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Query: UMLS:C1258215 (ileus)
 4,389 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to evaluate the Vest-Margulis test in the differential diagnosis between mechanical and paralytic ileus a retrospective study was undertaken on 51 such tests performed before and after operation. Transit of gastrografin (Sodium amidotrizoate) through the caecum 4 hours after ingestion was controlled through roentgenograms. The diagnostic value of a positive test in pure paralytic ileus can be confirmed. Indeed 23 positive cases proved to have paralytic rather than mechanical ileus. On the contrary a negative test has no diagnostic value. Twenty-eight patients in which the contrast medium had not reached the caecum within 4 hours had either form of intestinal obstruction. The attention is drawn on the interesting therapeutic action of gastrografin in patients with a paralytic ileus and the simplicity of the investigation.
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PMID:[Our experience of the Vest-Margulis test in the differential diagnosis of mechanical and paralytic ileus (author's transl)]. 58 Aug 24

Paralytic distension is a causative or important factor in the pathogenesis of early postoperative intestinal obstruction. The elimination of intestinal distension initiates a decisive change in the course of this disease. The long intestinal tube--comparable to an "intraluminary stoma"--renders the necessary intestinal decompression. The controlled placement of the tube using a gastroscope rules out technical problems. The procedure is highly effective, contributes to the reduction of relaparotomies, and avoids enterotomies with all their inherent risks in the state of ileus.
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PMID:[Closed intestinal decompression in postoperative paralysis: intestinal intubation (author's transl)]. 58 99

A case is described of meconium ileus equivalent presenting as a small bowel obstruction in an adult patient with cystic fibrosis. The importance of conservative management with acetylcysteine and intravenous fluids is emphasized.
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PMID:Meconium ileus equivalent an adult: a case report. 63 39

27 cases of intestinal obstruction primarily treated conservatively by means of Miller-Abbott-tubes are presented, technical details, clinical results, indications and risks of the procedure discussed. The controlled placement of the tube using a gastroscope rules out technical failures. Fifteen patients were cured, 2 patients removed the tube; in 8 cases the procedure turned out to be ineffective; they were cured by laparotomy. The separate monitoring of gastric and intestinal secretion permits early prognosis in respect to efficacy. Two patients died. Strict limitation of indication is of decisive importance. The method is highly effective in early postoperative intestinal obstruction--apparently of mechanical as well as of paralytic origin. In our experience, the possible mistaking of anastomotic leakage for postoperative ileus is practically negligible. For acute admissions with intestinal obstruction of unclear origin, however, the procedure should only be aimed at the resotration of general condition before surgery. In spite of the fact, that some cases of late postoperative intestinal obstruction could be cured conservatively, the risk of delaying operations of utmost necessity in cases of strangulation, incarceration and perforation is too high.
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PMID:[Conservative treatment of intestinal obstruction: prospects and limits. Experiences with 27 cases treated by Miller-Abbott-tubes inserted endoscopically (author's transl)]. 72 78

Colonic ileus is an unusual form of adynamic ileus that often mimics true intestinal obstruction and that, if not recognized and adequately treated, may be fatal. We have encountered three patients in whom this syndrome followed apparently uncomplicated laminectomy for herniated disc or spinal stenosis. Two of our three patients required abdominal exploration for diagnosis and treatment of the complication. At operation, a large distended colon without volvulus or tumor was found. Cecostomy was performed in both patients. The third patient was treated conservatively. All three patients recovered without sequelae. The pathogenesis of the illness is unknown, but the most widely held view is that ileus results from increased sympathetic activity that inhibits the bowel. Conservative management consisting of correction of any fluid or electrolyte abnormalities, continuous gastric suction via nasogastric tube, and placement of a rectal tube may relieve the symptoms. Patients should, however, be followed carefully and, if distention of the cecum exceeds 12 cm, a decompressive operation is indicated.
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PMID:Colonic ileus complicating laminectomy. 74 Jan 36

In dogs, a segment of an aborrally occluded small intestine was anastomosed to the right colic flexure; thus, distal to the trapping ileocecal valve a local intestinal obstruction developed within a week in the small and large intestines, which locally stimulates the ileus situtation in man. Distrubances of the energy metabolism, as demonstrated by significant changes in the adenylic acid and phosphocreatine system, were more intensive in the mucosal layers of the small intestine than in those of the large intestine, whereas the smooth muscle layers were unaffected. The results reflect different disturbances of blood flow, energy needs, and adaptability of intestinal mucosa and musculature.
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PMID:[Energy metabolism of the intestinal wall in ileus]. 75 4

Forty-five patients (25 male and 20 female) over 12 years of age with cystic fibrosis have been studied clinically, radiologically and physiologically. Their mean age at the first visit was 17 years; they were followed for a mean period of 4 years and attended at least every six months. The first symptom which developed before the age of five in 42 of the 45 patients was respiratory. Thirty-two of the 45 patients had severe lung disease (Group III) at the start of the study of the seven patients died during the study. Cough and sputum were almost universal, 23 had haemoptyses and eight pneumothoraces. Staphylococcus pyogenes, Haemophilus influenzae and Pseudomonas aeruginosa were the common pathogens isolated from sputum and the increasing prevalence of the latter was again confirmed. Acquisition of the mucoid strain of pseudomonas signified poor prognosis. Established infection was never eradicated. Forty-three patients had evidence of pancreatic insufficiency; in all but one patient the symptoms were mild and five patients abandoned dietary restriction and pancreatin without ill effect. Seven patients had symptoms of partial bowel obstruction (meconium ileus equivalent) but only one required surgical relief. The liver was enlarged in seven patients and the spleen was felt in three. Three patients had diabetes mellitus. The influence of cystic fibrosis on growth and development is reported--the growth spurt is late in the majority but growth failure is not confined to those with severe lung infection or malabsorption and in these circumstances remains unexplained. Mean weight was low in relation to height and puberty was delayed in both sexes.
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PMID:Cystic fibrosis in adolescents and adults. 82 Oct 91

Twelve patients with meconium ileus equivalent complicating cystic fibrosis in the postneonatal period were seen at the Mayo Clinic in the years 1950 through 1975. In a child or young adult with known or suspected cystic fibrosis, the triad of recurrent colicky abdominal pain, a mass in the right lower quadrant, and mechanical intestinal obstruction provides a clue to diagnosis of meconium ileus equivalent. The clinical suspicion of meconium ileus equivalent may be confirmed by meglumine diatrizoate (Gastrografin) enema, which in most uncomplicated cases also serves as treatment.
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PMID:Meconium ileus equivalent complicating cystic fibrosis in postneonatal children and young adults. Report of 12 cases. 83 31

Fifty-eight cases of intestinal obstruction requiring operative intervention were reviewed. Enterolysis alone as the treatment for bowel obstruction as a result of adhesions appears to be as good or better than the long tube stent. Patients treated with enterolysis alone had a shorter period of postoperative ileus, a shorter hospital confinement following operation, and fewer recurrent obstructions. These patients also had a longer interval between episodes of reobstruction than did those treated with an intraluminal long tube stent.
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PMID:Bowel obstruction and the long tube stent. 84 59

A bowel fluid gas index was developed for the degree of fluid filled distention in small intestinal obstruction, utilizing the proportion of fluid filled versus gas filled loops on plain abdominal films. Comparison of simple distal small bowel obstruction due to adhesions and gallstone ileus demonstrated a significantly higher index in gallstone ileus, indicating more cases of fluid filled distention. In an experimental study, fistulae between the gall bladder and duodenum were fashioned in a series of dogs. Distal small bowel obstruction was then produced in these dogs and in another series of dogs in whom a sham first operation had been performed. The bowel fluid gas index, as evaluated in a double blind study, was significantly higher in dogs with the fistulae and was similar to that in patients with gallstone ileus. The possible mechanism for these observations is proposed.
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PMID:Fluid filled small bowel loops in gallstone ileus: clinical and experimental observations. 88 94


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