia. Despite the availability of modern diagnostic tools, which allow an early diagnosis in most cases, the mortality from this disease has not significantly diminished over the years. The problem is that the syndrome is rare and unusual and the clinical presentation is usually vague or confusing. Particularly in cirrhotic patients, this diagnosis requires the exclusion of several other complications of liver disease, like spontaneous bacterial peritonitis, tense ascites or portal thrombosis. Here, we report the occurrence of acute mesenteric vein thrombosis in two patients with liver cirrhosis. Severe subcontinuous abdominal pain out of proportion to the physical findings and abdominal distension were the major symptoms in both patients. Magnetic resonance imaging in one case and ultrasound scan with color Doppler followed by computed tomography in the other patient confirmed the diagnosis and enabled an appropriate early therapy to be undertaken.
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PMID:Mesenteric vein thrombosis: a rare cause of abdominal pain in cirrhotic patients--two case reports. 949 85

Pyruvate plays a central role in intermediary metabolism. Pyruvate, however, is also a potent antioxidant and free radical scavenger, and numerous studies have shown that treatment with this compound can be salutary in numerous pathologic conditions that are thought to be mediated, at least in part, by redox-dependent phenomena. Unfortunately, aqueous solutions of pyruvate rapidly undergo an aldol-like condensation reaction to form 2-hydroxy-2-methyl-4-ketoglutarate (parapyruvate), a compound that is a potent inhibitor of a critical step in the mitochondrial tricarboxylic acid cycle. To circumvent this issue, our laboratory formulated a derivative of pyruvic acid, ethyl pyruvate, in a calcium- and potassium-containing balanced salt solution. We showed that treatment with this fluid could ameliorate much of the structural and functional damage to the intestinal mucosa caused by mesenteric ischemia and reperfusion in rats. In subsequent studies, we showed that treatment with ethyl pyruvate solution could improve survival in rodent models of hemorrhagic shock and resuscitation and also down-regulate a number of proinflammatory genes. Recently, ethyl pyruvate was also shown to improve survival in murine models of acute endotoxemia and bacterial peritonitis. Although the biochemical basis for the anti-inflammatory actions of pyruvate remain to be elucidated, this simple compound warrants further evaluation as a treatment for a number of conditions commonly encountered in the practice of critical care medicine.
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PMID:Ethyl pyruvate: a novel anti-inflammatory agent. 1254 77

Hepatorenal syndrome is complication of the advanced cirrhosis characterized by functional renal failure and changes of systemic blood pressure due to increased activity of endogenous vasoactive systems. Functional renal failure is due to severe renal cortical ischemia and reduction of glomerular filtration rate (GFR) developing in the late stages of cirrhosis. The pathogenesis of hepatorenal syndrome is the result of an extreme underfilling of the arterial circulation secondary to arterial vasodilatation located in the splanchnic circulation. Reduced effective arterial blood volume triggers a compensatory response with activation of systemic and renal vasoconstrictor systems. At the same time, the ascites becomes refractory in some patients, as it is no longer responsive to diuretic treatment. These changes result from combination of deteriorating liver function and increasing portal pressure, further splanchnic vasodilatation, increase of circulating vasoconstrictors, and decrease of renal blood flow and GFR. Hepatorenal syndrome can be precipitated by shock, infection, nephrotoxic drugs, bleeding, surgery or large volume paracentesis. Renal failure may be rapidly progressive (type I HRS) or may develop more slowly (type II HRS), which is usually associated with refractory ascites. The diagnosis of HRS is based on established diagnostic criteria aimed at excluding the nonfunctional causes of renal failure. The prognosis of patients with HRS is very poor. Liver transplantation remains the only curative treatment for the time being. Pharmacological therapies based on the use of vasoconstrictor drugs may serve as a bridge to liver transplantation. Prevention of HRS by albumin infusion is recommended in patients with spontaneous bacterial peritonitis and by pentoxifylline in patients with the acute alcoholic hepatitis.
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PMID:[Hepatorenal syndrome]. 1750 77